Respiratory Flashcards
How is acute respiratory failure defined? Present?
hypoxemia (PO2 < 50) or hypercapnea (PCO2 > 60)
cyanosis, tachypnea, nasal flaring, retractions
what can cause wheezing
asthma bronchiolitis CF Foreign body aspiration tracheomalacia
what is a bad sign in a kid with asthma
normal pCO2 (means tired of breathing and is not hyperventilating)
what are ADE of albuterol?
hypokalemia
What is triad of asthma
asthma + aspirin sensitivity + nasal polyps
What is Churg Strauss
asthma + eosinophillia + vasculitis
Freq/type of smx + Treatment for: Mild intermittent asthma Mild persistent Moderate persistent severe persistent asthma exacerbation status asthmaticus
Mild intermittent asthma: < 2x/wk | prn SABA (albuterol
Mild persistent: 2+x/wk | + low dose ICS
Moderate persistent: daily + nightime | + LABA (salmeterol)
severe persistent: consistent + feq nightime | + high dose ICS
asthma exacerbation: – | albuterol nebulizer + PO steroid burst
status asthmaticus: unresponsiveness to meds | admit and intubate
Tx for foreign body aspiration
rigid broncoscopy
barking cough, low-grade fever, respiratory distress; Dx AP neck X-ray shows “steeple sign”,
Dx + Tx
Croup (parainfluenza virus)
PO steroids + O2 > racemic epi > intubation
sore throat, fever, inspiratory stridor, drooling, “sitting on a table leaning forward”; Dx lateral neck
X-ray shows “thumbprint sign”
Dx and Tx?
Epiglottitis (H flu infection)
intubate + abx
what can you try to give in severe RSV bronchiolitis
ribavarin
MCC bug to cause pneumonia + treatment
Strep pneumo
ceftriaxone or fluroquinolone
presents w/ fever, malaise,
nonproductive cough; Dx CXR shows interstitial infiltrates,
Dx and Tx?
atypical pneumonia
Mycoplasma > legionella or chlamydia
azithromycin
respiratory distress; Dx CXR shows unilateral “white out” of lung
Dx and Tx
empyema from staph/strep infection in pleural space
vanc and chest tube
Treatment for latent TB
INH for 9 mos
Treatment for active TB
RIPE for 6 mos
TB meningitis
RIPE + steroids
fever, sore throat, “muffled voice”, drooling; Dx lateral neck X-ray shows bulging mass,
retropharyngeal abcess, usually staph, strep, or oral anaerobe
fever, sore throat, “hot potato voice”, deviated uvula
peritonsillar abcess with staph, strep, or oral anerobe
“whooping cough” (short bursts of cough followed by loud inspiratory sound) + paroxysmal cough
Dx and Tx
pertussis
azithromycin for pt and all close contacts
what is BPD
inadequate repair for acute lung injury in a premie that causes arrested lung development
**needs O2 > 1 mo
what is congenital cystic adenomatoid malformation
improper development of bronchioles → cystic mass in lungs → asx if small,
respiratory distress w/ mediastinal shift if large; Dx chest U/S, Tx surgical excision
inspiratory stridor relieved w/ opisthotonic position (“crowing” respiration)
vascular ring
*inspiratory stridor also seen in laryngeomalacia
seperates periodic breathing vs apnea
periodic stop breathing for < 20s
apnea > 20s
treatment for centra apnea
caffine or theophylline
What does ALTE
apnea + color change + limpness + chocking/gagging
reccurent pneumonia with hemoptysis and rapid clearing on CXR
Tx?
idiopathic pulm hemosiderosis
*bleeding into lungs
steroids
low pH with CO2 > 40
cause + treatment
hypoventilation
inc ventilation
high pH and CO2 < 40
hyperventialtion
2/2 pain, fever, ARDS, sepsis
low pH CO2 < 40 with normal anion gap
diarrhea, glue sniffine, RTA, hyperchloremia
Renal tubular acidosis Diarrhea Gastrointestinal fistula Post-hyperventilation Post-anion gap acidosis
low pH CO2 < 40 with high anion gap
"MUDPILES" Methanol intoxication Uremia Diabetic or alcoholic ketoacidosis Paraldehyde Isoniazid or Iron overdose Lactic acid Ethylene glycol intoxication Salicylate intoxication
high pH, CO2 > 40
vomitting, antacids, hyperaldosteronism
