Pulm 4 - Pediatric Presentations

Question 1

croup

Answer 1

upper respiratory infection that may cause swelling, resulting in airway obstruction; most common age 1-3 yrs in winter (75% caused by virus, parainfluenza most common)

Question 2

upper respiratory infection that may cause swelling, resulting in airway obstruction; most common age 1-3 yrs in winter

Answer 2

croup

Question 3

RSV/bronchiolitis

Answer 3

lower respiratory inflammatory infection; most common in children 6 months - 2 years in winter and spring

Question 4

lower respiratory inflammatory infection; most common in children 6 months - 2 years in winter and spring

Answer 4

RSV/bronchiolitis - RSV is a virus that can cause bronchiolitis

Question 5

URI

Answer 5

self limiting, usually caused by a virus but may be bacterial; typically occurs in fall/winter months i.e. common cold

Question 6

URI aka

Answer 6

common cold

Question 7

self limiting, usually caused by a virus but may be bacterial; typically occurs in fall/winter months i.e. common cold

Answer 7

URI

Question 8

pneumonia

Answer 8

infection of the pulmonary parenchyma, which can be bacterial, viral, fungal, or r/t chemical irritants; highest risk in infants < 2 years

Question 9

infection of the pulmonary parenchyma, which can be bacterial, viral, fungal, or r/t chemical irritants; highest risk in infants < 2 years

Answer 9

PNA

Question 10

croup is most common in what age

Answer 10

1-3 years

Question 11

RSV/bronchiolitis is most common in what age

Answer 11

6 months - 2 years

Question 12

croup s/sx
6

Answer 12

1. fever
2. congestion
3. hoarse voice
4. barking cough
5. inspiratory stridor
6. worsened sx at night

Question 13

RSV/bronchiolitis s/sx
6

Answer 13

1. fever
2. cough
3. congestion, copious nasal drainage
4. decreased appetite
5. wheezing
6. irritability

Question 14

URI s/sx
8

Answer 14

1. sick contacts
2. cough
3. fever
4. HA
5. malaise/fatigue
6. congestion
7. wheezing
8. eye pain

Question 15

PNA s/sx
8

Answer 15

1. fever/chills
2. cough
3. congestion
4. irritability
5. CP
6. wheezing
7. decreased appetite
8. lethargy

Question 16

croup PE findings
4

Answer 16

1. hoarse voice
2. coryza
3. tachycardia
4. tachypnea

Question 17

croup common etiology

Answer 17

viral - most often parainfluenza virus (not the same as influenza A/B)
then other commons are Influenza A or B

Question 18

URI common etiologies

Answer 18

1 rhinovirus

other can be adenovirus and 200+ more

Question 19

RSV/bronchiolitis PE findings
4

Answer 19

1. nasal flaring
2. tachycardia
3. tachypnea
4. nasal drainage

Question 20

URI PE findings
2

Answer 20

1. cough
2. congestion

Question 21

PNA PE findings
3

Answer 21

1. crackles/rales
2. tachycardia
3. tachypnea

Question 22

PNA viral etiology

Answer 22

RSV

Question 23

most common etiology in children for PNA

Answer 23

strep pneumonia

Question 24

img/testing

Answer 24

generally not necessary:

croup - may see steeple sign on AP x ray
RSV/bronchiolitis - cxr may show hyperinflation or bronchial thickening; consider rapid RSV screening
PNA - cxr

Question 25

croup tx 2

Answer 25

1. consider single dose of dexamethasone 0.6 mg/kg PO (max 10 mg) 2. consider humidified air/mist

Question 26

RSV/bronchiolitis tx 1

Answer 26

consider nasal suction

Question 27

URI - avoid OTC cough and cold medications for children of what age

Answer 27

< 2 but FDA recommends waiting til 6 years old or older

Question 28

PNA tx for well appearing w/ normal pulse oximetry 2

Answer 28

1. abx 2. antitussives

Question 29

when to refer to ER 3

Answer 29

1. toxic appearing 2. respiratory distress 3. dehydration/inability to tolerate PO

Question 30

best ranked cough medications for children 3

Answer 30

1. children's delsym (4 and older) 2. children's robitussin (4 and older) 3. children's mucinex (4 and older)

Question 31

croup is dx how

Answer 31

clinically

Question 32

fever, congestion, barking cough, inspiratory stridor

Answer 32

croup

Question 33

fever, wheezing, nasal drainage

Answer 33

RSV

Question 34

fever, cough, congestion, ear pain

Answer 34

URI

Question 35

fever, cough, congestion, lethargy, wheezing

Answer 35

PNA

Question 36

flu etiology

Answer 36

influenza virus - A, B, C, D