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pediatrics > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Croup - definition, causes

A

infection of the upper airway
- MC: Parainfluenza type 1+ 2
RSV is 2nd MC

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2
Q

Croup - presentation

A

barking cough, coryza, inspiratory stridor
- difficulty breathing when lying down and may show signs of hypoxia such as peripheral cyanosis and accessory muscle use

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3
Q

Croup - x-ray

A

STEEPLE SIGN: narrowing of the air column in the trachea

RARELY DONW AND IS ALWAYS WRONG ANSWER

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4
Q

Croup - diagnostic

A

clinically, can be aided by radiology if the symptoms are mild

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5
Q

it helps to differentiate croup from epiglotitis

A

hypoxia

croup: hypoxia on presentation
epiglottitis: hypoxia imminent

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6
Q

Croup - treatment

A

mild: steroids

moderate - severe: racemic epinephrine

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7
Q

epiglottitis - definition / causes

A

severe, life threatening swelling of the epiglottitis and arytenoids
- H. influenza type B

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8
Q

epiglottitis - presentation

A

HISTORY OF VACCINATION DELINQUENCY with:

  • potato voice
  • fever
  • drooling in the tripod position
  • refusal to lie flat
  • CHERRY RED EPIGLOTITIS
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9
Q

epiglottitis - x-ray

A

thumbprint signs

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10
Q

epiglottitis vs croup on x-ray

A

epiglottitis - thumbprint signs

croup - steeple sign

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11
Q

epiglottitis - diagnosis

A

clinically

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12
Q

epiglottitis - treatment

A
  1. incubate (in OR in case unsuccesful intubation makes tracheostomy necessary
  2. ceftriaxone for 7-10d
  3. Rifampin for all close contacts
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13
Q

epiglottitis vs croup on season

A

croup: winter
epiglottitis: year round

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14
Q

epiglottitis vs croup - most accurate test

A

croup: PCR
epiglottitis: C+S from tracheal aspirate

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15
Q

Whooping cough - definition / causes

A

form of bronhitis caused by Bortetella pertusis

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16
Q

Whooping cough - presentation

A

catarrhal stage: congestion and rhinorrhea: 14d
paroxysmal stage: severe coughing with extreme gasp of air (inspiratory whoop) followed by vomiting (14-30 days duration)
Convalescent: decrease of frequency of cough: 14d in duration
burst blood vessels in the eyes

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17
Q

Whooping cough - diagnostic tests

A
  • clinically diagnosis
  • Butterfly pattern on chest x-ray
  • PCR of nasal secretions or Bartonella pertusis toxin
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18
Q

Whooping cough - treatment

A
  • Erytrhomycin or azithrom aids only in the catarrhal stage, not in the paroxysmal
  • isolate the child
  • macrolides in close contacts
  • DTaP vaccine
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19
Q

Bronchitis - etiology / presentation / diagnosis / treatment

A
  • bacteria and viruses
  • produtive cough lasting 7-10 d
  • clinical diagnosis
  • supportive treatment
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20
Q

Diphtheria - treatment

A

antitoxin (antibiotics do not work)

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21
Q

Bronchiolitis - definition and etiology

A

viral infection of bronchioles caused by RSV (MC) or parainfluenza virus TYPE 3 (less common)

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22
Q

Bronchiolitis - season and age

A

winter and spring in children younger than 2

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23
Q

Bronchiolitis - presentation

A

nasal, cough, RESPIRATORY distress, WHEEZING, fever, crackles, prolonged expiration, hyperresonance to percussion

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24
Q

bronchiolitis - complications

A

increased risk of developing asthma

25
how to assess the maturity of fetal lungs
1. lecythin:sphingomyelin ratio more than 2 | 2. phosphatidyl glycerol in amniotic fluid
26
meconium aspiration syndrome - definition
aspiration of meconium causes obstruction + pneumonia
27
meconium aspiration syndrome - diagnosis
meconium stained amniotic fluid seen during delivery, | cyanosis, intercostal retractions, distended chest etc
28
meconium aspiration syndrome - radiology
CXR: atelectasis, hyperinflation, pneumothorax
29
meconium aspiration syndrome - treatment
suction nose, mouth, upper airway at birth, O2 intubation, surfactant treatment, maybe empiric antibiotics
30
characteristics of epiglottitis but not croup
drooling, tripod position
31
Primary ciliary dyskenesia vs CF regarding respiratory features
the same: 1. Chronic sinopulm infections 2. NASAL POLYPS 3. bronchiectasis 4. digital growth
32
primary ciliarry dyskenesia vs CF regarding extrapulm features
1ry ciliary: sinus inversus, infertility, NORMAL GROWTH | CF: pancreatic insuf, infertility, FAILURE TO THRIVE
33
1ry ciliary dyskenesia vs CF on growth
1ry ciliary has NORMAL GROWTH
34
in the delivery rook - respiratory distress and suspicion of diaphragmatic hernia - next step
incubation also gastric tube to decompress stomach and bowel never CPAP
35
foregin body aspiration - next step
bronchoscopy
36
bacterial pneumonia in CF
children: s. aureus | adults? Pseudomonas
37
hormones that influence surfactant secretion
cortisol --> increases | insulin --> decreases
38
common causes of neonatal respiratory distress - causes
1. transient tachypnea of newborn (term or posterm) 2. resp distress syndrome (preterm) 3. persistent pulm hypertension (term or posterm) --> makes R to L shunts (through foramen ovale, PDA)
39
CF in males - inferitily vs pancreatitis
- 100% have infertility | - 10 develops pancreatitis. If pancretic insufficiency in early life, low risk of developing pancreatitis
40
Apgar scores are helpful in assessing the
status of a neonate and sesponse to neonatal resuscitation | - DO NOT CORRELATE WITH PROGNOSIS OR RISK FOR CEREBRAL PALSY
41
born of baby with HR less than 60 -->
chest compression
42
subcutaneous emphysema 2ry to severe coughing coughing paroxysm -->
chest x-ray to rule out pneumothorax
43
infants bronchiolitis - complications
1. apnea (esp if younger than 2 months) | 2. respiratory failure (esp if younger 2 months)
44
emergency incubation is indicated for
oroph edema, significant stridor or resp failure
45
pneumonia and effusion on chest x-ray - management
small effusion and No resp distress or hypoxia --> oral antibiotics and close monitoring moderate/large effusion OR resp distress OR hypoxia --> U/S, IV antibiotics, drainege
46
exudative effusions - pleural fluid analysis
- pleural protein / serum protein ratio more than 0.5 - pleural LDH / serum LDH more than 0.6 - pleural LDH more than 2/3 upper limit of normal serum LDH
47
transient tachypnea of the newborn
compression of rib cage through vaginal canal --> helps to remove fluid from lungs (also resorption) if C-cection --> excess lung fluid --> hypoxic --> transient for LESS THAN 4 HOURS RF: C-section, prematurity, DM FLUID IN INTERLOBULAR FISSURES
48
transient tachypnea of the newborn - management / RF
supportive care self resolution in 1-3 days RF: C-section, DM, prematurity
49
vit D and K def in children --> think
pancreatitis
50
primary cilliary dyskenesia - diagnosis
1. low nasal NO levels 2. Genetic testing 3. Bronchoscopy and electron microscopic visualisation of ciliary abnormalities
51
thymus is visible in chest x-ray until .... years old / explain
3 sailed sign: triangular shape, scallope border, uniform density variable with phases of respiration shrink durung times of stress or illness and rebound to a larger size after recovery
52
factors that decrease the risk of RDS
1. IUGR 2. maternal hypertension 3. chronic intrauterine stress for prolonged rupture of membranes
53
RDS - initial treatment
continuous positive air pressure ventilation
54
indications for palivizumab in infants
1. preterm births less than 29 2. chronic lung diseaes of prematurity 3. hemodynamically significant CHF
55
causes of chylotoraces
1. traumatic causes (cardiothoracic surgery) 2. congneital malformations 3. specific syndromes (eg. down, Noonan syndrome) 4. malignancy
56
kartegener - classic triad
1. situs inversus 2. recurrent sinusitis 3. bronchiecatsis
57
health young children who attend day care or have older siblings may experience up to .... (number) resp infections per year
12
58
croup - prevention
1. handwashing 2. decontamination of surfaces 3. Ensure proper ventilation

pediatrics (16 decks)

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