Respiratory Flashcards
Characterized by reduced airflow rates; lung volumes within normal range or larger, typical have trouble with EXHALATION (i.e. asthma, chronic bronchiolitis, CF)
Obstructive disease
Reduced lung volumes and expiratory flow rates, difficulty with INSPIRATION (i.e. Pneumonia)
Restrictive disease
A disease of the lower respiratory tract that causes inflammation leading to obstruction of the small respiratory airways.
Bronchiolitis
What IM injection can be given for RSV prevention?
Synagis
Synagis is given IM how often
Every month during RSV season
Who should receive Synagis?
Less than 2 years of age with chronic lung disease
Premature infants (<32 weeks) during first year of life
Infants 32-35 weeks if they: attend daycare, have school-aged siblings, are exposed to environmental pollution, have abnormal airways, or have severe neuromuscular problems
A disease characterized by an increased responsiveness of the trachea and bronchi to various stimuli, and manifested by widespread narrowing of the airways that changes in severity either spontaneously or as a result of treatment.
Asthma
Asthma has ______ of smooth muscle.
Hypertrophy
Asthma has mucosal _____ and _____
edema and hyperemia
In asthma, there is ______ of mucus glands
hypertrophy
In asthma, there is a ________ of epithelial basement membranes. This is called what?
Thickening
Remodeling
Signs and symptoms of asthma reveal breath sounds that are ___________
hyper resonant
Ominous signs of asthma include: ____ breath sounds, inability to maintain ________, and __________.
Absent breath sounds
Inability to maintain recumbency (can’t lay down)
Cyanosis
Hospitalization is recommended if the peak flow is less than ___ liters/minute or there is no improvement in _______ after aerosol treatment.
60 L/min
ventilation
Is chest XRay required in the management of asthma?
No, unless ruling out other issue
What is the most important value when assessing lung function?
Forced expiratory volume
What stages of asthma are there? (4)
Intermittent, Mild persistent, moderate persistent, and severe persistent
What stage of asthma? Symptoms 2 days/week, nighttime awakenings: 2/month, rescue inhaler use: 2 days/week, interference with normal activity: none, lung function: FEV is more than 80% predicted
Intermittent Asthma
What stage of asthma? Symptoms more than 2 days/week, night time awakenings 3 to 4 times/mo, rescue inhaler use more than 2 days/week but NOT daily, Minor limitation on normal actiity, FEV greater than 80%
Mild persistent asthma
What stage of asthma? Daily symptoms with more than once/night nighttime awakenings but NOT nightly. Daily rescue inhaler use with some limitation on daily activity. FEV is 60-80% predicted.
Moderate persistent asthma
What stage of asthma? symptoms throughout the day with nightly nighttime awakenings, rescue inhaler use several times/day with extreme limitations on daily life, FEV is less than 60% predicted.
Severe persistent asthma
What is the goal of asthma treatment?
Focuses on achieving and maintaining control
What is part of a preferred treatment for persistent asthma across all age groups?
inhaled corticosteroids
Combination therapy is recommending with IHC with what drug?
Long acting beta agonist
What age should you implement LABAs?
greater than 12 years
What are the three distinct age groupings for asthma?
0-4
5-11
12 and older
How frequent should initial monitoring be completed for asthma?
Every 2-4 weeks until control is achieved
How long must continued control be present before stepping down therapy for asthma?
3 months
For intermittent asthma what is the recommended step for initiating therapy?
Step 1 preferred: SABA + PRN
For mild persistent asthma, what is the recommended step for initiating therapy?
Step 2 preferred: Low-dose ICS OR montelukast
For age group 0 to 4 for moderate to severe asthma, what is the recommended step for initiating therapy?
Step 3 and consider short course of oral systemic corticosteroids
For age group of 5-11 years in moderate persistent asthma, what is the recommended step?
Medium dose ICS option and consider short course of oral systemic corticosteroids
Age group 5-11, what is the process for 5 to 11 in severe persistent asthma, what is the recommended step for initiating therapy?
Medium dose OR step 5 ICS option and consider short course of oral systemic corticosteroids
Inflammation of the lower respiratory tract as microorganisms gain acces by aspiration, inhalation, or hematogenous dissemination.
Pneumonia
If a newborn gets pneumonia, what are the three most common offending pathogens?
GBS, chlamydia, E. coli
70-80% of ALL pneumonias are _____
Viral
H. influenzae, S. pneumoniae, Klebsiella shows what on XRay?
Lobar consolidation
E coli, staph, and pseudomonas reveals what on XR?
patchy infiltrates
What medication is used to treat pneumonia when infected with S. pneumoniae?
PCN
What medication is used to treat pneumonia when infected with M. Catarrhalis?
Macrolides such as Zithromax
What medication is used to treat pneumonia when infected with H. influnenzae?
Amoxicillin or cephalosporin
An autosomal recessive disorder with a chromosome 7 long arm mutation which produces a defect in epithelial chloride transport resulting in dehydrated, thick secretions.
Cystic Fibrosis
What lab diagnostic test can confirm CF?
Pilocarpine iontophoresis (sweat test)
What does the chest XR reveal on a CF patient?
Cystic lesions and atelectasis
Also known as whooping cough; contagious respiratory illness caused by Bordatella pertusis; can cause serious complications in infants and young children.
Pertussis
What antibiotics are used to treat pertussis? When should antibiotics be given during the disease course?
Azithromycin/Clairithromycin/Erythromycin
Within first 3 weeks of infection
