ENPC Respiratory Exam with Questions and Answers
What is Pertussis? ANSWER also known as whooping cough, is a highly contagious lower respiratory disease. It is caused by the bacterium Bordetella pertussis.
Incubation period of pertussis including 3 stages? ANSWER 7-10 days characterized by 3...
ENPC Respiratory Exam with Questions
and Answers
What is Pertussis? ANSWER also known as whooping cough, is a highly contagious
lower respiratory disease. It is caused by the bacterium Bordetella pertussis.
Incubation period of pertussis including 3 stages? ANSWER 7-10 days characterized
by 3 stages:
catarrhal stage - insidious onset of nasal secretions, low grade fever, mild cough.
cough becomes more severe over 1-2 weeks.
paroxysmal stage - numerous rapid coughs secondary to thick mucus in
trachobronchial tree, long inspiratory effort with high pitched whoop, cyanosis,
vomiting and fatigue after each episode
this lasts for 1-6 weeks.
convalescent stage - gradual recovery over 2-3 weeks.
How is the epiglottis different on pediatrics vs adults? ANSWER the epiglottis is
more U shaped, higher, and more anterior in the airway making it more prone to
infection and trauma
How is the larynx different on a pediatric pt vs an adult ANSWER larynx is more
positioned more anteriorly and cephalad (toward the head)
Difference in tidal volume of a pedi vs an adult? ANSWER pediatric tidal volume is
approx 10ml/kg
adult tidal volume is approx 50ml/kg
result is low residual capacity for pediatrics
Metabolic rate of pediatrics vs adults? ANSWER metabolic rate is twice as high in
the pediatric patient. This results in twice the O2 consumption. Hypoxia occurs more
rapidly when the child is in respiratory distress.
What is croup? ANSWER Insidious inflammation that results in partial upper airway
obstruction as the result of tracheal narrowing
Viral illness caused by parainfluenza A or RSV
Occurs most commonly in children 6-36 months, more in boys than girls
Presentation of croup? ANSWER presents with gradual onset of cold symptoms, a
barking cough that is worse at night, a hoarse voice, and low grade fever.
Tachypnea, tachycardia, retractions, and inspiratory stridor are common. X-rays may
reveal tracheal narrowing referred to as a steeple sign
Treatment of croup? ANSWER racemic epi 0.25ml
steroids
encourage fluids
, What is epiglottitis? ANSWER abrupt inflammation of the epiglottis that results in a
subglottic obstruction and acute upper airway emergency.
Bacterial illness with a decreased incidence as the result of availability of H.
influenzae type B vaccine; may also be caused by strep pneumoniae and staph.
Occurs mostly in children without vaccination.
Presentation of epiglottits? ANSWER fever, sore throat, difficulty swallowing, muffled
voice. Drooling may be present and tripod position may be used to maintain patency.
x-ray may indicate epiglottic and aryepiglottic swelling, referred to as the thumb sign
and the posterior triangle.
Treatment of epiglottitis? ANSWER no invasive procedure until airway stabilized
including rectal temp, throat exam, or bloodwork. After airway is secured collect
blood, administer antibiotics
What causes bronchiolitis? ANSWER bronchiolitis is an acute viral infection involving
the lower respiratory tract and is most commonly caused by the respiratory sychytial
virus (RSV). Infant symptoms generally worsen over the first 3-5 days and then
gradually improve.
Signs/symptoms of bronchiolitis? ANSWER rhinorrhea
pharyngitis
coughing/sneezing
tachypnea
retractions
wheezing and a long expiratory phase
decreased air entry or exchange
volume depletion 2nd to decreased oral intake
apnea spells
low grade fever common in early infection
Infectious process of bronchiolitis? ANSWER destruction of the lining of the
bronchioles, resulting in bronchoconstriction and mucus plugging. Edema and
secretions of the lower respiratory tract cause lower airway obstruction gradually.
Extensive plugging can lead to atelectasis and pneumonia. Occurs mostly in
winter/early spring to pediatric patients younger than 1 year.
Cyanosis becomes visible when ____ grams of blood per 100ml is not bound to
oxygen? ANSWER 5 grams. This will give an O2 reading of approx 70%
Anatomical and physiological features of the pediatric airway? ANSWER large
tongue relative to size of oropharynx
obligate nose breathers
smaller airway diameter
cricoid cartilage narrowest area
larynx more anterior and cephalad
cartilaginous larynx
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