Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Special Pops - Peds > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Stages of lung development

A
  • Embryonic (3-7 wks)
  • Pseudoglandular (5-17 wks)
  • Canalicular (16-26 wks, surfactant secreting)
  • Saccular (26-36 wks)
  • Alveolar (36 wks to 3-8 yo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe laryngomalacia

A
  • Benign congenital extrathoracic airway disorder

- Underdeveloped cartilaginous support of supraglottic structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical presentation of laryngomalacia

A

Intermittent to persistent stridor in first 6 wks of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stridor caused by laryngomalacia worsens:

A
  • In supine position
  • Increased activity (crying)
  • With URI
  • During feedings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What contributes to the inspiratory obstruction in laryngomalacia?

A

Approximation of posterior edges of the epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment and prognosis of laryngomalacia

A
  • Improves with age

- Surgical epiglottoplasty if FTT, obstructive sleep apnea or resp insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is surgical epiglottoplasty indicated in laryngomalacia?

A
  • Failure to thrive
  • Obstructive sleep apnea
  • Resp insufficiency or severe dyspnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe congenital vocal cord paralysis

A
  • 15-20% of laryngeal anomalies
  • Equal in both genders
  • MC idiopathic etiology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe subglottic hemangiomas

A
  • Congenital extrathoracic airway disorder
  • Females 2:1
  • Asymptomatic at birth w/progressive croup
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do subglottic hemangiomas present?

A

Asymptomatic at birth with progressive croup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe viral croup

A
  • Parainfluenza
  • Subglottic edema w/upper airway obstruction
  • Croup (barking) cough
  • Inspiratory stridor
  • Fall and winter months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical presentation of viral croup

A
  • Afebrile or low grade fever
  • Inspiratory stridor
  • Barking cough (worse at night)
  • Steeple sign on CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of viral croup

A
  • Cool, moist air
  • Racemic epi via nebulizer
  • Dexamethasone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical presentation of epiglottitis

A
  • High fever, toxic appearance
  • Drooling and dysphagia
  • Muffled voice
  • Inspiratory retractions
  • Soft stridor
  • Thumbprint sign on x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Etiology of epiglottitis

A
  • Hemophilus influenze type B (HIB)

- Now only in unimmunized children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of epiglottitis

A
  • Immediate ET intubation
  • Sedation for intubation/extubation is difficult to manage
  • IV abx (ceftriaxone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is extubation performed in epiglottitis?

A

After visual inspection of epiglottitis (usually 24-48 hrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is bacterial tracheitis?

A
  • Pseudomembranous croup
  • Severe, life threatening
  • S. aureus MC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical presentation of bacterial tracheitis

A
  • Early symptoms are consistent with viral croup

- Subsequent increasing fever, toxicity, progressive airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of bacterial tracheitis

A
  • Debridement of airway w/intubation
  • IV abx for H flu
  • Longer intubation than for epiglottitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which requires longer intubation - epiglottitis or bacterial tracheitis?

A

Bacterial tracheitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cause of vocal cord paralysis?

A

Injury to phrenic nerve

  • Difficult delivery
  • Neck/thoracic surgery
  • Trauma, mediastinal masses, CNS disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical presentation of vocal cord paralysis

A
  • Hoarseness
  • Aspiration
  • High pitched stridor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the narrowest part of neonate or infant’s airway?

A

Subglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MC cause of subglottic stenosis

A

ET intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of subglottic stenosis

A

May require tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cause of laryngeal papillomatosis

A

HPV 6, 11, 16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Age of onset of laryngeal papillomatosis

A

Usually 2-4 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How to prevent laryngeal papillomatosis?

A

HPV vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Treatment of laryngeal papillomatosis

A
  • Direct surgical resection

- Spontaneous remissions do occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe cartilage in infant airway

A

Softer, more pliable, can collapse easier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe tracheomalacia

A
  • Cartilage in infant airway is softer and can collapse

- Cough, stridor, wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is diagnostic of tracheomalacia?

A

Tracheal collapse of more than 50% during inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Congenital tracheomalacia may be a/w what?

A

Developmental abnormalities (tracheoesophageal fistula, vascular ring, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment of tracheomalacia

A

May vary:

  • Observation
  • PPV (positive pressure ventilation)
  • Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do vascular rings and slings present?

A

In infancy with stridor, wheeze, croupy cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Where do bronchogenic cysts typically occur?

A

Middle mediastinum near carina and major bronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How are bronchogenic cysts developed?

A

Abnormal budding of primitive foregut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment of bronchogenic cysts

A

Surgical resection with pulmonary PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

CXR finding of bronchogenic cyst

A

Filling of retrosternal clear space on lateral view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe foreign body aspiration

A
  • Actual event RARELY seen

- Children 6 mo to 4 yo at highest risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Clinical presentation of upper airway FB aspiration

A

Sudden onset cough and dysphonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Clinical presentation of lower airway FB aspiration

A

Sudden onset cough, possible persistent cough or wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Treatment of FB aspiration in the upper airway

A
  • Allow spontaneous cough reflex first
  • Otherwise, back blows per CPR
  • NO finger sweeps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When is bronchoscopy indicated?

A

Any 2 of:

  • History of possible aspiration
  • Focal abnormal chest exam
  • Abnormal CXR
46
Q

How many people are carriers of CF?

A

1 in 40

47
Q

Treatment of CF

A
  • Pancreatic enzyme supplements
  • High cal, protein and fat diet
  • Multivitamins (ADEK)
  • Salt supplement
  • Airway clearance/hygiene
  • Aggressive abx use
  • Inhaled mucolytic agent
48
Q

Prognosis of CF

A

Avg life expectancy 35 yo

49
Q

What is Kartagener syndrome?

A
  • Primary ciliary dyskinesia

- Ultra-structural defect of cilia demonstrated by electron microscopy

50
Q

Clinical presentation of Kartagener syndrome

A

Situs inversus in 50% of pts

51
Q

Situs inversus is found in 50% of pts with what condition?

A

Kartagener syndrome (primary ciliary dyskinesia)

52
Q

Define bronchiectasis

A

Permanent dilation of the bronchi due to retained mucus and inflammation from chronic secretions

53
Q

What does bronchiectasis look like on CXR?

A

Increased bronchovascular markings and areas of atelectasis with hyperinflation

54
Q

Treatment of bronchiectasis

A
  • Aggressive abx therapy

- Surgical resection of affected lung

55
Q

Describe bronchiolitis obliterans

A

Partial or complete occlusion of bronchiole lumen by inflammatory and fibrous tissue

56
Q

Causes of bronchiolitis obliterans

A
  • Infections (esp adenovirus)
  • Toxic gases
  • CT disease
  • SJS
57
Q

What does congenital agenesis of one lung result in?

A

Mediastinal shift and compensatory growth of the remaining lung

58
Q

What causes congenital lung hypoplasia?

A

Intrathoracic mass (e.g. diaphragmatic hernia)

59
Q

CXR findings of lung agenesis and hypoplasia

A

Mediastinal, tracheal shift

60
Q

Define pulmonary sequestration

A
  • Nonfunctional pulm tissue

- Not communicating with tracheobronchial tree, blood supply from anomalous systemic arteries

61
Q

Treatment of pulmonary sequestration

A

Surgical resection

62
Q

Prevalence of HMD (RDS type 1)

A

5% in infants 35-36 wks EGA

50% in infants 26-28 wks EGA

63
Q

MC bacterial source of pneumonia?

A

Strep pneumo

64
Q

What are conditions that increase risk of invasive pneumococcal disease?

A
  • Asplenia (functional or anatomic)

- Cochlear implant recipient

65
Q

Clinical presentation of bordetella pertussis

A

Stages

  • Catarrhal: 2 wks
  • Paroxysmal: 2 or more wks
  • Convalescent: wks to months (100 day cough)
66
Q

MC community acquired pneumonia?

A

Mycoplasma pneumo

67
Q

Clinical presentation of mycoplasma pneumonia

A
  • Insidious onset
  • Rales, bullous OM, sore throat
  • CXR: interstitial or bronchopneumonic infiltrates
68
Q

Describe mycobacterium tuberculosis

A
  • Widespread, often fatal disease

- Isolated pulm parenchymal disease in 85% of cases (transmission common)

69
Q

Who is MC affected by mycobacterium tuberculosis?

A
  • Homeless
  • AIDS
  • Residents in jails/nursing homes
  • Drug use
  • Healthcare workers
70
Q

Most pneumonias in children are:

A

VIRAL

  • RSV
  • Parainfluenza
  • Influenza A and B
71
Q

CXR findings of viral pneumonia in children

A
  • Perihilar streaking

- Increased interstitial markings

72
Q

Define bronchiolitis

A
  • Lower airway viral infection in children under 2 yo

- RSV MC pathogen

73
Q

Clinical presentation of bronchiolitis

A
  • Poor feedings
  • Disrupted sleep
  • Fever, rhinorrhea, cough
74
Q

Underlying conditions that can influence bronchiolitis presentation

A
  • Chronic lung disease (esp BPD)
  • CF
  • Congenital heart disease
  • Immunodeficiency
75
Q

How does aspiration pneumonia present?

A
  • Variably: based on position when aspiration occurs

- Right side is MC (esp RUL if supine)

76
Q

How does aspiration pneumonia MC present if it occurs while supine?

A

RUL

77
Q

What is children’s interstitial lung disease syndrome (chILD)?

A
  • Constellation of s/s rather than specific diagnosis

- Diagnosis requires certain criteria

78
Q

How to diagnose children’s interstitial lung disease syndrome (chILD)?

A

3 of 5 criteria

  • Impaired resp function symps
  • Impaired gas exchange
  • Diffuse infiltrates on imaging
  • Presence of adventitious sounds
  • Abnormal spirometry, PFTs, CO2 diffusion capacity
79
Q

How is hypersensitivity pneumonitis MC caused?

A

-Exposure to wild or domestic birds (or their droppings)
-Inhalation of organic dust
(and presents as chILD)

80
Q

Describe eosinophilic pneumonia

A
  • Presents as chILD

- Notable for elevated eosinophil counts and high serum IgE

81
Q

What do new pulmonary infiltrates in an immunocompromised patient represent?

A
  • 1/3 to 1/2 may NOT be infection

- May be toxicity to chemoRT, hemorrhage, embolism, atelectasis

82
Q

Pulmonary embolism in children?

A
  • Probably underdiagnosed in acute respiratory distress in children
  • Negative D-dimer is over 95% negative predictive value
83
Q

Describe pulmonary edema

A

Excessive fluid in lungs due to:

  • Increased pressure (cardiogenic)
  • Increased permeability (primary RDS or noncardiogenic)
84
Q

What is congenital pulmonary lymphangiectasia associated with?

A

Other congenital conditions

85
Q

Types of scoliosis

A
  • Congenital (vertebral anomalies and neuromuscular causes)

- Idiopathic (adolescents, females 5:1)

86
Q

When should congenital scoliosis be considered?

A

When it presents pre-puberty

87
Q

What does correction of pectus excavatum accomplish?

A
  • Subjective improvement in cardiopulmonary function has been reported
  • Mainly the treatment is based on cosmetic or psychological factors
88
Q

Pectus carinatum may be a/w:

A

Mucopolysaccharidoses or congenital heart disease

89
Q

Which congenital chest wall condition may be a/w mucopolysaccharidoses or congenital heart disease?

A

Pectus carinatum

90
Q

Classifications of pectus carinatum

A
  1. Chicken breast (chondrogladiolar)

2. Pouter pigeon breast (chondromanubrial)

91
Q

Describe eventration of the diaphragm

A

Striated muscles of diaphragm replaced by connective tissue

  • Congenital (incomplete formation of diaphragm)
  • Acquired (phrenic nerve injury)
92
Q

Treatment of eventration of diaphragm

A

If resp symptoms persist 2-4 wks, the diaphragm is stabilized with surgical plication

93
Q

Define transudative pleural effusion

A

Imbalance of hydrostatic and oncotic pressure (filtration exceeds reabsorption)

94
Q

Define exudative pleural effusion

A

Inflammation of pleural surface w/increased capillary permeability

95
Q

Pleural effusions are often associated with what condition?

A

Bacterial pneumonia

96
Q

Define empyema

A

Grossly purulent pleural effusion

97
Q

Treatment of empyema?

A

Abx (preferably directed by culture) and drainage of effusion

98
Q

When is a chest tube indicated with pleural effusion?

A

If effusion present over 7 days (greater chance that the effusion is loculated)

99
Q

Describe chylothorax in the newborn

A

Can be congenital OR due to birth trauma

100
Q

Treatment of chylothorax

A
  • Conservative w/spontaneous resolution

- If recurrent, ligation or sclerosis of thoracic duct

101
Q

When is spontaneous PTX MC in newborns?

A

Birth trauma

PPV

102
Q

What is an anterior/superior mediastinal mass most likely to be?

A

Thymus tissue

103
Q

What is a middle mediastinal mass most likely to be?

A

Lymphomas

Reactive lymph node

104
Q

What is a posterior mediastinal mass most likely to be?

A

Neural tissue

105
Q

Which children have higher incidences of obstructive sleep apnea?

A
  • Craniofacial abnormalities
  • Neuropathies
  • Use of hypnotics, sedatives, anticonvulsants
106
Q

When is central sleep apnea in a child considered significant?

A
  • If episodes over 20 seconds

- If associated bradycardia OR O2 desaturation

107
Q

Treatment of sleep apnea in children

A

Adenotonsillectomy (50% may still have sleep apnea post-op)

108
Q

Describe apparent life-threatening events (ATLEs)

A
  • Observed apnea, color change, hypotonia, choking
  • 50% remain unexplained
  • Unclear association w/SIDS
109
Q

Define SIDS

A

Sudden death of an infant under 1 yo which remains unexplained despite TEAR:

  • Thorough case explanation
  • Examination of death scene
  • Autopsy
  • Review of clinical history
110
Q

Risk factor for SIDS?

A

Back to sleep - prone position may:

  • Decrease arousal
  • Rebreath exhaled gases
  • Effects on ANS

Special Pops - Peds (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions