CLIPP 11 Flashcards
main reason we tx strep throat (group a beta hemolytic strep typically)
to avoid rheumatic fever
rapid strep antigen test has __sensitiviyt and __specificty
variable, high
when to do strep culture
to confirm results of negative rapid strep
Appropriate antibiotics started within __ days from the start of the acute illness will prevent acute rheumatic fever.
9
Rx of choice in GAS infxn
PCN tho the liquid form tastes bad so amox is often used instead - ideally wait for documented +test before starting abx
3 of the many things that can present as irritablity
fatigue, meningitis, increased ICP/intracranial irritation
noraml 5yo HR
80-100
JIA can be broken into these different categories
polyarticular, pauci/oligoarticular, systemic-onset (stills dz)
Kawasaki dz is a form of __ w these sx
vasculiis.
non purulent conjunctiva, rash on body, arthraglia, strawberry tongue, hands and feet skin desquaamating . fever >5days. swelling and erythema of extremities.
one example of fever for >= 5 d
kawaki
osteomylitis / septic joint
low grade temp, pain walking if in lower extremities
rmsf
rash on palsm/soles/wrists that spreads inwards
rash on palms/soles
Kawasaki disease, enteroviruses, syphilis
scarlet fever
Fever (generally < 5 days) (whereas MORE duration in kawsaki)!
A diffuse, erythematous, finely papular rash (described as having a “sandpaper” texture) is pathognomonic
Rash often begins at neck, axillae, and groin and then spreads over trunk and extremities, typically resolving within four or five days
SJS
severe itchy rash (EM), fever <7d, mucosal changes, conjunctivitis. affects mucucutaneous things
viral syn/ antibiotisc
fever 3-5 d, non desecript NONPAINFUL rash that can start plams/soles,
does enterovirus rash hurt to walk
no
leggs calves pertches
ccurs when blood supply is temporarily interrupted to the ball part (femoral head) of the hip joint. Without sufficient blood flow, the bone begins to die — so it breaks more easily and heals poorly. would see limp but no rash, fever or conjunctivitis
conjuncitviits fever and rash
could mean measles or kawasaki. measles unlikely in fully immunzated kid
can sinusitis cause rash?
nope
7 rashes assoc w/ fever and their distinguishing signs
enterovirus: often maculopapular, w high fever often, and often on palms/soles
erythema infectiousom: 5th dz/parvo, low fever–>rash 7-10d later w slapped cheek look and lacey and reticular on extremities. can cause arthralgia or aplastic anemia
measles: fever, cough, coryza, conjunctivitis–>rash at top of body–>spreads down to toes
meiningococcemia: due to NM. abrupt onset often w meningitis sx. can become purpuric.
roseola: fever–>fever goes–>rash on arms.neck often in kidsextremities/head. lesions of various stages. mild fever. dz is self limited, around a week.
koplick spots
in measles, erythematous spots w/ bluewhite centers in buccal mucosa
kawasaki mneuonic
CRASH and Burn
Conjunctivitis- non exudative, bilateral injection. >90%
Rash- anything….. but not vesicular and not bulla. >90%
Adenopathy > 1.5cm. typically cervical and unilateral. 90%
Hand- Swelling or Erythema or hands feet. progresses to peeling but this is late. >90%
and Burn… 5 days of daily fevers.
complications: coronary aneurisms.
Treatment is high dose aspirin(to prevent clots) and IVIG(reduces aneurisms from 20%-> 3%).
is generalized LAD w or w/o splenomegaly more or less concerning than isolated LAD
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