Respiratory flashcards
What are the characteristics of intermittent asthma?
SX:
What are the characteristics of mild persistent asthma?
SX: >2x/wk but
What are the characteristics of moderate persistent asthma?
SX daily, exacerbations are long and severely affect activity level, sx > 1x/wk at night
TX: medium dose inhaled steroid and long-acting beta agonist, alt = Singulair or theophylline, + SABA (albuterol) for acute sx, + systemic steroids if needed
What are the characteristics of severe persistent asthma?
SX continuous, uses SABA multiple times/day, frequent exacerbations, limited physical activity
TX: high dose ICS + long-acting beta agonist systemic steroids if needed, SABA for acute sx
Describe dyskinetic cilia syndrome.
- -causes bronchiectasis and chronic sinusitis
- -assoc. w/male infertility
- -if seen with situs inversus, look for Kartagener’s syndrome
What are steroids and when are they used?
- -reverses regulation of B receptors, prevents migration of inflammatory cells, prevents cytokine and histamine production
- -Inhaled: Fluticasone, use for long-term prevention of sx
- -Systemic: Prednisone, use in short bursts or to prevent sx in severe asthmatics
- -Side effects: cough, thrush, growth suppression, etc.
What is a B2 agonist and when is it used?
- -stimulates B2 receptors causing bronchodilation, stabilizes mast cells
- -short-acting: albuterol, epinephrine
- ->used to stop sx of asthma
- -long-acting: Formoterol/salmeterol
- -> used to prevent sx, long-term
- -Side effects: tachycardia, palpitations, tremors, dizziness, HA, nausea, decreased K, increased glucose
What are the mast cell stabilizers and when are they used?
- -inhibits degranulation of mast cells and mediator release from eosinophils, neutrophils, macros, and monos
- -> do not dilate bronchioles
- -Cromolyn/nedocromil
- -can be used before exercise to prevent E/A or as an additional alt TX for asthma
- -Side effects: bad taste, dry mouth, pharyngitis, cough, nausea, HA
What are the leukotriene modifiers and when are they used?
- -block leukotriene synthesis to prevent allergy response, bronchoconstriction, and mucous production
- -Montelukast/zafirlukast/zileuton (Singulair)
- -used to prevent allergic rhinitis/persistent asthma
- -Side effects: HA, nausea, abd pain, infection, dyspepsia, increased ALT
Describe the clinical course and TX of bronchitis
- -inflammation of the lower airways
- -> can be acute or chronic
- -Viral: rhinovirus, RSV, parainfluenza
- -Bacterial: Mycoplasma, pneumo, Chlamydiophilia pneumo, pseudomonas (in kids w/CF)
- -S/S: dry cough, substernal discomfort, SOB, possible productive cough, low or no fever, URI sx, fine/moist rales, rhonchi
- -TX: supportive, antibiotics if bacterial
What are the characteristics and tx of croup?
- -acute upper airway inflammation and obstruction
- -6-36mos, peak incidence at age 2
- -barking cough, URI sx, fever, stridor, sx worse at night, possible dyspnea
- -Symptomatic relief: cold, steam, humidity
- -corticosteroids: dexamethasone, 1-2mg/kg/day
- -bronchodilator
- -hospitalize if severe
- -“Steeple Sign” = radiologic sign
What are the causes and s/s of pneumonia?
- -Viral: RSV, CMV, influenza, rhinovirus– ALL AGES
- -Bacterial: Group B strep, gram negative
- -> Neonates: group B strep, Listeria
- -> 1-3 mos: Strep pneumo, chlamydia, staph
- -> 4mos-5yrs: Strep pneumo, HIB, M. pneumo
- -> >5yrs: Mycoplasma pneumo, Chlamydophila pneumo, S. pneumo
S/S: cough, wheeze, URI sx, chest pain, high fever (bacterial), GI sx, tachypnea, crackles, pleural effusion, dullness, retractions, nasal flaring
–> mycoplasma is usually mild
What are the clinical characteristics of cystic fibrosis?
- -autosomal recessive, dysregulation of chloride channels–dehydrated/viscous secretions in the airways, bile ducts, pancreas, intestines, vas deferens, sweat glands
- -leads to chronic pulmonary disease, nasal polyps, malnutrition, steatorrhea, biliary cirrhosis, male infertility, increased sweat production, pancreatitis, poor growth, diabetes, rectal prolapse
How is CF diagnosed and treated?
- -DX with sweat test (could be from newborn screen), family hx, and mutation detection
- -Refer to CF center, antibiotics to cover pseudomonas (Cipro Floxin + aerosolized Tobramycin), chest PT, pancreatic enzymes, nut support
Describe hyaline membrane disease/respiratory distress syndrome.
- -deficiency of surfactant –> poor lung compliancy
- -tachypnea, grunting, nasal flaring, chest retractions, cyanosis
- -ground glass appearance
- -TX: oxygen, CPAP, surfactant
- -most common resp. illness of the newborn
