Pulmonology

Question 1

Most common congenital syndrome associated with it is CHARGE syndrome

Answer 1

Choanal Atresia

Question 2

CHARGE syndrome

Answer 2

Coloboma
Heart anomalies
Choanal atresia
Retarded growth
Genital hypoplasia
Ear abnormalities

Question 3

Most common cause of common colds

Answer 3

Rhinovirus

Question 4

What are the sinuses present at birth?

Answer 4

Ethmoid and Maxillary

Question 5

Cough and colds for 10-14days, purulent nasal discharge, headache, sinus tenderness

Answer 5

Sinusitis

Question 6

Gradual onset, moderate throat pain, symptoms of viral URTI (conjunctivitis, coryza, cough)

Contacts with colds symptoms

Answer 6

Acute Viral Pharyngitis

Question 7

Sore throat and fever with headache, vomiting, abdominal pain

Palatal petechiae, diffuse erythema of tonsils and pillars

Sandpaper rash in inguinal and antecubital areas

Answer 7

Acute Bacterial (GABHS) Pharyngitis

Question 8

Antibiotics for GABHS

Answer 8

Penicillin or Amoxicillib for 10 days

Question 9

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

Answer 9

Recurrent Strep Pharyngitis

Consider Tonsillectomy

Question 10

Bacterial invasion through the capsule of the tonsils

Usually affects adolescents

Fever, sore throat, dysphagia, trismus

Asymmetric tonsillar bulge with displaced uvula

Answer 10

Peritonsillar abscess

Question 11

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

Fever, irritability, refusal to move neck, dysphagia, decreased oral intake

Answer 11

Retropharyngeal abscess

Question 12

Most common etiology of Laryngotracheobronchitis

Answer 12

Parainfluenza Virus

Question 13

Rhinorrhea, pharyngitis, cough and low grade fever (1-3days),
Inspiratory stridor, hoarse voice, barking cough

Answer 13

Laryngotracheobronchitis

Question 14

Subglottic narrowing or Steeple sign

Answer 14

Laryngotracheobronchitis

Question 15

Management for Laryngotracheobronchitis

Answer 15

Racemic Epinephrine
Oral dexamethasone (single dose)

Question 16

Serious and rapidly progressive infection of supraglottic structures

Answer 16

Acute Epiglottitis (Supraglottitis)

Question 17

Most common etiology of Epiglottitis in UNVACCINATED children

Answer 17

H. Influenza type B

Question 18

Most common etiology of Epiglottitis in VACCINATED children

Answer 18

Staphylococcus Aureus

Question 19

Acute onset of high fever, dysphagia, dyspnea, drooling, muffled voice, sniffing dog or tripod position

Cherry red epiglottis

Answer 19

Acute Epiglottitis

Question 20

Thumb sign or leaf sign on lateral neck x-ray

Answer 20

Acute epiglottitis

Question 21

Treatment for Acute epiglottitis

Answer 21

Secure airway
IV antibiotics (Cefotaxime, Ceftriaxone, Meropenem)

Question 22

More of an allergic reaction to viral antigens than direct infection

Symptoms are mostly at night with mild to moderate hoarseness, coryza and hoarseness

Awakens with Metallic barking cough

Answer 22

Spasmodic Croup

Question 23

Most common cause of Bacterial Tracheitis

Answer 23

Staph Aureus

Question 24

High fever, brassy cough, can lie flat, does not drool, no dysphagia

Often follows a viral respiratory infection

Answer 24

Bacterial Tracheitis

Question 25

Most commonly aspirated food

Answer 25

Peanut

Question 26

Sudden onset of respiratory distress, hoarseness, localized wheezing, localized absence of breath sounds

Answer 26

Foreign Body Aspiration

Question 27

Acute inflammation of the small airways in children

Answer 27

Bronchiolitis

Question 28

Most common cause of Bronchiolitis

Answer 28

Respiratory Syncitial Virus

Question 29

Low grade fever, rhinorrhea, cough, wheezing, hyperresonance to percussion, prolonged expiratory phase CXR: hyperinflation, interstitial infiltrates

Answer 29

Bronchiolitis

Question 30

Dry hacking cough then after several days sputum becomes purulent Low grade fever, nasopharyngitis, conjunctivitis, rhinitis

Answer 30

Acute bronchitis

Question 31

Most common etiology of Pneumonia

Answer 31

Neonates: Group B Streptococcus 3wks-4y/o: Respiratory Syncitial Virus >5y/o: M. Pneumoniae and S. pneumoniae

Question 32

Fever, cough, tachypnea | O2 saturation <92%

Answer 32

Pneumonia

Question 33

Cough, wheezing, stridor Diffuse streaky infiltrates; lymphocytosis Supportive treatment

Answer 33

Viral Pneumonia

Question 34

Cough, high fever, dyspnea, dullness to percussion Lobar consolidation; neutrophilia

Answer 34

Bacterial Pneumonia

Question 35

Less ill-looking, nonproductive cough Interstitial pattern in xray, and usually on lower lobes Walking pneumonia

Answer 35

Mycoplasma

Question 36

Staccato cough Maternal history of infection Hyperinflation "ground glass" appearance; eosinophilia Tx: erythromycin PO for 14 days

Answer 36

Chlamydia

Question 37

Treatment for non-severe cases of pneumonia without previous use of antibiotic

Answer 37

Amoxicillin 40-50 mg/kg/day TID for 3-7days | Alternative: Azithromycin or clarithromycin

Question 38

Treatment for severe cases of pneumonia without previous use of antibiotic AND requiring hospitalization

Answer 38

Complete Hib vaccination: Penicillin G Incomplete Hib vaccination: Ampicillin >15y/o: IV non-antipseudomonal beta lactam plus extended macrolide or respiratory fluoroquinolone

Question 39

3 components of asthma attack

Answer 39

Bronchospasn Airway edema Increased mucus production

Question 40

A reversible obstructive airway disease involving both small and large airways Increased residual lung volumes Decreased FEV1/FVC ratio

Answer 40

Bronchial Asthma

Question 41

Management of acute asthma attacks

Answer 41

Short-acting inhaled beta2 agonist Oral or IV steroids Anticholinergics - never used alone Methylxanthines - NOT first line

Question 42

(+) exposure to an adult or adolescent with active disease (-) PPD No signs/symptoms Negative CXR

Answer 42

TB exposure

Question 43

(+) exposure to an adult or adolescent with active disease (+) PPD No signs/symptoms Negative CXR

Answer 43

TB infection

Question 44

``` 3 or more of the ff criteria: (+) exposure to an adult or adolescent with active disease (+) PPD signs/symptoms suggestive PTB Abnormal CXR Laboratory findings ```

Answer 44

Tb disease