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43 Cards in this Set
- Front
- Back
What is the MCC of Croup?
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Parainfluenza
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What is Croup?
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Laryngotracheobronchitis
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A 12-month old child is brought to your office b/c of a barky cough. The mother states that over the past 3 days the child has developed a runny nose, fever, & a cough. The symptoms are getting worse, & the child seems to have difficulty breathing. He sounds like a seal when he coughs. Diagnosis?
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Croup
-Parainfluenza virus |
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Low grade fever + barking cough + intermittent inspiratory stridor = ?
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Croup
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Steeple sign = ?
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Croup
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What is given for Croup when the patient has stridor at rest?
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Racemic Epinephrine & Corticosteroids (Dexamethasone IM)
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Presentation similar to Laryngotracheobronchitis however there is usually no history of infection in the pt or their family. Although viruses may cause it, it is more often associated w/ triggers such as GER, allergic, or physchological factors
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Spasmodic croup
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This usually begins as a viral laryngotracheobronchitis, which becomes a bacterial complication of a viral disease
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Bacterial tracheitis
-pt usually has thick, purulent airway secretions -S. aureus is primary cause |
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Child has a toxic appearance, high fever, hoarseness, acute onset of symptoms, & dyspnea
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Epiglottitis
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A 2 year old presents to the ER w/ her parents b/c of high fever & difficulty swallowing. The parents state that the child had been in her usual state of health but awoke with fever of 104 F, hoarse cough, & difficulty swallowing. On exam, pt is sitting in a tripoid position. Pt is drooling, has expiratory stridor, nasal flaring, & retractions of the suprasternal notch & supraclavicular & intercostal spaces
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Epiglottitis
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What is the most common pathogen of Epiglottitis?
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HiB
-but has decreased due to vaccines |
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What is the presentation of Epiglottitis?
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SUDDEN onset of high fever, dysphagia, drooling, muffled voice, & respiratory distress
Pt may sit in a tripod position w/ neck hyperextended |
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Lateral roentgenogram of the neck shows the "thumb print" sign
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Epiglottitis
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What should NEVER be done to a patient w/ suspected Epiglottitis?
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use of Tongue blade to examine the pharynx b/c it may cause reflex laryngospasm & cardiorespiratory arrest
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Whta are the 3 components of an Asthma attack?
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1. bronchospasm
2. mucus production 3. Airway edema |
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Why might the liver & spleen be palpable in Asthmatic patients?
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secondary to hyperinflation
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Is clubbing seen in asthma?
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NO, b/c asthma is reversible
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A 6-month-old infant presents to the physician w/ 3 day hx of URI, wheezy cough, & dyspnea. On physical exam, the pt has a temperature of 39 C, respirations of 60 bpm, alae nasi flare, & accessory muscle usage. The pt appears to be air hungry & the oxygen saturation is 92%
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Bronchiolitis
-RSV MCC -hx of URI, rhinorrhea, & sneezing -pt develops fever of 38.5-39 C & gradually develops respiratory distress evidenced by tachypnea, wheezing, & cough. -pt may have difficulty feeding b/c of the rate of breathing. |
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How does a patient with Bronchiolitis present?
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Rapid breathing, usually 60-80 breaths/min
wheezing, rales, & intercostal & subcostal retractions In severe cases the patient may be restless & irritable from air hunger. Cyanosis may be present |
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What does Chest Roentgenogram show in Bronchiolitis?
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Hyperinflation of the lungs
-air trapping & peribronchial thickening may be present |
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What drugs are not indicated & may be harmful in Bronchiolitis?
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Corticosteroids
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What is the MCC of Bronchiolitis?
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RSV
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Meconium ileus may indicate what disease?
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Cystic Fibrosis
-failure to pass meconium in the first 24-48 hours of life |
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What metabolic disturbance may develop when patients with Cystic Fibrosis become dehydrated from warm weather or gastroenteritis?
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Hypochloremic Alkalosis
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What is the gold standard for the diagnosis of Obstructive Sleep Apnea?
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Polysomnography = a sleep study test
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What is the treatment for Apnea?
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Adenotonsillectomy
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What are some complications of Obstructive Sleep Apnea?
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Poor growth
Cor Pulmonale Poor school performance Death |
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This occurs in premature infants less than 36 wks of GA. In these patients apnea & bradycardia are seen. Diagnosis & Treatment?
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Apnea of Prematurity
Theophylline or caffeine or Intubation |
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Define "Cyanotic breath-holding". What is the treatment?
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Breath-holding spells caused by prolonged expiratory apnea & cerebral anoxia.
Pts exhibiting this entity are usually younger than 3 years of age & hold their breath b/c of anger. Fainting may be associated Rx is reassurance |
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This usually occurs after a painful stimulus. During this episode, the pt will turn pale (white) & have asystole & a seizure.
What is the treatment? |
Pallid breath-holding
Atropine |
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What are the risk factors for SIDS?
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Most occur b/w midnight & 9 am
More cases occur in winter Prematurity Lack of prenatal care Maternal smoking during pregnancy Lower SES Prone & Side sleep positions |
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What is the most common type of pneumonia in childhood?
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Viral
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What is the clinical triad for pneumonia?
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Fever
Tachypnea Cough |
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Infant has a "staccato" cough history of eye discharge during the first 2 weeks of life
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Chlamydia pneumonia
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CXR shows interstitial pattern found mostly in the lower lobes. Patient appears mildly ill with a non-productive cough. CXR appears worse than symptoms
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Mycoplasma pneumonia
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CXR shows ground glass appearance & staccato cough
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Chlamydia pneumonia
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Pneumonia w/ normal WBC counts with predominance of lymphocytes
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Viral pneumonia
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Pneumonia w/ increased WBC & neutrophilia
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Bacterial pneumonia
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Pneumonia w/ normal WBC & eosinophilia
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Chlamydial pneumonia
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What is the treatment for Chlamydial pneunomia?
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Erythromycin ethyl succinate drops by mouth for 14 days
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What is the treatment for GBS, E. coli, & Listeria pneumonia?
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Ampicillin + Aminoglycoside
or Ampicillin + third-generation cephalosporin |
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-
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-
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What is a complication of pneumonia?
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Empyema = pus in the pleural cavity
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