RESP CARDIO Flashcards
When do we need to do an exercise challenge test. Explain
Exercise challenges can help to identify children with exercise induced bronchospasm. Non-asthmatic patients improve FEV1 by 5-10%, while asthmatic patients can have decreases in FEV1 by > 15%, which can occur after vigorous challenge and can resolve within 30-60 minutes. Exercise challenges can miss some patients , and can induce severe bronchospasm and exacerbations in at risk patients. (NELSON)
what are the most organisms in cf ? from most to least ?
Organism Percent with positive respiratory cultures
Staphylococcus aureus 70.7%
Methicillin-resistant S. aureus (MRSA) 25.9%
Pseudomonas aeruginosa 45.7%
Multidrug-resistant P. aeruginosa (MDR-PA) 8.2%
Stenotrophomonas maltophilia 12.9%
Burkholderia cepacia complex 2.5%
B. cenocepacia
B. multivorans
Others
Achromobacter (Alcaligenes) xylosoxidans 5.8%
Nontuberculous mycobacteria (NTM) 12.7%*
* For NTM, this represents the patients with 1 or more mycobacterial species isolated, as a percentage of those who had a mycobacterial culture during 2017.
Data from: the Cystic Fibrosis Foundation Registry, 2017.
Graphic 55018 Version 11.0
What are 4 causes of central apnea ?
What number of central apenas are normal ?
of normal -1
chiari malformation
central hypopnea syndrome
What are some examples of parasomnias ? And how do you treat ?
ie. sleep walking/talking
night terrors
there are no memories of this, nor is there day time somnolence
tx - try to wake up nightly before they occur
NAME 5 CF COMPLICATIONS/ clinical signs/symptoms IN BOTH
A)RESP
B)GI
1) polyps, recurrent chest infections, asthma abpa, obstructive (fixed) on pft, recurrent sinu-sinus infections, cor polmonale, acute respiratory infection
b) FTT, pancreatic insufficiency, DIOS, meconium ileus, liver failure/injury, rectal prolpase,
What syndrome is PCD: primary ciliary dyskinesia associated with ?
Kartagener’s syndrome
Situs inversus, chronic sinusitis, bronchiectasis
What can cause False Negative for sweat chloride CF?
Edema Done too early (< 48hrs) Wt < 7lbs Poor technique Meconium Ileus
what can cause chloride alse positive?
Eczema Ectopic Dysplasia Malnutrition Hypoparathyroidism Adrenal insufficiency CAH Pseudohypoaldosteronism Hypothyroidism Nephrogenic DI Pancreatitis Hypogammaglobulinemia False Negative
Demonstrate/ teach how to use the MDI inhaler. (STACER PRAC)
Caring for your MDI
Once a week, remove the medication canister from the plastic casing and wash casing in warm, soapy water. When the casing is dry, replace the medication canister in the casing and put the cap on the mouthpiece.
Ensure the hole is clear.
Cue Words REMOVE CAP. SHAKE WELL. BREATHE NORMALLY & SLOWLY. EXHALE. OPEN MOUTH: TILT CHIN UP slightly or CLOSED MOUTH: SEAL LIPS around the mouthpiece and tilt head slightly back. INHALE and PUSH puffer down once. INHALE A SLOW DEEP BREATH. HOLD BREATH for 10 seconds. For a second puff, wait 30 seconds and repeat steps 2 to 8.
What are the 4 classifications in the Ross classification of heart failure ?
Ross 1 - no limitations or symptoms
Ross 2 mild tachynea or diaphoresis with feeding in infants
Older children - dyspnea a with exertion
3 marked tachyon was and diaphoreisis with feeding with prolonged feeding times and growth failure
4 symptomatic are twister with wob, grunting
Diagnostic criteria for TS (tuberous scelerosis) ?
An LA GRASSHUT
A angiofibromas /adenoma sebaceum L lymphangioleiomyomatosis A ash leaf spots (>3 5 mm in diameter) G giant cell astromcytoma, subependymal R cardiac rhabdomyoma A angiomyolipma of the kidney S shagreen patch S subependymal nodules H retinal hamartomas U ungal fibromas T tubers
A. thymmic wing sign would be indicative of what ? and how do you treat this ?
Pneumonmediastinum
-typically resolves on its own - typically spontaneous and resolves on own
The following is in keeping with what:
Intestinal loops fail to return to abdominal cavity (or lack of formation of anterior abdominal wall)
80% associated with anomalies
Beckwith Weidemann
OEIS
Pentalogy of Cantrell
Omphalocele
Name 4 electrolyte abdnormalities that can cause prolonged QTC ?
and one type of drug assides from SSRI ?
-low Ca
-low K
low mg
Drug : tcA
