Pulmonary Flashcards
What is another name for Croup
Laryngotracheobronchitis
What causes Croup
Parainfluenza
Sx of Croup
Barking Cough, Inspiratory Stridor, Hoarse Voice
Dx of Croup
CXR: Steeple Sign due to subglottic narrowing
Tx of Croup
Steroids and nebulized racemic Epinephrine
What is acute bronchitis
Upper airway disease
What causes Acute Bronchitis
Viral: Influenza, Parainfluenza
Sx of Acute Bronchitis
1-2 days URI (fever, rhinorrea, cough) followed by wheezing, tachypnea, respiratory distress
Dx of Acute Bronchitis
Nasal Swab can be done but not necessary
Tx of Acute Bronchitis
Supportive: Hydration, O2, Suction
Exposed child should avoid daycare (Quarantine)
Wash hands frequently
What is the most common cause of Bacterial Pneumonia
Strep. Pneumo (95%), followed by H.Flu, Mycoplasma, Klebsiella
BUT MOST PNEUMONIA IS VIRAL
Sx of Bacterial Pneumonia
Fever, Tachypnea, Cough, Dyspnea, Crackles, Diminished Lung Souunds
Tx of Bacterial Pneumonia
Age Dependent but generally Ampicillin for babies and Amoxicillin for older
5yrs: Macrolide, Amoxicillin, or Penicillin G
Dx for Asthma
FEV (airflow) / FVC (Air Volume)
What categorizes Intermittent Asthma. What is the Tx.
What categorizes Mild Persistent Asthma. What is the Tx.
> 2x/wk during the day
2x/month at night
Tx: SABA + Low Dose ICS (Beclomethasone, Budesonide, Flunisolone, Fluticasone, Triamcinolone)
What categorizes Moderate Persistent Asthma. What is the Tx.
Daily sx
>1x/wk at night
Tx: SABA + Medium Dose ICS +/- LABA (Salmeterol, Formoterol)
What categorizes Severe Persistent Asthma. What is the Tx.
Multiple times everyday
Nightly
Tx: SABA + High Dose ICS + LABA +/- Systemic Corticosteroid (Omalizumab)
What is Hyaline Membrane Disease
Most common neonatal respiratory distress syndrome
Caused by surfactant deficiency
When does Surfactant Production Begin? When is it complete?
Begins 24-28wks
Ends by 35wks
Sx of Hyaline Membrane Disease
Difficulty breathing at birth, gets progressively worse, cyanosis, nostril flaring, tachypnea, grunting sounds, chest retractions
Dx of Hyaline Membrane Disease
CXR: Ground Glass, hypoexapnsion, air bronchograms
Tx of Hyaline Membrane Disease
Endotracheal Tube
O2
Surfactant Replacement
Where is a foreign body most likely to go
Right bronchiole
Sx of Foreign Body Aspiration
Abrupt onset of chocking, coughing, inability to vocalize, cyanosis
Decreased breaths sounds, wheezing usually unilateral and localized to side of obstruction
Dx of Foreign Body Aspiration
Gold Standard: Bronchoscopy
CXR
Tx of Foreign Body Aspiration
Bronchoscopy
Back blows for infants 1yr
What causes Cystic Fibrosis
Autosomal Recessive defect in CFTR Gene (Chloride channel issue)
What structural problems occur with Cystic Fibrosis
Increased mucus buildup in lungs, pancreas, and intestines
Sx of Cystic Fibrosis
Bronchiectasis: Recurrent URIs, Productive Cough, Dyspnea, Chest Pain, Chronic Sinusitis
Pancreatic Insufficiency: Steatorrhea, Bulky stools and fat soluble vitamin deficiency
Growth Delays: Failure to thrive
Infertility
GI: Meconium Ileus at birth (intestinal obstruction
Dx of Cystic Fibrosis
Sweat Chloride Test is elevated
CXR: Bronchiectasis, permanent dilation of airways
What are sputum cultures likely to show with Cystic Fibrosis
Pseudomonas, Staph. Auerus, and H.Flu
Tx of Cystic Fibrosis
No Cure, just management. Airway Clearance Bronchodilators, Mucolytics Pancreatic enzyme replacement (Vit. A, D, E, K) Lung/Pancreas Replacement
Tx for Acute Bronchiolitis RSV. And what do you prophylaxis for other kids
Supportive: Hydration, O2, Freq. Suctioning
Quarantine affected child, avoid daycare
Wash Hands
Dx for Asthma
Both airflow and air volume are decreased, but airflow decreases more
FEV1(Airflow)/FVC(Air Volume)
Define Moderate Persistent Asthma and how you treat it
Daily Symptoms during the day with daily SABA use, Nightly sx 1x/wk
Tx: SABA as needed + ICS +/-LABA
SABA:Albuterol
ICS: Beclomethasone, Budesonide, Flunisolone, Fluticasone, Triamcinolone
LABA: Salmetrol, Formoterol
Sx of Hyaline Membrane Disease
Difficulty breathing at birth that gets progressively worse, GRUNTING, cyanosis, nostril flaring, tachypnea, chest retraction
CXR: Ground Glass
Dx RSV Bronchiolotis
Nasal Swab can be done but necessary
Starts as URI (fever, rhinorrhea, cough) that gets progressively worse to cough, tachypnea, respiratory distress, crackles or wheeze
H&P for newborn with Hyaline Membrane Disease
Premature infant in respiratory distress. Incidence is 5% from 35-36wks and increases to 50% from 26-28wks
Due to deficient surfactant production
Dx Hyaline Membrane Disease
Premature infant that is tachypnea, cyanosis, expiratory GRUNTING
CXR: Bilateral atelectasis (ground glass), air bronchograms
Cyanosis, nasal flaring, doming of diaphgram and hypoinflation
