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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
What 2 reason would **IM (Ceftriaxone)** be indicated for otitis media? | *antibiotic*
1. Concerns about PO compliance 2. Poor absorption due to **diarrhea** or **vomiting**.
26
What vital sign should be monitored before treatment of otitis media?
Temperature | assist w/ evaluation of treatment.
27
What causes chronic otitis media with effusion?
Persistant fluid in the middle ear (*weeks to months*)
28
What are symptoms of chronic otitis media w/ effusion?
1. Difficulty hearing 2. Fullness or ear popping sensation when swallowing. 3. mild to moderate pain (**NO severe** pain)
29
1. When is treatment indicated for chronic otitis media w/ effusion? 2. What is the treatment?
1. Fluid persists for > 3 months and hearing loss 2. Myringotomy
30
What are 2 indications to wear wax earplugs after a myringotomy?
1. When showering or washing hair (*due to soap*) 2. Swimming in non-cholorinated waters
31
What additional service might be indicated if a child had experienced hearing loss?
Speech therapy
32
When is the prevalance of croup highest?
Autumn to winter
33
What medications are indicated for **severe** laryngotracheobronchitis?
1. Corticosteroids 2. Racemic epinephrine (Inflammation ↓)
34
1. Which croup syndrome is associated with **gradual** onset? 2. which one has an **abrupt** onset?
1. laryngotracheobronchitis 2. Acute epiglottitis
35
What non-pharmalogical interventions can be implemented for laryngotracheobronchitis? | (3)
1. Elevate head of the bed 2. Cool air humidifer 3. Encourage fluids* | *Not recommended if tachypnea (risk of aspiration)
36
NPO is expected in which respiratory disease?
**severe** laryngotracheobronchitis and acute epiglottitis
37
Which respiratory infection is associated w/ a froglike croaking sound?
Acute Epiglottitis
38
What physiological change causes croup syndromes?
Swelling or obstruction in region of larynx (*e.g., subglottic tissue*)
39
What are the two types of croup syndrome?
1. acute laryngotracheobronchitis (LTB) 2. acute epiglottitis
40
What is the most common type of croup syndrome?
acute laryngotracheobronchitis (LTB) | La-ringo-trach-eo-bronch-itis
41
Which croup syndrom is associated with a "seal-like" cough?
acute laryngotracheobronchitis (LTB) | La-ringo-trach-eo-bronch-itis
42
Which croup syndrom is associated with dysphagia and sore throat? | difficulty swallowing
Acute epiglotitis
43
What type of infection causes acute laryngotracheobronchitis (LTB)
Viral
44
What type of infection causes acute epiglottitis?
Bacterial
45
When would hospitalization be indicated for severe laryngotracheobronchitis (LTB)
Presence of tachypnea and stridor
46
Which respiratory disease would inspection of the throat not be indicated? What would be an appropriate response?
Acute epiglottitis, transport to ER immediately. | Risk for airway spasm
47
Which strain of respiratory syncytial virus is more and serious?
Strain A
48
Which respiratory disease is associated with a prolonged expiratory phase?
Bronchiolitis Respiratory Syncytial Virus (RSV)
49
How is Bronchiolitis Respiratory Syncytial Virus (RSV) diagnosed?
Nasal pharyngeal swab (PCR) test
50
1. How is Bronchiolitis Respiratory Syncytial Virus (RSV) transmitted? 2. What PPE is worn?
1. Contact and Droplet 2. Gown, mask, gloves, and goggles.
51
What days are Bronchiolitis Respiratory Syncytial Virus (RSV) most contagious?
Days 2-4 | can be infectious for 1-3 weeks after symptoms subside
52
When are antibotics prescribed for Bronchiolitis Respiratory Syncytial Virus (RSV)?
If a secondary infection (pnemonia) is obtained following RSV infection
53
What are the three causes of bronchioles narrowing in asthma?
1. Mucus in airway 2. Swelling (edema) of airway lining 3. Spasm of muscle on wall of airway
54
1. Do all people with asthma have an allergic component? 2. Which immunoglobulin becomes elevated w/ allergic components?
1. No 2. IgE
55
Classification of asthma is based on what two clinical symptoms?
1. Lung function and frequency 2. Severity of exacerbations
56
What is the major difference b/w **intermittent** asthma and the other classifications?
Intermittent only requires a PRN inhaler before events that can cause an asthma attack
57
What is the most common symptom of asthma?
coughing (non-productive) in the absence of respiratory tract infection, especially at night
58
What chest sounds may be heard with asthma?
1. **rhonchi** (*mucus obstruction*) 2. **wheezing** (*airway narrowing*)
59
what physiological body changes may occur with chronic asthma?
Development of barrel chest | increase in anterior posterior diameter
60
What test measure the total volume of air the lungs can hold and whether there are any problems with the flow of the air
Peak expiratory flow rate (PEFR)
61
How is a Pulmonary Function Test (PFT) conducted?
1. Perform the PFT 2. Take albuterol 3. Repeat PFT to see if there are improvements | Improvements indicate asthma
62
# Signs and symptoms of what? 1. Sore throat 2. Tripod position 3. Muffled voice 4. Cyanosis
Acute Epiglottitis
63
Peak Flow Meters are not reliable for what ages?
**under the age of 4 **as they may not be able to do it properly
64
What tool is used to guide an asthma action plan?
Peak Flow Meter
65
Which asthma medication should not be used alone as it can exacerbate asthma?
Salmeterol (Serevent)
66
Which type of medication is indicated for children who use rescue inhalers (*albuterol*) > 2x/week?
Corticosteroids
67
Which medication is indicated for moderate/severe asthma associated w/ allergies for 6 years and up?
Anti-IgE monoclonal antibodies | (Xolair)
68
Which respiratory disease may require intubation or tracheostomy?
Acute Epiglottitis
69
What is indicated after using inhaled steroids?
rinse your mouth | *Decrease risk of thrush*
70
The **yellow** rating of a Peak Flow Meter is how much %?
50 to 80 % of personal best | Green - Yellow - Red
71
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)*
* 2-6 months (peak is 2-3) * By 3 years old

Pediatrics (10 decks)

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