Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Febrile Child > Flashcards

Febrile Child Flashcards

1
Q

What are frequently isolated organisms causing bacteriaemia in children?

A

E. Coli and Staph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are not good predictors of serious illness in a febrile child?

A
  • Degree of fever
  • Its rapidity of onset
  • Its response to antipyretics
  • Febrile convulsions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hx features in febrile child?

A
  • Localising symptoms
  • Travel Hx
  • Sick contacts
  • Immunisation Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Localising symtoms to assess on Hx?

A
  • Cough, choryza
  • HA, photophobia
  • N/D/V
  • Abdo pain
  • Joint symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What signs are suggestive of an unwell child?

A
  • Lethargic
  • Poor interaction
  • Inconsolability
  • Tachycardia
  • Tachypnoea
  • Cyanosis
  • Poor peripheral perfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PEx components febrile child?

A
  • General aspects to indicate likelihood of serious infection
  • Well or unwell i.e. signs of unwell child
  • Localising signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Localising signs to examine for in febrile child?

A
  • ENT exam
  • Neck stiffness
  • Work of breathing
  • Abdo signs
  • Skin rash
  • Joint swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Full sepsis work up in febrile child - components?

A

-FBE / film
-Blood culture
-Urine culture
+/- CXR if resp Sx / signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When should you not perform an LP in a child?

A

-Impaired LoC
-Focal near signs
-Haemodynamically unstable
Empirically treat, LP later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should a child be admitted / paediatric team be consulted?

A
  • Unwell child
  • Septic shock
  • High risk pts (immunosuppressed, chronic lung disease, congenital heart disease)
  • Advice needed regarding empirical Mx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should a febrile child be transferred to a tertiary centre?

A
  • Haemodynamic or respiratory instability
  • Encephalopathy
  • High risk patients
  • Child requiring care above level of comfort of local hospital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When can a child less than 1 month with a fever be discharged?

A

All infants less than 1 month with a fever should be admitted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When can children older than 3 months be discharged?

A
  • child is well

- follow up has been arranged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Child well and afebrile with S. pneumo +ve blood culture?

A
  1. If on ABx, a 7 day course should be completed.
  2. If not received ABx, they do not need Ix or Rx as have cleared infection themselves.
  3. Review if clinical deterioration occurs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Child unwell or febrile with S. pneumo +ve blood cultures?

A

Sepsis workup and admission for IVABx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Child with non S.pneumo positive blood cultures?

A

Sepsis work up and admission for IVABx

Discuss with consultant if ?contaminant

17
Q

High risk activity cues for febrile child?

A
  • No response to social cues
  • Appears ill to Dr
  • Doesn’t wake if aroused or doesn’t stay awake
  • Weak, high-piched or continuous cry
18
Q

Respiratory high risk cues for febrile child?

A
  • Grunting
  • tachypnoea: RR>60
  • moderate or severe chest indrawing
19
Q

Hydration mod/high risk cues?

A
  • Reduced skin turgor
  • Dry mucous membranes
  • reduced urine output
  • poor feeding
20
Q

Miscellaneous high risk signs febrile child?

A
  • Non blanching rash
  • Bulging fontanelle
  • Neck stiffness
  • Status epilepticus
  • Focal neuro signs
  • Focal seizures
  • Bile stained vomit
21
Q

Mod risk miscellaneous signs in febrile child?

A
  • Fever >5 days
  • Swelling of a joint or limb
  • NWB / not using extremity
  • New lump >2cm
22
Q

When can an infant 1-3 months be discharged?

A
  • child is well
  • investigations are normal
  • the child has been reviewed by a senior registrar / constultant
  • follow up has been arranged within 12h
23
Q

What are the key factors to keep in mind when assessing the febrile child?

A
  • Child’s age
  • presence of signs of toxicity
  • presence of infectious focus
24
Q

What are the signs of toxicity in a febrile child?

A

ABCD:

  • Alertness, arousal or activity decreased
  • Breathing difficulties (tachypnoea, increased WOB)
  • Colour (pale or mottled), circulation (cool peripheries), or cry (weak, high pitched)
  • Decreased fluid intake or decreased urine output
25
Q

What is preferred method of temperature measurement in 0-5 age group?

A

Axillary. Oral and rectal not recommended due to safety concerns; TM may be inaccurate

26
Q

What are important causes of fever and rash which must be considered?

A
  • Meningococcal

- Kawasaki

27
Q

What are the clinical features of Kawasaki disease?

A
  • high fever 5+ days
  • conjunctival infection
  • polymorphous rash
  • changes in mucous membranes
  • changes in extremities
  • cervical lymphadenopathy
28
Q

What are Ix results found in Kawasaki disease?

A
  • Neutrophilia
  • Thrombocytosis
  • Raised acute phase reactants
  • Elevated transaminases
  • Low serum albumin
29
Q

Approach to urine culture in febrile child?

A
  • All feb less than 3months, all toxic children
  • Clean catch appropriate but difficult
  • Bag urine inappropriate
  • Catheter recommended invasive technique
30
Q

What is recommended regarding febrile neonates? (0-4w)

A

All should have full septic workup and be admitted for parental antibiotics

31
Q

What is Kawasaki disease?

A

Acute, self limited systemic vasculitis of unknown aetiology. Mainly affects infants and young children. Coronary artery aneurysms may develop if untreated.

32
Q

What features are most useful for identifying UTI in febrile infants?

A
  • Previous UTI
  • Temp 40C+
  • Suprapubic tenderness

Paediatrics (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions