Resp disorders

Question 1

Transesophogeal Fistula

dx

Answer 1

quick diagnosis—NG into blind pouch

bronch is diagnosis of choice

Question 2

H type TEF

Answer 2

TEF without esophogeal atresia
3-4 months of age, cyanosis with feeding, resp distress and pneumonia
GERD causes biggest cause of recurrent resp distress
Maternal usually has polyhydrominos

Question 3

Preop TEF

Answer 3

low pressure ventilation
no pacificer
prone with HOB 30

Question 4

Croup

Answer 4

Diffuse inflammation of subglottic tissue
results in upper airway inflammation and narrowing
most common age group 3-36 months

Question 5

Causes of croup

Answer 5

para influenza*, RSV, Adenovirus

Question 6

S/S Of Croup

Answer 6

Low grade temp, Barking cough, URI symptoms, inspiratory stridor, retraction

Question 7

Chest xray of croup shows

Answer 7

Steeple sign (inverted V)

Question 8

Tx of croup

Answer 8

Neb rac epi
systemic or neb corticosteroids
intubation
avoid agitation

heliox in extreme cases (lower density and less turbulent)

Question 9

With croup–when complete obstruction imminent will see

Answer 9

normal gas exchange with low o2

Question 10

Epiglotitis

Answer 10

Swelling of epigolitis and surrounding structure–causes obstruction

most common between 2-6 years old but can occur at any age

Question 11

Causes of epiglotitis

Answer 11

bacterial infection–ie influenza

caustic ingestiton, thermal injury, trauma

Question 12

S/S of epglotitis

Answer 12

sudden onset of high fever
dysphagia, drooling, resp distress
tripod positioning
muffle voiced
hyperextension of neck 

pulm edema can occur from increased pressure gradient causing aviolar hypoxia

Question 13

chest xray of epiglotits will show

Answer 13

thumb sign on LATERAL not AP

Question 14

late sign of epiglotitis

Answer 14

stridor

Question 15

tx of epilotitis

Answer 15

antibiotics, DO NOT AGITATE, blow by o2, intubate in OR

rac epi if needed

Question 16

RDS

Answer 16

associated with prematurity and decreases surfacant

associated with increases reistance, decreased compliance, decreased FRC, V/Q mismatch and hypoxemia

Question 17

S/S of RDS

Answer 17

Tachypnea, grunting, flairing, retractions, tachycardia, cyanosis, murmmur, crackles, peripheral edema

Question 18

Chest xray of RDS

Answer 18

ground glass appearnce

Question 19

Tx of RDS

Answer 19

02 therapy, caffeine (less than28 weeks) surfactant therapy,

Question 20

BPD s/s

Answer 20

hypoxia and hypercapnia
resp distress
failure to wean vent
acidosis and fluid intolerance
rhales, rhonchi, wheezing
FTT
Heart failure

Question 21

Chest xray of BPD

Answer 21

scattered infilitrates, atelectasis, patchy area of hyperinflation, increased intersitial markings, cardiomegaly (swiss cheese appearance)

Question 22

TX Of BPD

Answer 22

Avoid High PIP
Po2 of 55
Pco2 45-60
bronchodialators
CPT
Nutrition

Question 23

POst op TEF complications

Answer 23

anamositis site leakage—s/s temp instabliity, frothy (purluent) chest tube drainage, increased WBCs