10: 6-month-old female with a fever

Question 1

What type of vaccines produce a potential fever within a few days of immunization?

Answer 1

Inert vaccines

Question 2

What type of vaccines produce a potential fever 6-14 days after immunization?

Answer 2

Live attenuated vaccines

Question 3

What are 2 examples of inert vaccines?

Answer 3

1. DTaP

2. PCV-13

Question 4

What are 2 examples of live attenuated vaccines?

Answer 4

1. MMR

2. Varicella

Question 5

Which type of meningitis has the following CSF findings?

Glucose: low
Protein: high
WBC: high
PMN's
\+ or - Gm stain

Answer 5

Bacterial

Question 6

Which type of meningitis has the following CSF findings?

Glucose: normal
Protein: high or normal
WBC: high
Lymphs
- Gm stain

Answer 6

Viral

Question 7

Does a normal UTI with a fever need to be treated with IV?

Answer 7

No

Question 8

In a child who has not recently been on antibiotics, what is the most common pathogen that causes pyelonephritis in kids?

Answer 8

E. Coli

Question 9

What are the 4 most common pathogens that cause UTI in kids?

Answer 9

1. E. Coli
2. Klebsiella
3. Proteus
4. Enterococcus

Question 10

What are 2 IV antibiotic options for pyelonephritis in kids?

Answer 10

1. Ampicillin/gentamicin

2. Ceftriaxone

Question 11

What are 2 good oral antibiotic options for pyelonephritis in kids?

Answer 11

1. Cephalexin (Keflex)

2. TMP-SMX

Question 12

When do you use Nitrofurantoin?

Answer 12

Cystitis

Question 13

What’s the most likely cause of SBI?

Answer 13

UTI

Question 14

What are the 4 initial workups for fever without a source?

Answer 14

1. Urinalysis/culture
2. CBC w/ diff
3. Blood culture
4. Lumbar puncture

Question 15

What does a positive nitrite indicate?

Answer 15

Presence of bacteria in urine

Question 16

What does a positive leukocyte esterase test indicate?

Answer 16

Presence of WBC in urine

Question 17

What’s the sensitivity/specificity of a nitrite test?

Answer 17

Sensitivity is poor; specificity good

Question 18

When would you use an US of kidneys/bladder?

Answer 18

Renal structure and dilation of collecting system

Question 19

When would you use a voiding cystourethrogram (VCUG)?

Answer 19

To check for vesicoureteral reflux, or after a second febrile UTI

Question 20

What disease might cause cough, tachypnea, fever, rales, or low SaO2?

Answer 20

Pneumonia

Question 21

What disease starts with a high fever for 3-5 days and then a rash?

Answer 21

Roseola (HHV-6)