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PHA 581 > Peds: Respiration > Flashcards

Peds: Respiration Flashcards

1
Q

Crackles (Rales): possible causes

A

bronchiolitis
pulmonary edema
pneumonia
asthma

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2
Q

Wheezes: possible causes

A

asthma
bronchiolitis
foreign body

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3
Q

Rhonchi: possible causes

A

pneumonia

cystic fibrosis

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4
Q

Stridor: possible causes

A 
croup
laryngomalacia
subglottic stenosis
allergic rxn
vocal cord dysfunction
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5
Q

Viral Croup:

  • age group
  • MC season
  • etiology
A

6mo-5yr

fall/winter

MC: parainfluenza
RSV

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6
Q

Viral Croup: presentation

A 
nasal congestion/URI 
afebrile
INSPIRATORY STRIDOR
hoarseness
BARKING/SEAL LIKE COUGH
subglottic narrowing 
respiratory distress
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7
Q

Viral Croup: diagnosis

A

westley croup score

mild: <2
mod: 3-7
sev: 8+

clinical (retractions)

xray (steeple sign)

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8
Q

Viral Croup: management: mild

A

supportive therapy

cool mist

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9
Q

Viral Croup: management: moderate

A

corticosteroids (dexamethasone)

epinephrine

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10
Q

Viral Croup: management: severe

A

airway support
corticosteroid
epinephrine
+/- admission

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11
Q

Epiglottitis:

  • etiology
  • presentation
A

Haemophilus influenza type B

sudden onset high fever
insp retractions
rapid onset stridor, muffled voice, dyspnea

DYSPHAGIA
DROOLING
DISTRESS

TRIPOD POSTURING

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12
Q

Epiglottitis: diagnosis

A

clinical

xray (lateral: thumb sign)

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13
Q

Epiglottitis: management

A

airway support
culture
empiric abx (3rd gen ceph + vanco)

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14
Q

Bronchiolitis:

  • what is it
  • age group
  • season
  • etiology
A

LRTI of sm airways

<2yo (peak: 2-6mo)

Nov - April (peak: jan/feb)

viral (MC: RSV)

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15
Q

Bronchiolitis: high risk patients

A 
Gestational age <37 weeks
Age <12 weeks
Chronic pulmonary disease
Congenital heart disease
Immunodeficiency
Congenital and anatomic defects of the airways
Neurologic disease
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16
Q

Bronchiolitis: presentation

A 
URI sx --> LRT sx 
shallow breathing pattern
nasal flaring 
irritability, poor feeding, vomiting
WHEEZING, CRACKLES
coughing, tachypnea, labored breathing, hypoxia
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17
Q

Bronchiolitis: diagnosis

A

clinical

also NP swab

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18
Q

Bronchiolitis: management

A

supplementary O2
hydration
nasal suctioning

mechanical ventilation

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19
Q

Respiratory Synctial Virus: high risk patients

A 
Infants < 6 mos &amp; preemies
2nd hand smoke exposure
Respiratory disease
Congenital heart disease
Immune deficiency
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20
Q

Respiratory Synctial Virus: presentation

A 
URI sx --> diffuse wheezing,
tachypnea
low fever
CRACKLES
PROLONGED EXPIRATION
WHEEZING
RETRACTIONS
congestion
LOTS OF MUCUS

CXR: hyperinflation, peribronchial thickening

21
Q

Respiratory Synctial Virus: diagnosis

A

clinical

rapid assay

22
Q

Respiratory Synctial Virus: treatment

A

supportive
ribavirin (if IM)
palivizumab (prophylaxis)

23
Q

Infant Respiratory Distress Syndrome:

  • aka
  • what is it
A

hyaline membrane disease

def of surfactant production + surfactant inactivation by protein leaks into airspaces

24
Q

What is the MC cause of respiratory distress in preterm infants?

A

Infant Respiratory Distress Syndrome

25
Q

Infant Respiratory Distress Syndrome: presentation

A

hypoxia
respiratory distress at birth
hypoxemia
dec air mvmt

CXR: GROUND GLASS APPEARANCE (atelectasis)

26
Q

Infant Respiratory Distress Syndrome: risk factors

A

PREMATURITY
maternal DM
advanced maternal age
family history

27
Q

Infant Respiratory Distress Syndrome: treatment

A

respiratory support
steroids
surfactant replacement

28
Q

Pneumonia: risk factors for pediatrics

A

Congenital heart disease
Bronchopulmonary dysplasia
Cystic fibrosis
Second hand smoke
Lack of routine pediatric vaccinations (Prevnar–PCV 13)
Asthma
Sickle cell disease
Neuromuscular disorders (depressed consciousness)
GI disorders (eg, gastroesophageal reflux)
Immunodeficiency disorders

29
Q

Pneumonia: afebrile pneumonia of infancy: MC pathogen

A

chlamydia trachomatis

30
Q

Pneumonia: presentation

A 
tachypnea, tachycardia
fever
retractions/nasal flaring
GRUNTING (imminent resp failure)
dec O2 saturation
CRACKLES, RHONCHI
DEC AIR MVMT
ILL APPEARANCE
dehydration, lethargy, irritable
31
Q

Pneumonia: 1-3 months

  • MC etiology
  • pathogen
A

viral: RSV

32
Q

Pneumonia: 3-12 months

  • MC etiology
  • pathogen
A

viral: RSV

33
Q

Pneumonia: 2-5 years

  • MC etiology
  • pathogen
A

viral: parainfluenza, influenza, etc

34
Q

Pneumonia: 5-18 years

  • MC etiology
  • pathogen
A

bacterial: S pneumoniae, atypicals

35
Q

What is the MCC of bacterial pneumonia in all ages?

A

S pneumoniae

**atypicals also join after 5yo

36
Q

Pneumonia: diagnosis

A

xray:

  • bacterial (air space disease or consolidation in lobar distribution)
  • viral (interstitial or peribronchial infiltrates)

blood/sputum cultures

37
Q

Pneumonia: treatment

A

admission (<3-6mo old, hypoxemic)

abx:
S pneumo: AMOX
atypical: macrolide

38
Q

Pertussis:

  • pathogen
  • transmission
A

bordatella pertussis

respiratory droplets

39
Q

Pertussis: catarrhal phase

A

phase 1 (1-2wks)
URI sx
fever

40
Q

Pertussis: paroxysmal phase

A

phase 2 (2-6wks)
persistent paroxysmal cough
inspiratory whooping
post tussive emesis

41
Q

Pertussis: convalescent phase

A 
phase 3 (wks-mos)
gradual resolution of cough
42
Q

Pertussis: diagnosis

A

PCR + culture (gold standard)

+/-serology
CBC (leukocytosis)
CXR (normal)

43
Q

Pertussis: treatment

A

abx (macrolide, bactrim)

prophylaxis for household contacts

44
Q

Cystic Fibrosis: presentation

A

high salt content in sweat glands
recurrent sinus infx
nasal polyps
chronic ear infx

45
Q

Cystic Fibrosis: MC pathogens

A

early: H flu, S aureus
older: pseudomonas

46
Q

Cystic Fibrosis: MCC of death

A

respiratory failure (med age: 40yo)

47
Q

Cystic Fibrosis: diagnosis

A

newborn screen

sweat test

48
Q

Cystic Fibrosis: management

A

airway therapies
physiotherapy
chest wall oscillation
expiratory pressure devices

PHA 581 (6 decks)

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