Pulmonology (Alice) (12%) Flashcards

1
Q

acute bronchiolitis in peds is mc caused by

A

RSV

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2
Q

3 sx of acute bronchiolitis

A

tachypnea
respiratory distress
wheezing

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3
Q

dx for acute bronchiolitis

A

nasal wash culture and assay

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4
Q

CXR findings of acute bronchiolitis

A

normal bro!

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5
Q

only tx that improves sx of bronchiolitis

A

O2

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6
Q

indications for hospitalization w. RSV infxn (6)

A

O2 sat 95-96%
< 3 mo old
RR > 70
nasal flaring
retractions
atelectasis on CXR

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7
Q

med NOT recommended for bronchiolitis in previously well kiddos

A

systemic steroids

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8
Q

med for RSV if kid has severe lung/heart dz or is immunocompromised

A

ribavarin

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9
Q

prophylaxis for RSV for high risk kiddos (immunocompromised, lung dz, premature, neuromuscular d.o)

A

palivizumab

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10
Q

2 PMH findings associated w. asthma

A

eczema
seasonal rhinitis

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11
Q

spirometry findings of asthma (2)

A

FEV1:FVC < 80%
FEV increase > 10% after bronchodilator

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12
Q

tx for asthma

A
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13
Q

tx for acute asthma attack (3)

A

O2
nebulized SABA/SAMA
steroids

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14
Q

what is this showing

A

steeple sign -> croup

narrowing of the trachea in the subglottic region

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15
Q

croup is caused by _ virus
and is mc in _ year olds

A

parainfluenza
3-6 mo

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16
Q

tx for croup

A

supportive
severe: IVF, nebulized racemic epi, steroids

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17
Q

growth retadation
recurrant PNA
chronic diarrhea/steatorrhea

A

cystic fibrosis

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18
Q

PE findings of CF

A

scattered ronchi bilat
dullness to percussion
mild hepatomegaly
mild LE edema

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19
Q

3 CXR findings of CF

A

focal atelectasis
mucus plugging
hyperinflation

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20
Q

dx for CF

A

sweat chloride test

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21
Q

CF is an autosomal recessive mutation in the _ gene

A

CFTR

22
Q

CF is associated w. recurrant respiratory infxns caused by

A

pseudomonas

23
Q

management of CF

A

chest physiotherapy
high fat diet
fat soluble vitamin supplements
exacerbations: abx

24
Q

mcc of foreign body aspiration

A

food

25
Q

5 rf for foreign body aspiration

A

institutionalization
advanced age
poor dentition
etoh
sedatives

26
Q

mc location for aspiration

A

mainstem
right lobar bronchus

27
Q

3 PE findings of foreign body aspiration

A

foul smelling nasal d.c
inspiratory stridor
wheezing
+/- decreased breath sounds

28
Q

CXR finding of foreign body aspiration

A

expiratory film: hyperinflation of affected side

29
Q

_ is necessary for appropriately evaluating/monitoring ventilation

A

ABG

30
Q

what type of bronchoscopy is preferred in peds

A

rigid

31
Q

what should you consider administering prior to removal of a nasal foreign body object

A

oxymetazoline drops -> shrinks mucous membrane

32
Q

2 topical pain agents useful when flushing foreign body in ear

A

benzocaine
anti-pyrene

33
Q

what 2 substances can be used to immobilize buggies in the ear prior to removal

A

viscous lidocaine
mineral oil

34
Q

what is this showing

A

rust ring -> metallic foreign body

35
Q

management of intraocular foreign bodies (3)

A

topical anesthetic
topical vs systemic abx
immediate ophtho referral

36
Q

what pathogen are you worried about w. eye injuries associated w. soil/vegetation

A

bacillus cereus

37
Q

dz that affects premature infants that are born before the lungs produce adequate amounts of surfactant

A

hyaline membrane dz

38
Q

mcc of respiratory distress in preterm infants

A

hyaline membrane dz

39
Q

CXR findings of hyaline membrane dz

A

diffuse bilat atelectasis -> ground glass appearance

40
Q

rf for hyaline membrane dz

A

infants < 30 weeks gestation at birth

41
Q

what 3 antenatal tx can help with hyaline membrane dz

A

-antenatal betamethasone IM x 2 w.in 24-48 hr of birth
-artificial surfactant thru endotracheal tube
-PEEP

42
Q

mcc cause PNA in peds vs adults

A

peds: RSV
adults: flu

43
Q

CXR finding associated w. viral PNA

A

bilateral interstitial infiltrates

44
Q

management of viral PNA

A

tamiflu w.in 48 hr
SABA
fluids

45
Q

what makes you think viral PNA vs bacterial

A

rapid onset
milder sx

46
Q

4 sx of bacterial PNA

A

fever
dyspnea
tachycardia/pnea
+/- sputum

47
Q

CXR findings of bacterial PNA

A

patchy, segmental lobar, multilobar consolidation

48
Q

dx for bacterial PNA (2)

A

blood cultures x 2
sputum gram stain

49
Q

outpt vs inpt tx for bacterial PNA

A

outpt: doxy, macrolides
inpt: ceftriaxone + azithro/FQ

50
Q

RSV is the mcc of _ in peds (2)

A

bronchiolitis
PNA