ENPC 6TH Ed Chap 10 Child with a Fever

Question 1

How is a fever defined in an infant less than 3 mos. old?

Answer 1

rectal temp of 100.4 (149)

Question 2

Which body part regulates temperature?

Answer 2

Hypothalamus by triggering prostaglandin (147)

Question 3

What percentage of the population will experience febrile seizures?

Answer 3

Occur in 2-5% of the population (151)

Question 4

At what age range are febrile seizures the most common?

Answer 4

6 mos to 5 years (151)

Question 5

What can predict the increased likelihood of another pediatric febrile seizure?

Answer 5

a younger age of onset (151)

Question 6

What two main categories should a pedi patient with a fever be divided into?

Answer 6

“Ill appearing” and “well appearing” (149)

Question 7

Concerning meningitis, which type is usually more serious and more common?

Answer 7

Viral usually less severe than bacterial
Viral is less common (esp. since vaccinations) (151)

Question 8

Describe Kawasakis Disease?

age range, sequalae, outcomes, physiologic manifesatation

Answer 8

An acute febrile illness causing vasculitis and organ inflammation
15-20% develop coronary artery aneurysm if not treated
most common under 5 year old
most common cause of acquired heart disease (152)

Question 9

What percent of Kawasaki disease patients develop artery issues?

Answer 9

15-20% develop coronary artery aneurysm if not treated (152)

Question 10

What are some Kawasaki disease symptoms?

Answer 10

fever >102
fever X 5 days
bilateral conjunctivitis
Strawberry tongue
hand and foot redness and peeling
maculopapular rash
cervical lymphadenopathy (152)

Question 11

What are some treatments for Kawasaki syndrome?

Answer 11

1. reduce inflammation
2. IVIG w/in 10 days
3. high dose aspirin until fever free for 48-72 hrs, then low dose for several weeks
4. steroids
5. monoclonal abx (infliximab)

Question 12

What is one adverse outcome of untreated strep?

Answer 12

Rheumatic fever (153) Inflammation that can affect the joints, brain and heart–by damaging valves

Question 13

What is a major cause of meningitis in neonates?

Answer 13

Vertical transmission of Group B strep (153)

Question 14

Hallmark signs of Scarlet Fever?

Answer 14

Sandpaper rash and strawberry tongue
other signs include;
fever x 1-2 days
sore throat
rash starts on trunk, spreads to limbs (154)

Question 15

What is MIS-C?

Answer 15

Multi System Inflammatory Syndrome in children
can be fatal in 1-2% of patients

Question 16

What causes MIS-C?

Answer 16

Has been linked to COVID
blood vessels, digestive system, skin or eyes become swollen and irritated

Question 17

MIS-C criteria per Mayo Clinic?

Answer 17

Either had COVID-19 or has a close contact who had COVID-19 in the 2 months before hospitalization.
Has a fever.
Has a blood test result that shows a high level of inflammation throughout the body, called systemic inflammation.
Has at least two of the following symptoms:
Heart problems.
Red, bloodshot eyes.
Redness or swelling of the lips and tongue.
Redness or swelling of the hands or feet.
Pain in the belly, vomiting or diarrhea.
Problems with blood clotting.
Shock.

Question 18

What are some treatments for MIS-C?

Answer 18

IVIG
steroids
ASA (154)