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Peds > Common Illnesses > Flashcards

Common Illnesses Flashcards

1
Q

MC cause of the common cold

A

rhinovirus

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2
Q

normal progression of mucus in the common cold

A

Nasal discharge is initially clear and watery, but soon becomes thick and colored in the first few days. The color could be yellow, white, or green. The drainage remains thick for several days and again becomes watery before the cold is resolved

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3
Q

MC predisposing factor for acute bacterial sinusitis

A

viral URI

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4
Q

tx of acute bacterial sinusitis

A

amoxicillin +/- clavulanate

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5
Q

tx for common cold

A

supportive- heated air, saline drops, menthol vaper

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6
Q

primary bacteria for pharyngitis

A

Group A, Beta Hemolytic Streptococcal Infections

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7
Q

clinical findings of GABHS

A 
sore throat
fever
headache
nausea, vomiting, abdominal pain
Strawberry tongue, sandpaper like rash
-Absence of conjunctivitis, coryza, hoarseness, anterior stomatitis, cough, diarrhea 
Tonsillar hypertrophy
patchy, discrete exudate
Tender, enlarged anterior cervical nodes
Beefy red, swollen uvula, petechiae on the palate and excoriation of nares
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8
Q

variations of GABHS

A

scarlet fever, Erysipelas, Streptococcal Perianal Infection and balanoposthitis

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9
Q

best lab tests for GABHS

A

throat culture (first line) & rapid strep test

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10
Q

objectives to tx GABHS

A

prevent rheumatic fever, not likely to prevent post streptococcal AGN

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11
Q

major complications of GABHS

A
  • retropharyngeal abscessed

- peritonsilar abscessed

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12
Q

tx for retropharyngeal abscessed

A

surgical drainage

1st line = clindamycin

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13
Q

tx for peritonsilar abscessed

A

1st line - PCN (clindamycin if pt is allergic)

incision and drainage

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14
Q

Treatment of Steptococcal Tonsillopharyngitis

A

PCN or amoxicillin

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15
Q

GABHS tx

A
  • PCN (10-30% failure)

- can tx w/ augmentin if there is suspected inactivation of PCN bacteria

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16
Q

acute otitis media MC pathogen

A

H. influenzae

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17
Q

pathogenesis AOM

A
  • Partial obstruction of Eustachian Tube leading to Eustachian Tube Dysfunction
  • Exudation of fluid into middle ear
  • negative middle ear pressure
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18
Q

RF for AOM or OME

A

Age <2 years, much more common
If <6mos, itll happen more times within that year
First episode of AOM when younger than 6 months of age
Absence of breast feeding
Atopy
Chronic sinusitis

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19
Q

AOM vs OME

A

AOM – Rapid onset of signs and symptoms of inflammation in the middle ear, bulging TM
OME – Inflammation with fluid in the middle ear without signs and symptoms of acute infection (fluid alone sometimes)

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20
Q

AOM criteria

A
  • Presence of middle ear effusion (MEE)
  • Inflammation as indicated by a bulging TM-must be
  • Otorrhea of new onset
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21
Q

AOM tx

A

First-line: Amoxicillin (high dose b/c cover highly resistant strep pneumoniae) 80-90 mg/kg/day in two divided doses

Second-line: Amoxicillin-Clavulanate 90 mg/kg/day in two divided doses
If a child has AOM concurrent with conjunctivitis or
had Amoxicillin therapy in the previous 30 days
Amoxicillin-Clavulanate should be the first line agent.

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22
Q

MC classic form of croup

A

Laryngotracheitis

23
Q

classic presentation of croup

A

barking cough
prodrome viral upper respiratory infection
inspiratory stridor

24
Q

Bacterial Tracheitis

A

Croup that goes away and then suddenly develops high fever* (but no drooling like epiglotitis)

25
Q

when is croup the worst

26
Q

radiographic signs of croup

A

steeples sign

overdistension of hypopharynx on lateral view

27
Q

is croup supra/subglottis

A

subglottis

28
Q

epiglotitis is supra/subglotis

A

supraglotis

29
Q

classic presentaion of epiglotitis

A

sore throat, drooling, and dysphagia

30
Q

epiglotitis most probable pathogens

A

be S aureus or group A streptococci.

31
Q

mild croup tx (stridor with excitement only or stridor at rest without signs of respiratory distress)

A

discharge home

32
Q

moderate croup tx (stridor at rest and intercostal/subcostal retractions)

A

Nebulized racemic epinephrine 0.5 ml of 2.25% (or equivalent dose of l-epinephrine preparation). –pretty good!
Oral dexamethasone 0.3-0.6 mg/kg or nebulized budesonide 2-4 mg

33
Q

severe croup (severe respiratory distress, decreased air entry, altered level of consciousness)

A

Nebulized racemic epinephrine or l-epinephrine (same dose as for moderate croup but can be used more frequently according to symptoms).

Oral dexamethasone 0.6 mg/kg or IM.

Alternatively, trial of helium-oxygen before intubation.

Prednisolone 1 mg/kg every 12 h orally or via nasogastric tube.

34
Q

bronchiolitis presentation

A

Afebrile/low grade, paraoxymal coughing, and wheezing

35
Q

chest x-ray of bronchiolitis

A

lung hyperinflation with a flattened diaphragm and bilateral atelectasis

36
Q

dx of bronchiolitis

A

clinically

37
Q

common agent causing bronchiolitis

38
Q

lower lobe pneumonia most probable pathogen

A

pneumococcal

39
Q

tx of bacterial pneumonia

A

IV ceftriaxone, Azithromycin (optional) and vancomycin

40
Q

pneumonia presentation

A

cough persistent day and night, tachypnea, hypoxia, poor feeding, and increased irritability, fever, crackles/wheezes on auscultation

*fever, rapid shallow breathes, and cough pretty characteristic

41
Q

empiric 1st line for outpt pneumonia

A

Young Children
-Amoxicillin
Adolescence
-Azithromycin

42
Q

empiric 1st line for inpt pneumonia

A

Young Children

- Ampicillin
- Cephalosporin + Azithromycin
43
Q

empiric 2nd line for outpt pneumonia

A

Macrolide or doxycycline

Fluoroquinolones (Levofloxacin or moxifloxacin)

44
Q

empiric 2nd line for inpt pneumonia

A

Vancomycin
Clindamycin
Linezolid

45
Q

fluids NOT recommended for acute diarrhea

A 
Tea
Juices
Cola or other soft drinks
Chicken broth
Boiled skim milk – frequent cause of hypernatremia 
Sports drinks such as Gatorade
Homemade solutions to which salt is added 
Kool-Aid and similar preparations 
Water alone
46
Q

recommended for acute diarrhea

47
Q

diet for diarrhea

A

ORS, drinks made with unsweetened yogurt (buttermilk), unsweetened orange juice, vegetable juices, mashed bananas or banana flakes, mashed potatoes, soda crackers, pretzels, beans, mashed cooked vegetables, pastas, noodles, breads, lentils, chicken meat or fish and eggs

BRAT

48
Q

when do you NOT give abx for acute diarrhea (what pathogen)

A

shigatoxin producing E. coli

may increase the risk of hemolytic uremic syndrome

49
Q

when do you use abx for diarrhea

A

only when it is complicated

50
Q

tx for streptococcal Tonsillopharyngitis

A

Pen V or amoxicillin

51
Q

ill appearing pt w/bacterial pneumonia

A

IV vancomycin, ceftriaxone, and azithromycin (optional)

52
Q

in children w/ a foreign body aspiration, best type of scope

A

rigid and can tx corticosteroids

53
Q

bacterial vs viral pnemonia

A

Clinical findings of high fever, rapid breathing, consolidated lobar pneumonia, and a WBC count of >13,000 generally suggest a bacterial rather than viral etiology

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