Peds Pulmonary Flashcards
another name for IRD (infant respiratory distress)
hyaline membrane disease
IRDS shows up usually when premature infants are __ gestational age
less than 28 wks
RF for infant to get IRDS
infant of DM mom
C-section
multifetal preg
Family Hx
what causes RDS
surfactant deficiency?
t/f kid with IRDS will have diminished breath sounds and falling blood pressure
true will also have..
mixed resp / metabolic acidosis
CXR with ground glass appearance…
infant respiratory distress syndrome
how do we prevent IRDS
beta methasone 48 hrs prior to delivery btwn 23-34 wks
IRDS TX
warm humidified 02 keep between 55-79.. so sats over 90
if an infant needs to be intubated at birth what should be given once stablized
surfactant
inflammation of bronchioles
bronchiolitis
was is the most common agent of bronchiolitis
usually caused by an acute viral infection
RSV most common
most common lower respiratory tract infection in infants and kids under 2yrs
bronchiolitis
when do bronchiolitis sx peak
day 3-4 of illness
children with bronchiolitis with a fever less than 60 days have..
high risk of serious bacterial infection (SBI)
evaluate for sepsis
bronchiolitis tx
hydrate
oxygenation
nasal suction
influenza antivirals
ribavirin severe cases
40% of bronchiolitis pts will have…
wheezing through age 5
about 10% will have wheezing past then
leading cause of infant death from viral infection
RSV
respiratory syncytial virus
t/f rsv is more common in boys than girls
true
incubation period for RSV
4 days
t/f rsv stays alive in dried secretions for several days
true
lab test for RSV
RSV rapid antigen test
useful at beginning of season
most common RSV infxn complication
otitis media
low % of pt get bacterial pneumonia
synagis is..
super expensive but for RSV prevention
IM injection qmo during RSV season
age of infant eligible for synagis
born less than 29 wks yet still under 12 mo old
infants under 2 with CLD
or
infants born under 32 wks who had 02 req for 28+ days after birth
asthma more common in boys or girls
boys
asthma more common in African American or non
African American
one of the most common causes of ED visits
pediatric asthma
80% asthma onset is before__yo
80% before 6yo
asthma is more common in …
lower ses
asthma sx are typically worse at…
night
URI sx for 1-3 days before sx of upper airway obstruction
croup
barky cough, hoarseness, inspiratory stridor
croup cough
ages of croup
3 mo - 5 yrs
peak incidence is 2yo
t/f croup sx worse at night like asthma
true
croup aka..
laryngotracheobronchitis
croup is usually due to…?
parainfluenza virus
croup more common in girls / boys?
boys
croup more common during what time of year?
late fall and winter
croup dx
CXR: steeple sign
croup tx at home
cool mists, steamy bathroom for exacerbations
croup tx ed
nebulized racemic epinephrine
corticosteroids
spasmodic croup related to..
allergic component
resolves rapidly with tx
acute, fulminating course of high fever, sore throat, dyspnea, rapidly progressing respiratory obstruction
acute epiglottitis
epiglottitis is less common now bc
of the HiB vaccine
main pathogens today for epiglottits
S. pyogenes
S. pneumonia
S. aureus
RF for epiglottitis
unimmunized or
underimmunized pts
thumb sign on radiology
epiglottitis
abx for epiglottits
ceftriaxone
cefixime
combo ampicillin and sulbactam
nickname of pertussis
whooping cough
pathogen for pertussis
bordetella pertussis
course of pertussis is how long?
6 wk course
incubation period for pertussis
3-12 days
non distinctive sx of congestion and rhinorrhea
catarrhal stage
dry cough, intermittent, irritative hack with paroxysmal episodes
paroxysmal stage
slow resolution of arxysmal episodes
convalescent stage pertussis
infants under 3 mo with pertussis..
can’t whoop - do not generate the - inspiratory pressure
gold standard of pertussis dx
culture
t/f pertussis is reportable dz
true
Suspect in patient who has predominant complaint of cough especially in the absence of fever, malaise, myalgia, exanthema or sore throat
pertussis
abx pertussis
erythromycin or azithromycin
when hospitialize for pertussis
infants under 3 mo
3-6 with severe paroxysm
premie infants
pertussis prvt
VACCINATION
