DIDACTICPeds 101 Cards Flashcards
TORCH
toxoplasmosis other (syphilis, zika, parvovirus B19) rubella CMV HSV
acquired in utero in vaginal canal
hallmark sign of toxoplasmosis
CNS involvement
three most common CNS s/s seen in baby with toxoplasmosis
chorioretinitis (inflammation of choroid and retina)
intracranial calcifications
hydrocephalus
when does treatment for toxoplasmosis occur?
prenatally and w/in 1-2 months
to decrease neurologic deficits
syphilis pathogen
Treponema pallidum
pediatric WNL temperatures
96 - 100 F
pediatric fever
100.4 F +
when do symptoms appear for newborns with syphilis?
can take weeks (3-14) to months to years (5)
serious complications of prenatal and neonatal syphilis
stillbirth, death shortly after birth, miscarriage, low birth wt, prematurity
most common early symptoms of syphilis
fever
low birth weight
skin problems (rash, sloughing of palms/soles)
most common late symptoms of syphilis (late = after age 5)
Hutchinson’s triad =
1) Hutchinson teeth - pegshaped upper incisors
2) Intersititial keratitis - blurred vision, tearing, eye pain
3) Sensorineural Defense - 8th CN deafness
syphilis treatment
penicillin
“PCN is curative!”
key finding of Zika
microcephaly
skull collapsing, brain damage
which trimester results in the most serious complications for rubella infection?
first trimester
most common single symptom of rubella?
hearing impairment
four key symptoms of prenatal rubella
cataracts
congenital heart disease (PDA or peripheral pulm art stenosis)
purpura (blueberry muffin skin lesions)
microcephaly
treatment of rubella
“treatment is PREVENTION”
what is the most common congenital viral infection?
CMV
most common symptom of CMV
sensorineural hearing loss
treatment of CMV
prevention
antivirals, for weeks, inpatient
when is HSV most commonly acquired?
during birthing process
what are the three types of congenital HSV?
SEM (Skin Eyes Mouth)
CNS Disease
Disseminated disease (multiple organ involvement)
treatment of HSV?
antivirals and supportive care
what happens if HSV is left untreated?
it’s fatal
name three causes for pediatric sore throat discussed by Ms. Schulte in Peds 101
Strep pharyngitis
Acute Rheumatic Fever
Kawasaki Disease
Strep Pharyngitis common s/s
"beefy red" palate petechiae exudates fever > 100.4 lymphadenopathy worsens quickly
Strep Pharyngitis can develop into
Scarlet Fever
s/s of Strep Pharyngitis-Scarlet Fever
scarlitina rash (sandpaper) in skin folds and spreads
fever
strawberry tongue
treatment of Strep Pharyngitis
amoxicilin - 10 days
if pt has PCN allergy, give cephalosporin, azithromycin
if secondary otitis occurs, bump amox to higher dosage
what develops if strep pharyngitis isn’t treated?
acute rheumatic fever
PANDAS
PANDAS
pediatric autoimmune neuropsychiatric disorders associated with streptococcus
what are common features of PANDAS?
sudden, severe personality and behavior changes
~4-6 weeks after infection
usually ages 3-12 yrs
treatment of PANDAS
Treatment of initial Strep infection is key to prevention!
tool for diagnosing acute rheumatic fever
Jones Criteria
what is Jones Criteria?
JONES
joints (they hurt)
carditis (new heart murmur)
nodules (firm, painless bumps found over joint extensor surfaces)
erythema marginatum (macular lesions on trunk and proximal extremities)
Sydenham chorea (wierd dancing movements)
treatment of acute rheumatic fever
Treatment is multidisciplinary – refer to cardiology, rheumatology, and infectious disease
what is Kawasaki Disease?
aka Mucotaneous Lymphnode Syndrome
A systemic, inflammatory febrile illness that affects medium sized arteries (particularly coronary arteries)
treatment of Kawasaki Disease
Treatment is URGENT -immune globulin (IVIG) and aspirin
s/s of Kawasaki Disease
Clinical manifestations:
Fever > 5+ days Conjunctivitis Mucositis Rash Cardiovascular Swelling of hands and feet
torticollis presents _____ (around what age)
Usually presents around 2-4 weeks old, worsens gradually
first line therapy for torticollis
gentle guided neck stretches by parent and tummy time to strengthen neck muscles
limit time in car seat, swing, stroller
what is encopresis?
diarrhea leaking around a hard stool blockage
define constipation
Constipation = infrequent, painful, difficult, and/or incomplete evacuation of hardstool
what charts do we use to dx constipation?
Diagnositic tools – Bristol Stool Chart and Rome III Criteria (2006)
Rome III Dx Criteria: must include two or more of the following, for a child at least 4 years old (there are six):
Two or fewer defecations in the toilet perweek.
At least one episode of fecal incontinence perweek.
History of retentive posturing or excessivevolitional stoolretention.
History of painful or hard bowelmovements.
Presence of a large fecal mass in therectum.
History of large diameter stools that mayobstruct the toilet.
treatment for constipation
fecal disimpaction (intially) miralax bomb
F/U: behavior modification daily maint w/ stool softeners (daily Miralax for ~3 months) dietary mod pt/family ed
when to refer for constipation?
Refer to GI specialists if not improving, abnormal findings/responses, or recurrent or non-compliant patient/family
what should never been used during teething?
numbing agents
treatment for teething
cold teething ring
soft chew toys
tylenol (ibuprofen if >6 mo old)
“period of purple crying”
This is a phrase used to describe a time in infant’s life when they cry the most (2 weeks- 3 months).
Peak of Crying Unexpected Resists Soothing Pain-like face Long lasting Evening
what improves colic?
Improves with increased body tone/strength to sit up
Improves with intro of solid foods
what is colic?
An otherwise healthy 2-3 month old infant seems to be in pain, cries for > 3 hours a day, for > 3 days a week, for > 3 weeks
colic treatment?
Must rule out other possible causes of excessive crying in an infant
(Corneal abrasion, UTI, trauma injuries, child abuse, parent/child interaction)
Keep child safely propped up for 15-30 minutes after every feed
Smaller feeds more frequently with effective burping
If projective vomiting after feeds with immediate hunger and weight loss —-> ultrasound for Pyloric Stenosis
when/where to refer non-resolving colic
If not improving, can refer to Peds GI, social work, family psychology
what is milia?
tiny white bumps on nose/cheeks/chin
treatment of cradle cap?
Medical term = Seborrheic dermatitis
Supportive/conservative treatments:
Soft brush, baby oil, Aquaphor/Vaseline
Happy Cappy et al washes
Low potency corticosteroid daily for 1- 2 weeks max if severe
if diaper rash is left untreated, what may develop?
If left untreated, can develop secondary yeast or bacterial infections
if diaper rash persists after first line adjustments (drying, Aquaphor, zinc oxide pastes), what treatment is used?
If persists for > 3 days, likely to have secondary C. albincans (Nystatin)
If not improving, think bacterial, allergic, contact, eczema
what causes Roseola?
Caused by Human Herpes Virus 6 (HHV-6)
when is roseola most often seen? and with what age group?
Common < 3yrs old
Usually seen in Fall and Spring
prodrome for Roseola?
Prodrome: 3-5 days of high fever (102+)
Fever often prompts office visit before rash is seen
Lethargy, irritability, vomiting/diarrhea
evolution pattern of Roseola?
as fever resolves, rash starts
Pink maculopapular rash
Trunk, then face, neck, andext
Lasts 1-2 days
NOT itchy or painful – bothers caregivers to see it but not child to have it!
treatment of Roseola?
Does not require antiviral therapy – all supportive
Family/patient education
Tylenol PRN
Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe
“slapped cheek” rash that fades as
LACY ERYTHEMATOUS trunk rash develops
Erythema Infectiosum = Fifth Disease (caused by Parvovirus B19)
treatment of Fifth Disease
Does not require antiviral therapy – all supportive
Family/patient education
Tylenol PRN
Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe
who are high risk groups for Fifth Disease?
pregnant women (fetal death) sickle cell or immune deficiencies (severe acute anemia)
herald patch
Christmas Tree pattern
Pityriasis Rosea
might be caused by HSV, but we’re not sure
common features of Pityriasis Rosea
Lasts 4-8 weeks
Usually itchy especially with heat/cold
Common older children, teenagers, young adults (75% are 10 – 35 yrs old)
treatment of Pityriasis Rosea?
Self-limited after 1-2 months, no specific treatment suggested
Family/patient education
Tylenol/Ibuprofen PRN
Keep skin cool and dry, hypoallergenic lotions or calamine if needed to soothe
UV therapy
