Term
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Definition
| cough, respiratory disress, prolonged expiratory phase, wheezing (but doesn’t have to have wheezing!), may just only have chronic recurrent cough |
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Term
|
Definition
NIH guidelines. Symptoms of recurrent episodes of airflow obstruction or airway hyperresponsiveness; airflow obstruction is at least partially reversible; alternative dx are excluded
Reversibility: increase in FEV1 >200 mL and >=12% from baseline after SABA |
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Term
| Asthma Mild Intermittent Symptoms |
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Definition
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Term
| Asthma Mild Intermittent Night Awakening: |
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Definition
| 0-4 none; other ages <=2 days/month |
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Term
| Asthma Mild Intermittent SABA use: |
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Definition
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Term
| Asthma Mild Intermittent FEV1 |
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Definition
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Term
| Asthma Mild Intermittent FEV1/FVC |
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Definition
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Term
| Asthma Mild Intermittent Lung Fxn: |
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Definition
| normal between exacerbations |
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Term
| Asthma Mild Intermittent Interference with normal activity: |
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Definition
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Term
| Asthma Mild Intermittent Treatment |
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Definition
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Term
| Asthma Mild Persistant Symptoms |
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Definition
| >2 days/week but not on the same day |
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Term
| Asthma Mild Persistant Nighttime Awakening |
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Definition
age 0-4: 1-2/month
age >4: 3-4/month |
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Term
| Asthma Mild Persistant SABA use |
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Definition
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Term
| Asthma Mild Persistant FEV1 |
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Definition
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Term
| Asthma Mild Persistant FEV1/FVC |
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Definition
age 5-11 >85%
age 12+ normal |
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Term
| Asthma Mild Persistent Interference with normal activity: |
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Definition
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Term
| Asthma Mild Persistent Treatment |
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Definition
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Term
| Asthma: Treating acute exacerbation out pt |
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Definition
1. SABA
2. then SABA with or without AC
3. then SABA with systemic corticosteroids |
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Term
| Asthma When to use montelukast |
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Definition
| mild persistent ages 0-4 also step 2, 4, 5,6 |
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Term
|
Definition
| step 2 (mild persistent) all ages |
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Term
| Asthma When to use systemic corticosteroids |
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Definition
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|
Term
What phase of airway narrowing is this:
peri-bronchial musculature contracts in response to an irritant or allergen; easiest to reverse |
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Definition
| 1st Phase of Airway Narrowing |
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Term
| What phase of airway narrowing is this: presence of histamine in the airways influences arachidontic acid metabolism and increases the production of leukotrienes and prostaglandins, both powerful mediators of the inflammatory process. Inflammation produces edema of the airways, further narrowing them. |
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Definition
| 2nd Phase of Airway Narrowing: |
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Term
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Definition
| True Asthma symptoms are reversible! Asthma is REVERSIBLE!!! |
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Term
| clear RN, nasal mucosa white-gray or pale pink, sometimes edematous nasl mucosa: externally trans-nasal crease, sometimes allergic shiners and or Dennies lines, sometimes: itchy watery eyes, injection of conjunctivae, atopic dermatitis, wheezing, bacterial and viral URIs |
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Definition
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Term
|
Definition
environmental controls
Meds:
Antihistamines
nasal steroid sprays
LM
Nasal cromolyn |
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Term
| Non-Sedating Antihistamines |
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Definition
1 Loratadine
2 Descloratidine
3 Fexofenadine |
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Term
|
Definition
purulent rhinitis that is getting worse at 7-10 day mark
OR
onset of symptoms that is sudden and acute with fever |
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Term
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Definition
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Term
| Sinusitis Symptomatic Treatment: |
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Definition
Treat symptoms first: saline AND topical corticosteroid spray and then maybe add topical decongestant. If this helps after 2-3 days, then the pt doesn’t need ABX
When to use ABX? (usually treat symptoms firs |
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Term
|
Definition
Topical corticosteroid spray
topical decongestant
THEN
ABX: Augmentin! If pcn allergy: cef, smxtmp, clairithro |
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Term
| Mechanisms of resistance in Pneumonia |
|
Definition
s pneumoniae: (PCN)
-H. influenza: (b. lactam)
-M. Cat: (b. lactam) |
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|
Term
pneumon:
acute lobar or segmental pneumo
fever 102, leukocytosis,
TACHYPNEA
coarse rhonchi
dullness to percussion
great response to betalactam abx
ill appearing
cough,
abd pain
PCV immuniz cont to decrease incidence, inspiratory crackles.
Other causes: GABHS, staph, h flu |
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Definition
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|
Term
sub-acute gradual onset
little or no fever
not ill appearing
cough for days-weeks
normal RR
no leukocytosis
cxr not helpful
crackles localized or diffuse
prominent extra pulm HA/sore throat/URI,
no clinical response to b lactam abx, slow improvement. Other causes: c. pneumo, influenza, adenovirus, rsv, hMPV |
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Definition
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Term
| inflammation of small peripheral bronchioles caused by RSV, hMPV, rhinovirus, mycoplasma, adenovirus, parinfluenza |
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Definition
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|
Term
acute onset, rhinorrhea, cough, wheezing, dyspnea, can only send home if mildly ill/good sats. Don’t want to send home with increased RR because can cause resp failure. Typical f/u within 1 day.
Symptoms: tachypnea, prolonged exp pphase, wheezing, young infants with s/s resp distress retractions nasal flaring, rhinorrhea, cough, rarely cyanotic, rarely need CXR but will see hyperinflation, usually no decreased BS, usually mildly ill, low grade fever |
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Definition
| Symptoms of Bronchiolitis |
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Term
|
Definition
|
|
Term
|
Definition
nasal saline
clean air humidified
chest PT
inhaled bronchodilator
consider PO steroid x 3-5 days. |
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Term
| Bronchiolitis Tx Mod-Severe |
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Definition
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Term
|
Definition
| : can range from no pain to acute ear pain, pull at ear, shake head, cry at night, pain/full, usu follows URI or pharyngitis/tonsillitius |
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Term
| Acute OM Tx B-lactam resistant |
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Definition
| B-lactam (h flu and m cat): Augmentin (amoxil plus clav acid), cefzil, ceftin, omnicef, pediazole, biaxin, rocephin, zithromax |
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Term
| Acute OM Tx PCN resistant |
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Definition
| pen-resistant strep pneumo: vanco, could try high dose amox, ceftin, rocephin |
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Term
| Acute OM Tx non resistant |
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Definition
| NOT against B lactam: amox, amp, tmp/smx, 1st gen cephs, some 3rd gen cephs |
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Term
| When do you treat Acute OM |
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Definition
-children <2 esp with fever or severe pain
-children >2 with significant fever AND severe pain
-any child with concurrent bacterial process |
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Term
|
Definition
Diagnosis: need to have an otoscope with pneumatic insufflator
1. TM immobile with pneumatic otoscopy
2. Frank pus visualized in the MES
3. TM visibly bulging
4. Obvious bullous lesion on the TM |
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Term
|
Definition
H. Influenzae
Strep. Pneumon
M. Cat
GABHS, Staph aureus. Sterp pneumo is increasing resistant to PCN (so are H. Influ and M. Cat) |
|
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Term
|
Definition
(GABHS) Strep
Pyogenes (Strep A)
others: H. flu., Staph aureus |
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