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40 Cards in this Set

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What is newborn screening test for CF
IRT- Immunoreactive Trypsinogen test
32 week former premie may have chronic lung disease (also known as bronchopulmonary _________)
32 week former premie may have chronic lung disease (also known as bronchopulmonary dysplasia)
vitamin D actions
lung volume
Dx of Asthma
You do NOT need to hear wheezing to make a diagnosis.
A chronic nighttime cough is a very common symptom and for the mildest asthma suffers, they may not have any audible wheezes during the day, but may have some in the evening
Asthma prevalence in nonhispanic blacks is nealry _x as high as that reported in nonhispanic whites.
AA child is _X as likely as a white child to be hospitalized for treatment of asthma.
AA children are rushed to the ER for asthma attacks at more than _X the rate (22.9 visits per thousand) of whites (4.9 visits per thousand) or those of other races (3.3 per thousand).
Asthma prevalence in nonhispanic blacks is nealry 2x as high as that reported in nonhispanic whites.
AA child is 3X as likely as a white child to be hospitalized for treatment of asthma.
AA children are rushed to the ER for asthma attacks at more than 4X the rate (22.9 visits per thousand) of whites (4.9 visits per thousand) or those of other races (3.3 per thousand).
MC asthma trigger in an 18 month old.
allergic response to viral capsid atigens
Upper airway diseases
Allergic rhinitis and sinusitis
Obstructions involving large airways
Foreign body in trachea or bronchus
Vocal cord dysfunction (VCD)
Vascular rings or laryngeal webs
Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
Enlarged lymph nodes or tumor
Obstructions involving small airways
Viral bronchiolitis or obliterative bronchiolitis
Cystic fibrosis
Bronchopulmonary dysplasia
Heart disease
Other causes of respiratory illness
Recurrent cough not due to asthma
Aspiration from swallowing mechanism dysfunction
Gastroesophageal reflux
How Do You Know Where the Obstruction Is?
(If it is mild to moderate it is not difficult)
If Intrathoracic – obstruction is first expiratory (Prolonged I:E ratio, then wheeze)
If Extrathoracic – obstruction is first inspiratory (Normal I:E, inspiratory stridor)
Arterial blood gasses are VERY helpful in estimating risk of significant morbidity or mortality from asthma.
__ saturation goes down first
Usually ___ C02 due to tachypnea
C02 normal or elevated demonstrates risk of imminent death or need for resuscitation
Arterial blood gasses are VERY helpful in estimating risk of significant morbidity or mortality from asthma.
O2 saturation goes down first
Usually LOW C02 due to tachypnea
C02 normal or elevated demonstrates risk of imminent death or need for resuscitation
Classification of Asthma Severity
Mild Intermittent: Symptoms less than 2 times a week, less than 2 nighttime episodes per month
Mild Persistent: Symptoms more than 2 times a week, 3-4 nighttime episodes per month
Moderate Persistent: Daily Symptoms, difficulty at night more than once a week
Severe Persistent: continual symptoms, frequent night time symptoms
Short-acting Beta Agonists (SABA)
Albuterol
Levalbuterol
Pirbuterol
Long-acting Beta Agonists (LABA)
Salmeterol
Formoterol
What is newborn screening test for CF
IRT- Immunoreactive Trypsinogen test
32 week former premie may have chronic lung disease (also known as bronchopulmonary _________)
32 week former premie may have chronic lung disease (also known as bronchopulmonary dysplasia)
vitamin D actions
lung volume
Dx of Asthma
You do NOT need to hear wheezing to make a diagnosis.
A chronic nighttime cough is a very common symptom and for the mildest asthma suffers, they may not have any audible wheezes during the day, but may have some in the evening
Asthma prevalence in nonhispanic blacks is nealry _x as high as that reported in nonhispanic whites.
AA child is _X as likely as a white child to be hospitalized for treatment of asthma.
AA children are rushed to the ER for asthma attacks at more than _X the rate (22.9 visits per thousand) of whites (4.9 visits per thousand) or those of other races (3.3 per thousand).
Asthma prevalence in nonhispanic blacks is nealry 2x as high as that reported in nonhispanic whites.
AA child is 3X as likely as a white child to be hospitalized for treatment of asthma.
AA children are rushed to the ER for asthma attacks at more than 4X the rate (22.9 visits per thousand) of whites (4.9 visits per thousand) or those of other races (3.3 per thousand).
MC asthma trigger in an 18 month old.
allergic response to viral capsid atigens
Upper airway diseases
Allergic rhinitis and sinusitis
Obstructions involving large airways
Foreign body in trachea or bronchus
Vocal cord dysfunction (VCD)
Vascular rings or laryngeal webs
Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
Enlarged lymph nodes or tumor
Obstructions involving small airways
Viral bronchiolitis or obliterative bronchiolitis
Cystic fibrosis
Bronchopulmonary dysplasia
Heart disease
Other causes of respiratory illness
Recurrent cough not due to asthma
Aspiration from swallowing mechanism dysfunction
Gastroesophageal reflux
How Do You Know Where the Obstruction Is?
(If it is mild to moderate it is not difficult)
If Intrathoracic – obstruction is first expiratory (Prolonged I:E ratio, then wheeze)
If Extrathoracic – obstruction is first inspiratory (Normal I:E, inspiratory stridor)
Arterial blood gasses are VERY helpful in estimating risk of significant morbidity or mortality from asthma.
__ saturation goes down first
Usually ___ C02 due to tachypnea
C02 normal or elevated demonstrates risk of imminent death or need for resuscitation
Arterial blood gasses are VERY helpful in estimating risk of significant morbidity or mortality from asthma.
O2 saturation goes down first
Usually LOW C02 due to tachypnea
C02 normal or elevated demonstrates risk of imminent death or need for resuscitation
Classification of Asthma Severity
Mild Intermittent: Symptoms less than 2 times a week, less than 2 nighttime episodes per month
Mild Persistent: Symptoms more than 2 times a week, 3-4 nighttime episodes per month
Moderate Persistent: Daily Symptoms, difficulty at night more than once a week
Severe Persistent: continual symptoms, frequent night time symptoms
Short-acting Beta Agonists (SABA)
Albuterol
Levalbuterol
Pirbuterol
Long-acting Beta Agonists (LABA)
Salmeterol
Formoterol
Systemic Corticosteroids
Rarely used for chronic asthma, unless refractory
Inhaled Cortico-steroids (ICS)
Beclomethasone
Budesonide
Fluticasone
Leukotriene modifiers
Montelukast (Singulair)
Zafirlukast
Zileuton
Immunomodulators
Omalizumab
Mast cell Stabilizer no longer considered acceptable alternatives
Cromolyn
Nedocromil
Methylxanthines
Theophyllin
Anticholinergics
Ipratropium bromide
Atropine
What DOESN’T Work for Bronchiolitis?
Corticosteroids – myriad studies using many agents IV, IM, PO, inhaled – none effective
Specific beta agonists – albuterol is rarely effective…if it IS, then this might instead be a URI with the first asthma exacerbation!
Inhaled ribavirin – what outcome are you studying and what is the risk/benefit for the patient? And for the staff and equipment?
What DOES Work for Bronchiolitis?
Inhaled epinephrine may temporarily provide some relief of obstruction (mechanism not entirely understood…not just beta agonist, since albuterol is not effective)
Supportive care with oxygen and IV fluids until able to support self
Watch for development of secondary pneumonias, especially for hospitalized kids
Bronchiolitis is usually caused by a viral infection, most commonly __________ ______ ________ . RSV infections are responsible for more than half of all cases of bronchiolitis and are most widespread in the winter and early spring. Other viruses associated with bronchiolitis include rhinovirus, influenza A and B, and human metapneumovirus.
Bronchiolitis is usually caused by a viral infection, most commonly respiratory syncytial virus (RSV). RSV infections are responsible for more than half of all cases of bronchiolitis and are most widespread in the winter and early spring. Other viruses associated with bronchiolitis include rhinovirus, influenza A and B, and human metapneumovirus.