Emma Holiday Review III Flashcards
1
Q
Pneumonia most common cause
(a) In neonates under 28 days
(b) 1-3 mo
(b) 4 mo- 5 yo
(d) > 5 yo
A
Pneumonia causes
(a) Neonates: GBS, E. coli, lysteria
(b) 1-3 mo: Chlamydia trachomatis, RSV, parainfluenza, strep pneumo
(c) 4 mo-5 yo: viral (RSV) then strep pneumo
(d) > 5 yo: mycoplasma, strep pneumo
2
Q
Sore throat, fever, fatigue, general adenopathy, splenomedately
A
Epstein-Barr virus- mono
3
Q
Most common cause of death in Friedrich’s ataxia
A
HOCM –> CHF
4
Q
Presentation of peritonsillar abscess
(a) Symptoms
(b) Signs
A
Peritonsilar abscess
(a) Symptoms: severe sore throat, muffled voice (hot potato voice), drooling, trismus (lockjaw)
(b) Signs: medical displacement of tonsil and uvular deviation
5
Q
Classic presentation of Fifths disease
A
Fifths disease = erythema infectiosum
- Immuncompetent children w/ slapped cheek rash = malar rash (on cheeks) or erythema w/ circumeral pallor
- lacy reticular rash on cheeks and upper body
6
Q
2 yo w/ 105 fever, 3 days later gets a pink, mac-pap rash on trunk arms and legs
A
= Roseola
- HHV6 (human herpes virus 6)
- 3-5 days of fever (high, can > 104) then abrupt defervescence and development of macular or maculopapular rash on trunk/neck that spreads to face and extremities
-self limited
7
Q
Kid w/ productive cough, runny nose, fever to 100.8
Based on PE findings
(a) coarse rhonchi
(b) decreased breath sounds crackles in LLL
Next steps?
A
Productive cough, rhinorrhea, fever to 100.8
(a) only coarse rhonchi on exam = acute bronchitis
=> supportive tx
(b) Decreased breath sounds + crackles in LLL = pneumonia
- CXR to confirm, CBC
8
Q
Clinical presentation of acute rheumatic fever
A
Acute rheumatic fever: 2-4 weeks after initial GAS pharyngitis => fever, multiple painful joints, chorea (involuntary muscle movements), erythema margenatum (characteristic rash)
9
Q
Name 4 nonsuppurative complications of GAS
A
Nonsuppurative = inflammatory w/o pus productive
Group A strep complications:
- acute rheumatic fever
- scarlet fever
- streptococcal toxic shock syndrome
- acute glomerulonephritis
- PANDAS = pediatric autoimmune neuropsychiatric d/o associated w/ group A streptococci
10
Q
9 mo who had previously been reaching milestones starts to lag
-seizures, hypotonia, cherry red macula
A
Tay-Sachs
11
Q
14 yo bball player w/ knee pain and swelling of the tibial tubercle
A
Osgood-Schlatter
-overuse injury from jumping
12
Q
Tx for Kawasaki’s
A
Require tx b/c of the risk of CV complications
Acutely: single dose IVIG + high dose aspirin
- continue aspirin until lab markers of acute inflammation (platelet count and ESR) return to normal
- not glucocorticoids b/c doesn’t decrease rates of complications
Later w/ aspirin + warfarin
13
Q
First line tx for strep pharyngitis
A
Strep pharyngitis first line tx = Penicillins (no resistance, so lets keep it that way by not giving higher stuff)
-Penicillin
-often Amoxicillin b/c tastes better
or can give IM penicillin
14
Q
2 yo w/ low grade fever, lacy reticular rash on cheeks and upper body that spares the palms/soles
A
5th disease/erythema infectiosum (parovirus B19)
=mild febrile illness w/ erythematous malar rash w/ circumoral pallor (slapped cheek rash)
Dx made clinically in immunocompetent children w/ malar rash of erythema infectiosum
15
Q
JRA Tx
(a) first line
(b) second line
(c) third line
A
JRA Tx: start w/ NSAIDS –> MTX –> steroids
16
Q
Hand-Foot-and Mouth disease
(a) Cause
(b) Presentation
(c) Tx
A
Hand-Foot-and Mouth disease
(a) Coxsackie virus A16
(b) Macules –> vesicles –> rupture to form painful superficial ulcers
(c) Self limited, resolves in 7 days
17
Q
5 yo M initially w/ a cold 1 week ago, now presents w/ limp and effusion in the hip.
-Xray normal
-ESR 35 (high)
Temp 99.8
WBCs- 10k
A
Transient synovitis = self-limited inflammation of the synovium (inner lining of the capsule of the hip joint)
- Xray often unremarkable
- elevated acute factors of inflammation
18
Q
Tx for recurrent peritonsilar abscesses
A
Tonsillectomy
19
Q
12 yo w/ 2 week history of fever (102) and salmon colored evanescent rash on trunk, thighs, shoulders
-swollen r and l knee
A
JRA = juvenile rheumatoid arthritis
- intermittent fever, rash, arthritis
- presents w/ pain, swelling, stiffness
20
Q
Retropharyngeal abscess
(a) Dx
(b) Etiology
(c) Complications
(d) Tx
A
Retropharyngeal abscess = rare but very serious infection of the retropharyngeal space
(a) CT scan
(b) Often polymicrobial: GAS + staph aureus + resp anaerobes
(c) Life threatening complications: airway obstruction, sepsis
(d) Tx: Hospitalize to ensure airway is maintained, start on empiric therapy (3rd gen cep + amp or clinda), surgically drain
- prevent spread into mediastinum
21
Q
Sandpaper quality to the skin
A
Sandpaper rash = buzzword for sclaret fever (after group A strep pharyngitis)
22
Q
Whooping cough
(a) CBC findings
(b) Tx
A
Whooping cough = pertussis
(a) CBC shows lymphocytosis
(b) Azithromycin for 14 days
23
Q
Tx for Rocky Mountain Spotted fever (muscle pain, fever, abdominal pain –> rash)
A
Doxyycline (at all ages)
24
Q
JRA
(a) Good prognostic factor
(b) Bad prognostic factor
A
JRA
(a) Good prognostic factor: young age of onset, fewer joints, +ANA
(b) Bad prognostic factor: older at age of onset, polyarticular, +RF
25
Shin pain that worsens w/ foot dorsiflexion
Toddler's fracture = spiral fracture of the shin bone (tibia)
-pain when foot bent upwards
26
Tx for peritonsilar abscess
- start empiric abx
| - often needs aspiration and I&D (incision and drainage)
27
Slapped cheek rash
Buzzword for 5th disease = erythema infectiosum
| -agent = Parovirus B19
28
Describe the classic presentation of Roseola
Roseola (HHV 6): 3-5 days of fever (high, can > 104) w/ abrupt defervescence and development of maculo-papular rash on trunk/neck that spreads to face/extremities
29
3 mo infant lays in "frog-leg" position, hypotonic, fasiculations of the tongue, absent DTRs
SMA-1 = spinal muscular atrophy
-most die before age 2
30
4 yo w/ inflamed conjunctiva + multiple blisters
| -positive Nikolsky's sign
= Staph scalded skin syndrome (SSSS) = toxin from staph aureus => cutaneous erythema, bullae, desquamation
- Nikolsky's signs = gentile pressure causes skin to wrinkle due to separation of the upper dermis
- febrile
Most have concomitant conjunctivitis
31
9 mo w/ severe coughing spells w/ loud inspiratory whoop w/ vomiting.
-2 weeks ago: runny nose and dry cough
Whooping cough = Pertusis
| -bordetella pertusis
32
Work up for meningitis
1- start empiric tx w/ Ceftriaxone + Vanco
2- Check CT for signs of increased ICP
3- LP: culture and gram stain, white count, protein and glucose levels
33
Bronchiolitis
(a) CXR findings
(b) Tx
Bronchiolitis
(a) CXR: hyperinflation w/ patchy atelectasis
(b) Tx = albuterol nebs, NO STEROIDS, hospitalize if respiratory distress
34
9 mo w/ runny nose, wheezy cough, T 101.5, RR of 60
- chest retractions
- pulse ox 91%
Bronchiolitis
35
How to differentiate UTI vs. pyelonephritis in neonate
Both present w/ vague symptoms: fussy, dehydration
If fever is present it's pyelo, cystitis (UTI) has NO fever
36
SCFE
(a) Risk factors
(b) Presentation
(c) Treatment
SCFE = slipped capital femoral epiphysis
(a) AA and overweight
(b) PResents w/ pain and altered gait
(c) Tx: operative stabilization
37
7 yo w/ exudative pharyngitis w/ tender cervical LN and fever to 102
Do rapid strep antigen- thinking strep pharyngitis
38
Why give penicillin for strep throat
To prevent complications of post-GAS pharyngitis such as acute rheumatic fever
39
Tx for otitis media
(a) if no improvement after 2-3 days
(b) when to place tubes
Otitis media tx = amoxicillin or azithromycin for 10 days
(a) Switch to augmentin (amox-clav) if no improvement
(b) Place tubes if bilateral effusion > 4 mo or if bilateral hearing loss
40
Classic presentation of Kawasaki's
5+ days of fever + 4 out of 5 signs of mucocutaneous inflammation:
(i) bilateral nonexudative conjunctivitis
(ii) erythema of the lips and oral mucosa: injected/fissured lips, injected pharynx, strawberry tongue
(iii) rash
(iv) extremity changes: erythema or edema or palm/soles, periungal desquamation
(v) cervical lymphadenopathy: > 1.5 cm diameter
- typically develop after a brief nonspecific prodrome of respiratory or gastrointestinal symptoms
41
2 yo F w/ 2 week history of daily fevers to 102 + desquamating rash on perineum
- swollen hands and feet
- conjunctivitis
- unilateral swollen cervical lymph node
Kawasaki's
42
Tx for scabies
5% permetrin for the entire family
Permetrin = anti-parasitic used for head lice and scabies
-treat for symptoms and to prevent transmission
43
12 y/o w/ decreased school performance, behavior change, ataxia, spasticity, hyperpigmentation
-hyperkalemia, hyponatremia, acidosis
Adrenoleukodystrophy = X-linked recessive d/o of peroxisomal FA oxidation => accumulation of very long chain fatty acids throughout the body
44
Mechanism of Kawasaki's
Vasculitis of medium sized muscular arteries
45
Anatomic risk for UTI
Anatomic risk for UTI = vesicoureteral reflux = retrograde flow or urine from bladder in ureter/kidney
-confirmed w/ VCUG = voiding cystourethrogram that visualizes urethra and bladder during voiding
46
Seizures
(a) 3-4 minute tonic-clonic seizure after fever of 102.4
(b) staring into space, lip smacking
(c) 6 mo old w/ symmetric contractions of neck, trunk, extremities
Seizures
(a) Febrile seizure
(b) Absence seizure
(c) Infantile spasms
47
Measles
(a) Cause
(b) Tx
Measles
(a) Paramyxovirus
(b) Tx: supportive care (fluids, antipyretics) + vitamin A
48
Steeple sign
Steeple sign = Xray buzzword for Croup
49
Koplik spots
= white/gray spots on buccal mucosa
-pathognomonic for prodromal phase of Measles
50
Developmental hip dysplasia
(a) Dx signs
(b) Tx
(c) Risk factors
Developmental hip dysplasia
(a) Clunk on Barlow
- can confirm w/ ultrasound of hip if unsure
(b) Tx = Pavilk harness (keeps hips in place), sometimes surgery
(c) Risk factors = 1st born female, breech position
51
Complications of Rocky Mountains potted fever
- vasculitis (R. rickettsii infects endothelial cells lining blood vessels)
- gangrene
52
Classic presentation of German Measles
German Measles = Rubella (paramyxovirus)
- fever, rash (red maculopapular on face), lymphadenopathy
- milder than measles
53
14 yo lanky M w/ nagging knee pain and decreased ROM of the hip on exam
SCFE = slipped capital femoral epiphysis = displacement of femoral epiphysis from femoral neck
-shearing forces to femoral head > stregnth of capital femoral physis
54
Extra bug to think about for meningitis if
(a) young and immunosuppressed
(b) recent brain surgery
Extra bugs besides strep pneumo, N. meningities, H. influenza
(a) young and immunosuppressed- Lysteria => tx w/ ampicillin
(b) recent brain surgery- Staph => vanco
55
5 yo M initially w/ painless limp now has pain in his thigh
Legg-Calve's-Perthes Disease = avascular necrosis of the femoral head
56
6 yo kid w/ fever who went camping in central PA
```
Lyme Disease (bacteria = borrelia burgdorferi)
-characteristic Target lesion
```
57
Fine, mac-pap desquamating rash begins on chest and spreads to neck, trunk, and extremities
- strawberry tongue
- sore throat 1-2 weeks prior
Scarlett fever
| -group A strep
58
Describe the 4 phases of the measles
(1) Incubation
(2) Prodrome
(3) Exanthem
(4) Recovery
Measles (paramyxovirus)
(1) Incubation- 6-21 days after exposure
(2) Prodrome- fever, malaise, anorexia, runny nose, conjunctivitis, Koplik spots (white/gray spots on buccal mucosa)
(3) Exanthem = break out of red maculopapular rash that classically starts on face
- rash resolves in 5-6 days
(4) Recovery- cough can persist for 1-2 weeks. If fever is present 3-4 days into rash, suggests a measles-associated complication
59
2 yo w/ fever to 104 and drooling w/ intercostal retractions and tripod position
= Epiglottitis
| -stridor, tripoding, chest retraction, febrile
60
3 ddx for bone pain due to cancer
- Presenting sign of Leukemia
- Ewing Sarcoma (more likely if under 10 yoa)
- Osteogenic sarcoma (more likely if over 10 yoa)
61
What is a left shift?
Increase in number of immature leukocytes in peripheral blood
-associated w/ neutrophil band cells
62
Most common presentation of adrenoleukodystrophy
Often presents in boys (X-linked) w/ emotional instability, hyperactivity, and disruptive school behavior
Adrenoleuodystrophy = d/o of peroxisomal FA oxidation
63
8 yo w/ difficulty balancing while walking
- no DTRs
- bilateral Babinski
- explosive, dysartric speech
Friedrich ataxia
- autosomal recessive
- trinucleotide repeat
64
Describe the rash of scarlet fever
Sandpaper appearance: diffuse erythema that blanches w/ pressure w/ numerous small papular elevations
- erythematous, blanching, maculopapular
- delayed-type skin rxn to strep pyogenes exotoxin
65
LP findings consistent w/ meningitis
Diagnostic is > 1,000 WBC in CSF (predominately neutrophils)
-positive gram stain
Supportive: high protein and low glucose in CSF
66
3 most common bugs for meningitis in children
- strep pneumo
- Neisseria meningitides
- H. Influenza
67
Indication for topical mupirocin
Topical muciprocin = abx ointment
| -for skin infections: furuncle (infxn of the hair follicle), impetigo, open wounds
68
Meningitis + petechiae indicates what bug
Petechaie w/ meningitis indicates Neisseria meningitides
69
Complications of untreated lyme disease
Arthritis, heart block, meningitis, Bells (partial face paralysis) , severe headaches w/ neck stiffness
70
1 yo w/ fever (100.5) and barking lough + loud noise on inspiration
Croup
- barking/seal like cough
- stridor = loud noise on inspiration
71
6 yo w/ clumsiness and frequent falls
- decreased muscle bulk and "stork like" lower leg
- multiple small injures on hands and feet
- pes cavus and claw hand
Marie-Charcot-Tooth Disease = peripheral neuropathy
| -pes cavus (high arch)
72
Indications for tonsillectomy
-recurrent peritonsilar abscesses
Recurrent strep throat:
- >5 episodes of strep/yr for 2 years or
- >3 episodes of strep/yr for 3 yrs
73
For which childhood viral illness would isolation room be indicated?
Measles- extremely contagious
-up to 90% exposed get infected
Also mumps- isolate until parotitis is down
74
Tx for Marie-Charcot-Tooth disease
stabilize ankles w/ surgical fusion
| -usually normal lifespan and most remain ambulatory
75
Infant w/ increasing head size, prominent occiput, cerebellar ataxia, delayed motor development
Dandy-Walker malformation = congenital malformation of absence of cerebellar vermis
76
Tx of
(a) UTI
(b) Pyelo
Tx of
(a) UTI- PO trim-sulfa (bactrum) or nitrofurantoin
(b) Pyelo- 14 days of IV ceftriaxone or amp + gent
77
Fever, N/V, headache, back pain
Think meningitis
78
Second line tx for strep phayngitis
2nd line tx for strep pharyngitis (after penicillins) = 1st gen cephalosporins
79
Why is rubella scary?
Congenital rubella syndrome- very dangerous for women to get rubella in first 20 weeks of pregnancy
=> fetal death, congenital abnormalities
-cataracts, deafness, heart and brain problems
80
Tay Sachs
(a) Mode of inheritance
(b) Pathophysiology
Tay Sachs
(a) X-linked recessive
(b) Deficiency of hexosaminidase A => accumulation of GM2 in brain
81
Muffled voice, stridor, refuses to turn head left
Torticollis/stiff neck, fever, dysphagia = r/o Retropharyngeal abscess = infxn of the retropharyngeal (deep neck) space
82
For which populations may 5th disease be very dangerous
Parovirus B19 can cause a transient aplastic crisis by temporarily suspending erythropoeisis
Dangerous in: pregnant women, sickle cell, thalassemia
83
What is seen on CT/MRI in Dandy Walker malformation?
Cystic expansion of 4th ventricle
| -can see agenesis of cerebellar vermis
84
Complications of meningitis
(a) Neurological
(b) Disseminated illness
Meningitis complications
(a) Seizures
(b) Septic arthritic, pericarditis
85
Most common cause of bullous impetigo
Impetigo = honey colored crusts plaques
| -if bullous, most common = staph
86
Treatment for lyme disease
Amoxicillin for kids under 8
| Doxycyclin if > 8
87
When is the MMR given?
2 doses
1st dose: 12-15 mo
2nd dose: no sooner than 28 days later, usually given btwn 4-6 yo
88
Tx for Infantile spasms
ACTH
2nd line- prednisone
89
Specific findings for chlamydia trachomatis pneumonia?
(a) type of cough
(b) White count
Chlamydia trachomatis
-often afebrile
(a) staccato cough
(b) eosinophilia
90
Which respiratory illness has a vaccine given to premies and immuncompromised?
Palivizumab = RSV antibody to prevent bronchiolitis in premies, CHD, lung and immune disease
91
Prognosis of Adrenoleukodystrophy
Death w/in 10 years
| -progressive demyelination
92
Thumbprint sign
Thumbprint sign = Xray buzzword for Epiglottitis
| -showing enlarged epiglottis
93
Tx for croup
-mist, nebulized epi, steroids
94
Transient synovitis vs. septic arthritis
(a) US findings
(b) How to differentiate
(c) Symptomatic difference
Transient synovitis = self-limited inflammation of synovirum
vs.
Septic arthritis = bacterial infxn of joint
(a) US on both shows effusion
(b) US guided needle aspiration to differentiate toxic synovitis from septic arthritis
(c) Septic arthritis will have more severe symptoms: febrile, irritability, inability to bear white, pronounced muscle guarding
95
Complications of mumps
- Orchiditis (testicular inflammation), sterility
- meningitis
- encephalitis (inflammation of brain)
96
Most common bug cause of
(a) Croup
(b) Epiglottitis
(c) Bronchiolitis
Most common bug
(a) Croup = parainfluenza virus
(b) Epiglottitis: strep pyo, strep pneumo, staph
- H. Flu B if unimmunized
- **bacterial
(c) Bronchiolitis = RSV
97
Next step for kid w/ meningocele or myelomeningocele
Do a head CT looking for hydrocephalus (Arnold Chiari II)
98
Treatment for scarlet fever
Really supportive and anti-inflammatory meds
- aspirin/corticosteroids (but be careful of Reye syndrome risk in children w/ aspirin)
- no vaccines against Strep pyogenes
- if throat tests (+) for Strep pyogenes: give Penicillin
99
EEG finding in
(a) absence seizure
(b) infantile spasm
EEG finding
(a) absence seizures: 3 Hz spike and wave discharge
(b) infantile spasms: hypsarrhythmia = asynchronous, chaotic, bilateral
100
Tx for 4 yo w/ conjuncitivitis + multiple blisters and + Nikolsky's sign
Staph scalded skin syndrome
Tx = penicillinase-resistant penicillin = IV oxacillin or nafcillin
101
Most common cause of limp in a kid
Trauma
102
Tx for epiglottitis
Secure airway: if necessary go to OR and intubate
Epiglottitis can be life threatening (airway obstruction) => start empiric tx before cultures come back
Tx = 3rd gen cephalosporin (ceftriaxone/cefotaxime) + anti-staph agent effective against MRSA (clindamycin/vancomycin
103
What is empiric tx for meningitis?
Empiric tx for meningitis = 3rd gen cephalosporin (Ceftriaxone) + Vanco
-then when agent confirmed you can make it more specific
104
How long after strep pharyngitis do you see
(a) scarlet fever
(b) acute rheumatic fever
Group A Strep pharyngitis
(a) 1-2 weeks later => scarlet fever (sandpaper rash)
(b) 2-4 weeks later => acute rheumatic fever (fever, multiple painful joints, involuntary muscle mov'ts, rash)
105
Best test for Kawasaki's
2D echo and EKG, then repeat echo after 2-3 weeks of tx
-most serious sequellae = cardiac
W/o complications, usually self-limited w/ symptoms lasting about 12 days
-so monitor for cardiac complications
Prognosis based on severity of coronary artery involvement => baseline EKG then repeat after tx
106
UTI gender preference
Before age 1: boys more likely than girls to get UTI
-girls more common after age 1
107
2 yo w/ fever (102) tugging on ear. Red and bulging TM
(a) most sensitive dx test
Otitis media
(a) Limited mobility of insufflation or visibility of air fluid level- indicating fluid behind TM
108
Hot potato voice
Buzzword for peritonsillar abscess
109
What to consider in any infant w/ HC > 95th %
Consider hydrocephalus
110
Roseola
(a) Peak age
(b) Cause
(c) Tx
Roseola
(a) Peak age: 7-13 mo
(b) HHV-6 (human herpes virus 6) = most frequent causes
- other causes: HHV-7, enteroviruses, adenovirus, parainfluenza
(c) Disease is self limited => just supportive tx
- antipyretics for fever discomfort
111
Most serious complication of Kawasaki's
Pathologic changes in coronary arteries => coronary artery aneurysm or MI
112
16 yo M w/ swollen parotid glands, fever, and headache
Mumps (paramyxovirus)
| -characteristic parotitis
113
18 mo F w/ asymmetric gluteal fold on exam
Asymmetric gluteal folds = developmental hip dysplasia
114
Why is warfarin in the first trimester of pregnancy relatively contraindicated?
Increased risk of Dandy-Walker (congenital absence of cerebellar vermis)
115
6 yo kid from costal NC went camping => fevers, myalgias, abdominal pain
Rocky Mountain spotted fever (rickettsia rickettsii)
- tick-borne disease
- starts w/ nonspecific pains: fever, headache, muscle pain
- prominent abdominal pain
- most develop rash btwn 3-5 days of illness
116
8 yo w/ multiple excoriations of arms, itchy at night
| -brother also has it
Scabies = erythematous papules in characteristic distribution (webbing of fingers, around nipple, in folds) very itchy worse at night
-pruritic eruption + family involvement
117
Transient synovitis
(a) presenting factors
(b) Diagnostic test
Transient synovitis
(a) Pain and limited hip movement, hip usually flexed externally rotated and abducted
(b) Diagnostic test = Ultrasound showing fluid inside the joint capsule (effusion)
118
2 y/o w/ gait disturbance
- loss of intellectual fxn
- nystagmus + optic atrophy
- cresyl violet --> metachromatic staining
Metachromatic leukodystrophy = auto recessive lysosomal storage disease due to mutation in ARSA (arylsulfatase A) gene => accumulation of cerebroside sulfate
119
12 yo in summer swim league w/ pain behind his ear
- thick exudates coming out of ear
- tender posterior auricular nodes
Otitis externa = swimmer's ear
120
What is a maculopapular rash?
```
Macules = small, flat discolored spots
Papules = small, raised bumps
```
Maculopapular rash = flat, red areas on the skin covered w/ small confluent bumps
Associated w/ scarlet fever, measles, Rubella, secondary syphilis, 5th disease
121
Ewings vs. Osteogenic sarcoma
(a) Age
(b) Gender
(c) History
(d) Radiologic evidence
(e) Tx
Ewings: more likely in under 10 yoa, M > F, more common if hx of retinoblastoma or previous radiation
(d) Onion skinning on xray- layers of periosteal development
(e) Tx: rads and/or surgery
Osteogenic sarcoma: more likely in over 10 yoa, M > F
(d) Sunburst and Codman's triangle on Xray
(e) Chemo +/- surgery
122
Mononucleosis
(a) Response to amp or amox
(b) Dx
(c) Tx
(d) Precautions
Mononucleosis (EBV)
(a) Maculopapular rash develops in response to amp or amox (immune mediated vasculitis)
(b) Dx: Monospot test = heterophile antibody test
or blood smear w/ lymphocytosis and atypical lymps
(c) Tx: rest and symptomatic therapy
(d) Precautions: splenic hemorrhage or rupture => avoid contact sports until splenomegaly resolves
123
Tx for otitis externa
Tx: topical cirpofloxacin
124
Cough, runny nose fever --> macular rash behind ears and spreads down
-gray spots on buccal mucosa
Measles (paramyxovirus)
gray spots on buccal mucosa = Koplik spots = pathognomonic for Measles
-appear about 48 hrs before exanthem (rash break out)
125
Baby w/ poor feeding. Vesicles in mouth, on palms and soles. Rash on buttocks
Hand-Food-Mouth disease (Coxsackie virus A16)
126
Tx for absence seizures
Ethosuxamide or valproic acid
127
When is an ultrasound indicated for a UTI?
IF pt is febrile
| -assess for anatomy, absces, or hydronephrosis
128
Sore throat, joint pain, fever --> pinpoint rash on face that spreads down
-rose spots on palate
Rubella (paramyxovirus)
