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Pediatrics > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Viral Croup Etiology

A

Parainfluenza virus or RSV. Fall/winter. 6mo-3yo.

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2
Q

Viral Croup Prodrome

A

URI symptoms

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3
Q

Viral Croup symptoms

A

Hoarseness, inspiratory stridor, barking (seal-like) cough.

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4
Q

Viral Croup Xray

A

To rule our foreign body aspiration. See a “steeple sign”

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5
Q

Mild Viral Croup

A

Stirdor only with activity

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6
Q

Moderate Viral Croup

A

Stridor with only mild retractions

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7
Q

Severe Viral Croup

A

Stridor, retractions, agitation, respiratory distress.

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8
Q

Mild Viral Croup treatment

A

Supportive. Use cool mist.

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9
Q

Moderate Viral Croup treatment

A
  1. ) corticosteroids: Dexamethasone IM 0.6 mg/kg

2. ) nubulized racemic epinephrine

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10
Q

Severe Viral Croup treatment

A

Admit. Airway management.

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11
Q

Epiglottitis Etiology

A

Haemophilus influenze B. EMERGENCY!

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12
Q

Epiglottitis Symptoms

A

Rapid onset. No cough. 3 D’s Dysphagia, drooling, distress. Tripod or sniffing position.

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13
Q

Epiglottitis diagnosis

A

DO NOT use a tongue blade. “thumbs up sign” on Xray.

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14
Q

Epiglottitis treatment

A

airway support (ET tube), +/- corticosteroids, Antibiotics (ceftriaxone)

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15
Q

Tracheomalacia Etiology

A

Floppy trachea due to abnormal collapse caused by inadequate cartilage. Aggravated by respiratory infections.

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16
Q

Tracheomalacia symproms

A

recurrent harsh/barking cough, stridor on expiration.

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17
Q

Tracheomalacia treatment

A

spontaneously resolves may need CPAP.

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18
Q

Foreign body aspiration symproms

A

abrupt onset of cough, wheezing or choking. history is key.

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19
Q

Foreign body aspiration peak incidence

A

12-24 months of age. Usually kids

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20
Q

Foreign body aspiration diagnostics

A

Bronchoscopy (usually in right main bronchus) is diagnostic and curative.

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21
Q

Pertussis (whooping cough) Etiology

A

Bordatella pertussis

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22
Q

Pertussis (whooping cough) complications

A

apnea, pneumonia, seizures, death.

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23
Q

Pertussis (whooping cough) phases

A
  1. ) Catarrhal: URI symptoms with a fever that lasts for 1-2 weeks.
  2. ) Paroxysmal: Persistent paroxysmal cough, inspiratory whooping, post-tussive emesis for 2-6 weeks.
  3. ) Convalescent: cough gradually resolves can last weeks-months.
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24
Q

Pertussis (whooping cough) Diagnosis

A

Nasopharyngeal swab/aspirate for nasal culture (gold standard). CBC will show leukocytosis.

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25
Q

Pertussis (whooping cough) treatment

A

Antibiotics: microlides.

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26
Q

Pertussis (whooping cough) hospitalization indications

A

Respiratory distress, cyanosis, apnea, inability to feed or

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27
Q

Respiratory Syncytial Virus (RSV) etiology

A

RSV. Most common cause of lower respiratory infections in kids

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28
Q

Respiratory Syncytial Virus (RSV) symptoms

A

Cough, conjunctivitis, congestion, fever.

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29
Q

Respiratory Syncytial Virus (RSV) complications

A

Brochiolitis, bronchospasm, acute respiratory failure, pneumonia.

30
Q

Respiratory Syncytial Virus (RSV) prophylaxis

A

Wash hands. Palivizumab for high risk children under 2.

31
Q

Bronchiolitis Etiology

A

RSV or rhinovirus. LRTI affecting the small airways in children

32
Q

Bronchiolitis prodrom

A

URI symptoms for 2-3 days.

33
Q

Bronchiolitis symptoms

A

Low grade fever, cough, expiratory wheezing with signs of respiratory distress.

34
Q

Bronchiolitis treatment

A

Supportive. Brochodilators can help with symptoms but don’t change course of the disease.

35
Q

Bronchiolitis hospitilization

A

If severe to maintain hydration and oxygenation.

36
Q

Cystic Fibrosis etiology

A

Most common fatal autosomal recessive disease. abnormal Cl transport causes viscous secretions in the lungs, pancreas, liver, intestine. 1/2 of the children with “failure to thrive” will be diagnosed with CF.

37
Q

Cystic Fibrosis Symptoms

A

persistent productive cough, hyperinflation on CXR.

38
Q

Cystic Fibrosis Diagnosis

A

Cl sweat test with >60.

39
Q

Cystic Fibrosis Treatment

A

antibiotics for infections, chest physiotherapy, mucolytics, steroids, bronchodilators.

40
Q

Bronchiectasis etiology

A

Abnormal dilation of the bronchi.

41
Q

Bronchiectasis symproms

A

chronic cough with sputum

42
Q

Bronchiectasis diagnosis

A

pulmonary function test shows an obstructive pattern.

43
Q

Bronchiectasis treatment

A

antibiotics, pulmonary drainage, and +/- bronchodilators.

44
Q

Pneumonia Causes by age

A

Viral (RSV): 1mo-5yo

Bacterial: 5yo-18yo

45
Q

Pneumonia bacterial etiology by age

A

Chlamydia: neonates
S. pneumonia: 1mo-5yo
Atypicals (mycoplasm): 5yo-18yo

46
Q

Pneumonia symptoms in infants

A

poor feeding, irritability, restlessness, often can be afebrile (chlamydia).

47
Q

Pneumonia symproms in children

A

Fever, cough, myalgia, HA, malaise, pleuritic chest pain and abdominal pain.

48
Q

Pneumonia signs

A

tachypnea, tachycardia, fever, decreased O2 sats, ill appearing, dehydration, lethargy. Lungs: crackles, ronchi, decreased air movement. Grunting=imminent respiratory failure.

49
Q

Pneumonia atypical LS

A

wheezing

50
Q

Pneumonia due to chlamydia

A

inclusion conjunctivitis

51
Q

Pneumonia Outpatient treatment

A

Need to rule out viral etiology with a rapid flu/RSV
Younger: Amoxicillin or a 2nd/3rd generation cephalosporin or clindamycin.
Older: Amoxicillin or azithromycin (mycoplasm)

52
Q

Pneumonia inpatient treatment

A

Ampicillin/sulbactam: 200mg/kg Q6
Cefuroxime: 150 Mg/kg Q8
Ceftriaxone: 50-100 mg/kg Q12-24

53
Q

Pneumonia hospitalization indications

A

70 (infants) or >50 (kids), inability to eat.

54
Q

Infant Respiratory Distress Syndrome Etiology

A

Deficiency of surfactant leading to hypoxia. Premies, diabetic mothers, family hx.

55
Q

Infant Respiratory Distress Syndrome symptoms

A

Starts within minutes of birth. tachypnea, retractions, grunting, nasal flaring, cyanosis. Lasts 2-3 days.

56
Q

Infant Respiratory Distress Syndrome CXR

A

Diffuse bilateral alectasis with a ground glass appearance.

57
Q

Infant Respiratory Distress Syndrome treatment

A

O2 with CPAP, fluids, ET tube, exogenous surfactant.

58
Q

Infant Respiratory Distress Syndrome prevention

A

antenatal glucocorticoids are given to the mother to hasten lung maturing (dexamethasone or betamethasone) if expected to deliver early.

59
Q

Asthma definition

A

chronic airway inflammation, hyper-responsiveness and reverisble obstruction. With common triggers.

60
Q

Asthma symptoms

A

cough (often nocturnal), wheezing, dyspnea, chest tightness.

61
Q

Asthma diagnosis

A

Spirometry. Measure FEV1/FVC which will be decreased (obstructive) then use bronchodilators and see an increase in FEV1.

62
Q

Asthma treatment

A

Stepwise approach:

  1. ) short acting bronchodilators (SABA) PRN
  2. ) inhaled corticosteroids
  3. ) Long acting bronchodilators (must be perscribed alon with steroids)
  4. ) leukotriene antagonists
  5. )Oral steroids.
63
Q

Asthma, do they need more than a SABA?

A

Rules of TWO. More than twice a week, more than twice a month at night, more than two refills a month.

64
Q

Vocal cord dysfunction etiology

A

Inappropriate vocal cord motion that can cause partial airway obstruction. Often misdiagnosed as asthma.

65
Q

Vocal cord dysfunction symptoms

A

Inspiratory stridor, cough, choking/throat tightness. Can be triggered.

66
Q

Vocal cord dysfunction treatment

A

speech therapy.

67
Q

Obstructive sleep apnea definition

A

habitual snoring, gasping or apnea.

68
Q

Obstructive sleep apnea risk factors

A

adenotonsillar hypertrophy and obesity.

69
Q

Obstructive sleep apnea diagnosis

A

sleep study

70
Q

Obstructive sleep apnea treatment

A

adenoidectomy with/without tonsilectomy or CPAP.

Pediatrics (8 decks)

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