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Pulm 7 Peds Pulm

Pediatric Pulmonology

QuestionAnswer
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
Created by: sarah3148