Pulmonary

Question 1

Leading cause of infant hospitalization

Answer 1

Acute bronchiolitis

Question 2

Peak age of acute bronchiolitis

Answer 2

6 mo

Question 3

Age most common for bronchiolitis

Answer 3

First 2 years

Question 4

Monoclonal antibody used for acute bronchiolitis, particularly seasonally.

Answer 4

“Synagis”

Question 5

Can you treat acute bronchitis with antibiotics?

Answer 5

No, usually not. 90% viral

Question 6

“Seal like” cough.

Answer 6

CROUP

Question 7

Age for group.

Answer 7

36mo-7yrs

Question 8

Main at home treatment for coup.

Answer 8

Cool humidifier

Question 9

“Steeple sign”

Answer 9

CROUP

Question 10

Common differential for croup

Answer 10

Epiglottis

Question 11

Sx: Use accessory muscles. Strider.

Exam: Cyanosis. Tachypnea

CXR: Steeple sign

Answer 11

CROUP

Question 12

Cause high mortality in infants and elderly

Answer 12

Influenza

Question 13

What can happen to young children who have a viral infection when you give them aspirin?

Answer 13

Reye syndrome 30% mortality

Question 14

Tests for influenza

Answer 14

Rapid influenza diagnostic tests

Reverse transcriptase polymerase chain reaction

Question 15

Most common type of Influenza in humans

Answer 15

A

Question 16

Is the cough in influenza productive or non-productive?

Answer 16

Non-productive

Question 17

What particular exposure can lead to acute bronchitis in children?

Answer 17

Smoking

Question 18

“Whooping cough”

Answer 18

Pertussis

Question 19

Is pertussis bacterial or viral?

Answer 19

Bacterial. “Bordetella pertusis”-highly contagious!

Question 20

Diagnosis for pertussis?

Answer 20

Culture and PCR-nasal swab

Question 21

Tx for pertussis

Answer 21

Azithromycin!

Keep elevate to cough stuff out.

Supportive care

Question 22

Caseating granuloma in the apical lung

Answer 22

TB

Question 23

TB is caused by_________

Answer 23

Mycobacterium-obligate aerobe-“LIKES O2!”

Question 24

HOw long does acute bronchitis usually last?

Answer 24

5 days and up to 3-4 weeks

Question 25

Risk factors for acute bronchitis:

Answer 25

Smoking. Exposure. Compromised immune system

Question 26

Acute bronchiolitis occurs mostly in_______

Answer 26

Infants-leading cause of infant hospitalization

Question 27

What virus causes acute bronchiolitis?

Answer 27

Respiratory Syncytial Virus

Question 28

What season is RSV most common?

Answer 28

Winter Oct-Jan

Question 29

What can happen to children with RSV later in life?

Answer 29

Persistence of airway activity

Question 30

Risk factors for acute bronchiolitis:

Answer 30

<3 mo Low birth weight Low socioeconomic group Crowded living

Question 31

Sx of bronchiolitis

Answer 31

Wheezing URI Sx Cough Irritability Poor feeding Apnea

Question 32

Exam findings of bronchiolitis:

Answer 32

Tachypnea Nasal flaring Fine rales Wheezing Hypoxia

Question 33

Main diagnostic test for bronchiolitis?

Answer 33

RSV rapid viral antigen testing-nasal swab

Question 34

Tx for bronchiolitis

Answer 34

Humidified 02 Bronchodilator Nebulized hypertonic saline Nasal and oral auctioning Nebulized Ribavirin-broad-spectrum antiviral agent-severe cases!

Question 35

Monoclonal antibody for acute bronchiolitis?

Answer 35

Palivizumab (Synagis)

Question 36

A viral infection of the LARYNX, TRACHEA, & the UPPER BRONCHIAL TREE.

Answer 36

Croup

Question 37

How long do Sx of croup usually last?

Answer 37

5-7 days

Question 38

Are labs needed for Croup?

Answer 38

Not usually

Question 39

What is nebulized race ic epinephrine used for?

Answer 39

Tx of croup

Question 40

How long is the incubation period of influenza?

Answer 40

1-4 days

Question 41

How long does viral shedding last for influenza?

Answer 41

5-10 days

Question 42

What virus causes influenza?

Answer 42

Orthomyxovirus-invades airway and respiratory tract cells

Question 43

Which test will allow you to determine if influenze is A or B?

Answer 43

Reverse transcription-polymerase chain reaction testing or viral culture of nasopharyngeal. CRITERION STANDARD!

Question 44

In which patients with influenza would you get a CXR?

Answer 44

Elderly or high risk w/ pulmonary symptoms

Question 45

Should pregnant women get flu vaccines?

Answer 45

Yes, ALL!

Question 46

When would you use neuraminidase inhibitors with influenza?

Answer 46

Within 24-48 hrs. Really only useful for those @ the highest risk.

Question 47

What is the criterion standard for diagnosis of pertussis?

Answer 47

Nasopharyngeal swab for culture of B. Pertussis-takes a long time to get results

Question 48

What is a test you can do in the office to diagnose pertussis in a later stage?

Answer 48

PCR assays and antigen detection