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Peds > Pulmonology > Flashcards

Pulmonology Flashcards

1
Q

Hx and symptomology of pulmonary dz

A 
Dyspnea
Cough
Pain
Wheezing
Stridor
Snoring
Apnea
Cyanosis
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2
Q

PE of pulmonary dz

A

RR
Presence of grunting
Nasal flaring
Tripod position
Cyanosis
Inspiratory stridor (extrathoracic etiology)
Expiratory wheeze (intrathoracic etiology)

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3
Q

When will percussion be dull?

A

Restrictive lung dz and

With the presence of pleural effusion, pneumonia, or atelectasis

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4
Q

When will percussion be hyper-resonant?

A

Also tympanic in obstructive dz such as asthma, emphysema or with the presence of pneumothorax

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5
Q

RR in a premature neonate

A

40-70

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6
Q

RR in 0-3 mos

A

35-55

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7
Q

RR in 3-6 mos

A

30-45

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8
Q

RR in 6-12 mos

A

25-40

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9
Q

RR in 1-3 yrs

A

20-30

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10
Q

RR in 3-6 yrs

A

20-25

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11
Q

RR in 6-12 yrs

A

14-22

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12
Q

RR in >12 yrs

A

12-18

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13
Q

ABG

A

The single most useful rapid test of pulmonary function

Overall assessment of the functional state of the resp system and clues about the pathogenesis of the dz

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14
Q

Nl pH in ABG

A

7.35-7.45

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15
Q

Nl CO2 in ABG

A

35-45

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16
Q

Nl pO2 in ABG

A

80-100

17
Q

Nl HCO3

A

22-26

18
Q

O2 Sat

A

95-100%

19
Q

Choanal atresia

A

Congenital problem that presents in the neonatal period
Occurs when there is obstruction of the nasal passage- resulting in respiratory distress, esp during feedings
Inability to pass a small catheter through the nostrils is suspicious for choanal atresia and warrants CT for confirmatory diagnosis
Tx- surgical revision and airway protection

20
Q

Laryngomalacia

A

Results from exaggerated collapse of the glottis structures during inspiration
MC cause of stridor in infants
Typically presents between 3-5 mos of age and resolves by 6-12 mos
Watchful waiting unless severe, in which case surgical repair may be warranted

21
Q

Laryngitis

A 
Often occurs in children 5 yrs and older
Presents with a prodrome of URI/sore throat
MC symptom is hoarseness
Lab findings and exam are essentially nl
Tx is supportive- vocal rest
22
Q

Croup (laryngotracheobronchitis)

A

Common childhood dz typically presenting from 6 mos - 3 yrs
80% of cases are caused by parainfluenza virus
Seal-like, barking cough with inspiratory stridor
X-ray: Steeple sign
Tx: supportive with oxygen and racemic epi as well as steroids

23
Q

Bacterial tracheitis

A

Presents like croup, but does not improve with supportive tx, and is refractory to racemic epi
MC pathogens are S. pneumonia and S. aurea
X-ray will also show a steeple sign, though this is typically pathognomonic for croup
If possible, send a culture
Tx: Abx including 3rd gen cephalosporins, oxacillin, and/or clinda

24
Q

FB aspiration

A 
Typically 6 mos-5 yrs
Small objects esp coins
Sudden onset
Stridor may be heard
Tx: endoscopic removal
Prevention: pay attention to choking hazards on toys
25
Q

Sx of FB aspiration

A

Resp distress
Drooling
Wheezing
Perhaps stridor

26
Q

Retropharyngeal abscess

A 
Often occurs <6 yoa
MC pathogens: S. aureus and S. pyogenes
Typically sudden onset with drooling, fever, and leukocytosis with bands
Muffled voice is common
Imaging: lateral X-ray
Tx: I and D by ENT and abx
27
Q

Epiglottitis

A 
Often from 2-6 yoa
Rapid onset with high fever
Tripod positioning with drooling
Imaging: lateral neck (thumb print sign)
Tx: emergent intubation and airway protection
Prevention: hib vaccine
28
Q

Peritonsillar abscess

A

Typically in pts >10 yoa
Associated with group A strep anaerobes
These pts present with hot potato voice, rigors, drooling and are often times febrile
Tx: I and D and abx

29
Q

Anaphylaxis

A

Typically secondary to allergic rxn
Can occur at any age
MC causative agents: peanuts, shellfish, meds (PCN, cephalosporins)
Tx: supportive- epi, O2, airway protection, Benadryl, H2 blocker
Prevention: avoidance of allergens

30
Q

Spasmodic croup

A

Occurs most commonly from 3 mos-3 yoa
Has similar presentation to croup, however, this often results from allergy or reflux disorders
Does not respond to racemic epi
Tends to be recurrent in nature and resolve quickly
If GERD is the cause, start the pt on a PPI

31
Q

Tracheomalacia

A

Major airway malformation- abnl collapse of the tracheal airway walls, most commonly the distal 1/3 of the trachea

32
Q

Type 1 tracheomalacia

A

Primary trachomalacia. Developmental defect in the tracheal cartilage, often improves and resolves with airway growth (typically 4-8 wks of age)

33
Q

Type 2 tracheomalacia

A

Secondary tracheomalacia due to extrinsic compression

34
Q

Type 3 tracheomalacia

A

Secondary tracheomalacia due to intra-airway irritation or inflammation

35
Q

Bronchiolitis

A

95% occur in children <12 yo
Infectious/inflammatory process of the bronchioles
Always viral illness: MC RSV
Leading cause of hospitalizations of infants
Presents with wheezing, cough, and in severe cases apnea

36
Q

Bronchitis

A

Most cases are secondary to viral illness including rhinovirus, coronavirus, or RSV
Characterized by cough, dyspnea, fever and expiratory rhonchi or wheeze
Tx: Supportive- hydration, expectorants, analgesics, breathing txs and cough suppressants
CXR will be essentially nl; no evidence of PNA

Peds (11 decks)

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