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#DAY4_PEDIATRICS > PULMONOLOGY > Flashcards

PULMONOLOGY Flashcards

1
Q

ASTHMA CLASSIFICATION (GINA 2015)

A
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2
Q

main feature of acute bronchitis

A

dry hacking cough

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3
Q

DOC for pertussis

A

Macrolide

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4
Q

PPD INTERPRETATION

A
  • Equal or >10 mm is (+)
  • Equal or >5 mm is (+) in the presence of any or all of the ff:
  1. history of close contact with a known or suspected case of TB
  2. clinical findings suggestive of TB
  3. chest X ray findings suggestive of TB
  4. immunocompromised condition
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5
Q

MANAGEMENT of PTB

A
  • INH 10 mg/kg/day PO (10-15 mkday; max 300 mg/day)
  • Rif 15 mg/kg/day PO (10-20 mgkday; max 600 mg/day)
  • PZA 25 mg/kg/day PO (20-40 mkday; max 2 grams/day)
  • Ethambutol 15 mg/kg/day PO (15-25 mkday; max 1.2 grams/day)
  • Streptomycin IM 20-40 mg IM once daily (max 1 gram/day)
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6
Q

PCAP C (severe) and D (very severe) both present with retractions, head bobbing, and cyanosis. The differences between the two are

A

the presence of the following in PCAP D: G –A- S (grunting, apnea, sensorium changes)

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7
Q
  • Extensive areas of hemorrhagic necrosis
  • Irregular areas of cavitation
  • Pneumatoceles, empyema and bronchopulmonary fistulas
A

Staphylococcus

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8
Q

+/- exposure, (+) PPD, no signs/symptoms, negative chest x ray findings

A

TB infection

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9
Q

PCAP C, incomplete HiB vaccination. treatment?

A

ampicillin 100 mkday in 4 divided doses

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10
Q

What sinuses are pneumatized at 4 years old?

A

Sphenoid

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11
Q

high fever, patient is in distress, acutely ill, brassy cough, copious purulent sputum

A

Bacterial Tracheitis

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12
Q
A
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13
Q

Whooping cough, Post tussive vomiting

A

Bordetella

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14
Q

The most common complication of acute nasopharyngitis is:

A

Otitis media

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15
Q

Etiologies of pneumonia in 0-28 days

A

GBS, E. coli, Listeria S. pneumoniae

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16
Q

barking cough and hoarseness are characteristic of

A

LTB

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17
Q
  • Diffuse infection with interstitial pneumonia
  • Necrosis of tracheobronchial mucosa, formation of large amounts of exudate, edema, and local hemorrhage
  • Involvement of lymphatic vessels and pleural
A

GABHS

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18
Q

most common cause of lobar consolidation

A

Pneumococcus

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19
Q

Incubation period of pertussis

A

3-12 days

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20
Q

PNEUMONIA, ETIOLOGY, S/SX, CXR/CBC, TX

A
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21
Q

To prevent occurrence of glomerulonephritis or rheumatic fever in children, cases of acute tonsillopharyngitis is best treated with:

A

Penicillin

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22
Q

Tuberculin sensitivity develops _____ after its administration on the forearm.

A

72 hours

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23
Q

considered the most consistent clinical manifestation of pneumonia in children

A

Tachypnea

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24
Q

TB disease

A

3 or more of the ff criteria:

  1. Exposure to an adult/adolescent with active TB disease
  2. (+) PPD
  3. Signs/symptoms suggestive of TB
  4. Abnormal chest x ray findings
  5. Laboratory findings (histological, cytological, biochemical, immunologic, and/or molecular)

SIGNS AND SYMPTOMS mentioned in #3 of TB disease (ANY 3 OR MORE):

  • Cough w/ or w/o wheezing for > 2 wks
  • Unexplained fever for > 2 wks
  • Failure to gain weight; weight loss, weight faltering
  • Failure to respond to 2 wks appropriate antibiotic therapy for LRTI
  • Failure to regain previous state of health after two weeks of a viral infection
  • Fatigue, reduced playfulness or lethargy
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25
Q

A 3 year-old boy has a positive tuberculin skin test. Which of the following is suggestive of military TB?

A

Hepatosplenomegaly

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26
Q

RECURRENT STREP PHARYNGITIS

A

Culture (+) strep pharyngitis that has been severe and frequent: >7 episodes in the previous year or >5 in each of the preceding 2 years → consider tonsillectomy!

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27
Q

PCAP C, No previous antibiotic use, complete HiB vaccination. Treatment?

A

Penicillin G 100 000 units in 4 divided doses

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28
Q

Etiologies of pneumonia in 5-15 yrs

A

Mycoplasma*, S. pneumoniae

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29
Q

2012 PAPP GUIDELINE FOR PNEUMONIA

A
30
Q

Patchy infiltrates & ragged tracheal column

A

Bacterial tracheitis

31
Q

PCAP A and B are both non-severe but the difference between the two is

A

presence of mild dehydration in PCAP B

32
Q

MC pathogen for Epiglotittis

A

If vaccinated: Staph. aureus; if unvaccinated: Hib

33
Q

What sinuses begin to develop at 7-8 years old?

A

Frontal

34
Q

MC pathogen for bacterial tracheitis

A

S. aureus

35
Q

Ragged air column on lateral neck xray due to debris and sloughed off mucus membranes

A

Bacterial Tracheitis

36
Q

PE: drooling, neck held in hyperextension, bulging of the posterior pharyngeal wall, neck pain, muffled voice, respiratory distress

A

RETROPHARYNGEAL ABSCESS

37
Q
  • 1-3 years old; similar to LTB EXCEPT the history of a viral prodrome and fever in the patient and family are often absent; causes are viral, allergic, psychologic
  • mostly nighttime symptoms with mild to moderate coryza and hoarseness
  • awakens with a metallic, barking cough, noisy inspiration, appears frightened
A

SPASMODIC CROUP

38
Q

MC pathogen for LTB/ croup

A

parainfluenza virus

39
Q

CLASSIFY ASTHMA BASED ON SEVERITY

A
40
Q

CHARGE syndrome

A
  • C – coloboma of the eye
  • H – heart defect

• A – atresia choanae

  • R – retarded growth and development or CNS anomalies
  • G – genital anomalies or hypogonadism
  • E – ear anomalies
41
Q

The most common extrapulmonary form of tuberculosis in children is:

A

Scrofula

42
Q

mild erythematous posterior pharynx and bulging of the posterior pharyngeal wall

A

Retropharyngeal abscess

43
Q

Patient presents with sore, scratchy throat, nasal obstruction and rhinorrhea. Paroxysms of cough leaving the baby breathless & subconjunctival hemorrhages.

A

Pertussis or whooping cough

44
Q

Treatment for LTB

A
  • All levels of respiratory distress: Dexamethasone;
  • moderate to severe distress: steroid and add racemic epinephrine

* Racemic epinephrine works by relaxing the muscles in the airways and tightening of the blood vessels. Thus, bronchial and tracheal secretions and airway wall edema decreases. Racemic epinephrine stimulates both α- and β-adrenergic receptors. It acts on vascular smooth muscle to produce vasoconstriction which markedly decreases blood flow at the capillary level. This shrinks upper respiratory mucosa and reduces edema.

45
Q

Thump sign / leaf sign

A

Epiglotittis

46
Q

Wheezes are heard loudest over the trachea. Persistent wheezing never seems to go away

A

Chondromalacia

47
Q

(+) exposure to and adult/adolescent with active disease, (-) PPD, no signs/symptoms, negative chest x ray findings

A

TB exposure

48
Q

Period of communicability of pertussis

A

from 7 days after exposure to 4 wks after onset of typical paroxysms; most infectious during the catarrhal stage

49
Q

Staccato cough

A

Chlamydia

50
Q

Tx of Bacterial Tracheitis

A

Vancomycin or Clindamycin AND a 3rd generation cephalosporin

51
Q

most common over all cause of PCAP worldwide.

A

Viruses

52
Q
  • Fever, sore throat, dysphagia, trismus
  • asymmetrical right tonsillar bulge with displacement of the uvula and erythematous posterior pharyngeal wall
A

Peritonsillar abscess

53
Q

Brassy cough

A

Staphylococcus

54
Q

Etiologies of pneumonia in 3 wks – 3 mos

A

RSV*, parainfluenza, Chlamydia, Mycoplasma, S. pneumoniae*,

55
Q

main features of bronchiolitis

A
  • fever, cough, and wheezing in the 1st 2 years of life; there is inflammation of the lining of epithelial cells of bronchioles causing mucus production, inflammation and cellular necrosis
  • history of wheezing with exposure to ill family members, affecting young children points to this diagnosis
  • Bronchiolitis is caused by obstruction and collapse of the small airways during expiration.
  • Bronchiolitis is more common in boys, non-breastfed, those who live in crowded conditions, with mothers who smoked during pregnancy
56
Q

PCAP A and B treatment

A

Oral amoxicillin - 40 - 50 mkday in 3 divided doses

57
Q

Management of EPIGLOTTITIS

A

Intubation and antibiotics (Cefotaxime, Ceftriaxone, or Meropenem IV)

58
Q

Management of bronchiolitis

A

SUPPORTIVE MANAGEMENT

59
Q

Patient presents with sore, scratchy throat, nasal obstruction and rhinorrhea. Persistent rhinorrhea w/ onset in the first 3 mos of life (snuffles)

A

Congenital syphilis

(snuffles is catarrhal discharge from the nasal mucous membranes in congenital syphilis)

60
Q

Barking “Seal” cough

A

Parainfluenza

61
Q

3 stages of pertussis

A

Catarrhal, Paroxysmal, Convalescent

62
Q

LEVELS OF ASTHMA CONTROL (GINA 2006)

A
63
Q

“steeple sign” / Subglottic narrowing

A

Croup or laryngotracheobronchitis (LTB)

64
Q

muffled voice, drooling, tripod position, high fever, very toxic-looking patient

A

EPIGLOTTITIS

65
Q

Hyperinflation w/ bilateral interstitial infiltrates & peribronchial cuffing

A

RSV

66
Q

Etiologies of pneumonia in 4 mos – 5 yrs

A

viruses*, S. pneumoniae*, H. influenzae type b, Mycoplasma

67
Q

• What are the sinuses present at birth?

A

Maxillary, Ethmoid

68
Q

most common bacterial cause of PCAP in children 4mos-5 years of age.

A

S. pneumoniae

69
Q
  • Attaches to respiratory epithelium
  • Inhibits cellular destruction
  • Sloughed cellular debris and inflammatory cells and mucus cause airway obstruction
A

Mycoplasma

70
Q

Local edema that aids in the proliferation of organisms and spread into adjacent areas resulting in focal lobar involvement

A

Pneumococcus

#DAY4_PEDIATRICS (15 decks)

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