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pds test 2
wwallace pds 2
| Question | Answer |
|---|---|
| CF is | a hereditary autosomal disease that controls movement of Cl ions through the cell membrane |
| Affects of CF on mucous glands is | abnormal production of thick secretions |
| CF affects which exocrine glands | sweat glands, pancreas, lungs |
| Exocrine pancreatic insufficiency causes what in CF patients | sever decrease in digestive enzymes causing decreased digestive enzymes, malnutrition and diarrhea and sometimes diabetics |
| The standard test for CF is | the sweat test, checks for increased sodium and chloride in perspiration |
| A positive sweat test is what | greater than 60 mEg/L Cl |
| Does CF affect sterility? | yes in males |
| What is an autosomal disease | hereditary with both parents carriers, 50% chance of offspring being a carrier, 25% chance offspring having disease, 25% no disease no carrier |
| CF survival age is | 29 years |
| Increased mortality in year 1 because of | recurrent infections |
| CF children present with | respiratory distress, hypoxemic and cyanotic, appear malnourished often admitted with failure to thrive |
| CF infections usually are what type | staph and pseudomonas |
| Newborns with in 2 days present with what, are highly suggestive of CF | meconium illeus (blocked poop) |
| The most common signs of CF are | digital clubbing, chronic sinusitis, crackles in upper lobes |
| CF CXR will show | hyperinflation due to always trying to take deep breaths |
| Why do CF patients have cor pulmonale | chronic hypoxemia |
| The best way to treat and prevent respiratory tract infections in CF is | bronchial hygiene |
| CPT in CF | postural drainage, percussion, PEP and flutter |
| Percussion in CF | 2-3 mins in 10 diff postural drainage positions for adequate clearance 45 minutes total 3-4 times per day |
| Bronchial hygiene in CF includes | CPT, hydration of secretions, pt and family education, antibiotics, bronchodilators, pulmonzyme (dnase mucolytic), O2 therapy PRN, lung transplant |
| RX for pancreatic insufficiency includes | pancreatic enzymes, vitamin supplements, both prior to meals or heavy snacks |
| Supraglottic | involves not just epiglottis, but also aryepiglotic fold and arytenoids cartilages (folds around the hole) |
| Epiglottitis | acute inflammation and selling of the supraglottic structures and partial or complete upper airway obstruction…a true airway emergency for 2-6 yr olds |
| Why is epiglottitis not as common as it once was | development of the H-flu vaccine |
| How can we differentiate Epiglottitis from croup | drooling, pt with Epiglottitis cannot swallow so they are big droolers |
| Symptoms of Epiglottitis | high fever, sore throat, toxic appearance, apprehensive/irritated, drooling, muffled voice but not hoarse, inpir stridor, tachycardic, no cough, sterna retractions |
| Dx of Epiglottitis | lateral neck xray with oblong swollen epiglottis with thumb print, ballooning of the hypopharynx |
| Tx of Epiglottitis | first priority in all cases is establishing artificial airway, ETT 1 size smaller, o2 for hypozemia, monitor SaO2, freq spO2 & vitals, cyanotic O2 with blow by, sedation PRN, cultures, ICU 24-48 hrs, antibiotics, IV fluid, humidity, CPT if secretions |
| What is the most common cause of upper airway obstructions in children | croup |
| What is the most common cause of croup | acute laryngotracheobronchitis LTB |
| What population gets croup | 6 months to 3 years |
| What causes LTB | parainfluenza type I is most common at 75%, RSV, flue and mycoplasma pneumonia at 25% |
| Is the onset of Epiglottitis fast or slow | very fast 4-5 hours |
| Is the onset of croup fast or slow | slow 2-3 days |
| Symptoms of croup are | swelling of subglottic area leading to partial obstruction, inspiratory stridor, hoarse, barking cough, low grad or no fever, suprasternal reatractions tachypnea, prefers to lie down |
| 1mm of edema in subglottic area can lead to how much decrease in airflow | 60% |
| Moderate stages of croup symptoms will be | anxious, increased WOB, audible stridor, decreased breath sounds, dyspneic, decreased PaO2 |
| Severe stages of croup symptoms will be | increased anxiety, lethargic, dusky or cyanotic, pronounced stridor, barely audible, breath sounds way decreased, gasping totally exhausted leading to respiratory failure |
| DX of croup | neck xray with hourglass or steeple sign, ballooning hypopharynx, lateral neck will have normal epiglottis |
| Tx of Croup | cool mist, O2, racemic epi, hydration, primary caregiver present, steroids, avoid intubation if possible |
| Spasmodic croup | accours with prodrome, child just wakes with barking cough, hoarseness and insp stridor |
| Prodrome is | with out precursor symptoms |
| RX for spasmodic croup | cool mist or cool nite air, usually gone after a nite or two |
| Bacterial tracheitis aka | pseudomembranous croup |
| Bacterial tracheitis is | a rare bacterial croup that looks like LTB, but have staph. 25% have sudden repiatory arrest |
| RX bachterial tracheitis | IV antibiotics, humidity for crusty secretions, bronchoscopy to remove obstructive exudates, artificial airway for airway mgmt and pulm toilet, intub, long resolution, trach is often |
| ICU with bacterial tracheitis when | stridor at test, suprasternal chest wall retractions, SaO3 less 95% on 50% fio2, vapo, heliox, Decadron, intubate |
| Bronchiolitis is | highly contagious acute infection of the lower respiratory tract that causes inflammation, swelling and constriction of the bronchioles and small bronchi |
| What causes Bronchiolitis | RSV |
| What precautions need to be taken with bronchiolitus | gown, mask, gloves shower and change prior to picking up own kids |
| Bronchiolitis usually affects what age | 6 months to 2 years |
| What kids are most susceptible to bronchiolitus | cf bpd and asthma |
| Bronchiolitis usually starts with what | URI or common cold, runny nose, cough and fever |
| Signs of Bronchiolitis are | small airway obst and congestion, intercostals retraction, wheezes, fine crackles, tachypnea, tachycardia and poor feeding |
| Most severe symptoms of bronchiolitis lasts for how long | 2 to 3 days |
| CXR in bronchiolitis looks like | hyperinflation, peribronchiolar thickening, patchy consolidation |
| How is bronchiolitis diagnosed | presents with rsv culture from nasopharynx positive with lower respiratory tract infection |
| Prevent rsv and bronchiolitis with | immunoglobulin Synagis given monthy during winter |
| Hypoxemia in kids is | SPO2 less than 92% and PaO2 less than 70 mmhg |
| Drugs for bronchiolitis are | albuterol and racemic epi, hydration and antibiotics and cpt |
| Complications of bronchiolitis are | apnea, residual decrease in pulm func, may dev asthma later |
| ARDS is | adult resp distress syndrome, caused by lung injury, from sepsis, trauma, aspiration |
| Signs of are ARDS are | sever dyspnea, hypoxemia, refractory to o2, rales or crackles, sterna retractions from decreased CL CXR |
| Treatment of ARDS includes | intubation and ventilation with PEEP for decreased PaO2 and Increased PaCO2, diuretics, vasoactive agents for BP, inotropic cardiac, in haled b drugs and antibiotics |
| Near drowning is less than how long | 24 hours |
| What age do most drowning happen | 1 to 4 years and teen boys |
| Result of near drowning is what | hypoxia and acidosis |
| What is dry drowning | laryngospasm reflex |
| What is diving reflex | face hits cold water and cns stimulated trigeminal nerv causes body to slow down, bradycardia, transient increase in arterial BP, peripheral vasoconstricion |
| CPR in children compress to breaths is | 30 compressions 2 breaths or 15 to 2 with a partner |
| Infant cpr compressions per min is | 80 |
| What first cpr or 911 | in kids cpr for 5 cyes then 911 in adults 911 then cpr |
| Treatment for hyperhydration in near drowning is | continuous PEEP, 02 diuretics |
| Treatment for hyperventilation is | intubate, vent and sedation |
| Treatment for Hyperpyrexia in near drowning is | induce hypothermia with cooling blanket |
| Treatment Hyrexcitability in near drowning is | barbiturate sededation |
| Treatment of hyperrigidity in near drowning is | posturing |
| Close monitoring in near drowning includes | ABG, CBC, electrolytes, CXR, hemodynamic status and ICP needs to be low 20’s |
| Febrile seizures are | 6 months to 3 yrs, at 101.8, happen at temp rise |
| Pneumonia | inflammation of gas exchange units, common in children, viral more common than bacterial, common with uri and rsv |
| Pneumonia presents with | fever, malaise, rapid shallow breath, cough chest pain, chills |
| Pneumonia rx is | abx, bedrest, oral fluid, antipyretics for fever |
| Muscular dystrophies are | largest group of muscle diseases affecting children, progressive weakness wasting of muscles, degeneration of muscle fibers |
| What is most common Muscular dystrophy | duchenne’s, age 3, waddling gate, wheelchair by 12, scoliosis causes resp probs, death by 20 |
| What is milder form of muscular dystrophy | becker’s, milder and presents older in life |
| AIDS risk factors for prenatal are | parents esp mom are IV drug user, maternal promiscuity or prostitution, parental homosexuality |
| Other causes of pediatric aids | exposure to infected blood products, infected breast milk, and small percentage of unkown |
| Kids who do not meet requirements of aids are said to have | ARC aids related complex |
| Incubation of aid is | 6 weeks to 10 years |
| Kids with aids present with | failure to thrive, developmental delays, lymphadenopathy, chronic diarrhea, progressive neurologic dysfxn, hepatosplenomegaly, thrush, sepsis, hep b |
| Opportunistic infections in aids are | pcp, Kaposi sarcoma, tb, cmv retinitis, MAC |
| Aids is diagnosed by | ELISA, western blot, PRC, P24, HIV culture, ILISPOT, IVAP, IgA, IgM |
| What AIDs test does not check for antibodies | PCR |
| What pulmonary symptoms do aids pt get | severe dyspnea, fever, cough, toxic appearance, chest pain, variable sputum, thrush, lymphadenopathy |
| Aids meds are | antiretrovirals, Abx, antifungals, antiparasitic, Zidovudine or ZDV when tcells below 500, ddl and ddC, IV TMP SMX, dapsone and aerosolized pentamidine and steroids for PCP |
| Precautions with aids is | hand washing , eye shields, clothing covers, gloves, masks |
| SIDS happens at what age | 40 percent at 1 to 12 months |
| Risk factors of sids are | apnea, prematurity, sib with sids, low birth weight, maternal drug use, maternal smoking, more males, low apgar, history of alte’s prone position |
| What is ATLE | apparent life threatening event, episode frightening enough to cause apnea, cyanosis or pallor, change in muscle tone (limp) |
| What do most ATLE result from | GI reflux, upper airway obstruction, congenital anomalies of airway or heart, infection |
| SIDS monitors for what | apnea of 10-15 seconds, low or high HR |
Created by:
williamwallace
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