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Peds I & II > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Describe the sound of rales/crackles. When do you predominantly hear it?

A

Scratchy, bubbly

Inspiration

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2
Q

What mainly causes rales/crackles in peds?

A

Bronchiolititis

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3
Q

Describes wheezes

A

continuous, high pitches

Expiration

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4
Q

Describe Rhonchi

A

continuous, low pitched

Snoring

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5
Q

Causes for Rhonchi

A
  1. Pneumonia

2. Cystic Fibrosis

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6
Q

Describe Stridor

A

High pitch, harsh

Inspiration

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7
Q

What is the main cause for stridor?

A

Croup

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8
Q

si/sx’s of Viral Croup (laryngotrachobronchitis)

A
  1. Inspiratory stridor
  2. Hoarseness
  3. Cough: barking, “seal-like”
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9
Q

What is the #1 cause for viral croup? other MC?

A 
#1=Parainfluenza Virus Type 1
Other= RSV
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10
Q

What are the 5 components of the Westley Croup Score?

A
  1. Level of consciousness
  2. Cyanosis
  3. Stridor
  4. Air entry
  5. Retractions
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11
Q

List the signs of imminent respiratory failure

A
  1. Fatigue and listlessness
  2. Marked retractions
  3. Decreased/absent BS
  4. Depressed LOC
  5. Tachycardia out of proportion to fever
  6. Cyanosis/pallor
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12
Q

Based on the Westley Croup Score, what is considered Mild Croup? Treatment plan?

A

Score= <2

  1. Supportive tx
  2. Cool mist
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13
Q

Based on the Westley Croup Score, what is considered Moderate Croup? Treatment plan?

A

Score=3-7

  1. Corticosteroids: Dexamethasone IM/IV
  2. Nebulized racemic Epi
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14
Q

Radiographic findings in Viral Croup

A

Steeple Sign

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15
Q

Epiglottitis etiology

A

Hib: Haemophilus influenza type b

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16
Q

Epiglottitis si/sx’s

A

3 D’s + Tri-pod posturing:

  1. Dysphagia
  2. Drooling
  3. Distres
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17
Q

Epiglottitis radiograph findings

A

“Thumb sign”

18
Q

Epiglottitis treatment

A
  1. Airway supports! ET tube

2. Abx: 3rd generation Cephalosporing + Vancomycin

19
Q

What age is Bronchiolitis MC in?

A

Age <2

20
Q

What is the #1 cause of Bronchiolitis?

A

RSV

21
Q

Si/sx’s in Bronchiolitis

A
  1. Tachypnea, labored breathing
  2. Cough
  3. Hypoxia
22
Q

Lung exam findins in Bronchiolitis?

A

Wheezing

Crackles

23
Q

Bronchiolitis treatment

A
  1. Oxygen
  2. Maintain hydration
  3. Nasal suctioning
24
Q

What is the most important cause of LRTI in children <1 yr

A

Respiratory Syncytial Virus: RSV

25
Q

RSV si/sx’s

A
  1. Crackles
  2. Prolonged expiration wheezing
  3. Retractions
  4. MUCUS!!!
26
Q

CXR findings in RSV

A

Hyperinflation

Peribronchial thickening

27
Q

RSV diagnosis

A

Rapid assay (nasal swab/wash)

28
Q

When would you give Ribavirin for tx of RSV?

A

ONLY if immunocompromised

29
Q

What is the MCC of respiratory distress in preterm infants?

A

Respiratory Distress Syndrome (RDS)= “Hyaline Membrane Disease”

30
Q

Etiology of Respiratory Distress Syndrome (RDS)

A

Deficiency of Surfactant production + surfactant inactivation by protein leak into airspaces

31
Q

CXR findings in RDS

A

“Ground-glass appearance”= Atelectasis

32
Q

RDS treatment

A
  1. Oxygen, nasal CPAP, intubation
  2. Surfactant replacement
  3. Steroids
33
Q

When do you admit for pneumonia?

A

<3-6 mos. old

Hypoxemic

34
Q

Pneumonia abx treatment

A

Amoxicillin 90 mg/kg per day

35
Q

If atypical pneumonia suspected, abx treatment?

A

Azithromycin

36
Q

Pertussis (whooping cough) etiology

A

Bordatella pertussis

37
Q

Phase 1 of pertussis

A

1-2 weeks:
URI sx’s
Fever

38
Q

Phase 2 of pertussis

A

2-6 weeks:
Persistent paroxysmal cough
Inspiratory “whooping” postussive emesis

39
Q

Phase 3 of pertussis

A

Weeks to Months:

Cough gradually resolves

40
Q

Complications of pertussis

A
  1. Hypoxia
  2. Apnea
  3. Pneumonia
  4. Seizures
41
Q

Pertussis treatment

A

Macrolides
TMP-SMX

*Tx everyone in the household

Peds I & II (8 decks)

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