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Pulm 7 Peds Pulm
Pediatric Pulmonology
Question | Answer |
---|---|
What medication combination is used in the tx of TB meningitis? | Isoniazid, rifampin, ethambutol, and pyrazinamide. |
What is the preferred diagnostic test for a pulmonary embolism? | Spiral CT (CT angio) with PE protocol with IV contrast. V/Q scan if contrast is contraindicated. |
What are the indications for surgical parathyroidectomy for a parathyroid adenoma? | Symptomatic hypercalcemia, serum Ca >1mg/dL above ULN, Cr clearance decr by 30%, T score <-2.5 at any site, age <50yo |
12-72h or mild fever and coryza, hoarseness and barking cough, and peak respiratory distress at 24-48h with resolution in 1 week. Dx? | Croup |
When are the sx of croup worse? | At night |
Tx for croup? | Racemic epi if stridorous, steroids (decadron) |
Characteristic X-ray find for croup? | Steeple sign (subglottic narrowing of airway) |
Between stridor and wheezing, which one is an upper airway sound and which is lower airway sound? | Wheeze= lower airway. Stridor= upper airway. |
MCC of croup? | Parainfluenzae virus type 1 |
What are the 3 S's of croup? | Seal-bark cough, subglottic swelling, and stridor |
Viral infection of lower airways caused by RSV | Bronchiolitis |
CXR findings in bronchiolitis? | Hyperinflation of lungs and patchy infiltrates (a discrete infiltrate is more suggestive of pneumonia) |
Tx for bronchiolitis? | Albuterol nebs or racemic epi. |
Name 2 treatments that aren't so great for bronchiolitis? | Steroids- NOT effective. Ribavirin- expensive and controversial (like Kim Kardashian!) |
Dysphagia, muffled voice, thumb sign. Dx? MC etiology? | Epiglottitis. H flu B |
Presentation within 2 days of birth: cyanosis, nasal flaring, expiratory grunting, intercostal retractions, RR >60, crackles, decreased breath sounds | Respiratory Distress Syndrome of the newborn |
Respiratory distress syndrome of the newborn puts a neonate at increased risk of developing what disease? | Incr risk of developing asthma in childhood |
Cyanosis, intercostal retractions, distended chest, and tachypnea seen in a LGA full-term infant with a stressful delivery. Dx? | Meconium aspiration syndrome |
What are the CXR findings in meconium aspiration syndrome? | Atelectasis, areas of hyperinfaltion, or pneumothorax |
Name 2 complications of meconium aspiration. | Pulmonary HTN if not promptly treated. Incr risk of developing asthma in childhood |
What is the cause of cystic fibrosis? | AR d/o caused by defect in chloride pumping channel in exocrine glands leading to clogging of the ducts in lungs, pancreas, and reproductive glands with thick secretions |
MC fatal AR disorder in US? | Cystic fibrosis |
What birth complication is assoc'd with CF? | Meconium ileus at birth |
Tx for CF? | DNase (deoxyribonuclease), chest PT, bronchodilators, NSAIDs, abx, and ADEK and pancreatic enzyme supplementation |
Tx for epiglottitis? | Keep kid calm, intubation, abx x7-10d (ceftriaxone + clinda or vanc) |
At what time period are the fetal lungs considered mature? What ratio indicates this? | 35 weeks. Lecithin:sphingomyelin (L:S) ration of >2= fetal lung matruity |
What ratio predicts a 75% chance of a neonate developing RDS? | Lecithin: sphingomyelin (L:S) ratio <1.5 |
What is the difference in CXR appearance between RDS and transient tachypnea of the newborn (TTN)? | RDS: low lung volumes, ground glass appearance. TTN: increased lung volumes, sunburst pattern. |
What sweat chloride test cut-off indicates CF? | >60mEq/L on 2+ occassions in kids. (>80 in adults) |
What gene is mutated in cystic fibrosis? | CFTR |
What organism is the common culprit in CF infections. What abx are used? | Pseudomonas. Abx= azithromycin and fluoroquinolones |
What are the general strategies for managing the GI component of CF? | Pancreatic enzymes, ADEK supplementation, and nutritional counseling |
Shortly after birht a child has stridor, wheezing, and shortness of breath despite medical therapies. What is likely to be causing this pt's sx? | Vascular rings |