Pediatric Pulm
Asthma < 18yo MC in.. - Females > males
bugs causing typical PNA - Streptococcus pneumoniae, Staphylococcus aureus, Group A
Streptococcus, Klebsiella pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
*more acute onset, typica fever + cough + toxic appearance
MCC of atypical PNA in younger age groups - mycoplasma pneumoniae
What ear condition was historically associated with Mycoplasma pneumoniae infection? - Bullous
myringitis
what are these? - visible sebaceous glands that can appear as skin-colored, white, or red and are
present in the mouth, genitals, or face. They are not associated with measles or other infections
what are these? - koplik spots -- multiple red spots with white centers on the soft and hard palates
as well as the buccal mucosa bilaterally; assoc w/ measles
bugs causing atypical PNA - Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella
species
*more indolent onset, not the typical fever + cough + toxic appearing pt
RFs for asthma - Family hx, tobacco smoke, obesity, pollution, atopy, male (if >18yo)
Samter's triad is associated with ... - ASA induced asthma
Samter's triad - Allergic rhinitis w/ nasal polyps
Asthma
Sensitivity to ASA and other NSAIDs
List some triggers for asthma - Pollen, dust mites, animal dander, mold, cold air, exercise, GERD,
ASA/NSAIDs, beta blockers, stress, anxiety, viral resp infections
, 4 classic sx of asthma exacerbation - Wheezing, cough (worse at night), SOB or trouble breathing,
chest tightness
Describe the classic wheeze of asthma - Musical, high pitched, widespread
Worse with expiration & usually absent betw exacerbations
Signs/sx for impending resp failure - Cyanosis
Tachypnea
Inability to maintain resp effort
Depressed mental status
SpO2 < 90%
PEF < 25%
PaCO2 > 40mmHg
What kind of pattern is seen on pulmonary fx tests w/ asthma? - Obstructive — low FEV-1% (<70%)
BUT reversible when given a bronchodilator! Goes up by 12%
FENO: high — part of the pathophysiology of asthma
Management of asthma (chronic) - Everyone gets a rescue inhaler / albuterol neb treatments!
Step-wise fashion
1. First best controller is an ICS used daily
2. Then we add a LABA controller
3. Next, we incr dose of ICS
4. Eventually, once ICS dose is higher, we can add things like singulair
*always giving oral steroids with TRUE asthma exacerbations
*give ABX if pt presents with fever or long-standing URI sx
Management of asthma (exacerbations) - O2 support if SpO2 <90% or showing signs of resp distress
Asthma < 18yo MC in.. - Females > males
bugs causing typical PNA - Streptococcus pneumoniae, Staphylococcus aureus, Group A
Streptococcus, Klebsiella pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
*more acute onset, typica fever + cough + toxic appearance
MCC of atypical PNA in younger age groups - mycoplasma pneumoniae
What ear condition was historically associated with Mycoplasma pneumoniae infection? - Bullous
myringitis
what are these? - visible sebaceous glands that can appear as skin-colored, white, or red and are
present in the mouth, genitals, or face. They are not associated with measles or other infections
what are these? - koplik spots -- multiple red spots with white centers on the soft and hard palates
as well as the buccal mucosa bilaterally; assoc w/ measles
bugs causing atypical PNA - Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella
species
*more indolent onset, not the typical fever + cough + toxic appearing pt
RFs for asthma - Family hx, tobacco smoke, obesity, pollution, atopy, male (if >18yo)
Samter's triad is associated with ... - ASA induced asthma
Samter's triad - Allergic rhinitis w/ nasal polyps
Asthma
Sensitivity to ASA and other NSAIDs
List some triggers for asthma - Pollen, dust mites, animal dander, mold, cold air, exercise, GERD,
ASA/NSAIDs, beta blockers, stress, anxiety, viral resp infections
, 4 classic sx of asthma exacerbation - Wheezing, cough (worse at night), SOB or trouble breathing,
chest tightness
Describe the classic wheeze of asthma - Musical, high pitched, widespread
Worse with expiration & usually absent betw exacerbations
Signs/sx for impending resp failure - Cyanosis
Tachypnea
Inability to maintain resp effort
Depressed mental status
SpO2 < 90%
PEF < 25%
PaCO2 > 40mmHg
What kind of pattern is seen on pulmonary fx tests w/ asthma? - Obstructive — low FEV-1% (<70%)
BUT reversible when given a bronchodilator! Goes up by 12%
FENO: high — part of the pathophysiology of asthma
Management of asthma (chronic) - Everyone gets a rescue inhaler / albuterol neb treatments!
Step-wise fashion
1. First best controller is an ICS used daily
2. Then we add a LABA controller
3. Next, we incr dose of ICS
4. Eventually, once ICS dose is higher, we can add things like singulair
*always giving oral steroids with TRUE asthma exacerbations
*give ABX if pt presents with fever or long-standing URI sx
Management of asthma (exacerbations) - O2 support if SpO2 <90% or showing signs of resp distress
