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Pediatrics > Pulmonary > Flashcards

Pulmonary Flashcards

0
Q

What are the 2 cells in lungs?

A

Type 1: 90%

Type 2: 10% - makes surfactant

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1
Q

Respiratory distress vs respiratory failure?

A

distress: RR goes up but NOT compensating
failure: COMPENSATING d/t no good O2 and ventilation –> acidotic

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2
Q

Transient tachypnea of new born (TTN)?

A

delayed fluid clearance

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3
Q

TTN - PE?

A

tachypnea

nasal flaring

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4
Q

TTN - prognosis?

A

resolves w/in 3 days

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5
Q

TTN - dx?

A

nasal cannula/CPAP

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6
Q

TTN - labs?

A

CXR: hazy bilaterally w/ streaking in perihilar area

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7
Q

TTN - tx?

A

abx based on PE and hx until culture is negative

maintain glucose

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8
Q

Respiratory distress syndrome (RDS)?

A

premature babies females

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9
Q

Increase risk w/ RDS?

A

diabetic moms

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10
Q

RDS - patho?

A

no good surfactant –> V/Q mismatch –> hypoexmia (acidosis) –> pulmonary vasoconstriction and leaking of protein –> hyaline membrane dz

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11
Q

RDS - PE?

A

GRUNTING
cyanosis
hypoxemia
nasal flaring

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12
Q

RDS - dx?

A

CXR: ground glass appearance

premature

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13
Q

RDS - tx?

A 
antenatal corticosteroids 
vent support to prevent barotrauma 
prevent complications
give surfactant 
nitric oxide: decrease pulmonary HTN
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14
Q

RDS - prognosis?

A

bad news bears: 40%

survivors end up with bronchopulmonary dysplasia

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15
Q

What is meconium aspiration syndrome (MAS)?

A

dark green vomit
normally passes through via GI but ends up in lungs –> damages lungs
> 38wks of gestation

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16
Q

Why is meconium bad?

A

deactivates surfactant

aspiration of bile acids –> chemical pneumonia

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17
Q

MAS -PE?

A

metabolic acidosis

yellow clubbing fingers, umbilical cord

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18
Q

MAS- labs?

A

CXR: opacities w/ surrounding hyperinflation

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19
Q

MAS - complications?

A

pneumonia
acidosis
pneumothorax

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20
Q

MAS - delivery room managment?

A

stick a vacuum down the nose and see if there is anything that sucks up

  • yes: continue to suck
  • no: DON’T SUCK
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21
Q

MAS - tx?

A 
surfactant therapy (b/c the bile deactivated surfactant proteins) w/in 6hrs of brith for 2-3 doses 
be on look out for pneumothorax, +/-chest tube
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22
Q

What dz can cx wheeze?

A

asthma
bronchiolitis
CF

23
Q

What bug is bronchiolitis?

A

RSV

esp during fall/winter season

24
Q

What is bronciolitis?

A

lower resp tract in <2 yo

acute inflammation of the bronchioles that causes increased MUCUS PRODUCTION AND BRONCHOSPASM

25
Q

Bronchiolitis - RF?

A

premature - low surfactant
LBW
heart dz
immunodeficient

26
Q

Bronchiolitis -dx?

A

rales/rhonic
wheezes after/with viral resp infxn
during RSV fall/winter seasons

27
Q

Bronchiolitis - labs?

A

CXR: cuffing and atelectasis

+/- nasopharyngeal swab

28
Q

Bronchiolitis vs asthma?

A

presents the same way but bronchiolitis may not have an effect w/ bronchodilator (if there is an effect - continue)
O2 if premature, cardio probs, <12 wks old
DO NOT USE:
corticosteroids
antivirals
abx

29
Q

When to admit bronchiolitis?

A

multiple RF

severe: <90%, retractions

30
Q

Bronchiolitis - prevention?

A

avoid RSV by hand washing, hygiene
breast feed
vaccine may be considered (palivizumab/synagis) IF premature, chronic lung dz of prematurity, congenital heart dz

31
Q

CF - risk?

A

inherited

caucasian

32
Q

Cystic fibrosis - pathophysio?

A

defect of membrane pumps that lead to increased salty secretion from sweat glands
also affects the lungs b/c it builds up mucus that is obstructive AND destructive

33
Q

What membrane pump is broken in CF?

A

CFTR

34
Q

What organ systems start to fail w/ CF?

A 
lungs
GI
Gu
Metabolic
Pulm
35
Q

CF - PE?

A

lungs: WHEEZE/CRACKLES, recurrent URI
GI: steatorrhea and diarrhea; HEPATOSPLENOMEGALY
GU: sterility
Metabolic alkalosis
NASAL POLYPS
sciolosis/kyphosis d/t lack of Ca development in bones

36
Q

CF -dx?

A

Cl test

37
Q

CF - labs?

A 
hypohloremic
metabolic alkalosis 
increased serum glucose
sputum cultures
high LFT 
CXR:
-pulmonary nodules d/t abscesses
38
Q

CF - tx?

A

pancreatic enzymes (to help with the hepatosplenomegaly)
mucolytics
bronchodilators
chest physiotherapy for the mucus

39
Q

Baby has poor growth w/ multiple hospitalization for pneumonia?

A

check CF

40
Q

Baby has nasal poly?

A

CF

41
Q

Baby has pseudomonas pneumonia?

A

CF

42
Q

Baby has rectal prolapse?

A

screen for CF

43
Q

Pneumonia cx?

A

VIRAL&raquo_space;» bacterial

44
Q

Pneumonia vital signs?

A

fever

tachypnea

45
Q

Pneumonia- PE?

A

crackles
wheezes
decreased breath sounds

46
Q

Bacterial pneumonia - CXR?

A

focal infiltrate
loss of lung vol
loss of heart sillhouette
air bronchograms

47
Q

Bacterial pneumonia -neonates bugs?

A

group B
listeria monocytogenes
gram neg - E. coli, Klebsiella pneumoniae

48
Q

Bacterial pneumonia - neonates tx?

A

admit
gentamicin
febrile? ADMIT

49
Q

Bacterial pneumonia - 1mo ~5yrs bugs?

A 
S pneumoniae
H influ - if unimmunized
chlamydia
strep pyogenes
staph aures
50
Q

Bacterial pneumonia - 1mo ~5yrs bugs -tx?

A

admit if <4-6mo

outpt therapy: HD amox or augmentin

51
Q

Bacterial pneumonia >5yrs -bugs?

A

myocplasma

strep pneumoniae

52
Q

Bacterial pneumonia >5yrs- tx?

A

admit if toxic

outpt therapy: macrolide

53
Q

When to use cough supressents?

A

only if older than 6yo

ONLY TO HELP SLEEP

54
Q

How to tx cough?

A 
humidified air
limit exposure to smoke
hydration
warm water + brown sugar/honey
NO HONEY in <1yo

Pediatrics (12 decks)

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