Respiratory Flashcards
What condition is “steeple sign” seen on x-ray
Croup
(narrowing of the trachea in the subglottic region)
What virus is Croup caused by
parainfluenza
Pt presents with barking cough and stridor. What is the most likely Dx?
Croup
Tx for croup
mild- oral dexamethasone
moderate (difficulty breathing, signs of distress, stridor at rest): Nebulized racemic epi + corticosteroids
What is the MCC of bronchiolitis
RSV
Dx for bronchiolitis
nasal washing for RSV culture and antigen assay
When should a patient with Bronchiolitis be hospitalized? (4)
O2 < 95%
age < 3 months
respiratory rate > 70
atelectasis on chest radiograph
Tx for Bronchiolitis. Which treatment is the only one shown to improvement?
- Tx: nasal suctioning, humidified O2, and antipyretics
- Only one to improve Bronchiolitis: Oxygen
When is Ribavirin given to patients with bronchiolitis
severe lung or heart disease and in immunocompromised patients
which cause of pneumonia also causes bullous myringitis
Mycoplasma
MCC viral PNA in kids
RSV, 1st episode of wheezing
outpatient tx for pneumonia
Doxycycline
Macrolides
Indications for hospitalization in patients with PNA
> 50 with comorbidities
altered mental status
poor fluid status
INPATIENT tx for pneumonia
Ceftriaxone plus azithromycin, respiratory fluoroquinolones
which PNA has an elevated cold hemagglutinin titer?
Mycoplasma pneumonia
When is the pneumovax indicated
Pneumovax is licensed for use in children over the age of 23 months and is indicated for all pediatric patients at increased risk for pneumococcal disease.
when is doxycycline contraindicated and why
under 8y/o
Due to damaging effects on bone and teeth enamel
When are fluoroquinolones contraindicated
< 18y/o
due to damaging effects on the cartilage
What is the treatment of choice for an infant with Chlamydial pneumonia
Erythromycin
or
sulfisoxazole
Tx for RSV
Supportive: albuterol via nebulizer, antipyretics and humidified oxygen
Steroids (controversial)
Indications for Palivizumab (Synagis) prophylaxis
- Infants born at ≤ 28 weeks 6 days and <12 months at the start of RSV season
- Infants < 12 months of age with chronic lung disease (CLD) of prematurity
- Infants ≤ 12 months of age with hemodynamically significant CHD
- Infants and children < 24 months of age with CLD of prematurity necessitating medical therapy (eg, supplemental oxygen, bronchodilator, diuretic, or chronic steroid therapy) within 6 months prior to the beginning of RSV season
“Thumbprint sign” on x-ray
Epiglottitis
Tx for epiglottitis
Ceftriaxone
First line tx for allergic rhinitis
Intranasal Glucocorticoids (fluticasone, beclomethasone, mometasone)
+/- 2nd gen antihistamine (cetirizine/loratidine)
