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CVPR > PEDS mod 6 > Flashcards

PEDS mod 6 Flashcards

1
Q

SIDS is only unexplained after

A

Complete autopsy • Examination of death scene • Review of clinical history

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2
Q
  • Maybe assoc with congenital heart disease, neuromuscular disorders, primary ciliary dyskinesia
A

Pectus excavatum

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3
Q

Normal <25 seconds

High elevation

Prematurity

Genetic/neuro disorders

A

CSA

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4
Q
  • Less effective than nasal corticosteroid
  • Take at night
  • equal in effectiveness to cromolyn
A

2nd gen “new” less drowsy (cetirizine, fexofenadine, loratadine)

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5
Q
  • works well but not 1st line
A

Ipatropium bromide

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6
Q

Corticosteroid nasal spray

A

Fluticasone

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7
Q

Decongestant:

A

pseudoephedrine

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8
Q
  • mast cell stabilizer
A

Cromolyn

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9
Q
  • Episodic symptoms of airflow obstruction are present
  • Airflow obstruction or symptoms are at least partially reversible
  • Alternative diagnoses are excluded
A

Asthma Dx

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10
Q

What is the most common underlying diagnosis in children with pneumonia?

A

Asthma

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11
Q

· +- breathless after physical activity such as walking

· Can talk in sentences and lie down

· +- be agitated

A

Mild acute

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12
Q

· Breathless while talking

· Infants have feeding difficulties and a softer, shorter cry

A

Moderate to severe asthma

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13
Q

· Breathless during rest

· Not interested in feeding

· Sit upright

· Talk in words (not sentences)

· Usually agitated.

A

Severe

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14
Q

· Drowsy and confused

Adolescents +- drowsy/confused until they are in frank respiratory failure

A

Imminent respiratory arrest

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15
Q

(acute severe asthmatic episode that is resistant to appropriate outpatient therapy):

  • Medical emergency that requires aggressive inpatient management
  • ICU for the treatment of hypoxia, hypercarbia, and dehydration and possibly for assisted ventilation because of respiratory failure
A

Status asthmaticus

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16
Q
  • Conjunctival congestion/inflammation
  • Allergic shiners
  • Nose crease
  • Pale violaceous/blue nasal mucosa
A

Signs of atopy or allergic rhinitis

17
Q
  • Accessory muscles of respiration are not used
  • The heart rate is less than 100 beats per minute
  • Pulsus paradoxus is not present
  • Auscultation of chest reveals moderate wheezing, which is often end expiratory
  • Oxyhemoglobin saturation with room air is greater than 95%
A

Mild acute asthma episode

18
Q
  • Accessory muscles of respiration typically are used
  • Suprasternal retractions are present
  • The heart rate is 100-120 beats per minute
  • Loud expiratory wheezing can be heard
  • Pulsus paradoxus may be present (10-20 mm Hg)
  • Oxyhemoglobin saturation with room air is 91-95%
A

Moderately severe asthma

19
Q
  • The respiratory rate is often greater than 30 breaths per minute
  • The heart rate is greater than 120 beats per minute
  • Loud biphasic (expiratory and inspiratory) wheezing can be heard
  • Pulsus paradoxus is often present (20-40 mm Hg)
  • Oxyhemoglobin saturation with room air is less than 91%.
A

Severe asthma episode

20
Q
  • Paradoxical thoracoabdominal movement
  • Wheezing may be absent (in patients with the most severe airway obstruction)
  • Severe hypoxemia may manifest as bradycardia
  • Pulsus paradoxus may disappear; this finding suggests respiratory muscle fatigue
A

Status asthmaticus with often imminent respiratory arrest:

21
Q

· Tracheobronchomalacia

· Hyperventilation syndrome

· Vocal cord dysfunction

· Pulmonary edema

· Collagen vascular disease

· Reactive airway disease

Pediatric Gastroesophageal Reflux

Primary Ciliary Dyskinesia

Sinonasal Manifestations of Cystic Fibrosis

A

Other problems that can come from asthma

22
Q

· Spirometry: essential objective measure for establishing the diagnosis of asthma

· +-Eosinophil counts and IgE levels

· +-Bronchial provocation tests (specialized test)

A

Eval for asthma

23
Q

Pulmonary function testing: not reliable under what age?

A

<5

24
Q

· (3-6 y) and older children who are unable to perform the conventional spirometry:

A

Impulse oscillometry system

25
Q

· Normal forced vital capacity (FVC)

· Reduced forced expiratory volume in 1 second (FEV1)

· Reduced forced expiratory flow more than 25-75% of the FVC (FEF 25-75)

A

Typical findings of asthma

26
Q

Does a normal peak flow rate necessarily mean a lack of airway obstruction?

A

No

27
Q

o F/u q 2-6 wks until controlled; q 1-6 mo thereafter

A

Asthma follow up

28
Q

montelukast (Singulair)

A

Mast cell stabilizer

CVPR (8 decks)

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