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Pediatrics - clinical > Pulm > Flashcards

Pulm Flashcards

1
Q

What is the most common casue of acute bronchiolitis and when does it typically present

A

Most often caused by RSV - commonly in fall and winter months

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2
Q

How is Acute Bronchiolitis diagnosed

A

Nasal washing for RSV culture and antigen assay
CXR = normal

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3
Q

what is the treatment for Acute Bronchiolitis

A

Oxygen
+ supportive

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4
Q

when should a patient be hospitalized with Acute Bronchiolitis

A

if O2 saturation < 95-96%
Less than 3 months old
>70 years old
nasal flaring
retractions
atelectasis on CXR

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5
Q

what is a reversible inflammatory airway disease with recurrent attacks of breathlessness and wheezing

A

Asthma

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6
Q

what tool is used to diagnose and monitor asthma

A

Peak flow spirometry

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7
Q

What is Intermitten asthma
and what is the treatment

A

less than 2x/week or < 2 night symtpoms/month
- SABA PRN

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8
Q

What is Mild persistent asthma
and how is it treated

A

more than 2x/week or 3-4 night symptoms/month
- Low dose ICS daily

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9
Q

What is moderate persistent asthma
and how is it treated

A

daily symptoms or more than 1 nightly episode/week
- Low dose ICS + LABA daily
- Medium dose ICS + LABA daily

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9
Q

What is severe persistent asthma
and how is it treated

A

Symptoms several tiems per day and nightly
- High dose ICS + LABA daily
- High dose ICS + LABA + oral steroids daily

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9
Q

What is the acute treatment for asthma

A

oxygen, nebulized SABA, ipratropium bromide and oral corticosteroids

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10
Q

what is an infection of the upper airway that obstructs breathing and causes a barking cough

A

croup

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11
Q

what pathogen causes Croup

A

Parainfluenza virus

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12
Q

what is seen on AP CXR in Croup

A

Steeple sign
(narrowing of the trachea in subglottic region)

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13
Q

What is the treatment for Croup

A

Supportive (air humidifier) and antipyretics

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14
Q

What is cystic fibrosis

A

autosomal recessive mutation in the CFTR gene causing abnormally thick mucus, causing difficulty to clear the mucus

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15
Q

what is the presentation of CF

A

recurrent respiratory infections (esp. Pseudomonas), Steatorrhea

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16
Q

What is steatorrhea

A

excretion of abnormal quantities of fat with feces due to reduced absoprtion of fat by intestines

17
Q

How is CF diagnosed?

A

Quantitiative sweat chloride test
- CXR may reveal hyperinflation, mucus plugging and focal atelectasis

18
Q

what is the treatment of CF

maintenance and acute exacerbatiosn

A

Maintenance: chest physiotherapy, hight-fat diet, supplement fat-soluble vitamins (A, D, E, K).
Acute exacerbations: antibiotics

19
Q

what are risk factors for foreign body aspiration

A

institutionalization
advanced ageg
poor dentitition
alcohol
sedative use

20
Q

what test is required to appropriatly assess ventilation

A

ABG

21
Q

what is the presentation of nasal foreign body

A

persistent foul-smelling purulent unilateral nasal discharge in a young child without respiratory symtpoms

22
Q

What can be used with nasal foreign bodies to shrink the mucous membrane prior to removal of the FB

A

Oxymetazoline drops

22
Q
A
23
Q

how are ocular foreign bodies diagnosed

A

full inspection of lids, conjunctiva and cornea
Slit lamp exam will assist in ID and removal

24
Q

What is hyaline membrane disease

A

when infants are born before the lungs are producing adequate amounts of surfactant

24
Q

What causes hyaline membrane disease

A

prematuraty
deficiency in sufactant resulting in poor lung compliance an dn atelectasis

25
Q

what is the presentation of hyaline membrane disease on CXR

A

diffuse bilateral atelectasis causing a “ground glass appearance”

26
Q

What is the treatment of hyaline membrane disease

A

antenatal steroid within 24-48 hours of birth (Betamethasone IM x 2)
- artificial surfactant can be given via endotracheal tube
- mechanical ventilation with postivie pressure

27
Q

What is the common viral cause for pneumonia in kids

A

RSV: comes on fast

28
Q

What is the common viral cause of pneumonia in adults

A

influenza

29
Q

how are viral pneumonias diagnosed

A

CXR: bilateral insterstitisl infiltrates
-rapid antigen testing for flu, RSV nasal swab

30
Q

what is the treatment for viral pneuomnia

A

flu - tamiflu if sxs began <48hours
symptomatic tx: BEta2 agonists, fluid and rest

31
Q

what is the presntation of bacterial pneumonia

A

fever, dyspnea, tachycardia, tachypnea, cough, +/- sputum

32
Q

how is bacterial pneumonia diagnosed

A

CXR: patchy, segmental, lobar, mulitlobar consolidation
Blood culutres x2, sputum gram stain

33
Q

what is the outpatient treatment for bacterial pneumonia

A

Doxycycline
Macrolides

34
Q

what is the inpatient treatment for bacterial pneumonia

A

Ceftriazone + azithromycin/respiratory FQs

35
Q

what is the most common cause of lower respiratory tract infection in children worldwide

A

RSV (respiratory synctial virus)

36
Q

what is the presentation of RSV

A

rhinorrhea, wheezing/coughing that persists for months, lowgrade fever, nasal flaring/retractions, nail bed cyanosis

37
Q

what are indications for hospitalization with RSV

A

tachypnea with feeding difficulties
visible retractions
oxygen desaturation < 95-96%

38
Q

who are RSV vaccinations approved for

A

individuals 60+ years and older

39
Q

what is the preventative management for infants and younger children with RSV

A
  • 1 dose Nirsevimab for all infants younger than 8 months born during/entering their first RSV seaso
  • 1 dose Nirsevimab for infants/children 8-19months who are at increased risk for severe RRSV disease and entering their second RSV season
40
Q

what is the prophylaxis for RSV

A

Palivizumab (Synagis) - FDA approved for children at high risk for severe RSV

Pediatrics - clinical (13 decks)

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