Pulmonology/Allergy Flashcards
Most common peri-operative complication of asthma
Bronchospasm or laryngospasm
Risk factors for asthma
Atopy or FHx of atopy Early viral respiratory infection Maternal smoking or passive smoke exposure Prematurity Maternal age < 20 yo at birth Male sex (until adolescence)
Faster acting LABA
Formoterol
Side effects of montelukast
behavioral disturbance
Anti-IgE therapy
omalizumab (Zolair)
indicated if > 12 yo w/+ allergy testing
Asthma severity: daily symptoms
Moderate
Asthma severity: night awakenings 3-4x/month
Mild
Asthma severity: nighttime awakenings > 1x/week (not daily)
Moderate
Asthma severity: SABA use daily
Moderate
Asthma severity: SABA uses > 2d/week (not daily)
Mild
Asthma severity: FEV1 = 60-80
Moderate
Most common congenital lung lesion
CPAM
Vascular supply of CPAM
pulmonary circulation
Pulmonary sequestration location
lower lobes (L > R)
Vascular supply of pulmonary sequestration
systemic circulation
Pulmonary sequestration at risk for recurrent infection
Intralobar (ILS)
Congenital lobar emphysema location
left upper lobe
Bronchogenic cyst location
mediastinum
Most common type of TEF
Type C (84%) - esophageal atresia with distal TEF
Complications of TEF
stricture, tracheomalacia, GER/aspiration
TEF association
VACTERL
Inspiratory crowing
Laryngomalacia
Biphasic wheezing
Tracheomalacia
Biphasic high-pitched stridor
Subglotti stenosis
Dysphonia/aphonia
Vocal cord palsy
Complete vascular rings
Double aortic arch (most common)
Right AA with aberrant left subclavian
Vascular ring with NO esophageal compression
Innominate artery compression
Heiner syndrome
cow’s milk hypersensitivity
airway bleeding –> pulmonary hemosiderosis
Rate of allergic disease in children
20-30%
Early phase allergic mediators
Histamine, prostaglandin D2, proteases, proteoglycans
Late phase allergic mediators
Leukotrienes, cytokines
Dennie-Morgan lines
Multiple infra orbital orbital folds associated with allergic rhinoconjunctivitis
Most effective control of dust mites
Plastic mattress wraps, remove carpet
Seasonal allergens: March - May
Tree pollen
Seasonal allergens: May - June
Grass pollen
Seasonal allergens: August - October
Ragweed
Anaphylactoid reactions
Non-IgE mediated mast cell degranulation (contrast dye, opiates)
Most common medication to trigger allergy
Penicillin
Most common allergic foods
Peanut, milk, egg, soy, fish, wheat, shellfish, nuts
Hereditary angioedema genetics
AD
Diagnosis of hereditary angioedema
C4 level
Etiology of hereditary angioedema
Absence of C1 inhibitor
Risk of asthma in child of affected parent
25% (50% if both parents)
Asthma severity: symptoms < 2d/week
Intermittent
Asthma severity: nighttime awakenings < 2x/month
Intermittent
Flow volume loop axis
Y = flow X = volume
Obstructive Lund disease: PFTs
Concave, decreased FEV1 > FEV1/FVC > FVC
Restrictive lung disease: PFTs
Decreased volume, decreased FEV1, FVC, increased or normal FEV1/FVC
Vocal cord dysfunction symptoms
Dramatic onset at onset of exertion, “throat closing”, “unable to get breath in”
Vocal cord dysfunction finding
Vocal cords in adduction with posterior glottic chink
Recommendation of children > 16 yo and anaphylactic reaction to insect sting
Skin testing +/-immunotherapy (95% effective!)
First line therapy for allergic rhinitis
Intranasal corticosteroids
Radio contrast media anaphylaxis recommendations
Pretreat with antihistamine and corticosteroids
Type I hypersensitivity reaction
IgE mediated
Type II hypersensitivity reaction
Antibody mediated cytolysis (ie hemolytic anemia)
Type III hypersensitivity reaction
Immune complex (ie serum sickness)
Type IV hypersensitivity reaction
T cell mediated (contact dermatitis, PPD)
Dust mite reduction
humidity < 50%
Rhinitis medicamentosa
associated with OTC nasal decongestant use > 3-4 days, beefy red nasal turbinates, treatment = intranasal corticosteroids
Hyperattenuated mucin
allergic fungal sinusitis
