Respiratory

Question 1

Best treatment for the common cold

Answer 1

Increase fluid intake

-NOT pharmacologic tx: avoid aspirin, OTC cough suppressants or decongestants

Question 2

Most common lower respiratory tract infection in the first two years of life

Answer 2

= Bronchiolitis = inflammation of the bronchioles (viral) that causes inflammatory bronchiolar obstruction

Question 3

Influenza

(a) How to confirm diagnosis
(b) Strain that causes diarrhea and vomiting
(c) duration of fever
(d) seasonal preference

Answer 3

Influenza (A, B, and C infect humans)

(a) Confirm diagnosis w/ nasal swab or nasal washing
(b) H1N1 (influenza A) => D/V
(c) Febrile illness for 2-4 days
(d) common over winter months

Question 4

Tx for pregnant women with H1N1

Answer 4

Pregnant women w/ influenza A (H1N1) should receive 5-day course of antiviral tx

Oseltamivir preferred during pregnancy = Tamiflu

Question 5

Why are salicylates avoided in young children?

Answer 5

Salicylates (aspirin) is avoided in young children due to theoretical risk of Reye sydnrome

Reye syndrome = rapidly progressive encephalopathy w/ hepatic dysfxn several days after apparently recovering from viral illness
-associated w/ salicylate tx

Question 6

Normal RR in children

(a) first 6 weeks
(b) 6 weeks - 2 years
(c) 2-6 years
(b) 6-10 years
(c) > 10 years

Answer 6

Normal respiratory rate in children

(a) first 6 weeks = 45-60 bpm
(b) 6 weeks-2 mo = 40 /min
(c) 2-6 yoa: 30/min
(d) 6-10 yoa: 25/min
(e) > 10 years: 20/min

Question 7

Differentiate intramuscular vs. intranasal flu vaccine

Answer 7

Flu vaccine

Intramuscular

• children > 6 months
• killed virus => cannot cause the flu

Intranasal

• children > 5 years old
• live attenuated vaccine
• contraindicated in immunosuppressed ppl

Question 8

What type of virus is influenza?

Answer 8

Orthomyxovirus

= family of RNA viruses

Question 9

Pharyngitis + rhinitis + conjunctivitis

Answer 9

Pharyngitis + rhinitis + conjunctivitis = Adenovirus

-common cold

Question 10

Typical presenting features of rhinovirus

Answer 10

Rhinovirus = one of the common cold

Usually start as sore/scratchy throat + runny nose

-

Question 11

Treating influenza in otherwise healthy children

Answer 11

Symptomatic treatment: fluids, rest, acetaminophen (not aspirin b/c of Reye syndrome)

Question 12

Differentiate stridor and grunting

Answer 12

Stridor = inspiratory sound
-localizes respiratory distress to the upper airway

Grunting = due to exhalation against a partially closed glottis

• expiratory sound
• indicates moderate to servere hypoxia

Question 13

What do the different types of parainfluenza cause?

(a) type 1
(b) type 2
(c) type 3
(d) type 4

Answer 13

Parainfluenza virus

Types 1 and 2 => croup
Type 3 => bronchiolitis
Type 4 => common cold

Question 14

Causes of the common cold

Answer 14

> 200 viruses:

• most common (1/3) rhinovirus
• parainfluenza
• respiratory syncytial virus (RSV)
• adenovirus

Question 15

Name some clinical signs of respiratory distress in children/infants

Answer 15

• intercostal retractions
• nasal flaring
• use of accessory muscles to breathe
• pallor/cyanosis
• wheezing, stridor, or grunting

Question 16

Oseltamivir

Answer 16

= Tamiflu

• inhibits viral enzyme needed to facilitate viral particle release
• use to treat Influenza A and B and prevent flu after exposure in high risk populations

Question 17

What type of virus is parainfluenza?

Answer 17

Paramyxovirus