CLIPP 10

Question 1

If fever occurs, when would it present after vaccination with an inactivated, subunit, or toxoid vaccine?

Answer 1

within a few days of immunization

Question 2

If fever occurs, when would it present after vaccination with a live attenuated vaccine?

Answer 2

6-14 days later

Question 3

define fever without a source

Answer 3

no identified source of the child’s fever even after a complete Hx and detailed PE

Question 4

What tests should be obtained with a fever without a source?

Answer 4

UA

Urine culture

CBC with differential

Blood culture

Lumbar puncture

Question 5

What are the 4 ways to obtain a urine sample from a young child? Which one is has a high risk for contamination?

Answer 5

clean catch

catheterization

suprapubic aspiration

bag (high rate of contamination)

Question 6

What does a positive nitrite urine test mean?

Answer 6

A positive nitrite test occurs when gram-negative bacteria, which can reduce urinary nitrate into nitrite, are present in the urine

Question 7

What does a positive leukocyte esterase urine test mean? Is it sufficient to make the diagnosis of a UTI?

Answer 7

A positive leukocyte esterase usually indicates the presence of white blood cells WBCs in the urine

pyuria can be seen in a variety of conditions in addition to urinary tract infection. Thus, a positive leukocyte esterase test alone is insufficient to make the diagnosis of a urinary tract infection.

Question 8

name 3 follow up studies after UTI diagnosis

Answer 8

US of kidneys and bladder

Renal technetium scan

VCUG

Question 9

What is the differential diagnosis for infant with a fever?

Answer 9

UTI
Pneumonia
Sepsis/bacteremia
Occult bacteremia
meningitis
roseola
HSV gingivostomatitis
Viral URI