CLIPP 31: 5 y/o female with puffy eyes Flashcards
List 3 causes of conjunctivitis
Infection
Allergy
Chemical Irritation
Are children <6 more likely to have bacterial or viral conjuctivitis?
Bacterial
is bacterial or viral conjunctivitis more likely to be associated with purulent drainage/eye crusting over?
Bacterial
Most common pathogens in periorbital cellulitis?
Most often caused today by pneumococci, Moraxella catarrhalis, or non-typeable Haemophilus influenzae
4 top differential diagnosis for fatigue, periorbital edema and increased abdominal girth
Acute glomerulonephritis
CHF
Hepatic failure
Nephrotic syndrome
Periorbital edema is an early sign of what?
Hypoalbuminemia
Why are mildly enlarged tonsils normal in children aged 4-6?
Because peak growth of lymphoid tissue occurs at 4 to 6 years of age, and because of frequent viral upper respiratory infections in children of this age, it is very common to see mildly enlarged tonsils
In addition to hematuria, what is an additional common finding seen in pts with acute glomerulonephritis?
HTN
Lipid findings in hypoalbuminemia?
Hyperlipidemia
Most common nephrotic syndrome in children?
Minimal change disease
Accounts for >90% of children < 10
Management of minimal change disease?
Corticosteroids
Sodium restriction to 1500-2000mg/day
During edema accumulation, the patient usually excretes less than 5 mEq of sodium per day. A diet of 50 mEq per day will result in the net gain of a kilogram of body water every 3 days. Current guidelines recommend sodium restriction to a level of 1500-2000 mg daily
What indicates a need for a renal biopsy in someone with minimal change disease?
Steroid resistant patients
What are the 4 most common infectious complications from nephrotic syndrome?
Spontaneous peritonitis (usually strep pneumo)
Pneumonia
Cellulitis
Urinary Tract Infection
when in remission, what prophylaxis should patients with minimal change disease/nephrotic syndrome receive?
Polyvalent pneumococcal vaccine
Two doses of varicella vaccine (if not already immunized)
An annual influenza vaccine
How are compliments affected in PSGN?
C3 is low