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Pediatrics > Respiratory system and infections > Flashcards

Respiratory system and infections Flashcards

1
Q

stridor

A

upper airway

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2
Q

wheeze

A

lower airway

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3
Q

rhonchi

A

low note, fluid in big airways

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4
Q

crackles/rales

A

fluid or atelectasis in small airways (fine sounds)

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5
Q

foundation of lung studies

A

CXR

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6
Q

what would a barium swallow show us

A

TEF, GER, vascular rings

Good if you wanted to see if a structure was compressing the trachea

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7
Q

what will a lung CT show us

A

parenchymal changes , lung interstitium, Masses

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8
Q

what will laryngoscopy/bronchoscopy show us

A

obstructions and malacia, foreign bodies, intubation

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9
Q

bugs for croup

A

Parainfluenza (RSV, influenza, adenovirus, roseola,mycoplasm pneumoniae)

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10
Q

when/who gets croup

A

Fall and early winter, younger children(6mo-3yr)

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11
Q

Acute inflammatory disease of the larynx - common

Acute Inspiratory Stridor

A

croup

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12
Q

xray with croup

A

with subglottic narrowing and normal epiglottis

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13
Q

testing for croup

A

Viral swab for respiratory viruses

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14
Q

treatment for croup

A

if mild cases – supportive. (+/- mist)

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15
Q

how do you know when a kid with croup can go home?

A

If symptoms resolve within 3 hrs and there is no stridor at rest – can go home. If recurrent nebs (Q 20 min > 1-2 hrs) needed, hospitalize

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16
Q

bacterial croup

A

bacterial tracheitisInvasion of bacteria into mucosa of pt with viral croup

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17
Q

cause of bacterial tracheitis

A

Staph Aureus ( H flu, S. pyogenes, Morax cat)

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18
Q

Inflammatory edema, purulent secretions,
High fever, toxic, severe obstruction
Severe life threatening from of laryngotracheobronchitis

A

bacterial tracheitis

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19
Q

treatment for bacterial tracheitis

A

Hospitalization and monitoring, suctioning, hydration. IV ABX for Staph Aureus. More likely to need intubation.

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20
Q

bugs for epiglottitis

A

Hflu type B ( deceased incidince since HiB immunization) – now GAS , and Staph A

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21
Q

Kid comes in with inspiratory stridor
Resp distress
Drooling
Sudden onset

A

epiglottitis

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22
Q

Kid comes in, you think it is epiglottitis. What do you do first?

A

Emergency – anticipate intubation

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23
Q

Epiglottitis x ray

A

Lateral neck xrays. “Thumb sign” means thickened epiglottis

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24
Q

most common cause of stridor in infants

A

laryngomalacia-Underdeveloped cartilaginous structures

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25
Q

kid comes in w stridor-Worse supine, with activity, with infection, during feedings

A

laryngomalacia

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26
Q

Congenital or trauma/injury

Hoarseness, aspiration and high pitched stridor

A

vocal cord paralysis

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27
Q

Congenital or from intubation
Mild to severe with serious obstruction of airway
Stridor after extubation
Suspect in Pt with recurrent croup

A

subglottic stenosis

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28
Q 
stridor or wheeze
Airway compression (PDA, abberant inominant artery)
A

vascular ring or sling

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29
Q

tracheomalacia and vascular ring: upper or lower airway disorder?

A

Could be EITHER!

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30
Q

acute lower airway obstruction

A

asthma, bronchiolitis , foreign body

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31
Q

progressive lower airway disorders

A

CF or bronchiolitis obliterans

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32
Q

pt with chronic wheeze, pneumonias, asymmetric chest sounds presents with sudden cough, wheeze of respiratory distress

A

Foreign body- lower resp tract

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33
Q

treatment foreign body upper resp tract

A

Heimlich (over 1)Child < 1 turn over onto their chest and 5 measured back blows between the shoulder blades, followed by 5 chest compressions if needed – repeat

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34
Q

treatment foreign body lower resp tract

A

Beta adrenergic nebs and CPT (pounding)

35
Q

organism for bronchiolitis

A

RSV. (Human metapneumovirus, Parainfluenza, influenza, adenovirus )

36
Q

leading cause of hospitalization of infants

A

bronchiolitis

37
Q

a young infant presents with cough, coryza, rhinorrhea… over 3-7 days to noise raspy breathing and audible wheeze , and apnea. What do you think?

A

bronchiolitis

38
Q

time for bronchiolitis

A

late winter months from November through March

39
Q

x ray for bronchiolitis

A

Hyperinflation

Increased interstitial markings

40
Q

monoclonal antibody for RSV

41
Q

most common cause of pneumonia in children

42
Q

bacterial cause of pneumonia

A

strep pneumo

43
Q

bugs for viral pneumonia

A

RSV , parainfluenza , influenza A and B, human metapneumovirus

44
Q

URI prodrome + wheezing and stridor +/-fever

Myalgia, malaise, headache

A

viral pneumonia

45
Q

viral pneumonia CXR

A

perihilar streaking, increased interstitial markings or patchy bronchopneumonia

46
Q

therapy for viral pneumonia

A

supportiveIdentify at risk pt (BPD, asthma, RSV, CHD) for hospitalization (antibiotics commonly started)

47
Q

CXR bacterial pneumonia

A

Patchy infiltrates, atelectasis, hilaradenopathy, pleural effusions. Possibly complete lobar consolidation in infants

48
Q

treatment for bacterial pneumonia

A

Amox, augmentin, Erythromycin Cefuroxime

Occurs anytime of year

49
Q

common time of year for bacterial pneumonia

50
Q

1-5 year old kids with pneumonia common bugs

A

Most common causes are respiratory syncytial virus (RSV) in infants , respiratory viruses (parainfluenza viruses, influenza viruses, adenoviruses)

51
Q

kid older than five, common pneumonia bugs

A

most common is Mycoplasma pneumoniae

52
Q

principle causes of atypical pneumonia

A

M. pneumoniaeand Chlamydophila pneumoniae

53
Q

which age is affected by strep pneumo for pneumonia?

A

occurs in children of any age, outside the neonatal patient

54
Q

bug for pertussis

A

Whooping Cough due to Bordetella pertussis

55
Q

how and when is pertussis spread

A

Highly contagious , July – October (via cough)

Incubation 6 days – most contagious

56
Q

three stages of pertussis

A

Catarrhal : URI 1-2 weeks
Paroxysmal : Staccato cough with inspiratory whoop and post tussive vomiting 2-4 weeks
Convalescent: Dry cough 1-2 weeks

57
Q

gold diagnostic standard pertussis

A

Culture from NP Swab gold standard

58
Q

treatment for pertussis

A

Treatment Erythromycin /azithromycin– treat family

59
Q

“classic pertussis” common in what age

A

1-10 years old

60
Q

adolescent presentation with pertussis

A

Adolescents present with prolonged bronchitis, persistent non-productive cough – often begins as a URI.
Don’t whoop but may have paroxysms
Cough can last weeks to months

61
Q

how can young infants present with pertussis

62
Q

chronic progressive disease that can present with protein and fat malabsorption (failure to thrive, hypoalbuminemia, steatorrhea), liver disease (cholestatic jaundice), or chronic respiratory infection

63
Q

Diagnostic presentation of newborn with CF

A

meconium ileus

Severe intestinal obstruction from inspissation of tenacious meconium in terminal ileum

64
Q

how do you diagnose CF

A

sweat test..It is positive (elevated sweat chloride > 60 mEq/L) in 99% of patients with CF

65
Q

PE: digital clubbing , chronic sinusitis, nasal polyposis and failure to thrive:
Frequent bulky foul smelling greasy stools
Protein and fat malabsorption
Frequent pneumonias / bronchitis

66
Q

treatment of CF

A

manage infections ( may need IV antibiotics or longer courses of antibiotics)
Pancreatic enzyme replacement
ADEK

67
Q

Congenital malformation: non functioning pulmonary tissue that does not communicate with tracheobronchial tree. Blood supply from anomalous blood supply

A

pulmonary sequestration

68
Q 
Congenital malformation:
decreased in alveolar number and airways
Lack of space , achondroplasia or CDH (1:2200)
Low amniotic fluid
Low amount of fetal breathing
A

pulmonary hypoplasia

69
Q

Congenital malformation:
95% congenital cystic lung disease, large airspaces R=L
cystic tissues
CXR . Surgery

70
Q

thanatophoric dwarf at risk for

A

lung hypoplasia

71
Q

elevation of part or all of diaphram
Striated muscle replaced with connective tissues
Congenital , acquiried
If large, paradoxical movement of diaphram
Surgery

A

eventration of the diaphragm

72
Q

Herniation of abdominal contents into chest

73
Q

depression of sternum/ anterior chest wall

A

pectus excavatum

74
Q

protrusion of sternum/ anterior chest wall – more common in males

A

pectus carinatum

75
Q

NM disease can cause breathing problems how?

A

poor air entry, or poor diaphram excursion

76
Q

type I alveolar cells

A

form the structure of an alveolar wall

77
Q

type II alveolar cells

A

secrete surfactant

78
Q

surfactant deficiency in premies

79
Q

treatment for RDS

A

give surfactant via ETT (endotracheal tube)

80
Q

this disease is a sequel of surfactant deficiency. You still need oxygenation at 1 month of age

A

Chronic lung disease, or BPD

81
Q

ALTEs in infancy

A

Apnea / color change / decreased muscle tone / emesis/ choking/ gagging

82
Q

most common frequent associated problems with ALTE

A

GER and laryngomalactia most common (50%)

83
Q

Most deaths in < 6 mo
Most number of deaths ages 2-4 months
Most deaths between midnight and 8am, and in winter

84
Q

3:2 males to females

Risk factors: Low birth weight, smoking, teenage mother, drug addicted mother

Pediatrics (15 decks)

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