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Pulmonary > pulmonary > Flashcards

pulmonary Flashcards

1
Q

what is the safest and most effective way to confirm the dx of foreign body aspiration in a 1 y/o child

A

airway fluoroscopy

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2
Q

dx of swallowing dysfunction

A

1- barium swallow study

2- video fluoroscopy

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3
Q

pulsus paradoxus

A

the difference in blood pressure during inspiration and expiration >20

should not be >10

suggestive of cardiac or pulmonary problems

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4
Q

why is not a good idea to give supplemental O2 to a pt with chronic hypoxemia?

A

can send into respiratory arrest

goal to maintain sat 90%

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5
Q

CBC changes with chronic hypoxemia

A

H/H increase (d/t increased EPO)
worry about Hct >65 –> HA, joint pain, clots, PE, hemoptysis
low plts –> d/t decreased lifespan, risk of bleeding

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6
Q

methemoglobinemia

A

iron in hemoglobin is defective and unable to carry O2

results in cyanosis

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7
Q

treatment for methemoglobinemia

A

methylene blue

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8
Q

work up for chronic cough (3)

A

1- sweat test
2- TB testing
3- CXR

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9
Q

what is an abnormal sweat test finding indicative of CF

A

60 mEq or greater is diagnostic

*sweat test is the gold standard for diagnosing CF!

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10
Q

what is the inheritance of CF

A

AR

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11
Q

what is the incidence of CF in the general Caucasian population

A

1/3000

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12
Q

what vitamin deficiency do you often see in CF

A

think fat soluble- DEAK
E deficiency is a major problem and need supplementation before age 5
K deficiency can lead to prolonged PT and PTT

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13
Q

how sensitive is the newborn screen for CF

A

95% (this is not very good)

remember sensitive means it rules out- a negative is truly negative

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14
Q

acid/base abnormality with CF

A

hypochloremic alkalosis

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15
Q

presentation of meconium ileus

A

can present as polyhydraminos in utero
can also see ground glass appearance on abdominal film 2/2 decreased bowel gas

** think CF

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16
Q

presentation of meconium peritonitis

A

can present as pseudocyst (calcified meconium)

** think CF

17
Q

bacterial infections in CF (name 4 bugs)

A

1- staph aureus
2- H flu
3- pseudomonas
4- burkholderia (severe dz)

18
Q

treatment of acute CF exacerbation

A

aminoglycoside (gent, neo, amikacin, tobra) & piperacillin

19
Q

infant who is hypoxic — post ductal sat low, pre ductal sat appropriate with cyanosis to the LE and notable precordial lift

A

there is some type of R to L shunt (likely across the PDA – with persistent fetal circulation

precordial lift indicates the RV is working hard!

20
Q

inheritance of primary ciliary dyskinesia

A

AR

21
Q

how to dx primary ciliary dyskinesia

A

biopsy

22
Q

chylothorax make up

A

electrolyte concentrations close to the serum

TG > 110
elevated lymphocytes
protein >3

** post op pt - think after heart surgery

23
Q

LDH and protein values in transudate vs exudate

A

EXUDATE

  • LDH > 2/3 LDH serum
  • protein > 3
  • see in pna, ca, trauma, inflammatory dz

TRANSUDATE

  • LDH < 2/3 LDH serum
  • protein <3
  • typically see in CHF
24
Q

what is the most accurate testing in determining whether a parapneumonic effusion is an exudate or transudate

A
  • test the pH
    exudates have a pH < 7.3
    transudates have a pH > 7.45 or greater than the blood pH
25
Q

how to diagnose bronchiectasis

A

chest CT

26
Q

what race is more at risk for SIDS

A

AA

27
Q

what gender is more at risk for SIDS

A

males

28
Q

affect of pacifiers on SIDS

A

may help prevent-

use after 1 mo in BF babies so they do not interfere

29
Q

are ALTE and SIDS related?

A

NOOOOO
they are separate entities
ALTE does not put you at risk for SIDS

30
Q

what is the best diagnostic text to confirm a pna dx by CXR

A

blood cx

31
Q

what is a likely cause of stridor in infants with trisomy 21

A

congenital subglottic stenosis

32
Q

what is a likely cause of stridor in infants with hydrocephalus

A

BL vocal cord paralysis

common with CNS defects (myelomeningocele, arnold chiari, hydrocephalus)

33
Q

what is the carrier rate of CF in the general caucasian population

A

1/25

34
Q

what is winter’s formula

A

used to calculate respiratory compensation

pCO2 = 1.5[HCO3]+8+/-2

35
Q

what is the safest and most effective way to confirm FB aspiration in a young child?

A

airway fluoroscopy

not CXR (will not detect radiolucent food objects)

Pulmonary (1 decks)

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