Respiratory from Book ?s

Question 1

What is typical RSV season?

Answer 1

December through March

Question 2

In what age is RSV typically seen? Presentation?

Answer 2

• -O-12 months of age

- -fever, tachypnea, and wheezing with retractions is classic

Question 3

What is tx of choice for bronchiolitis?

Answer 3

–tx on outpt basis unless severe: fluids and observation

Question 4

Pts with exposure to prison population, HIV-affected person, or are recent immigrants, are at higher risk of what?

Answer 4

TB (and should be tested)

Question 5

Reasons to be tested for CF?

Answer 5

• -sibling with the disease
• -poor growth
• -frequent resp. infections
• -nasal polyps

Question 6

Nasal polyps can be a sign of…

Answer 6

cystic fibrosis

Question 7

What is the most common agent for nonviral pneumonia from school age to young adulthood?

Answer 7

Mycoplasma pneumoniae

Question 8

What organism do you see in children

Answer 8

Staph aureus

–also, Ureaplasma in neonates and young infants

Question 9

Which one of the following dx’s would not be part of the differntial for recurrent lobar pneumonia in a 2yo?

a) Cystic fibrosis
b) Foreign body aspiration
c) Atelectasis
d) Bronchitis

Answer 9

d) Bronchitis

–bronchitiis is a nonspecific dx and is usually a symptom of another resp. condition

Question 10

What is the most common clinical presentation of pneumonia?

Answer 10

–cough, fever, tachypnea, abd pain

Question 11

The classic radiographic sign in croup is:

Answer 11

steeple sign (classic tapering of the subglottic trachea)

Question 12

Why is insufficient caloric intake a concern with a newly discharged ex-preemie with bronchopulmonary dysplasia?

Answer 12

–diuretic use and limitation of fluids are part of the management plan –> may make it difficult to provide adequate caloric intake

Question 13

Why might you not hear wheezing in a 4yo with RR of 14, shallow respirations with no retractions, and hx of asthma?

Answer 13

• -RR of 14 in a 4yo is slow –> indicates that there is muscle fatigue or that the child is in extreme resp. distress
• -when the wheezing child develops muscle fatigue, a wheeze may not be generated, even in the presence of severe obstruction

Question 14

If a child has a positive TB skin test and known exposure to to TB, what should you do?

Answer 14

• -start on Isoniazid therapy (even if no clinical or radiographic evidence of disease)
• -refer to a peds pulmonary specialist
• -report to health dept.

Question 15

Astha is characterized by (pathophys):

Answer 15

Inflammation, that can lead to:

• -airway hyperresponsiveness
• -reversible airway obstruction
• -clinical sx

Question 16

What is the most common trigger for an acute asthma episode in the very young child?

Answer 16

viral respiratory infections

Question 17

The most common typical chest radiographic finding consistent with the dx of asthma is:

Answer 17

hyperinflation
–may be seen on x-ray bc of air trapping
(but normal x-ray does not r/o asthma)

Question 18

The primary tx for bronchopulmonary dysplasia is:

Answer 18

adequate oxygenation

Question 19

The predominant characteristic of a young infant with bronchopulmonary dysplasia is:

Answer 19

hypoxemia on room air