ABP Pediatric Pulmonology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Surfactant-producing cells

Type II alveolar epithelial cells synthesize and secrete surfactant, which lowers alveolar surface tension and prevents end-expiratory collapse; surfactant production increases substantially during the third trimester.

Infant chest wall compliance

The infant chest wall is highly compliant, so functional residual capacity is maintained mainly by laryngeal braking and early inspiratory muscle activity rather than by rigid chest wall recoil.

Alveolar multiplication

Alveolarization begins in fetal life and continues after birth, with most alveolar septation occurring in early childhood; the adult complement is roughly 300 million alveoli.

Hypoxic pulmonary vasoconstriction

Alveolar hypoxia constricts small pulmonary arteries, diverting blood from poorly ventilated lung regions toward better-ventilated areas; in the newborn it can contribute to persistent pulmonary hypertension.

Asthma reversibility criterion

An increase in FEV1 of at least 12 percent after a short-acting beta-agonist supports reversible airflow obstruction, but the result must be interpreted with symptoms and baseline spirometry.

First-line persistent asthma

Inhaled corticosteroids are the preferred long-term controller for persistent asthma in children because they reduce symptoms, exacerbations, and airway inflammation with relatively low systemic exposure.

Croup treatment

Dexamethasone is given for croup, and nebulized epinephrine is added for moderate or severe stridor because it rapidly reduces subglottic edema; observation after epinephrine is required.

Vocal cord dysfunction

Paradoxical vocal fold adduction causes inspiratory stridor and a truncated or flattened inspiratory flow-volume loop, often without bronchodilator-responsive obstruction on spirometry.

RSV bronchiolitis management

Bronchiolitis is usually managed supportively with hydration, suctioning, and oxygen for hypoxemia; routine bronchodilators, corticosteroids, and antibiotics are not recommended because they do not improve outcomes.

Typical bacterial pneumonia

Streptococcus pneumoniae is the most common cause of community-acquired bacterial pneumonia in children; presentation includes fever, tachypnea, focal crackles, and sometimes lobar consolidation.

Pertussis antibiotic

Azithromycin is preferred for pertussis treatment and postexposure prophylaxis; it shortens infectiousness but may not alter the paroxysmal cough once established.

Empyema drainage criteria

Pleural fluid with pH below 7.20, glucose below 40 mg/dL, loculation, or a large collection suggests complicated parapneumonic effusion or empyema and usually requires drainage.

CF sweat chloride

A sweat chloride of 60 mmol/L or greater on two occasions is diagnostic of cystic fibrosis; values from 30 to 59 mmol/L are intermediate and require CFTR genetic or functional testing.

Pancreatic insufficiency marker

Fecal elastase below 200 micrograms per gram indicates pancreatic insufficiency, a common complication of cystic fibrosis that leads to malabsorption and requires pancreatic enzyme replacement.

CF exacerbation treatment

A pulmonary exacerbation in cystic fibrosis is treated with intensified airway clearance and antibiotics chosen from recent respiratory cultures, often intravenous for severe or refractory symptoms.

Bronchiectasis imaging sign

Bronchiectasis appears as dilated airways that fail to taper toward the periphery and may be larger than the adjacent pulmonary artery, often with bronchial wall thickening.

RDS chest radiograph

Respiratory distress syndrome shows low lung volumes, diffuse ground-glass opacity, and air bronchograms in a premature infant with surfactant deficiency; exogenous surfactant is the key treatment.

TTN cause

Transient tachypnea of the newborn results from delayed clearance of fetal lung fluid, typically in term or near-term infants, and produces tachypnea with perihilar streaking on chest radiograph.

CDH immediate concern

Congenital diaphragmatic hernia causes pulmonary hypoplasia and persistent pulmonary hypertension; immediate intubation and gastric decompression are needed, and bag-mask ventilation should be avoided because it distends intrathoracic bowel.

BPD definition

Bronchopulmonary dysplasia is chronic lung disease of prematurity defined by ongoing oxygen or respiratory support at 36 weeks postmenstrual age, reflecting disrupted alveolar and vascular development.

Pediatric OSA cause

Adenotonsillar hypertrophy is the most common cause of obstructive sleep apnea in children, producing snoring, restless sleep, and daytime behavioral or learning problems.

OSA diagnostic test

Overnight polysomnography is the gold standard for diagnosing pediatric obstructive sleep apnea and quantifying its severity through the obstructive apnea-hypopnea index.

Apnea of prematurity

Apnea of prematurity is a pause in breathing lasting 20 seconds or longer, or shorter if accompanied by bradycardia or cyanosis, and caffeine citrate is standard therapy.

Down syndrome sleep risk

Children with Down syndrome have a high prevalence of obstructive sleep apnea because of midface hypoplasia, hypotonia, and large tonsils, so polysomnography screening is recommended.

Obstructive spirometry pattern

Obstruction on spirometry is identified by a reduced FEV1/FVC ratio, typically below the lower limit of normal, with a reduced FEV1 and sometimes air trapping.

Restrictive spirometry pattern

Restriction is suggested by reduced forced vital capacity with a normal or elevated FEV1/FVC ratio, but total lung capacity measurement is needed to confirm restriction.

Exhaled nitric oxide

Fractional exhaled nitric oxide is elevated in eosinophilic airway inflammation and can support asthma diagnosis, but it is not specific and should be interpreted with clinical findings.

Sweat test technique

The sweat test uses pilocarpine iontophoresis to stimulate sweating, then quantitatively measures chloride; adequate sweat volume and proper technique are essential to avoid false results.

Type 1 respiratory failure

Type 1 respiratory failure is hypoxemia with a PaO2 below 60 mm Hg and normal or low PaCO2, commonly caused by pneumonia, pulmonary edema, or asthma.

Pediatric ETT size

For children older than one year, uncuffed endotracheal tube internal diameter in millimeters is estimated as age in years divided by four plus four.

ARDS tidal volume

Lung-protective ventilation for pediatric acute respiratory distress syndrome uses tidal volumes near 6 mL/kg predicted body weight and sufficient positive end-expiratory pressure to recruit collapsed alveoli.

Status asthmaticus magnesium

Intravenous magnesium sulfate, about 25 to 50 mg/kg up to a maximum, is an adjunct for severe asthma exacerbations not responding to inhaled bronchodilators and systemic corticosteroids.