Respiratory Flashcards

1
Q

Pathogenesis of croup?

A

Parainfluenza mostly. Sometimes RSV, influenza, others.

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2
Q

How does patient with croup present?

A

With viral prodrome, seal-like cough, inspiratory stridor

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3
Q

How to diagnose croup?

A

XR showing steeple sign

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4
Q

How to treat croup?

A

Supportive, if not responsive, treat with racemic epi and corticosteroids (especially if patient has stridor at rest)

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5
Q

Epiglottitis pathogenesis

A

H. Flu, but can also be caused by staph aureus

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6
Q

How does a patient with epiglottitis present?

A

Patient is sick as shit, 3-6 years old. Tripodding, drooling, febrile >104, rapid onset

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7
Q

How to diagnose epiglottitis?

A

XR showing thumbprint sign

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8
Q

How to treat epiglottitis?

A

DO NOT touch trachea. Take patient to OR for intubation. Give antibiotics.

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9
Q

Bacterial tracheitis pathogenesis?

A

Bacterial infection with strep pneumo or staph

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10
Q

How does patient with bacterial tracheitis present?

A

Has cold/flu like symptoms and suddenly becomes incredibly febrile with horrible sore throat and stridor.

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11
Q

How to diagnose bacterial tracheitis?

A

XR showing steeple sign, subglottic narrowing with hazy border.

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12
Q

How to treat bacterial tracheitis?

A

No response to racemic epinephrine. Culture and give antibiotics.

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13
Q

Retropharygneal abscess pathogenesis

A

Caused by bacterial infection (usually strep and staph)

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14
Q

How does patient with retropharyngeal abscess present?

A

Fever and drooling with hot potato voice. Patient likes to lie supine with neck extended.
Patient usually has unilateral lymphadenopathy.

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15
Q

How to diagnose retropharyngeal abscess?

A

Get a lateral XR, will show increased soft tissue swelling that expands up to 50% of vertebrae

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16
Q

How to treat retropharyngeal abscess?

A

I+D, culture. Give antibiotics for strep and staph, then based on culture.

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17
Q

Pathogenesis of peritonsillar abscess

A

Caused by staph and strep

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18
Q

Patient with peritonsillar abscess presentation?

A

Fever, drooling, hot potato voice. Patient has tonsillar shift with visible abscess.

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19
Q

How to diagnose peritonsillar abscess?

A

Clinical

20
Q

How to treat peritonsillar abscess?

A

I+D and culture

21
Q

Foreign body airway obstruction presentation?

A

Unsupervised child with sudden onset shortness of breath. Stridor if in upper airway, wheezing if in lower airway.

22
Q

How to diagnose FBAO?

A

XR AP and lateral = coin sign

23
Q

How to treat FBAO?

A

Rigid bronch.

24
Q

Bronchiolitis pathogenesis

A

RSV, sometimes parainfluenza. Inflammation of bronchioles

25
Q

Typical bronchiolitis presentation

A

Wheezing child, fever.

26
Q

How to diagnose bronchiolitis?

A

CXR and PFTS (normal)

27
Q

How to treat bronchiolitis?

A

Will resolve spontaneously, however if SpO2

28
Q

CF pathogenesis

A

Autosomal recessive mutation in the CFTR gene

29
Q

How does CF patient present?

A

Usually found on prenatal screen, salty kid with mucus plug, FTPM 2/2 mec ileus, failure to thrive, infections with pseudomonas, short stature.

30
Q

How to diagnose CF?

A

Prenatal screen or sweat chloride test

31
Q

Tx for CF?

A

Pulmonary toilet, NAC, pancreatic enzymes, treatment for pseudomonal pneumonia

32
Q

Otitis media pathogenesis

A

URI bugs (H.Flu, S. pneumo, moraxella). Middle ear inflammation

33
Q

How does patient with otitis media present?

A

Unilateral ear pain, no pain with pinna pull. Loss of light reflex, bulging TM.

34
Q

How to diagnose otitis media?

A

Pneumatic insufflation

35
Q

How to treat otitis media?

A

Amoxicillin

36
Q

Pathogenesis of otitis externa?

A

Outer ear inflammation with pseudomonas (swimmers), S. aureus (digital trauma).

37
Q

How does patient with otitis externa present?

A

Unilateral ear pain with pain on pinna pull. Erythematous canal.

38
Q

How to treat otitis externa?

A

Spontaneous or cipro gtt

39
Q

Sinusitis pathogenesis?

A

URI bugs infected sinuses

40
Q

How does sinusitis patient present?

A

Congestion, nasal discharge, purulence, pain with facial tap.

41
Q

How to diagnose sinusitis?

A

Clinical

42
Q

How to treat sinusitis?

A

Treat only if >7d OR with cough. Treat with amoxicillin

43
Q

Difference between sinusitis and a cold?

A

Cold lasts less than 7 days and does not have a cough.

44
Q

Choanal atresia pathogenesis

A

Big tonsils

45
Q

Choanal atresia pathogenesis

A

Snoring child, blue while resting, pink when crying.

46
Q

How to diagnose choanal atresia?

A

NG tube fails to pass

47
Q

How to treat choanal atresia?

A

Surgery