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pretest +uworld peds > Respiratory > Flashcards

Respiratory Flashcards

1
Q

LGA age baby born to a mother with gestational diabetes has issues with breathing and and decreased tone in his arm. What is the cause of the breathing and arm issue

A

LGA babies are at risk for birth trauma i.e. shoulder dystocia leading to damaged

  • brachial plexus–>Erbs/Duchenne’s palsy
  • phrenic nerve–>hemidiaphragm–>trouble breathing
    - ->Dx: Ultrasound of chest/diaphragm
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2
Q

kid <2 years old with fever, runny nose, cough (URI symptoms) followed by respiratory distress (cyanosis, retractions, nasal flaring, tachypnea wheezing, crackles)

A

Bronchiolitis
<2 years of age
cause: RSV>parinfluenza, influenza
mech:inflamm of lower airways (bronchioles)

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3
Q

Bronchiolitis

  • how to diagnose
  • treatment
A

diagnose

  • clinical signs (URI signs cough, sneezing, runny nose, then resp distress)
  • chest xray: interstitial infiltrates, hyperinflation, atelectasis
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4
Q

lung empyema are usually in the setting of

A

Bacterial pneumonia

  • xray: whiteout of the lung with loss of costophrenic angle
  • def:accum of pus in the pleural space
  • causes
    1. bacterial pneumonia>rupture of lung abscess, extension of mediastinits,
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5
Q

child with recurrent hemoptysis, anemia, pneumonia, rapidly clearing chest x-ray

A

idiopathic pulmonary hemosiderosis

hemoptysis-due to alveolar hemorrhage–>crackles
dyspnea-
anemia-due to loss of blood
occult blood stool loss-blood is swallowed and enters the GI tract

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6
Q

A child with pulmonary hemosiderosis with a hypersensitivity to _______has this disease______

A

hypersensitiv. to cow’s milk
Heiner syndrome
RX: dairy free diet

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7
Q

Dx for pulmonary hemosiderosis

A

bronchoscopy to obtain a bronchioalveolar lavage

findings-hemosiderin laden macrophages

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8
Q

croup like symptoms followed by toxic appearance, high fever

A

Bacterial tracheitis

Tx: Intubation+IV antibiotics

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9
Q

Croup vs Bacterial Tracheitis

A

Croup

  • viral symptoms: low fever, inspir. stridor, seal like cough
  • Rx: mild-cool mist, moderate-racemic epi+steroids

Bacterial tracheitis

  • viral like symptoms of croup (or no viral like symptoms) then a high fever, toxic appearance
  • or croup like symptoms that don’t respond to epi+steroids
  • RX: intubate+IV antibiotics
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10
Q

cold for >10 days+fever+facial pain

A

rhinosinusitis

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11
Q

what is the first step in treating anaphylaxis

A

Airway intubation (not epi treatment)

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12
Q

Rule of 2s for asthma

A

Determines whether asthma is intermittent or persistent

  • asthma attacks >2x per week
  • use of rescue inhaler>2x per week
  • nightime symptoms>2x per month
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13
Q

Rule of 2s for asthma

A

Determines whether asthma is intermittent or persistent

  • asthma attacks >2x per week
  • use of rescue inhaler>2x per week
  • nighttime symptoms>2x per month
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14
Q

Neonatal conjunctivitis caused by: Neisseria vs Chlamydia

A

Neisseria gonorrhea

  • purulent discharge, occurs 1st days of life
  • toxic baby: septic, febrile
  • RX: IM ceftriaxone

Chlamydia

  • watery eye discharge, occurs usually after 1st week of life
  • nontoxic baby, nonfebrile
  • RX: oral macrolide (for active infection), topical macrolide for prophylaxis
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15
Q

recurrent unilateral pneumonia in a healthy child

A

-foreign body aspiration
-on xray inspiration film normal, expiration film will see air trapping (blacker) distal to the obstruction
Dx: bronchoscopy

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16
Q

kartegeners vs cf

A

kartegeners: dynein arm defect, bronhiectesis (recurrent pneumonias), situs inversus, infertility

CF: (+) sweat test, diabetes (pancreatic insuff), infertility, malabsorption (failure to thrive) recurrent pneumonias

17
Q

cause of infertility in kartegeners vs cf

A

Kartegeners-dynein arm of cilia abnormal
men-sperm immotile
women-cilia in fallopian tubes abnormal, can’t move egg normally

CF-male infertility: bc absence of vas deferens to due inspissated mucous blocking vas deferens development–>obstructive azoospermia (sperm have normal motility though)

18
Q

acetaminophen or ibuprofen should be given to pts who experience febrile seizures after taking antibiotics. T or F?

A

False

  • antipyretics can reduce the antibody response to vaccinations
  • antipyretics have not been shown to reduce fever or prevent febrile seizures
19
Q

boy is at a picnic and develops wheezing and inc work of breathing

  • diagnosis
  • treatment
A

anaphylaxis-type 1 hypersensitivity rxn
symptoms: wheezing, +/-hives, pruritis
treatment-IM epinephrine

20
Q

point of maximum impulse is displaced to the right…..disease

A

Kartegeners (primary ciliary dyskinesia)

  • PMI displaced to the right–>situs inversus
  • sinusitis/pneumonias
  • bronchiectasis
21
Q

stress, trauma, dental procedures followed by facial swelling, colicky pain

A

hereditary angioedema=c1 inhibitor deficiency

  • kallekrien–>bradykinin->angioedema
  • C1–>angioedema
  • Ci inhibitor inhibits both C1 and kallekrein
  • without C1 inhibitor, increased bradykinin, dec C4 (C1 cleaves C4), dec C1 inhibitor
22
Q

CF mediated pneumonia

  • in adults
  • in kids
A

adults-pseudomonas–>RX: fluoroquinolones

peds-staph aureus–>for MSSA, strep cover with nafcillin, for MRSA cover with vancomycin

23
Q

complication of bacterial pneumonia

A

pleural inflammation->pleural effusions

  • signs: loss of costophrenic angle
  • fluid layering on lateral decubitus film
24
Q

Name the B cell deficiencies and unique characteristics

A

Brutons x linked agammaglobulinemia

  • tyrosine kinase deficiency->failure of pre B cell maturation into B cells
  • dec B cells, dec in all Igs
  • baby>6 months: bc for 1st 6 months there’s maternal IgG protection

CVID

  • milder version of brutons, recurrent sinopulm infections in teenager
  • -dec in all Igs, but normal B cells

IgA deficiency

  • dec Iga, inc IgG and IgM which compensate so pt often asymptomatic
  • after blood transfusion–>anaphylaxis

hyper IgM syndrome

  • can’t convert IgM to IgG
  • inc IgM, dec IgG, IgA, IgE
25
Q

CATCH 22

A

Digeorge syndrome-Chrom 22q11 microdeletion
C-cardiac abnormalities
A-abnormal facies: wide set eyes, low set ears
T-absent thymic shadow (no T cells)and absent parathyroid glands
C-cleft palate
H-hypocalcemia

26
Q

what infections do pts with DiGeorge syndrome get

A

recurrent fungal and Pneumocystis pneumoniae-RX TMP, SMX

27
Q

recurrent lung infections and skin abscesses

A

Chronic granulomatous disease (CGD)

-dihydrorotamine test and nitroblue test to check for neutrophil oxidative burst (produce H2O2 function)

28
Q

Leukocyte adhesion deficiency

A

L-leuokocytosis-neutrophils trapped in bv bc of defective integrins
A-absent neutrophils in pus
D-delayed umbilical cord separation

recurrent

  • mucosal infections (periodontitis)
  • skin infections: omphalitis, abscesses, cellulitis
29
Q

recurrent skin and mucosal infections

A

LAD

30
Q

scant lymphoid tissue

A

Brutons X linked agammaglobulinemia

31
Q

cryptochordism, wrinkled belly, vesicouteral reflux

A

Prune belly syndrome=bladder outlet blockage that impairs renal function

pretest +uworld peds (6 decks)

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