Pulm Flashcards
MCC bronchiolitis
RSV
what ages are MC affected by bronchiolitis
2 months - 2 years old
sx bronchiolitis
viral URI prodrome - low grade fever, nasal congestion (URI) –> wheezing, coughing, tachypnea, cyanosis (LRI)
respiratory distress
what is the best predictor of dz outcome for bronchiolitis
pulse ox
tx bronchiolitis
supportive
palivizumab for prevention
croup is also called
laryngotracheitis
MCC croup
parainfluenza type 1
croup is due to (pathophys)
subglottic narrowing –> partial obstruction
sx croup
seal-like barking cough
inspiratory stridor
hoarseness
dx croup
clinical
frontal cervical XR - steeple sign
what scored is used to classify the severity of croup
Westley croup score
tx croup
steroids - should be administered in ALL stages of croup
if severe - nebulized epinephrine
sx intermittent asthma
symptoms two or fewer times per week
two or fewer night awakenings per month
use of short-acting beta-agonist inhaler two or fewer times per week
no interference with normal daily activity
tx intermittent asthma
SABA prn
sx mild persistant asthma
symptoms > 2 days per week (but not daily)
three to four episodes of night awakenings due to symptoms per month
use of short-acting beta-agonist inhaler more than two times per week (but not daily and not more than once per day)
minor limitations to daily activity
tx mild persistent asthma
low-dose ics + SABA prn
sx moderate persistent asthma
symptoms daily
night awakenings at least once per week (but not nightly)
use of SABA daily
some limitations in daily activity
tx moderate persistent asthma
low-dose ICS + LABA
OR
medium-dose ICS + LABA
SABA prn
sx severe persistent asthma
symptoms daily
nightly awakenings due to sx
use of SABA multiple times per day
extreme limitations in daily activity
tx severe persistent asthma
medium- or high-dose ICS + LABA + LAMA + oral systemic corticosteroids
FEV1 mild intermittent asthma
> 80%
FEV1 mild persistent asthma
> /= 80%
FEV1 moderate persistant asthma
> 60 and < 80%
FEV1 severe persistent asthma
</= 60%
inheritance of cystic fibrosis (CF)
autosomal recessive
pathophys of CF
abnormal chloride and water transport
common sx of CF in infancy
meconium ileus
sx of CF (not in infancy)
bronchiectasis (MC due to pseudomonas)
recurrent pulmonary infections
may have steatorrhea etc due to pancreatic insufficiency
infertility in men
dx CF
elevated seat chloride via pilocarpine
> 60 on 2 occasions
tx CF
airway clearance
high fat diet with fat-soluble vitamins
pancreatic enzyme replacement
if abx - macrolides usually
MC foreign body aspiration in kids
peanuts
why is the right main bronchus the MC location for foreign body aspiration
wider, more vertical, and shorter
tx foreign body aspiration
rigid bronchoscopy
dx foreign body aspiration
chest imaging - usually start w XR –> CT if negative
PE for pneumonia
bronchial breath sounds
dullness to percussion
increased tactile fremitus
inspiratory rales (crackles)
MCC typical vs atypical pneumonia
typical - strep Pneumonia
atypical - mycoplasma pneumonia
tx mycoplasma pneumonia and legionella pneumonia
macrolide (erythromycin, azithromycin)
tx community acquired pneumonia
PCN (amoxicillin)
if inpatient - PCN + macrolide
if MRSA - vancomycin
classic sx strep pneumo
rust colored sputum
classic sx klebsiella Pneumonia
currant jelly sputum + alcoholic or DM
