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CVPR > PEDS mod 5 > Flashcards

PEDS mod 5 Flashcards

1
Q

What are the 4 diagnostic criteria for ARDS?

A

Hypoxemia profound Acute onset dyspnea Bilateral pulmonary infiltrates Absence of left atrial hypertension

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2
Q

What is a late finding of bilateral pulmonary infiltrates?

A

Pulmonary fibrosis

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3
Q

In ARDS, what will be high vs what will be low in respect to the pulmonary artery pressure and the left atrial pressure?

A

The pulmonary artery pressure will be high but the left atrial pressure will be low.

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4
Q

What should the pulmonary artery pressure be in order to be classified as elevated?

A

Mean PAP >20 mmHg

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5
Q

Pulmonary HTN should be thought to be associated with what?

A

Underlying cardiac or lung disease* like bronchopulmonary dysplasia, idiopathic or familial.

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6
Q

What are two common respiratory causes of ARDS?

A

Infections and CF

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7
Q

What are some common cardiac causes of ARDS?

A

Congenital, infections, tamponade

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8
Q

What are some GI causes of ARDS?

A

Aspiration, abd pain, abd distention.

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9
Q

What are some other non respiratory, non cardiac, non GI causes of ARDS?

A

Metabolic, hematologic, toxins/drugs, head trauma.

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10
Q

Pulmonary action does not match body’s needs for gas exchange.

A

ARDS

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11
Q

What are the 4 mechanisms of ARDS?

A

No oxygen in No CO2 out Mechanical problem Control problem

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12
Q

What is the main symptom of ARDS?

A

Increased work of breathing or dyspnea.

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13
Q

What is a hallmark of obstruction in the upper airway? Could also be from swollen airway seen in croup.

A

Stridor

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14
Q

This sound will be from an obstruction in the lower airway.

A

Wheeze

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15
Q

This sound is fine and can be from fluid, or atelectasis (dry).

A

Crackles/Rales

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16
Q

Lower airway obstruction sound common in pneumonia.

A

Grunting (@20 min mod 5)

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17
Q

This sound is a rough snoring sound from the large airways.

A

Rhonchi

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18
Q

What would you suspect if lung sounds were absent?

A

Fluid, air around, collapsed lung, Lung tissue dz.

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19
Q

abnormal tone, decreased interactiveness, poor color, abnormal stare, weak cry.

A

Appearance

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20
Q

Abnormal airway sounds, a position of comfort that maximizes airway opening, and use of accessory muscles. Tripoding.

A

Breathing

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21
Q

Pallor or cyanosis, decreased perfusion, poor capillary refill or cool skin

A

Circulation

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22
Q

What pulse ox saturation is needing oxygen?

A

Less than equal to 94%

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23
Q

Transient and remains unexplained after an appropriate medical evaluation If you find an explanation it’s no longer this.

A

BRUE

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24
Q

What are some of the characteristics of a BRUE?

A

< 1 yr 20-30 sec Cyanosis or pallor Absent, decreased or Irregular breathing Hyper or hypotonia Alt level of responsiveness

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25
Q

What are some risk factors of BRUE?

A

Feeding difficulties Recent URI < 2 mo old Hx of prior episodes +/- premature birth/low birth weight, maternal smoking

FU 2 PPM

26
Q

What are the warning signs of BRUE?

A

Toxic appearance Lethargy Unexplained recurrent vomiting Respiratory distress Sustained cyanosis or LOC, CPR Bruising Hx or prior events Sibling Abuse or maltreatment Dysmorphic features.

LTS VCR ABD

27
Q

What does the AAP guidelines recommend for low risk?/

A

No need for routine testing and recommends against eval for systemic infection. For low risk they recommend parent education, CPR, and reassurance. High risk: r/o underlying conditions/ admit.

28
Q

The most common cause of respiratory distress in premature infants is?

A

Hyaline membrane disease.

29
Q

Deficiency of surfactant Surfactant also leaks into airspaces

A

Hyaline membrane disease

30
Q

• decreases surface tension during expiration • allows alveoli stay partially expanded • PPX given to neonates <27wks • Tx for infants with hyaline membrane dz

A

Surfactant

31
Q

Lack of surfactant =

A

poor lung compliance and atelectasis

32
Q

What is a big red flag of neonatal respiratory distress/Hyaline membrane dz?

A

If there is greater than 16 breaths per min. Absent breath sounds due to faulty alveoli Ground-glass appearance and or bronchogram. Ground-glass will be on atelactasis.

33
Q

What is the treatment of Neonatal Respir Distress/Hyaline membrane dz?

A

O2, nasal CPAP, early intubation, surfactant, umbilical artery and vein line placement,

34
Q

What will lessen the chance for Neonatal Respir Distress/Hyaline membrane dz if the mom takes what > 24 hours prior to a pre-term birth?

A

Maternal steroids. Have better neonatal outcomes and lower chances of hyaline membrane disease.

35
Q

Most common lethal inherited disease in caucasians?

A

CF

36
Q

CF affects what organ systems mostly?

A

Lungs and GI

37
Q

What is the pathophysiology of CF?

A

Disruption of salt and water balance. Mucus becomes thick and sticky.

38
Q

If a patient has nasal polyps and cough what should you think?

A

CF

39
Q

When is CF usually diagnosed?

A

6-8 mo old

40
Q

Why does CF cause greasy malodorous stools?

A

The impact on the pancreas causing malabsorption.

41
Q

Neonates with intestinal blockage is suspicious for?

A

CF

42
Q

Undescended testicles Clubbing fingers (older kids)

A

CF

43
Q

What are the normal ranges of the sweat chloride test?

A

30-60 Positive is greater than 60mmol/L

44
Q

What other additional criteria do you need if the sweat chloride test is positive?

A

Either COPD Dx, Exocrine pancreatic insufficiency (via fecal test) or + fam hx of CF CFTR genetic test is easier than doing the sweat test and the additional criteria.

45
Q

is the abnormal distortion and dilation of the bronchial tree.

A

Bronchiectasis

46
Q

Loss of elasticity and will have tram tracks on CXR

A

Bronchiectasis

47
Q

S/Sx are daily chronic cough with mucopurulen sputum over months to years.

A

Bronchiectasis

48
Q

What is the standard dx for bronchiectasis?

A

CT scan

49
Q

Are Brochiectasis airway obstruction reversible with bronchodilators?

A

No, the only helpful treatments are antibiotics and chest therapy.

50
Q

defined as a single entity of oxygen requirement either at 28 postnatal days or 36 weeks postmenstrual age

A

Bronchopulmonary dysplasia

51
Q

NICHD criteria also proposed that the requirement of supplemental oxygen be confirmed by using a physiologic test after a room air challenge test. What is a positive test?

A

If they drop below 90% on RA within 1 hour.

52
Q

What is the most significant sequelea of ARDS

A

Bronchopulmonary dysplasia

53
Q

Most cases of Bronchopulmonary dysplasia will have a birth weight below what?

A

1250 g

54
Q

What is the main symptoms of bronchopulmonary dysplasia?

A

Tachypnea

55
Q

What is the Tx of bronchopulmonary dysplasia?

A

Surfactant

56
Q

In Bronchopulmonary dysplasia, muscles of arterioles can thicken leading to what?

A

Pulmonary hypertension.

57
Q

This is usually a diagnosis of exclusion. It is a restrictive group of disorders. This is a parynchama problem as opposed to mucus or swollen airways.

A

Interstitial lung disease (diffuse lung disease)

58
Q

Presents as unexplained respiratory failure in newborns, tachypnea, crackles, “velcro rales” hypoxemia, This is a chronic lung disease out of proportion to the degree of prematurity.

A

Interstitial lung disease (diffuse lung disease)

59
Q

How do you Dx Interstitial lung disease (diffuse lung disease)?

A

Dignosis of exclusion

60
Q

What is the treatment for Interstitial lung disease (diffuse lung disease)?

A

supportive, lung lavage, lung transplant.

CVPR (8 decks)

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