Take My Breath Away
Common Respiratory Conditions
Common Respiratory Conditions
This viral infection is the most common cause of bronchiolitis in infants.
What is RSV?
The most common congenital heart defect overall has a murmur described as _____.
What is a holosystolic murmur (VSD)?
These maintenance IV fluids are recommended for most PICU patients today with what potential additives (2).
Isotonic fluids (NaCl, LR, plasmalyte) with dextrose and potassium as needed
This gram-positive organism is the most common cause of bacterial meningitis in infants over 1 month of age.
Streptococcus pneumoniae
The initial fluid bolus for pediatric septic shock is this amount, given rapidly.
20 mL/kg isotonic crystalloid (NS or LR)
This disease, characterized by subglottic narrowing on X-ray often described as the “steeple sign,” is typically treated with what two medications?
What is racemic epinephrine and steroids?
[Croup]
This cyanotic heart defect presents with right-to-left shunt, “boot-shaped” heart, and spells relieved by squatting.
What is Tetralogy of Fallot?
This is the most common cause of hyperkalemia in the PICU.
Cell lysis or tissue breakdown (e.g., rhabdomyolysis, hemolysis, tumor lysis).
Albuterol (half points)
Empiric antibiotic coverage for suspected bacterial meningitis in a 2-year-old includes these two IV antibiotics.
Ceftriaxone (or cefotaxime) + vancomycin
The most common cause of distributive shock in children.
Sepsis
A 2 year old child with cystic fibrosis is admitted with worsening cough and thick sputum. The most common bacterial pathogen is ____.
Staph aureus
Staph is often the first and most common bacterium isolated, particularly in younger children.
Pseudomonas becomes the most prevalent organism as individuals with CF get older.
A continuous “machine-like” murmur in a premature infant improves with what treatment?
What is indomethacin or tylenol?
(PDA)
Oliguria is defined as urine output less than ___ mL/kg/hr over at least 6 hours.
<0.5 mL/kg/hr
A 4-year-old with influenza develops rapid deterioration and cavitary pneumonia - you correctly suspect this organism.
Staphylococcus aureus (often MRSA)
After fluids, the first-line vasoactive agent for fluid-refractory pediatric septic shock is usually this medication.
Epinephrine (or norepinephrine if cold shock vs warm shock - context dependent)
In severe asthma exacerbations, this arterial blood gas finding suggests impending respiratory failure.
What is rising PaCO₂ (hypercapnia) despite ongoing tachypnea?
A neonate with differential cyanosis (lower extremity desaturation, upper extremity pink) likely has this ductal-dependent lesion.
What is coarctation of the aorta?
During DKA treatment, a rapid drop in serum osmolality increases the risk for this neurologic complication.
Cerebral edema
A neutropenic child with leukemia develops fever, pleuritic chest pain, and halo sign on chest CT. Which organism is most likely, and what is the empiric treament of choice?
Aspergillus species
Treat with voriconazole (first-line)
This infection prevention strategy is the most evidence-based intervention to reduce ventilator-associated pneumonia (VAP).
Head-of-bed elevation, daily sedation interruption, oral care with chlorhexidine.
This parameter on the ventilator reflects alveolar ventilation and is primarily affected by changes in respiratory rate or tidal volume.
What is PaCO2?
This congenital lesion presents with severe cyanosis at birth, an “egg on a string” cardiac silhouette, and requires mixing lesions to sustain life.
What is transposition of the great arteries (TGA)?
A 12-year-old with traumatic brain injury on mannitol develops polyuria, hypernatremia, and low urine osmolality. What is the diagnosis and initial treatment?
Central diabetes insipidus
Treat with desmopressin (DDAVP) and free water replacement.
A 3-year-old presents with fever, irritability, and neck rigidity. Gram stain shows small gram-negative coccobacilli. Identify the organism and first-line empiric treatment.
Haemophilus influenzae type b (Hib)
Treat with ceftriaxone (or cefotaxime) + dexamethasone
A child on mechanical ventilation has increasing peak inspiratory pressures and hypotension. What is the most likely cause, and what is your immediate intervention?
Tension pneumothorax
Disconnect from ventilator and perform needle decompression followed by chest tube placement.