Respiratory disorders

Question 1

Bronchitis
Inflammation of____

Old ppl tx
Eval for ___ w peds

Answer 1

trachea, bronchi, bronchioles inflammation w cough up to 3wks, self limiting mostly viral
give abx if old w copd/chf

Question 2

antitussive age

Answer 2

6yrs+
FDA=2yrs
Manufacturers=4yrs

Question 3

Bronchitis tx

Answer 3

fluids, antipyretic, decongestant, cough suppressants
Albuterol/IGC
Olsetamivir <48hrs
NO mucolytics, NO honey <1, NO antitussive w COPD
honey not for <1yr

Question 4

bronchitis abx only if a treatable cause is present
a.Pertussis/atypical bacteria
B. moraxella, chlamydia, mycoplasma
C.Abx failure in elderly/comorbidites)

Answer 4

Clarithromycin or azithromycin
Doxycycline
Quinolone

Question 5

Chronic cough time

Answer 5

adults 8weeks+

children 4wks+

Question 6

Chronic cough causes

Answer 6

upper airway cough syndrome/abnormalities,
rhinitis w PND,
postviral,
asthma,
GERD

Question 7

Cough tx

Answer 7

fluticasone, budesonide;ppi; benzonatate (10+)
gabapentin
ICS only with asthma etc

Question 8

Inflammation/obstruction of small airways =^resp effort/wheezing
Mostly in NB-2yrs, males
antibodies do NOT transfer from mom

Answer 8

Bronchiolitis

Question 9

Bronchiolitis prevention for at risk pts

Answer 9

palivizumab inj

Question 10

Bronchiolitis NG feedings avoid

Answer 10

hypotonic fluids d/y hyponatremia

Question 11

Bronchiolitis tx

Answer 11

nothing proven to work, need respiratory score to use aerosols
Ribavirin for immunocompromised pts w severe RSV (toxic to nurses)

Question 12

Bronchiolitis antimicrobials

Answer 12

severe resp distress w poss pna, worth risk, UTI, OM

Question 13

Seal barking cough, inspiratory stridor
(Laryngotracheitis or laryngotracheobronchitis)
most common cause of upper airway obstruction or stridor in children

Answer 13

Croup

Question 14

Croup caused by
most common type
most severe type

Answer 14

parainfluenza virus
most common-1
type 4=severe illness

Question 15

Croup xray dx signs

Answer 15

steeple, or thumb sign

Normal supraglottic appearance

Question 16

Croup tx

Answer 16

nebulized epi
PO dexamethasone
Budesonide
Racemic epi for hospitalized pts
if d/t flu=oseltamivir

Question 17

Community acquired pneumonia causes
A.Most common,2nd
B.Smokers
C.Aspiration 
D. Children 
E. Immunocompromised

Answer 17

A-mycoplasma pna, strep pna
B- H.flu
C-anaerobic bacteria 
D-viral
E-pneumocystitis carinii

Question 18

Findings w \_\_\_\_
Consolidation on percussion
Egophony
Bronchophony
Whispered pectoriloquy
Tactile fremitus

Answer 18

Community acquired pneumonia

Question 19

CAP tx typical bacteria

Answer 19

Amoxicillin, amox-clavulanate

Question 20

CAP tx healthy w/o recent Abx

Answer 20

amoxicillin or doxy

Question 21

CAP tx healthy w recent abx

Answer 21

Resp fluoroquinolone
Or adv macrolide
Or adv macrolide +^amox-clav

Question 22

CAP tx w comorbidity

Combo tx

Answer 22

Amox-Clav OR Cephalosporin
AND
Macrolide OR doxycycline

Question 23

Bronchiolitis most common cause

No need to dx=over tx

Answer 23

RSV

Question 24

CAP Atypical bacteria tx

Answer 24

Macrolide, doxycycline

Question 25

CAP tx w comorbidity

Monotherapy

Answer 25

Resp. Fluoroquinolone

Levofloxacin, moxi, gemifloxacin

Question 26

Hospitalization CURB65

Answer 26

Confusion 
Uremia
RR
vBP
65+