Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

EOR Pediatrics > Chapter 10-1: Infectious Disease > Flashcards

Chapter 10-1: Infectious Disease Flashcards

1
Q

What counts as “fever of unknown origin”

A

fever for > or = 14 days, document temperature greater than 101 on multiple occasions and uncertain etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DDX of FUO

A

Infection (most common)
Connective Tissue Dz
Malignancy
Other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does occult bacteremia mean

A

bacteria in the blood of a child who appears well and w/o signs of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most cases of occult bacteremia are caused by

A

strep pneumo

most resolve spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does sepsis imply?

A

bacteremia w/ evidence of a systemic response (tachypnea, tachycardia) and altered organ erfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common cause of sepsis in neonates

A
  • group B streptococci
  • enteric gram negative bacilli
  • listeria monocytogenes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common cause of sepsis in older children <5

A
  • s. pneumo

- neisseria meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common cause of sepsis in child > or = 5

A

-staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who is AOM most common in

A

children 6-24mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common causes of AOM

A

-Virus = #1 (RSV, parainflu, influenza)

Bacterial

  • s. pneumo (40%)
  • nontypeable h. influ (25%)
  • m. catarrhalis (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk factors for AOM

A
  • caretaker smoking
  • bottle feeding
  • day-care attendance
  • allergic disease
  • craniofacial anomalies
  • immunodficiency
  • genetic tendencies
  • pacifier use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When can you make the diagnosis of AOM?

A
  • acute history of symptoms and bulging
  • poorly or non mobile tympanic membrane
  • presence of signs of local or systemic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is otitis media w/ effusion

A

apparent fluid behind the ™ but no evidence of inflammation

does not respond to abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is myringitis

A

inflammation of the eardrum w/ normal mobility
**often accompanies a viral URI
(does not respond to abx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who should be treated for AOM w/ abx

A
  • patient younger than 24mo
  • patients at risk for poor follow up
  • ill-appearing patients
  • patient’s w/ chronic illnesses
  • severe or perforated AOM

**children >24mo with less severe disease may be offered the choice of watchful waiting and pain control or immediate abx (give abx rx to fill in 48h if they choose to watch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

First line tx for AOM

A

amoxicillin
-patients who have even treated w/ abx within the last month, those who have not improved w/in 48 hours are eligible for amoxicillin/clanuvate aka augmentin, oral 2nd or 3rd gen cephalosporin, or IM ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common complication of AOM

A

-OME; if it persists longer than 3 months they should be referred for a hearing evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What sinuses are present at birth

A

maxillary and ethmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what pathogens are responsible for sinusitis

A 
#1 = viruses
2 = s.pneumo
3 = h. influ
4 = m. catarrhalis 
(identical to those of AOM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do you treat sinusitis with?

A

Amoxicillin or Augmentin (or others used for AOM) but treatment should persist for 14-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Children w/ recurrent or chronic sinusitis would be evaluated for

A

cystic fibrosis, ciliary dyskinesia, or primary immune deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Herpangina=

A

symptom complex caused by enteroviruses
**groups A and B coxackie viruses
(initially have HIGH fever and sore throat)
-self limited (5-7 days) and requires no specific treatment
hand, foot, and mouth dz if also in these locations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Strep Pharyngitis most commonly affects

A

-school aged kids and adolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is scarlet fever

A

Erythematous sandpaper-like rash accompanies fever and pharnygitis

  • *begins at neck and axillae and groin and spreads to the extremities
  • may desquamate 10-14 days later
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Specificity and sensitivity of rapid antigen test for strep throat vs throat culture
**rapid antigen test specificity is than 95% (so false positive tests are rare) The sensivity is more variable and highly dependent on throat swab specimen **therefore negative rapid antigen test should be confirmed by throat culture
26
Tx of strep pharyngitis
10 day course of oral penicillin or single dose of IM benzathine penicillin G (acceptable alternative for those allergic = erythromycin, azithromycin, and clindamycin)
27
What is acute rheumatic fever
Occurs about 3 weeks after strep pharyngitis in a small percentage of untreated patients
28
What is criteria for rheumatic fever diagnosis
2 or mor major or one major and 2 minor plus supportive evidence of group A strep infection Major: -carditis, polyarthritis, sydenham choea, erythema marginatum, subQ nodules Minor -fever, arthralgia, elevated ESR, C-reactive protein, prolonged PR interval on EKG
29
Mono clinical manifestations
**predominant symptom = severe, exudative, pharyngitis -fever, generalized lymphadenopathy, and profound fatigue (malaise may persist for several weeks) -other manifestations = hepatosplenomegaly, palatal petechiae, jaundice, rash **rash involves the face and trunk and is usually maculopapular (those diagnosed w/ bacterial infection and treated w/ amoxicillin or ampicillin are more likely to get rash)
30
Diagnosis of Mono
``` heterophile antibody (monospot) for EBV -limited sensitivity in those <4y/o ```
31
Tx of Mono
Supportive | -avoid contact sports (until splenomegaly resolves)
32
Croup is caused by
Most commonly caused by parainfluenza virus (next is other viruses like RSV, influenza)
33
Signs and Symp of Croup
- hoarse voice, seal like cough, inspiratory stridor | - steeple sign on CXR
34
Txx of croup
-cool air or humidity | If in ER: racemic epi, oral/iv/im corticosteroids
35
Epiglottitis cause and symp
H. influ * **failure to maintain Hib vaccination status is the biggest risk factor for developing epiglottitis - child appears toxic, leaning forward with chin extended, drools - thumbprinting on CXR (but not recommended b/c delays tx)
36
Tx of Epiglottitis
-IV ampicillin/sulbactam or 3rd gen cephalosporin provides appropriate empirical coverage until the organism is identified by culture
37
Bronchiolitis is caused by
``` RSV = #1 (others = parainflu, flu, adenovirus) ```
38
Risk factors for
chronic lung dz congenital heart dz congential or acquired immunodeficiencies
39
When does bronchiolitis occur
-between november and april
40
Signs and symptoms of bronchiolitis
- lasts 5-10 days acutely and recover over next 1-2 wks * *infected neonates may develop life threatening apnea** - fever, tachypnea, mild to severe respiratory distress - lung hyperinflation, peri-bronchial thickening "cuffing" and increased interstitial markings
41
Treatment of bronchiolitis
- Hypoxic or ill-appearing children require hospitalization * *most of these only require supportive care palivizumab is an IM RSV monoclonal antibody that provides passive prophylaxis and is recommended during theindter months for selected patients younger than 2 who are at risk for severe dz -if not so ill and oxygen >94% and reliable caretakers can be treated outpatient
42
Pertussis clinical manifestations
1) Catarrhal phase: 1-2 weeks of low grade fever, cough, coryza; post-tussive emesis is common; facial petechiae and scleral hemorrhages from cough 2) Paroxysmal phase: intense spasms of coughing followed by sudden inhalation (causes whoop) 3) Convaslecent phase: most symptoms remit but cough can last for 2-8 weeks
43
Treatment of pertussis
- hospitalize if apnea, cyanosis, hypoxia, feeding difficulties - erythromycin estolate, or azithromic shortens the duratio not illness if given early in the catarrhal phase - a 14 day course of erythromycin or a 5 day course of azithromycin completely irradiates organism from the nasopharynx and respiratory tract; household and other close contacts require chemophrophylaxis with erythromycin or azithromycin regardless of immunization status
44
Most common cause of pneumonia in young children
Viruses
45
When does chylamida trachoma tis pneumonia manifest in infants born to women w untreated genital chlamydia infections?
AT 2-3 months of age | -afebrile w/ w/ conjunctivitis and staccato cough
46
Most common cause of pneumonia in 1mo to 5yr old
S. pneumoniae
47
Most common cause of pneumonia in school age/adolescent children?
mycoplasma pneumoniae
48
Onset of viral pneumonia
develops gradually over 2-4 days
49
Onset of bacterial pneumonia
abrupt onset of fever, chills, dyspnea, and chest pain
50
What does bacterial pneumonia look like on CXR
lobar consolidation | -sometimes atypical mycoplasma presents this way too
51
What does viral or atypical pneumonia look like on CXR
diffuse or interstitial infiltrates
52
Outpatient rx for bacterial pneumonia
amoxicillin or amoxicillin/clanuvate
53
what rx for walking pneumonia
erythromycin, azithromycin, clarithromycin
54
what rx for chlyamdia tachomatis pneumonia
azithromycin or clarithromycin
55
Iv abx for bacterial pneumonia
ampicillin/sulbactam, clindamycin, cefuroxime, ceftriaxone, azithromycin, vancomycin
56
Most frequent complication of pneumonia
development of a pleural effusion large enough to compromise respiratory effort (when lung infection drains into pleural space) -large effusions more likely to result from staph aureus (but can happen with all)
57
Most common pathogens of meningitis
1) viruses | 2) s. pneumoniae and n. meningitidis
58
What increases risk of meningitis in neonates?
low birth weight, prolonged rupture of membranes, chorioamnionitis (predispose to septicemia and meningitides) meningomyelocele also increases the risk
59
Lyme meningititis presentation
low grade fever, headache, stiff neck, photophobia developing over the course of 1-2 weeks
60
Kernig signs
flexion of the leg at the hip w/ subsequent pain on knee extension (rarely present in <1y/o)
61
Brudzinski sign
involuntary leg flexion on passive neck flexion (rarely present in <1y/o)
62
How to diagnose meningitis
CSF fluid (lumpar puncture) - Bacterial = >1000 WBC, >75% neutrophils, high protein, low glucose - Viral = <30% neutrophils, Normal or high protein, normal glucose
63
Treatment of meningitis
Vancomycin plus a third generation cephalosporin (cefuroxime, ceftriaxone) - bacterial meningitis tx = 10-14 days - meningococcal meningitis = 5-7 days - lyme meningitis = 14-28 days - neonatal meningitis = 14-21 days
64
Most common bacterial cause of gastroenteritis
-salmonella -shigella -e.coli yersinia enterocolititica -campylobacter -vibrio cholerae
65
Patient's w/ bacterial diarrhea symp
- fever, abdoinal cramps, malaise, tenesmus | - vomiting is less common
66
patients w/ shigellosis sometimes present w/
neurologic manifestations (lethargy, seizures, mental status changes)
67
What causes HUS
shigella dysenteriae | e. coli
68
What causes erythema nodosum
y.enterocolitica
69
colorless flecked with mucus stools "rice water"
cholera
70
major cause of non-bacterial gastroenteritis
rotavirus | -occurs in later months
71
Most common intestinal parasite dz in the US
Giardiasis | -frequent foul smelling watery stools rarely contain blood or mucus
72
Tx of shigellosis
TMP/SMX | azithromycin
73
tx of giardia
metronidazole
74
Pinworm infection
itching in the perianal and vulvar regions | -touch perianal skin w/ transparent adhesive tape to collect eggs
75
Drugs of choice for pinworm infection
Mebendazole, prantel pamoate, albedazole - treat all members of family - hand washing is most effective way to prevent
76
Which hepatitis are most common
A, B, C
77
Which are transmitted fecal oral
A, E
78
Which cause chronic illness
B, C
79
What other viruses can cause hepatitis
EBV, CMV, enterovirus, other final infections
80
Diagnostic eval of Hep A
Anti-HAV IgM
81
Diagnostic eval of acute Hep B
HBsAG positive antiHBc ositive Negative AntiHBe (chronic looks similar)
82
Diagnostic eval of resolved Hep B
HBsAG negative | AntiHBs positive

EOR Pediatrics (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions