Pulmonology & Atopy Flashcards
what is the MC reason for pediatric hospitalization?
respiratory dz
hallmark airway noise for upper airway obstruction
stridor
hallmark distinction of lower airway obstruction
wheezing
air trapping & prolonged expiratory phase can occur in?
either upper or lower obstruction
ventilation & oxygenation occur_________from one another
independent
processes compromise each function differently
ventilation & oxygenation both may be affected by what?
severe obstruction
respiratory rate in infant
24-38
respiratory rate 1-3 yo
22-30
respiratory rate 4-6 yo
20-24
respiratory rate 7-14 yo
16-24
respiratory rate 14-18 yo
14-20
you want to always count respiratory rate for how long?
60 seconds
what is the most sensitive sign of pneumonia in CH?
tachypnea
continuous sound caused by turbulent flow in narrow airways
wheezing
fine, interrupted sounds that suggest pulmonary parenchymal dz
rales (crackles)
course, interrupted sounds that suggest large airway dz
rhonchi
predominately inspiratory, monophasic noise
stridor
expiratory stridor
pretty rare
means there’s most likely an obstruction in larger thoracic part
children mount a progressive effort w/ worsening compromise in respiratory distress how?
tachypnea
labored breathing
positioning
what will you see in labored breathing?
retractions
nasal flaring
grunting
retractions include?
abdominal (“subcostal”)
intercostal
supraclavicular
grunting is an attempt to?
maintain area for gas exchange by providing extra end expiratory pressure
positioning
upright
tripodding
sniffing positon
upright positioning
gravity aids diaphragmatic contraction
tripodding
allows more efficient scalene & intercostal work
sniffing position
opens upper airway
what is a good screening test for parenchymal or pleural dz?
plain chest film
a plain chest film is a poor test of?
pulmonary function
what is the best plain chest film in respiratory distress?
upright film at limit of inspiration
- often difficult in small children, may require repeat of film
- radiography tech often forgets to compensate for child size when determining exposure
if you have a prolonged expiration you have?
an obstruction
ventilation is used to do what?
get CO2 out
mild obstruction effects what?
ventilation
what test is good to measure pulmonary function?
arterial blood gas- esp. useful if serial measurements allow description of trends
- cap blood gas easier to obtain, but pO2 less helpful
- no utility of pO2 in venous blood gases
ABG worrying findings include?
respiratory acidosis
hypoxemia
uncompensated acidosis
rising pCO2 over 45 mmHg
respiratory acidosis
rales (crackles) sound like what?
crumpled seran wrap un-crumpling
decreasing pO2 less than 85 mmHg
hypoxemia
acidemia
uncompensated acidosis
stridor DDx
laryngeal papillomatosis laryngeal trauma larygomalacia viral croup epglottitis bacterial tracheitis anaphylaxia vocal cord paralysis/ dysfunction FB subglottic stenosis retropharyngeal abscess congenital anomalies
congenital anomalies include
Pierre-Robin sequence
neuromuscular dz
hemangioma
a respiratory illness (inflammation of larynx & surrounding airways) that manifests in young children
croup
signs of croup
hoarse voice
dry, barking cough
inspiratory stridor
croup is most commonly what type of infxn
viral- fever & cough
viral croup typically occurs before the age of?
6 yo
viral croup can occur any time of year, but most commonly occurs when?
late fall & winter
viral croup symptoms are typically worse?
at night
2nd & 3rd night usually the worst
what type of virus is most commonly the cause of viral croup?
parainfluenza viruses
but also: influenza A & B, adenovirus, RSV (respiratory syncytial virus)