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Pediatrics > pulmonology > Flashcards

pulmonology Flashcards

1
Q

epiglottitis- epi and etiology

A

2-7yr
HIB
GABHS, Strep pneumonia and Staph

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2
Q

clinical epiglottitis

A

abrupt onset- high fever, toxic, muffled speech, dysphagia with drool, sitting forward in tripod

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3
Q

diagnosis epiglotitis

A

cherry red swollen epiglottis

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4
Q

epiglottitis on xray

A

thumbprint on lateral

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5
Q

antibiotic for epiglottitis

A

2nd or 3rd gen. cephalosporin IV

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6
Q

if HIB infection and ppx

A

rifampin

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7
Q

laryngotrachealbronchitis (croup)

A

inflamm. and edema of the subglottic larynx, trachea, and bronchi
viral croup –> stridor - 3 months to 3 yrs - M2:1F
spasmodic - preschool age

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8
Q

viral croup can be caused by:

A 
parainfluenza
RSV
rhino
adeno
influenza A and B
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9
Q

clinical pres. of viral croup

A

URI 2-3 days followed by stridor and cough
barky cough, stridor, fever –> 3-7 days
stridor worse at night with agitation

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10
Q

xray of viral croup

A

steeple sign

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11
Q

management of croup

A

supportive
cool mist
systemic corticosteroid -
racemic epinephrine if resp. distress

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12
Q

bacterial tracheitis

A

acute inflammation of the trachea - causes stridor

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13
Q

causes of bacterial tracheitis -

A

staph, strep, nontypeable H. flu

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14
Q

bronchiolitis

A

inflammation of the bronchioles - viral infection that causes inflammatory bronchiolar obstrucion
most common in

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15
Q

bronchiolitis etiology

A

RSV

less common: para, adeno, rhino, influenza

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16
Q

clinical of bronchiolitis

A 
onset is gradual
tachypnea, fine rales, wheezing 
spleen and liver might enlarge
hypoxia
apnea
CXR hyperinflation - patchy infiltrates and atelectasis
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17
Q

typical causes of pneumonia in 0-3 month

A 
syphilis, toxo, CMV, rubella, herpes, tb
GBS
gram - rods 
listeria 
rsv
 (afebrile) chlamydi, CMV, PCP
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18
Q

typical pneumonia in 3 months - 5 yrs causes

A

adenovirus, influenza A and B, para , RSV,

bacterial: strep pneumoniae, staph and HIB

19
Q

age >6 pneumonia cuase

A

mycoplasma pneumoniae and chlamydia pneumoniae
viruses - adenovirus, influenza A and B, parainflue
bacterial - strep. pneumoniae

20
Q

viral pneumonia presentation

A

URI - nasal congestion and rhinorrhea - then fever, cough, dyspnea

21
Q

bacterial pneumonia presentation

A

rapid onset and greater severity - fever, cough, dyspnea, without preceding URI

22
Q

viral pneumonia xray

A

interstitial infiltrates

23
Q

bacterial pneumonia xray

A

lobar consolidation

24
Q

chlamydia trachomatis - pnemonia

presentation, diagnosis

A

most common is afebrile - 1-3 months of age
stoccato-type cough
history of conjunctivitis after birth - >50%
eosinophilia and cxr with interstitial infiltrates - definitive diagnosis by culture

25
Q

how to manage chlamydia trachomatis pneumonia

A

erythromycin or azithromycin

26
Q

mycoplasma pneumoniae

A

most common in older children
low-grade fever, chills, nonproductive cough, HA, pharyngitis, malaise
cough 3-4 wks
widespread rales

27
Q

diagnosis of mycoplasma pneumonia

A

positive cold agglutinins -
cxr - bilateral diffuse infiltrates
IgM titer for mycoplasma

28
Q

manage of mycoplasma pnemonia

A

erythromycin

29
Q

who is at risk for pertussis?

A
30
Q

stages of pertussis

A 
incubation 7-10 days
catarrhal stage (1-2 wks) URI + low grade fever
paroxysmal stage (2-4wks) forceful coughing and whoop - inspiatory gasp heard at the very end of a coughing fit -- might vomit post cough attack - otherwise well and afebrile
convalescent phase - (weeks to months) - paroxysmal cough continues but become less frequent and less severe over time
31
Q

diagnosis of pertussis

A

lymphocytosis

32
Q

when to give antibiotics to alter course in pertussis?

A

during the catarrhal stage or earlier

33
Q

isolation and pertussis

A

need to be on isolation until 5 days of abx

34
Q

IgE release?

A

eosinophils, histamine, mast cells, basophils

35
Q

asthma pathophys

A

smooth muscle bronchoconstriction, airway mucosal edema, increased secretions with mucous plugging, eventual airway wall remodeling and production of inflammatory mediators IgE

36
Q

cxr of asthma

A

hyperinflation
peribronchial thickening
patchy atelectasis

37
Q

CF etiology

A

AR - ch. 7

38
Q

pathophys for CF

A

abnormal ion-channel regulator protein - causes sodium and choride transport dysfunction in epithelial cells
abnormal mucus produced in airways helps create airwy obstruction inflammation and infection

39
Q

clinical present of CF

A 
chronic progressive pulmonary insuff. 
pancreatic insuff. 
high sweat electrolyte 
meconium ileus at birth(20%)
FTT - recurrent chronic resp. symptoms
respiratory signs 
PFTs decreased respiratory flow rates and decrease lung volumes 
pneumonia- staph and then pseudomonas
nasal polyps and precurrent pneumonia
40
Q

diagnosis of CF

A

one or more phenotypic feature OR positive fam. history OR increased immunoreactive trypsinogen on newborn screen
- sweat chloride test
2 CF mtn
characteristic ion transport abnormality across the nasal epithelium

41
Q

management of CF

A 
antibiotics
pul. toilet 
bronchodilator
pancreatic enzyme replacement - fat soluable vitamine (A, D, E, K)
anti-inflammatory and immunosuppressive
lung transplant
psychological help
42
Q

CF and mutation

A

CFTR gene ch. 7

43
Q

ddx of ALTE

A 
seizure
GERD
upper airway obstruction
intracranial mass lesion
sepsis
metabolic abnormalities including electrolyte imbalance and hypoglycemia
inborn errors of metabolism
arrhythimia
abnormal central control
munchausen by proxy
nonaccidental trauma

Pediatrics (10 decks)

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