PULMO Flashcards
Pathophysiology of Bronchial Asthma (4)
- Airway hyperresponsiveness or hyperreactivity
- Bronchoconstriction
- Airway wall inflammation
- Mucus hypersecretion
Definitive test for cough variant asthma
Peak Flow test w bronchial provocation
>20% increase or more - positive
> Bronchodilator challenge: can be diagnostic and therpaeutic
if FEV1 increase =>12% or more - positive
Major immunoglobulin in the respi tract?
IgA
Light’s criteria (3)
PLL
1. Protein >3.0g; PF/Serum CHON ratio: >0.5
2. PF LDH >200IU/L
3. PF/Serum LDH >0.6
pH of <7.2 = exudative
Indications for chest tube thoracostomy (4)
- pH <7.2
- PF glucose <50
- clearly purulent fluid
- (+) organism on gram stain
Lab determination of chylothorax (3)
- Pleural fluid trigly >110mg/dL
- PF:S trigly ratio >1.0
- PF:S chole ration <1.0
Carboxyhgb level presenting w memory loss, hallucination and imminent cardiovascular collapse?
40-60%
Carboxyhgb level presenting w coma and seizures?
61-70%
Immediately fatal level of carboxyhgb?
> 80%
Indications for tonsillectomy. (3)
With documented histories of GAS infection.
1. at least >7 in the previous year or
2. at least > 5 in each of the previous 2 yrs or
3. at least >3 in each of the previous 3 yrs
TRUE or FALSE. Removal of tonsils results in major immunologic deficiency.
FALSE
Peak incidence of Retropharyngeal abscess?
3-4yrs
> because lymph nodes begin to involute by 5 yo
Sinuses in order of ascending appearances
Birth: Maxillary and ethmoid
Maxillary pneumatized at 4yo
Sphenoid: 5th yr of life
Facial: 7-8yo
Difference between Viral and Bacterial pharyngitis?
Bacterial pharyngitis – ABSENCE of prodrome
Prodrome sx:
> Cough
> Coryza
> Hoarseness
> Conjunctivitis
McIsaac scoring for GAS (5)
FAACCS
1. Fever >38degC
2. Age 3-14y
3. Absence of cough
4. anterior CLAD
5. tonsillar Swelling/exudates
If =>4– do testing for GAS
MC cause of epiglottitis in children?
Prophylaxis and indication?
H. influenza B
Rifampicin 20mg/kg OD x4days
> Age <12mos without primary vaccination
> Age <4yo with incomplete immunization
> Immunocompromised child
MC cause of UAO in children
MC etiology
Laryngotracheobronchitis
Parainfluenza
Clinical finding on Xray, and what Xray view?
1. Croup
2. Epiglottitis
- Croup
> AP CXR: steeple sign - Epiglottitis
> Lateral NECK Xray: thumb sign
Croup vs Spasmodic croup?
Spasmodic croup- NO Fever
MC cause of bacterial tracheitis?
S. aureus
Common location for foreign body aspiration?
Right main bronchus:
> wider and straighter
MC cause of bronchiolitis.
Peak age?
RSV
> infancy, 1-2yo, peak 6-12mos
> TWR
1. Tachypnea
2. Wheezes
3. Retractions
MC etiology of neonatal pneumonia
GBS
MC cause of pleural effusion in neonates
Chylothorax
