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Pediatrics A > Pulmonology > Flashcards

Pulmonology Flashcards

0
Q

Narrowest portion of airway in pediatrics

A

Cricoid cartilage

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1
Q

Narrowest portion of airways in adults

A

Vocal cords

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2
Q

Clinical significance of airway diameter

A

Adult has widder diameter than pediatrics. Patient with narrow airway will develop resistance thus leading to HYPOXEMIA

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3
Q

1st line of defense in the respiratory tract:

A

Vibrissae
Ciliated lining epithelium
Physiologic mechanism
Immunologic mechanis

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4
Q

Boundary between the upper and lower airways

A

Glottis or Larynx

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5
Q

What are the three paired cartilages of the larynx?

A

Artyenoid
Cuneiform
Corniculate

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6
Q

What are the unpaired cartilages of the Larynx?

A

Epiglottis
Thyroid
Cricoid

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7
Q

Anything found inside the thoracic cavity is part of the ____

A

Lower respiratory tract

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8
Q

Anything found outside the thoracic cavity is part of the ____

A

Upper respiratory tract

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9
Q

Cough receptor is found mostly at the ___

A

Airways

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10
Q

Cough receptor may even be present at the ___

A

Middle ear

Base of the lungs

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11
Q

Good treatment to be given

A 
Oxygen
Fluid
Drugs with one pharmacological action
Fever relief
Chest physiotherapy
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12
Q

Oil based is not good for internal applications because it can cause ____

A

Lipoid bronchitis

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13
Q

This is known as deep tissue neck infection which is located ____ to the esophageal wall

A

Retropharyngeal abscess

Posterior

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14
Q

The nodes that drain from the retropharyngeal abscess

A

Nasopharynx
Paranasal sinus
Middle ear

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15
Q

Retropharyngeal abscess is seen in which age group?

A

3-4 years old

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16
Q

Causative agents of Retropharyngeal abscess

A

Group A strep
Anaerobes
S. Aureus

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17
Q

Differentials of Retropharyngeal abscess

A

Foreign body aspirate
Epiglottitis
Meningitis

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18
Q

Clinical manifestation of Retropharyngeal Abscess

A 
High grade fever
Irritability
Decrease food intake or dysphagia
Drooling
Sorethroat
Neck pain
Muffled voice
Stridor
Distress
Cyanosis
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19
Q

Physical finding examination of Retropharyngeal abscess

A

Foward buldge in the pharyngeal wall

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20
Q

Complication of retropharyngeal abscess

A

Upper airway obstruction
Aspiration pneumonia
Extension to the mediastinum

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21
Q

Treatment for retropharyngeal abscess

A

3rd gen cephalosporin + ampicillin-sulbactam or clindaymycin

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22
Q

Foreign body aspiration is commonly seen in what age group

A

Older infants and toddlers less than 5 years old

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23
Q

More severe inflammatory reactions if _____ because it can cause ____

A

Organic material

Pneumonitis

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24
Q

When will a FBA be a medical emergency

A

If it causes airway obstruction

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25
Q

This property can determine the clinical manifestation of an FBA

A

Size

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26
Q

FBA clinical manifestation

A

Choking

Coughing + wheezing

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27
Q

Location of the majority of the FBA

A

Right bronchus

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28
Q

FBA 3 stages of signs

A

Paroxysmal stage of coughing, choking, and gagging and airway ostruction
Asymptomatic interval
Complications of obstruction, erosion, infection

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29
Q

FBA management

A

Bronchoscopy
Antibiotics
Steroid
Surgery

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30
Q

4 croup syndromes manifestations

A

Bark like or brassy cough
Hoarseness
Stridor
Respiratory distress

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31
Q

4 croups syndromes

A

Epiglottitis
Acute laryngeotracheobronchitis
Acute laryngitis
Bacterial tracheitis

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32
Q

The most common cause of epiglottitis

A

H. Influenzae type B

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33
Q

Other causes of epiglottitis

A

S. Pyogenes
S. Pneumoniae
S. Aureus

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34
Q

The age group in epiglottitis which dont preclude adulthood

A

2-4 years old

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35
Q

Hyperextension of the neck is seen in ___

A

Epiglottitis

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36
Q

Obstruction in the epiglottis will manifest ___

A

Dysphonia
Dysphagia
Dyspnea
Drooling

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37
Q

In epiglottitis the attempt to breathe will cause them to assume the ___

A

Tripod position

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38
Q

Lateral xray of the neck of the epiglottitis will manifest what sign?

A

Thumb sign

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39
Q

The DOC for epiglottitis

A

Ampicillin

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40
Q

If patient is resistant to Ampicillin for epiglottitis what will you give?

A

Ceftriaxone

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41
Q

For household who are exposed to epiglottitis you give?

A

Rifampicin for 1 day

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42
Q

A serious case of Croup

A

Acute lanryngotracheobronchitis

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43
Q

The common cause of croup

A

Parainfluenza virus

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44
Q

Other causes of croup

A

Influenza
Adenovirus
RSV
Measle

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45
Q

The age group usually affected by croup

A

3 months to 5 years peak at 2 years

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46
Q

Neck xray in patients with Croup

A

Steeple sign or Pencil sign

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47
Q

Drugs that is used in managing Croup

A

Racemic epinephrine
Dexamethasone
Budesonide

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48
Q

What of the etiology of Acute Laryngitis

A

Parainfluenza virus

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49
Q

Age onset of Acute Laryngitis

A

2-4 years old

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50
Q

Mode of transmission of Acute Laryngitis

A

Droplet nuclei

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51
Q

A child with frequent throat infection is predisposed to ____

A

RHD

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52
Q

Management of Acute Laryngitis

A

No DOC

supportive teatment with Lozenges and Ginger

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53
Q

This Croup syndrome doesnt involve the epiglottis

A

Bacterial tracheitis

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54
Q

The most common etiology of bacterial tracheitis

55
Q

Minor causes of bacterial tracheitis

A

M. catarrhalis
H. influenza
Anaerobe

56
Q

Age group onset of bacterial tracheitis

A

5-7 years old

57
Q

How to differentiate bacterial tracheitis with others?

A

Can lie flat
No drooling
No dysphagia

58
Q

Is xray suggestive of bacterial tracheitis

59
Q

The treatment for bacterial tracheitis

A

Vancomycin

Beta lactamase resistance antibiotics (meth, naf, -cillin)

60
Q

Parenchymal disease

61
Q

What is the course of CAP

A

Acute onset, few hours to 1-2 days

62
Q

Etiology of CAP in the following:
Developing countries:
Developed countries:
Philippines:

A

Bacterial
Viral
Mixed

63
Q

Etiology of CAP in these age group: NEWBORN

A

A - group A strep (local)
B - group B strep (worldwide)
Treatment: Ampicillin

E - E. coli
Treatment: Gentamycin

64
Q

Etiology of CAP in these age group: 2-11 months

A

C. trachomatis with history of conjunctivitis
Treatment: Macrolides

CMV
P. carinii (with HIV)

65
Q

Patient presents with cough, crackles, playful and suck well but NO FEVER

A

Afebrile pneumonia syndrome

66
Q

Etiology of CAP in these age group: PRESCHOOL

A 
RSV
Parainfluenza
Influenza A and B
Rhinovirus
Adenovirus
S. pneumonia (>2y/o)
H. influenza (up to 2 years old)
S. aureus
67
Q

Etiology of CAP in these age group: SCHOOL AGED GROUP

A

Mycoplasma pneumoniae
Parainfluenza
Influenza
S. pneumonia

68
Q

4 stages of pneumonia

A

Consolidation
Red hepatization
Gray hepatization
Resolution

69
Q

Name the usual agents involved in LOBAR PNEUMONIA

A

H. influenza

S. pneumonia

70
Q

Name the usual agents involved in BRONCHO-PNEUMONIA

A

H. influenza
S. pneumonia
S. aureus

71
Q

Name the usual agents involved in INTERSTITIAL PNEUMONIA

A

Mycoplasma
Chlamydia
Viral

72
Q

Bacterial pneumonia usually produce what kind of fever?

A

High grade fever

73
Q

Cough IS ALWAYS present in pneumonia except in ?

74
Q

The most important clinical predictor of pneumonia ?

75
Q 
Fill in the Resipratory rate of the following:
>5 y/o
1mo - 12mo
13mo - 5y/o
Neonate
A

> 30
50
40
60

76
Q

Bacterial pneumonia associated with skin infection, etiology:

A

S. aureus
S. pneumonia
H. influenza

77
Q

Bacterial pneumonia associated with eye infection + rash, etiology:

78
Q

Two manifestations that is more common in viral pneumonia than bacterial pneumonia:

A

Wheezing

Grunting

79
Q

Two common etiology of Atypical pneumonia

A

Mycoplasma

Chlamydia

80
Q

Delayed resolution of sx

A

Atypical pneumonia

81
Q

DOC for atypical pneumonia and in case of refractory to ampicillin you will used?

A

Macrolide

2nd gen of Cephalosporin

82
Q

In chest xray atypical pneumonia will usually present as ___

A

Interstitial pneumonia

83
Q

Gold standard in the diagnosis of bacterial pneumonia

A

Culture of lung aspirate

84
Q

Gold standard in the detection of viral pneumonia

A

Tissue culture

Viral antigen

85
Q

Tracheal aspirate must only be done within __ of intubation

86
Q

Is sputum culture and gram stain suggested in children?

A

NO. Unable to expectorate

87
Q

Is blood culture suggestive in determining pneumonia?

A

Low yield but MUST DO IN CONCOMITTANT SEPSIS

88
Q

CAP complications:

A

Pleural effusion
Pneumothorax
Atelectasis

89
Q

Normal pleural fluid per hemithorax

90
Q

Fill in the following:
Pneumothorax Pleural effusion Consolidation
Percussion:
Tactile fremitus:

A

Hyperressonant Dull Dull
None Decreased Increased

91
Q

Differentiate between PF CHON and LDH between Transudate and Exudate:

A

CHON LDH

Transudate: 3g/dl >200IU

92
Q

Transudate are secondary to ___ and examples are:

A

Inflammation
CHF
Tb
Kidney disease

93
Q

Exudate are secondary to ___ and examples are:

A

Infection

Pneumonia

94
Q

Serum analysis of CHON and LDH for pleural effusion

A

CHON LDH

Transudate: 0.5 >0.6

95
Q

Etiology of a SEROUS pleural effusion and their treatment:

A

Infant: H. influenza -> ampicillin
Preschool: Strep -> penicillin

96
Q

Etiology of a PURULENT pleural effusion and their treatment:

A

Staph -> oxacillin

97
Q

Indication of Tb pleural effusion:

A

Protein >5g/dl

98
Q

Hemothorax indication:

A

Hematocrit is >50%

99
Q

The most common cause of PF in neonates

A

Chylothorax

100
Q

Indication of Chylothorax

A

TAG >110 mg/dl

101
Q

The most common cause of pneumothorax in adults?

A

Stab or trauma

102
Q

Major components of air in pneumothorax

103
Q

The most common cause of pneumothorax in children?

A

Infection due to alveolar rupture

104
Q

Patient experince an abrupt onset of dyspnea and CHEST PAIN, what is your diagnosis?

A

Pneumothorax

105
Q

What is the PATHOGNOMONIC sign of a PNEUMOTHORAX?

A

Absent of lung markings

106
Q

Pneumothorax management for the following:
Mild
Massive
Emergency

A

Mild: 100% oxygen principle fo denitrogenation
Massive: chest tube thoracostomy
Emergency: direct needle aspiration

107
Q

Imperfect expansion or collapse of a segment or lobe of a lung

A

Atelectasis

108
Q

Three etiology of atelectasis:

A

External pressure
Intrabronchial obstruction
Reduced amplitude of expansion

109
Q

The most common cause of Atelectasis

A

Intrabronchial obstruction

110
Q

The cause of external pressure:

A

External compression within the thoracic cavity

111
Q

The usual cause if intrabronchial obstruction in atelectasis

A

Mucus plug

112
Q

Nitrogen is absorbed within __

113
Q

Oxygen is absorbed within ___

114
Q

All distal to the occluded airway will be ___

115
Q

Usually in atelectasis if only one segment is involved it is ___

A

Asymptomatic

116
Q

The most commonly collapsed segment in atelectasis

A

RLL and LLL

117
Q

The most common segment collapsed in atelectasis due to PTB?

118
Q

The kind of angle of the horizontal fissure in consolidation? atelectasis?

A

Obtuse or same

Acute

119
Q

Typical findings of Atelectasis in CXR?

A 
Opacity:
Wedge shape
Triangle shape
Fan shape
Pyramid shape
120
Q

Only atelectasis will cause the mediastinal shift to the?

121
Q

Management of atelectasis

A

Antibiotics and Bronchodilators in pneumonia
Bronchoscopy in Foreign body
Corticosteroid in asthma
Tb drugs in PTB

122
Q

Gold period for observation of Atelectasis

123
Q

Etiology of bronchitis

A

Parainfluenza virus

Adenovirus

124
Q

Only seen in bronchitis as clinical manifestation

125
Q

Auscultation in bronchitis is usually but can also manifest

A

Normal

Wheezing, crackles, rhonchi

126
Q

Resolvement of bronchitis is usually in ___

127
Q

In some cases of bronchitis there is ___ in bronchial markings

128
Q

Etilogy of Bronchiolitis

A

RSV
Parainfluenza
Adenovirus
No bacterial cause

129
Q

Usually bronchiolitis is seen in __

A

Infancy 1-2 yo, peaks at 6-12months

130
Q

Triad of bronchiolitis

A

Tachypnea
Chest retraction
Wheezing

131
Q

The most important differential diagnosis of bronchiolitis is ___

132
Q

The CXR findings of bronchiolitis

A

Flattening, imperfect dome diaphragm
Widening intercostal spaces
Hyperlucency

133
Q

Drugs to be given in bronchiolitis

A

Ribavirin
Corticosteroids
Bronchiodilators

134
Q

Is antibiotic recommended in bronchiolitis?

A

NO, negative bacterial etiology

Pediatrics A (9 decks)

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