166. Peds fever

Question 1

Fever def in peds

Answer 1

> 38

Question 2

6 age groups that change mgmt

Answer 2

o	0-28d
o	1-2 month
o	2-3 months
o	3-6 months
o	6-36 months
o	3 to adult

Question 3

7 most common cause of serious bact infection

Answer 3

o	UTI
o	Bacteremia
o	Meningitis
o	Cellulitis
o	Osteo
o	Gastro
o	PNA

Question 4

Most common bacteria (5) and viral (4) in 0-28d

Answer 4

Bacteria
- GBS
- E coli
- Listeria
- N gon
- Chlam
Viral
- HSV
- Varicella
- ENtero
- Flu

Question 5

Most common bacteria (4) and viral (4) in 1-3m

Answer 5

Bacteria
- H flu
- Strep P
- N. meningitis
- E coli
Viral
- Varicella
- entero
- RSV
- Flu

Question 6

Most common bacteria (3) and viral (7) in 3-36m

Answer 6

Bacteria
- S pna
- N menignits
- E coli
Viral
- Varicella
- Entero
- RSV
- Flu
- Mono
- Roseola
- Adeno

Question 7

Most common bacteria (4) and viral (4) in 3 year on

Answer 7

Bacteria
- S pna
- N menignits
- E coli
- G a strep
Viral
- Varicella
- Entero
- RSV
- Flu
- Mono
- Roseola
- Norwalk

Question 8

use of WBC in Dx

Answer 8

• <50 or >15 can be signs of bacteremia
• can be normal, esp meningitis
• more extreme increases chances

Question 9

use of CRP

Answer 9

• more sensitive than WBC alone

- poor data

Question 10

define positive UA

Answer 10

bacteria and pyuria

- Enhanced UA can RO if no bacteriuria and pyuria

Question 11

4 requirement on CSF fluid for low risk

Answer 11

None of:	
- pos CSF gram stain
o	CSF ANC < 1000
o	CSF protein > 80
o	Peripheral blood ANC >10

Question 12

6 contraindications to LP

Answer 12

o	Cellulitis
o	Unstable
o	Bleeding disorder
o	PLT < 50
o	Focal neuro deficits
o	Signs of ICP

Question 13

mgmt of shock

Answer 13

o IV/IO
o 20ml/kg up to 60
o then pressors

Question 14

5 part of wup for febrile 0-28d

Answer 14

o	CBC
o	Blood Cx
o	UA and Cx
o	LP
o	CXR

Question 15

ABx for febrile 0-28

Answer 15

-Ampicillin plus genta

or cefotaxime

Question 16

3 different criteria for 28-60d infant

Answer 16

Philidelphia
Rochester
Boston

Question 17

4 most common cause of fever in 3-36 months

Answer 17

o URTI, croup, bronchitis, stomatitis

Question 18

risk for febrile seizure in infant

Answer 18

rapid rise

Question 19

4 feature of febrile sz

Answer 19

breif
<15min
single
non-focal or GTC

Question 20

mgmt of febrile sz

Answer 20

RO infection
LP if:
- meningeal signs, first Sz and no immunizations

Question 21

6 DDx for fever and petechia

Answer 21

Meningitis
o	Rocky mountain
o	Strep pyogenes infection
o	Viral infecitons
o	HSP
o	Leukemia

Question 22

criteria for kawasaki

Answer 22

Fever > 5 days and 4/5

• conjunctivitis
• rash
• edema
• adenopathy
• mucositis

Question 23

4 clinical features to suspect toxic shock

Answer 23

o fever
o hypotension
o diffuse erythroderma
o multisystem involvement

Question 24

7 criteria for toxic shock syndrome

Answer 24

Fever
HypoT
orthostatic Sx
diffuse erythroderma
desquamation
multisystem involvment
negative results of
- blood, throat, csf Cx
- sero test for rocky mountan, leptospriosis

Question 25

bacteria at higher risk if SCD

Answer 25

encapsulated

• s pneumo
• h flu

Question 26

infection in congenital heart disease

Answer 26

endocarditis

Question 27

DUKE criteria for endocarditis

Answer 27

MAJOR
- blood Cx positive
- evidence endocardial involvment
- TEE positive
- New valve regurge
MINOR
- predisposing condition
- Fever
- vascular pheomenon
- immune phenomenon
- micro not usual bacteria