Pulmonary Clinical Medicine V: Pediatric Pulmonology Flashcards
What is vocal cord dysfunction (aka paradoxical vocal fold motion disorder) characterized by?
Abnormal closing of the vocal cords making it hard to move air in and out of lungs
What age group is most susceptible to vocal cord dysfunction?
Which sex?
1) Teenagers
2) Females
Classification of asthma is determined by assessment of?
1) Impairment (symptoms)
2) Risk (# of exacerbations requiring steroids
What is the suspected diagnosis if a child presents as breathlessness while at rest, silent, and is noticeably drowsy/confused?
Imminent respiratory arrest
What are first line options for acute exacerbation of asthma?
1) Albuterol + ipratropium (anticholinergic)
2) Steroids
3) Oxygen
What is the inheritance pattern of cystic fibrosis?
Where is CFTR located?
It is a disease of what function that involves multiple organ systems ?
1) Autosomal recessive
2) Chromosome 7
3) Exocrine gland function
CFTR encodes for a protein that functions as a?
cAMP regulated Chloride channel across epithelial cells
What population in the U.S. does CF affect the most?
Caucasians
Why does CF not present the same way in every patient?
CFTR mutations have poor penetrance
Most common clinical presentations of CF include?
1) Chronic lung disease
2) Exocrine pancreatic insufficiency
What pathogens are common during early childhood (first 10 years of life) in CF patients?
What is ultimately isolated from the respiratory secretions of most patients by the second and third decade of life?
1) Staphylococcus aureus and Haemophilus influenzae
2) Pseudomonas aeruginosa
What are the three components of cardiopulmonary arrest in children?
1) Respiratory (O2)
2) Cardiac (pump, perfusion, BP)
3) Circulatory volume (perfusion, BP)
Most pediatric arrests are due to?
Respiratory issues
What does restlessness, anxiety and combativeness in a child suggest?
Hypoxia
What appearance of a child in not reassuring and suggests respiratory distress?
1) Poor tone
2) Lethargy
3) Listlessness
What indicates a very sick child in terms of interaction?
If nobody can comfort or distract the child
In terms of their appearance and behavior, what indicates a decreased level of consciousness?
Unfocused gaze
The initial response to respiratory compromise is usually?
But as respiratory compromise progresses what ominous sign occurs?
1) Tachypnea
2) RR often decreases and has an irregular pattern
What physical findings are indicative of respiratory distress?
1) Sternal retractions
2) Nasal flaring
3) Tripod position
Pale, mottled, cool, or ashen skin are concerning in that they may indicate?
Hypoxia and shock
What is done to check circulation and perfusion?
What is considered normal?
1) Capillary refill
2) Less than 2 seconds
What is the most common cause of infectious airway obstruction in kids ages 6-36 months?
What sign is associated with this?
1) Croup (acute laryngotracheobronchitis)
2) Stridor
While the vaccine has nearly eliminated its occurence what pathogen can cause epiglottitis?
Haemophilus influenzae type B
What condition can RSV (respiratory syncytial virus), influenza, parainfluenza, and adenovirus cause?
What age range?
What is it characterized by?
1) Bronchiolitis
2) Less than 2
3) Progressive cough and wheezing
What is characterized by inflammation, edema, bronchospasm, and mucus?
Asthma
If an allergy is reported, what should always be asked?
What is the regimen to treat anaphylaxis?
1) What happens when exposed to allergen
2) Epi, O2, steroids
What is the most common cause of pneumonia in infants/children?
If it is not the above then what is most common?
What is the most common cause in adolescents?
1) Viral infection
2) If it’s bacterial then streptococcus pneumoniae
3) Mycoplasma pneumonia
If a child presents with sudden dramatic coughing, stridor, and drooling what is the most probable cause?
Choking from foreign body
