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Pediatrics > Respiratory Diseases > Flashcards

Respiratory Diseases Flashcards

1
Q

What are the two anatomical differences in the respiratory tract of children and adults?

Why are children more susceptible to respiratory infection?

A
  1. Diameter of airway is smaller
  2. Distance b/w structures within the tract is shorter

Shorter tract allows for rapid movement of pathogens.

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2
Q

Name the adventitious sound

High pitched (musical sound)
heard on expiration

A

Wheezing

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3
Q

Name the adventitious sound

Lower-pitched, snoring

A

Rhonchi

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4
Q

Name the adventitious sound

clicking, rattling, snap, pop
hear on inspiration

A

Crackles

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5
Q

What is the first sign of respiratory distress in infants?

A

Tachypnea

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6
Q

What are the following signs and symptoms of?

  • Tachypnea
  • Nasal flaring
  • Grunting
  • Use of accessory mucles
  • Color change
  • Adventitious sounds (stridor)
  • Absence or diminished breath sounds
  • Clubbing
  • Cough
A

Respiratory distress

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7
Q

Which respiratory disease effects epithelial cells in the lungs?

A

Bronchiolitis Respiratory Syncytial Virus (RSV)

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8
Q

What medication and intervention is contraindicated in RSV?

Bronchiolitis Respiratory Syncytial Virus

A
  • Steroid (does nothing)
  • Chest physiotherapy (worsen symptoms)
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9
Q

What retractions are associated w/ upper respiratory tract infections?

A
  1. Suprasternal
  2. Superclavicular
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10
Q

What medication helps to prevent RSV for high risk populations?
How is it administered?

Bronchiolitis Respiratory Syncytial Virus

A

Monoclonal antibody IM injection

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11
Q

What are the vaccine options for acute otitis media?

A

HIB and Prevnar

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12
Q

What is a nonpharmacological Tx for AOM for ear pain?

A

Warm soak in ear

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13
Q

What is the most prevalent disease of early childhood?

6 months to 2 years

A

Otits Media

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14
Q

Otitis Media incidence rates are highest during which season?

A

Winter

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15
Q

What structural ear differences in children puts them more at risk for otitis media compared to adults?

A

Childrens eustachian tube is shorter and more horizontal.

secretions go back up easier and stay longer

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16
Q

What are the potential causes (4) of otitis media?

A
  1. Bacterial or viral infection (S. pneumonia, M. catarrhalis H. influenza)
  2. Inflammation of middle ear (e.g., allergies)
  3. Second hand smoke
  4. Bottlefeeding (breast milk provide IgA)
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17
Q

Name 5 out 7

What are some clinical manifestation of otitis media?

A
  1. Irritiability (e.g., pulling on ear)
  2. Pain (fluid accmulation causing pressure
  3. Decreased appetite (change in pressure from sucking)
  4. Fever* (R/T infection)
  5. Lymphadenopathy (postauricular and cervical glands)
  6. Rhinorrhea
  7. Vomiting & diarrhea
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18
Q
  1. What changes can occur overtime to the tympanic membrane due to otitis media?
  2. What two things can it lead it?
A
  1. Scarring
  2. Decreased mobility of tympanic membrane and hearing loss
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19
Q

(4)

What do you expect to see when inspecting the tympanic membrane for otitis media?

A
  1. Redness
  2. Bulging (beefy)
  3. Missing cone of light
  4. Missing bony prominence
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20
Q

Acute otitis media is treated for mild symptoms and low grade fever in which population?

A

Infants under 6 months of age

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21
Q

What two reasons are 6 months to 2 year olds treated for acute otitis media?

A
  1. Bilateral acute otitis media
  2. Unilateral AOM w/ severe symptoms (earache for 48hrs and temp ≥ 102.2F)
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22
Q

When would a 6 month to 2 year old NOT be treated for acute otitis media?

A
  1. Uniateral AOM w/ mild symptoms

(redness, irritability, low grade fever, mild pain)

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23
Q

What predisposing factors would indicate for acute otitis media to be treated in children?

A

predisposing diseases such children who are immunosuppressed and/or craniofacial abnormalities

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24
Q

Which antibiotic is the first line treatment for otitis media?

A

Amoxicillin

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25
Q

What 2 reason would IM (Ceftriaxone) be indicated for otitis media?

antibiotic

A
  1. Concerns about PO compliance
  2. Poor absorption due to diarrhea or vomiting.
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26
Q

What vital sign should be monitored before treatment of otitis media?

A

Temperature

assist w/ evaluation of treatment.

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27
Q

What causes chronic otitis media with effusion?

A

Persistant fluid in the middle ear (weeks to months)

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28
Q

What are symptoms of chronic otitis media w/ effusion?

A
  1. Difficulty hearing
  2. Fullness or ear popping sensation when swallowing.
  3. mild to moderate pain (NO severe pain)
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29
Q
  1. When is treatment indicated for chronic otitis media w/ effusion?
  2. What is the treatment?
A
  1. Fluid persists for > 3 months and hearing loss
  2. Myringotomy
30
Q

What are 2 indications to wear wax earplugs after a myringotomy?

A
  1. When showering or washing hair (due to soap)
  2. Swimming in non-cholorinated waters
31
Q

What additional service might be indicated if a child had experienced hearing loss?

A

Speech therapy

32
Q

When is the prevalance of croup highest?

A

Autumn to winter

33
Q

What medications are indicated for severe laryngotracheobronchitis?

A
  1. Corticosteroids
  2. Racemic epinephrine (Inflammation ↓)
34
Q
  1. Which croup syndrome is associated with gradual onset?
  2. which one has an abrupt onset?
A
  1. laryngotracheobronchitis
  2. Acute epiglottitis
35
Q

What non-pharmalogical interventions can be implemented for laryngotracheobronchitis?

(3)

A
  1. Elevate head of the bed
  2. Cool air humidifer
  3. Encourage fluids*

*Not recommended if tachypnea (risk of aspiration)

36
Q

NPO is expected in which respiratory disease?

A

severe laryngotracheobronchitis and acute epiglottitis

37
Q

Which respiratory infection is associated w/ a froglike croaking sound?

A

Acute Epiglottitis

38
Q

What physiological change causes croup syndromes?

A

Swelling or obstruction in region of larynx (e.g., subglottic tissue)

39
Q

What are the two types of croup syndrome?

A
  1. acute laryngotracheobronchitis (LTB)
  2. acute epiglottitis
40
Q

What is the most common type of croup syndrome?

A

acute laryngotracheobronchitis (LTB)

La-ringo-trach-eo-bronch-itis

41
Q

Which croup syndrom is associated with a “seal-like” cough?

A

acute laryngotracheobronchitis (LTB)

La-ringo-trach-eo-bronch-itis

42
Q

Which croup syndrom is associated with dysphagia and sore throat?

difficulty swallowing

A

Acute epiglotitis

43
Q

What type of infection causes acute laryngotracheobronchitis (LTB)

A

Viral

44
Q

What type of infection causes acute epiglottitis?

A

Bacterial

45
Q

When would hospitalization be indicated for severe laryngotracheobronchitis (LTB)

A

Presence of tachypnea and stridor

46
Q

Which respiratory disease would inspection of the throat not be indicated?
What would be an appropriate response?

A

Acute epiglottitis, transport to ER immediately.

Risk for airway spasm

47
Q

Which strain of respiratory syncytial virus is more and serious?

A

Strain A

48
Q

Which respiratory disease is associated with a prolonged expiratory phase?

A

Bronchiolitis Respiratory Syncytial Virus (RSV)

49
Q

How is Bronchiolitis Respiratory Syncytial Virus (RSV) diagnosed?

A

Nasal pharyngeal swab (PCR) test

50
Q
  1. How is Bronchiolitis Respiratory Syncytial Virus (RSV) transmitted?
  2. What PPE is worn?
A
  1. Contact and Droplet
  2. Gown, mask, gloves, and goggles.
51
Q

What days are Bronchiolitis Respiratory Syncytial Virus (RSV) most contagious?

A

Days 2-4

can be infectious for 1-3 weeks after symptoms subside

52
Q

When are antibotics prescribed for Bronchiolitis Respiratory Syncytial Virus (RSV)?

A

If a secondary infection (pnemonia) is obtained following RSV infection

53
Q

What are the three causes of bronchioles narrowing in asthma?

A
  1. Mucus in airway
  2. Swelling (edema) of airway lining
  3. Spasm of muscle on wall of airway
54
Q
  1. Do all people with asthma have an allergic component?
  2. Which immunoglobulin becomes elevated w/ allergic components?
A
  1. No
  2. IgE
55
Q

Classification of asthma is based on what two clinical symptoms?

A
  1. Lung function and frequency
  2. Severity of exacerbations
56
Q

What is the major difference b/w intermittent asthma and the other classifications?

A

Intermittent only requires a PRN inhaler before events that can cause an asthma attack

57
Q

What is the most common symptom of asthma?

A

coughing (non-productive) in the absence of respiratory tract infection, especially at night

58
Q

What chest sounds may be heard with asthma?

A
  1. rhonchi (mucus obstruction)
  2. wheezing (airway narrowing)
59
Q

what physiological body changes may occur with chronic asthma?

A

Development of barrel chest

increase in anterior posterior diameter

60
Q

What test measure the total volume of air the lungs can hold and whether there are any problems with the flow of the air

A

Peak expiratory flow rate (PEFR)

61
Q

How is a Pulmonary Function Test (PFT) conducted?

A
  1. Perform the PFT
  2. Take albuterol
  3. Repeat PFT to see if there are improvements

Improvements indicate asthma

62
Q

Signs and symptoms of what?

  1. Sore throat
  2. Tripod position
  3. Muffled voice
  4. Cyanosis
A

Acute Epiglottitis

63
Q

Peak Flow Meters are not reliable for what ages?

A

**under the age of 4 **as they may not be able to do it properly

64
Q

What tool is used to guide an asthma action plan?

A

Peak Flow Meter

65
Q

Which asthma medication should not be used alone as it can exacerbate asthma?

A

Salmeterol (Serevent)

66
Q

Which type of medication is indicated for children who use rescue inhalers (albuterol) > 2x/week?

A

Corticosteroids

67
Q

Which medication is indicated for moderate/severe asthma associated w/ allergies for 6 years and up?

A

Anti-IgE monoclonal antibodies

(Xolair)

68
Q

Which respiratory disease may require intubation or tracheostomy?

A

Acute Epiglottitis

69
Q

What is indicated after using inhaled steroids?

A

rinse your mouth

Decrease risk of thrush

70
Q

The yellow rating of a Peak Flow Meter is how much %?

A

50 to 80 % of personal best

Green - Yellow - Red

71
Q
  1. What age does the greatest occurance of RSV occur?
  2. By what age are most children infected with RSV at least once?

Bronchiolitis Respiratory Syncytial Virus (RSV)

A
  • 2-6 months (peak is 2-3)
  • By 3 years old

Pediatrics (10 decks)

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