Respiratory Block Flashcards
expiratory wheezing
Intrathoracic airway obstruction
A 5 y.o., presents with status asthmaticus, able to speak 2 words, with scant wheezing, respiration of 40 bpm, and an O2 saturation of 95%. You provided 3 nebulized albuterol treatments and the patient can now speak in sentences, has musical wheezing throughout, and an O2 saturation of 85%. The decrease in the O2 saturation is due to this phenomenon.
V/Q mismatch with “dead space ventilation”
A 3 y.o boy is undergoing mechanical ventilation 12 hr after repair of an atrial septal defect. Opioids and benzodiazepines are being used for analgesia and sedation. The mandatory ventilatory rate has been decreased from 20 to 10 bpm in preparation for removal of the endotracheal tube. The PaO2 is 120 mmHg and the PaCO2 is 75 mmHg. The arterial pH is 7.13. The child has no spontaneous respirations. Auscultation of the chest demonstrates that the breath sounds are slightly reduced on the left side. Occasional crackles can be heard over both bases. The most likely cause of acidosis is
respiratory depression
A 1 month old infant is breathing supplemental oxygen from a hood at a measured concentration of 45% after developing respiratory distress. A PO2 of 60 mmHg, a PCO2 of 50 mmHg, and a pH of 7.30 are measured in a blood sample obtained from the left radial artery.
Blood gas anomalies are caused by ventilation-perfusion inequality
A premature infant is undergoing mechanical ventilation for respiratory distress syndrome. Peak inspiratory pressure is 32 cm H2O, positive end-expiratory pressure (PEEP) is 5 cm H2O ad ventilatory rate is 30 bpm. The infant has decreased peripheral perfusion, manifested as a prolonged capillary refill time and weak arterial pulses. The central venous pressure measured at the right atrium with an umbilical venous catheter is 2 mmHg (or approximately 3 cm H2O. PaO2 is 80 mmHg, and PCO2 is 38 mmHg. Cause of improvement in infant’s perfusion.
Administer 10mL/kg of normal saline
Clubbing
Cystic fibrosis
Chronic congestive heart failure
Thalassemia
Cirrhosis
A 2 y.o new to your practice has a history of multiple respiratory illness. You note the presence of mild stridor on exam. Test to be indicated
Barium swallow
A 4 month old African-American infant was found unresponsive in his crib by his mother in the early morning and could not be resuscitated. He had been placed for sleep on his back but was found on his stomach. At a well-child examination the previous day, he had been found to be in a good health and receive his routine immunizations. He was born at 36 wks of gestation and weighed 2,420 g. His medical history was otherwise unremarkable. After a thorough scene investigation, autopsy, and review of the medical history, the cause of death was determined to be sudden infant death syndrome (SIDS). Factors to be of risk for SIDS in this patient.
Prematurity
Movement to a prone position after having been supine to sleep
Exposure to tobacco smoke
Low birth weight
Strongest risk factor associated with SIDS
Smoking by the mother in the prenatal period
Most common congenital abnormality of the nose
Choanal atresia
Nasal foreign bodies may caused
Aspiration
Local tissue necrosis
Infection
Toxic shock syndrom
Most important consideration when a disk battery is seen as a nasal foreign body
It may leak and cause local tissue damage
Nosebleeds are commonly associated with
Digital trauma
Family history of epistaxis
Sinus infection
Dry winter air
Nosebleeds in children most commonly arise from
Kiesselbach plexus (anterior septum)
Nasal polyps in children
Associated with allergic rhinitis
A parent of a 9 month old complains that her child is always sick with a cold. She wonders if her child needs antibiotics to clear infection. You have review the child’s chart and note normal growth and development and several phone calls for cold management. Most appropriate response
Otherwise healthy young children may have as many as 12 colds per year
Withdrawing the child from daycare may decrease number of colds
Antibiotics are not effective in the treatment of cold viruses
Over the counter cold remedies are not effective in decreasing symptoms in infants
Frontal sinuses in children
Begin development around age 7-8 years
Predisposing factors for bacterial sinusitis
Viral upper respiratory tract infections
Cigarette smoke exposure
Allergic rhinitis
Cleft palate
Common pathogen in acute sinusitis
Streptococcus pneumoniae
Staphylococcus aureus
Moraxella catarrhalis
Nontypable haemophilus influenzae
Important bacterial causes of pharyngitis
Group A streptococcus Fusobacterium necrophorum Mycoplasma pneumoniae Neisseria gonorrhea Group C streptococcus Corynebacterium diphtheria
Viral cause of pharyngitis
Adenovirus Rhinovirus Epstein-Barr virus human immunodeficiency virus Herpes simplex virus Enterovirus
A 17 y.o boy presents to the emergency department with difficulty breathing. He has had a sore throat and fever all week. Chest radiograph show multiple nodules. Blood culture will show
Fusobacterium necrophorum
Typical development of retropharyngeal abscess
Neck cellulitis to boil to deep abscess
Pharyngitis to infected lymph node to node cellulitis to phlegmon to abscess
Rapid enlargement of one tonsil is highly suggestive of
Tonsillar malignancy
