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57 Cards in this Set
- Front
- Back
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90% of alveolar development occurs after birth |
alveoli increase in number until age 8 |
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pulm vascular resistance AFTER birth |
DECREASES |
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obstructive: decreased airflow through narrow airways |
Ex: asthma, bronchiolitis, foreign body |
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restrictive: pulmonary process decreases lung VOLUME (not enough air in alveoli) |
Ex: pulm edema, fibrosis, scoliosis, resp muscle weakness |
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possible pulm INFECTIONS |
1 EPIGLOTTITIS 2 Laryngotracheobronchitis (CROUP) 3 Bacterial TRACHEITIS 4 BRONCHIOLITIS 5 PNA 6 PERUSSIS |
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top 3 organisms causing EPIGLOTTITIS |
Hib>strep pneumo.>staph a |
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most common age EPIGLOTTITIS |
2-7yo |
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dysphagia/droling****** |
epiglottitis |
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sitting fwd in tripod**** with neck extended fwd**** |
epiglottits |
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"thumbprint" on lateral neck XR |
epiglottitis |
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cherry red swollen epiglottis |
epiglottitis |
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epiglottitis |
-tripod, neck extension -drool/dysphagia -cherry epiglottis -"thumbprint" -2-7yo -Hib>strep>staph |
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Tx epiglottitis |
EMERGENCY!!! -humidified O2 (NO TONGUE DEPRESSOR, could cause distress!) -nasotracheal intubation!!!! -IV Cephalosporin |
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what to do if you've been exposed to epiglottitis 2/2 to Hib |
RIFAMPIN prophylaxis!!! |
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#1 cause of stridor |
viral croup: kids 3mo-3yrs |
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causes of viral croup |
usually PARAINFLUENZA |
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"prodrome" of URI for 3 days, then stridor/cough |
VIRAL CROUP!!! |
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stridor worse at night |
croup |
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"steeple sign" on A/P XR neck |
croup (subglottic narrowing) |
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Viral Croup |
-parainfluenza -starts with URI, then* stridor/cough -"steeple sign" -worse at night |
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Tx of croup |
supportive |
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what if kid has stridor even at REST* |
give corticosteroids, dexamethasone |
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kids in respiratory distress from croup may benefit from: |
racemic EPI aerosols***: vasoconstricts subglottic tissues |
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when does RSV bronchiolitis occur? |
Nov-April |
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gradual onset of URI Sx, then wheezing, rales, etc. with "hepatosplenomegaly" from lung hyperinflamtion |
bronchiolitis |
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Dx of Viral PNA |
-interstitial infiltrates on CXR -WBC <20 with Lymph predominance |
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Dx bacterial PNA |
-usually quicker/more severe -WBC >20 with neutrophil predom -lobar consolidation on CXR |
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most common cause of AFEBRILE* pna in 1-3mo |
chlamydia |
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"staccato" cough without fever, Hx conjunctivits* after birth |
chlamydia PNA |
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eosinophilia*, CXR shows interstitial infiltrates |
chalmydia PNA |
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Tx of chlamydia PNA |
erythromycin or azithromycin |
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low grade fever*, chills, nonproductive cough, headache |
mycoplasma PNA (older kids) |
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CXR for mycoplasma pna |
-b/l diffuse infiltrates
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definitive Dx for mycoplasma PNA |
elevated IgM titers for mycoplasma |
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"whopping" couh |
bordetella pertussis |
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3 stages of pertussis |
1. catarrhal (1-2weeks) 2. paroxysmal (2-4 weeks) 3. convalescent (weeks -months) |
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catarrhal stage |
URI: rhinorrhea, congestion, conjunctival redness, low fever |
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fits of forceful cough, cyanosis/apnea/choking with young infants |
paroxysmal stage |
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CBC on pertussis |
high WBC with lymphocytosis |
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Dx of pertussis |
culture or Regan-Lowe/Bordet stain or direct fluorescent antibody tests |
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Tx of young infant with pertussis |
hospitalize because could get apnea from "whoop" |
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Antibiotics in pertussis |
azithro and erithro |
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CXR on asthma |
hyperinflation, peribronchial thickening*, patchy atelectasis* |
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PFT on asthma |
low FEV |
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which glands does CF affect |
EXOCRINE* |
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top pathogens of sinopulmonary Dz in CFs |
staph aureus & pseudomonas |
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trypsinogen level on newborn screen in CF |
INCREASED |
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baby is O2 dependent BEYOND* 28 days |
BPD!!! |
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cause of bronchopulmonary dysplasia |
premie who had hyaline membrane Dz or surfactant deficiency |
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ABG in BPD |
low Pa02 high PaCO2 (hypercarbia) |
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intermittent episodes of tachypnea, wheezing, sputum, FTT |
bpd |
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cough, hoarseness*, inspiratory*stridor |
laryngotracheal FBA!! |
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assymetric findings on auscultaiton*, localized wheezing |
bronchial FBA |
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what type of apnea is OK at any age??? |
short central apnea 15seconds or less!!!!! |
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apnea of prematurity |
cessation of breathing up to 20+seconds in premie |
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risk factors for SIDS |
-prone sleeping -soft bedd, overbundling, overheating -premie -low birth weight -no breastfeeeding -recent illness -maternal smoking/drugs/infxn |
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what is apnea of prematurity caused by? |
immature central respiratory center control |
