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Peds exam 1 > Resp and EENT > Flashcards

Resp and EENT Flashcards

1
Q

What are the difference in ped upper airways than adults?

A
  • Smaller airway diameter
  • Narrower trachea
  • Position of R mainstem bronchus (smaller angle)
  • Increased airway resistance
  • Tongue larger proportion of mouth
  • Larger epiglottis
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2
Q

What are the diameters of a newborn and adult’s airway?

A

4mm and 20mm

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3
Q

Where is an aspirated foreign body most likely to lodge in an infant?

A

R bronchus stem

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4
Q

Do adults or children breath more diaphragmatically?

A

Children until 6-7yo (adults breath w/ thoracic cavity)

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5
Q

When is alveoli development complete?

A

Puberty

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6
Q

What is considered in a respiratory assessment?

A
  • Auscultation
  • Resp effort
  • Tactile (palpation)
  • Observation
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7
Q

Are breast sounds louder or softer in a child (vs. adult)?

A

Louder- absence of breast tissue makes auscultation louder

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8
Q

When is hyperventilation seen in peds?

A

Fevers, anemia, acidosis, diarrhea

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9
Q

When is hypoventilation seen in peds?

A

CNS depression, diaphragmatic paralysis, metabolic alkalosis

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10
Q

What is assessed via tactile resp assessment?

A
  • Fremitus (vibrations = expected; 99)

- Resonance (dull = fluid or masses)

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11
Q

What can be observed in a peds patient in resp distress?

A
  • Nasal flaring
  • Use of accessory muscles/retractions
  • Cyanosis (lips)
  • Tripod position
  • Tachypnea (>60)
  • Grunting
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12
Q

What accessory muscle retractions indicate severe resp distress?

A

Supraclavicular and suprasternal

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13
Q

What can cause ARDS (acute respiratory distress syndrome)?

A
  • Sepsis
  • Pneumonia
  • Meconium aspiration
  • Smoke inhalation
  • Near drowning
  • Airway obstruction
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14
Q

How is foreign body aspiration dx in peds?

A
  • X-ray
  • Visualization
  • Bronchoscopy
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15
Q

What is a 1st degree obstruction?

A

Air can be passed in both directions

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16
Q

What is a 2nd degree obstruction?

A

Air can only travel in one direction (inhale or exhale)

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17
Q

What is a complete obstruction?

A

Air cannot move in either direction

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18
Q

What is an apnea machine?

A

Assesses pulse ox and beeps if patient doesn’t breath every 20 seconds

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19
Q

Why are peds more susceptible to apnea than adults?

A

Babies have blunted resp. centers (less reactive to changes in CO2 concentration).

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20
Q

When would a child with a URI be admitted?

A
  • Younger age (2mo vs. 5yr)
  • Caregiver fatigue
  • Ability of parent to “make the call” at home
  • Fever severity
  • Cause of URI
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21
Q

What are possible serial sequelae of acute strep pharyngitis?

A
  • Rheumatic fever

- Glomerularnephritis

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22
Q

What is the most significant risk factor of a tonsillectomy?

A

Bleeding (assess for excessive swallowing, bloody drool, or vomitus)

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23
Q

How are straws and tonsils related?

A

Straws must be avoided after a tonsillectomy to prevent surgical incision extravasation.

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24
Q

What are the s/s of croup?

A
  • Barking cough

- Inspiratory stridor

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25
Q

How is edema visualized with croup?

A

Viewed as “church and steeple” in diagnostic imaging (subglottic tissue is closed off)

26
Q

What is a respiratory clinical emergency in the peds population?

A

Acute epiglottitis

27
Q

What ped population is at highest risk of acute epiglottitis?

A

3+yo (not seen in newborns or younger infants)

28
Q

What is priority tx of acute epiglottitis?

A
  • Prevent laryngospasms (vocal cord paralysis = obstructed airway)
  • Airway management
29
Q

What is the “thumb sign”?

A

The “thumb sign” describes the edema of the epiglottis visualized in lateral neck view imaging of a ptnt w/ acute epiglottitis.

30
Q

What is the most common cause of pediatric hospitalization?

A

Bronchiolitis (RSV)

31
Q

How is bronchiolitis dx?

A

S/s and chest x-ray

32
Q

What is the care of a child with bronchiolitis?

A

Maintain ABCs with:

  • O2
  • Nebs
  • Meds
  • Humidifier
33
Q

What age is bronchiolitis most common?

A

2-9mo

34
Q

What meds are used to tx bronchiolitis?

A
  • Steroids

- Antibiotics (if bacterial)

35
Q

What are the 3 categories of asthma classification?

A

Mild, moderate, severe

36
Q

How is asthma classified?

A
  • Duration

- Amount of meds needed to control condition

37
Q

What meds are used to tx asthma?

A
  • Short-term = albuterol and metered dose inhalers

- Long-term = corticosteroids

38
Q

What is status asthmaticus?

A

Continued asthma related resp distress despite intervention

39
Q

How is status asthmaticus tx?

A

Epinephrine

40
Q

What is the max dose of Epi for status asthmaticus?

A

0.3mL

41
Q

What are interventions for asthma tx?

A
  • Exercise
  • Chest PT
  • Hyposensitization
  • Education
42
Q

What is CF?

A

Autosomal recessive disorder of the exocrine glands

43
Q

What organ systems are affected by CF?

A
  • Resp
  • GI
  • Musculoskeletal
  • Reproductive
  • Skin
44
Q

How is CF dx?

A

Sweat test (2-5x increased Na+ production by body)

45
Q

Is genetic testing available for CF?

A

Yes, but it does not test for all 50 different strains of CF

46
Q

What is the 1st symptom of CF?

A

Fatty stools (linked to poor digestion as enzymes are lacking secondary to pancreatic inadequacy)

47
Q

What is a common CF-related complications in newborns?

A

SBO secondary to meconium aspiration

48
Q

What do CF r/t resp manifestations lead to?

A
  • Pulm HTN
  • Cor pulmonale
  • Resp failure (death)
49
Q

What is steatorrhea?

A

Fatty stools

50
Q

What is Azotorrhea?

A

Protein-packed stools

51
Q

How are CF r/t GI conditions managed?

A

Pancreatic enzyme supplements dosed w/ every meal.

52
Q

What happens to the pancreas over time in a CF patient?

A

Eventually pancreas becomes fibrotic (secondary to mucous duct occlusion), can lead to diabetes

53
Q

How is pink eye tx?

A
  • Quarantine for 24hr
  • Don’t touch eyes
  • Warm compresses
54
Q

When is vision completely developed?

A

6-7yo should have 20/20 vision

55
Q

What is the most common ear disorder in peds?

A

Otitis media (middle ear infection)

56
Q

What increases the risk of otitis media?

A

Tobacco smoke exposure

57
Q

How is otitis media tx?

A
  • Antibiotics

- Possible use of antipyretic (tylenol) and analgesic (ibuprofen)

58
Q

How is otitis externa dx?

A

Gentle tug on outer ear = pain

59
Q

How is otitis externa tx?

A
  • Steroid and/or antibiotic drops

- Remove trapped water/fluid

60
Q

How can otitis externa (swimmer’s ear) be prevented?

A

A couple drops of rubbing alcohol in each ear after swimming

61
Q

Why do ear infections occur more frequently in peds than adults?

A

Horizontal positioning of ped eustachian tube (drainage is slower)

62
Q

Why do infants have increased ear infection exposure when bottle feeding?

A

Sucking opens eustacian tubes (since tubes are horizontal, more exposure to pathogens and less drainage)

Peds exam 1 (3 decks)

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