Common Pediatric Complaints Flashcards
Fever phobia
Misinformation
Pre-vaccine era
Febrile seizures
Cannot be prevented
Can fever cause brain damage?
No. It is not possible to exceed the hypothalamic temperature that will cause brain damage
Tylenol or ibuprofen are given for sypmtom-relief yes or no?
Yes
Do cool baths help or cure fevers?
No. They increase the metabolic demands on the child
GAS Pharyngitis
Examine ears, throat and mouth
Pneumonia
Most common type is viral
Tachypnea and hypoxia. Also fever, belly pain and cough
Round (pneumococcus)
Viral syndromes
Ex: Bronchiolitis (caused by RSV)
Wheezing, respiratory distress
Viral exanthems
Typical for Coxsackie virus
Croup
Fever, cough, sublingual narrowing
Roseola
High fever and pinpoint macular (flat) rash. Usually doesn’t come on palms and soles of feet. Not bothersome to kids
Rash only starts after fever
Other causes of fever
Kawasaki’s disease, rheumatologic disease
Are labs/imaging needed for acute infectious fevers in kids?
Typically not
Neonate (0-28 days) symptoms
Change in feeding, alertness, hypothermia and fever
What sort of testing needs to be done for neonates?
All neonates need a FULL WORKUP
29 days- 3 months exam?
Urinalysis on exam
3mths- 3 years
Always consider the urine
UTI presentation and labs
Well-appearing febrile girl.
Check urinalysis
Rx for low risk patients over 6 months with fever
Alternate Ibu and Aceta every 3 hours
Things to check for in children
Change in activity level, refusing to drink or not wetting diapers normally, difficulty breathing
Causes of abdominal pain in kids
Constipation GERD Gastroenteritis Vomiting Diarrhea hematemesis or hematochezia
Intususseption
Bowel loops on itself causing edema
Surgical emergency
Mallory-Weiss tears
Tear of esophagus with forceful vomiting
Getting a good belly exam in infants
Avoid making them scream
Don’t put them on exam table
Use distraction
Use caretakers
Why should abdominal CT scans in kids?
High level of radiation, likelihood of developing malignancy
Coxsackie virus presentations
Fever, won’t drink, papular rash and blisters in hand, foot and mouth, no exudates
Rx: Maalox+Diphenyhydramine solution(numbs blisters so infant can drink)
Acute limp
Pay attention to identify what leg is causing the limp
Common causes of acute limp
Fracture (toddler’s fracture-mid shaft of tibia)
Transient synovitis
Runny nose and cough
-Presentation and Rx
Breathing fast and hard
Rx: Hydrate
Sore throat (Pharingitis)
Hand on throat
Causes: Mono
Ear infection (otitis media)
Buldging, redness, usually unilateral
Pulling ears
Rx: Ask parents to see how things go first
Wheezing Differential
Heart failure, foreign bodies, asthma, viral pneumonia, reactive airway disease, viral pneumonia
Are rashes that blanch good or bad?
They are good
Are petechiae and purpura blanching or non-blanching?
They do not blanch and are more concerning. Also, vesicular rashes (ex: Coxsackie)
