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Pediatric Primary > Infection > Flashcards

Infection Flashcards

1
Q

Hepatitis A

A

Fecal-oral route. Risks: contaminated food, travel, men-men sex, illicit drug use. <6y rarely jaundiced. Incubation: 28-30days. Sheds 1-3 weeks. Pre-Icteric phase: abrupt fever, malaise, n/v, headache, abd. Complaint. dull RUQ pain. Icteric phase: jaundice lasting days to month. Dark urine clay stools, diarrhea infant constipation adult. Mild helatomegaly and tenderness and lymphadenopathy may occur. IgM testing.

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2
Q

Hepatitis A treatment

A

Supportive. IVIG or HAV vaccine within first 2 weeks. Food workers off work for 1 week. Good hygiene, safe water, vaccine.

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3
Q

Hepatitis B

A

Mostly in blood, semen, vaginal secretions, and others. Highly contagious and severe liver disease. Immigrants high risk, mom to baby, men men sex, etc, needle use, healthcare workers, getting tattoos, ESRD. Older you are at exposure less risk of disease. Incubation 120 days. Gradual onset. Arthralgia, skin changes > hepatomegaly, fever, nausea. Tests: hepB core antigen, hepB antigen, PT, liver enzymes.

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4
Q

Hepatitis B treatment

A

Supportive. Active or passive vaccination. Chronic hepB: interferon alpha >12mo, lamivudine >3y, Adefovir/tenefovir >12y, entecavir >16y. Yearly liver US, liver enzymes, HAV vaccine, a-fetoprotein. No HBIG or steroids. HepB Can lead to cirrhosis, liver failure, carcinoma

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5
Q

Hepatitis C

A

Blood transmission. Highest rate chronic disease. Highest transmission mom> baby, but ok to ebm and vaginal delivery. 1/2 can resolve spontaneously by 2 or 7 years old. Injection drug use big transmission means. Incubation of 45 days. Prodromal phase: jaundice, RUQ pain, nausea, anorexia. Chronic cirrhosis can be 20-30 years later. No serology for acute infection. Immunoassay or HCV PCR, most seroconvert within 15 weeks of exposure or 5-6 weeks from symptoms. Retest infants after 18mo.

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6
Q

Hepatitis C treatment

A

Supportive. 3-17years can have non-nonpegylated interferon alfa-2b and ribavirin.no alcohol, don’t share tooth brushes or razors, use condom.

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7
Q

Hepatitis D

A

can only infect if with HBV. parenteral, mucosal, percutaneous blood exposure. Incubation 2-8 weeks. Risks: drug users, hemophilia, immigrants. Prevented with HBV vaccine.

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8
Q

Hepatitis E

A

Fecal oral transmission. Usually due to contaminated water. Symptoms appear within 15-60 days exposure. S/s: jaundice, malaise, anorexia, fever, abd pain, arthralgia. Diagnosed with viral RNA in stool or serum. Supportive tx, usually full recovery.

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9
Q

Neo Sepsis History/Symptoms

A

“not doing well”, temperature instability, jitteriness, poor feeding/vomiting, lethargy/irritability, RDS, seizures. Jaundice, pallor, petechiae, rash, hepatosplenomegaly, poor tone/perfusion. abnormal HR, tachypnea.

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10
Q

Sepsis Diagnostics

A

CBC, culture, urinalysis/culture (after 72h life), ammonia, CSF culture/gram stain

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11
Q

Sepsis management

A

broad-spectrum antibiotic coverage; treat for listeria with ampicillin, GBS with penicillins/cephalosporins, and gram negatives with ahminoglycosides and cephalosporins.

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12
Q

Polio

A

enterovirus. Fecal-oral and respiratory transmission. Suspect if under immunized kid with fever, aseptic meningitis, or paralytic symptoms. Diagnostic test: viral culture from stool and throat within 14 days of symptoms. Differential diagnoses: paralysis like myelitis, Guillain-Barre, peripheral neuritis, encephalitis, transverse myelitis, rabies, tetanus, etc, and scurvy, nerve trauma, osteomyelitis

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13
Q

Polio Treatment

A

Supportive. Don’t exercise or fatigue because increases risk of paralysis.

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14
Q

Infectious Mononucleosis

A

Most caused by EBV. transmitted by kissing, sexual contact, or saliva exchange. Incubation thought to be 30-50days. S/s: enlarged lymph nodes. Prodrome: malaise, fatigue, fever. Acute: + pharyngitis, discrete contender non-reddened lymphadenopathy, tonsillopharyngitis. hepatosplenomegaly. Rash (especially with those taking amoxicillin or amp)

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15
Q

Infectious Mononucleosis

A

Resolution phase gradual decrease fatigue/fever, organs may take 1-2months to return to size. CBC with atypical lymphocyte. Elevated heterophiles and liver numbers; diagnostics is EBV viral culture and EBV specific core and capsule. Differential diagnosis: any infectious disease.. strep throat, leukemia, CMV, rubella, toxoplasmosis, etc.

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16
Q

Infectious Mononucleosis treatment

A

Supportive, bedrest, OTC pain/fever meds, increased calories and fluid intake. Avoid contact sports/ strenous exercise for 4 weeks. Symptoms resolve 2-4 weeks; fatigue may be up to 12months post infection.

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17
Q

Roseola Etiology

A

D/t HHV-6. Oral, nasal, conjunctival transmission route. mostly between 7-24months. Rare <3mo/ >4years. Reactivation can occur in immunocompromised. Incubation: 9-10 days. Most contagious with fever pre-rash.

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18
Q

Roseola Symptoms

A

Sudden high fever for 3-7 days, sometimes lymphadenopathy, lethargy, eyelid edema, reddened TMs, febrile convulsion; usually not many symptoms. Then after fever a diffuse, nonpruritic, discrete, rose maculopapular rash, fades on pressure and rarely coalesces. Lasts hours to 3 days, starting on trunk and spreading out.

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19
Q

Roseola Diagnostics

A

Clinically diagnosable. WBC will show a distinctive drop with fever pattern. Titers 2-3 weeks apart more reliable for antibody. RT-PCR assay says acute or latent.

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20
Q

Roseola Differentials/treatment

A

viral rashes, drug hypersensitivity, parvovirus, sepsis, meningitis. Supportive treatment, Tylenol if uncomfortable.

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21
Q

Chickenpox

A

VZV etiology. Shingles is reactivation of latent infection. Immunity lifelong and reinfection rare. Disease peaks in 10-14 years. Incubation period 10-21 days; communicable 1-2 days pre rash and until all lesions crust. Not always a prodrome but if so: low fever, listless, headache.

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22
Q

Chickenpox s/s

A

Rash: starts scalp/head/trunk, itchy drop vesicles that cloud and umbilicate in 24-48hours and then burst and scab; can have high fever. Breakthrough can happen 42 days after vaccine (contagious). Diagnostic: PCR or DFA. Diagnosis usually clinical because rash is classic symptom.

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23
Q

Chickenpox treatment

A

supportive. Oatmeal baths, antihistamines, Tylenol, penicillin or cephalosporin for superinfection. if fever more than several days, increasing temp 4+ days after rash appearance should be watched for invasive disease. No aspirin! Acyclovir can help with severe cases.

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24
Q

Influenza

A

A/B strains epidemic disease, C mild sporadic. type A also by hemagglutinin and neuraminidase aka H1N1 etc. Highly contagious, direct contact or respiratory transmission. flu epidemics generally in winter for 2 months. kids shed for 10 days. incubation period 1-4 days. infectious 24 hours prior to symptoms. shedding peaks day 3 and stops day 7.

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25
Q

Influenza symptoms

A

sudden high fever, headache, chills, coryza, vertigo, pharyngitis, back pain, dry hacking cough, vomiting, diarrhea, croup conjunctival infection, epistaxis. Infants can be septic. Acute s/s usually 2-3 days. viral cultures for diagnostics or PCR, IFA, molecular assays.

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26
Q

Influenza differentials and management

A

RSV, rhino, epiglottitis, croup, bacterial infections. Supportive: bed rest, fluids, OTC antipyretics, cough meds. Warn of bad symptoms like dehydration, difficulty breathing, muscle weakness. Can treat with tamiflu for immunosuppressed, <2 years, chronic illnesses, pregnant or postpartum 2 weeks, <19years old with aspirin, obese, or residential care kids, or native Americans. start med within 2 days of s/s, continue until no s/s for 2 days. no aspirin!

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27
Q

HIV etiology

A

most disease from type 1, but some in Africa from 2 still. retroviruses. Infection is for life; latent hides in blood, brain, bone marrow, genital tract. incubation period of 8-12 years. high risk drug users, male/male sex. Vertical from mom too. Transmits in blood, semen, cervical secretions, EBM through sex, contaminated needles/blood, perinatal exposure, breastfeeding.

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28
Q

HIV treatment

A

C-section to decrease risk to fetus; zidovudine, no breastfeeding unless in countries where necessary for food. need 3 oral ART drugs from minimum 2 classes. Typically 2 NRTIs and an NNRTI or PI with low dose ritonavir. Greatly drops mortality. zidovudine prophylaxis birth - 6 weeks. Also Bactrim prophylactically from 4-6 w until 1 year, and if uninfected can d/c.

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29
Q

HIV s/s

A

flu like for 2-4 weeks, then asymptomatic for months to 15 years. CD4 declines about 50 a year. then s/s: lymphadenopathy often first symptom > hepatosplenomegaly. failure to thrive, chronic diarrhea, pneumonia, oral candidiasis, bacterial infections, parotid swelling, progressive neurological deterioration. older children more pneumonitis too. cardiac hypertrophy, anemia, CHF, all infections.

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30
Q

HIV diagnostics/ differentials

A

newborn HIV screening. babies may take up to 19months to seroconvert. AIDS is CD4 <200. CBC and diff prior to starting meds. test antibodies and virology testing. Differentials: immunosuppressive meds, diseases, IBS, diverge, ITP, allergies, CF, GVH, CMV, toxoplasmosis, ataxia, telangiectasia

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31
Q

Measles (rubeola)

A

morbillivirus. characteristic rash indicating viremia. spreads by respiratory, blood, urine. peaks late winter/spring. super contagious. Incubation 8-12 days. modified up to 21 days. contagious 1-2 days prior to s/s and 4 days after rash.

32
Q

Measles s/s

A

prodrome: 4-5 days of URI, cough, coryza, conjunctivitis (3 C’s of measles) and Koplik spots on oral mucosa. rash and fever day 3, rash starts behind ears/forehead. papule enlarge, coalesce, move downwards. by the time it gets to legs, face starts clearing. respiratory symptoms most severe on day 3 of rash. can be hemorrhagic. fades after day 4, clears and has residual desquamating for 1 week.

33
Q

Measles diagnostics and differentials, treatment

A

IgM when s/s appear. Report within 24 hours. differentials: viral rash, scarlet fever, Kawasaki, Rocky Mountain, drug rash, serum sickness. Treatment is supportive (antipyretics, bed rest, fluids, air humidification, warm room, antibiotics for superinfection). also vitamin A for 2 days. can do IVIG within 6 days of exposure to susceptible.

34
Q

Mumps

A

acute general viral disease with enlargement of one or more salivary glands (painful). paramyxoviridae family. common late winter/spring in <10 years; crosses placenta. can cause fetal malformations. incubation 12-25 days. communicable 1-2 days prior to swelling and 5 days after onset.

35
Q

Mumps s/s

A

prodromal: rare but can be fever, headache, anorexia, neck/muscle pain, malaise. swelling: 24h post, painful swelling of parotids. back to size in 3-7days. rarely, maculopapular, truncal, pink discrete rash is seen. pain with eating sour (pickle sign). can have orchitis post puberty.

36
Q

mumps diagnostics

A

buccal swab, RT-PCR, IgM, leukopenia, elevated amylase. within 3 days of s/s. differentials: lymphadenitis, CMV, HIV, enteroviruses, bacterial/viral issues, cancer.

37
Q

Mumps treatment

A

supportive antipyretics, bed rest, diet for chewing discomfort. Steroids/NSAIDs for arthritic complications. elevate scrotum for orchitis. no school until 9 days post swelling. immunize.

38
Q

Fifth disease

A

erythema infectiosum, d/t parvovirus B19. vertical transmission, respiratory, or percutaneous exposure. childhood disease in 5-15 year olds. late winter/early spring. incubation 4-21 days, symptoms between 2-3 weeks after exposure. highest communicability is before rash/joint pain/edema.

39
Q

Fifth disease s/s

A

prodrome: mild fever, myalgia, headaches malaise, URI. Rash: 7-10 days after prodromal in 3 stages: on face as intense red on cheeks with circumoral pallor for 1-4 days. then ally maculopapular eruption on trunk moving peripherally minus palms/sores (1 month). mild pruritic. Then, rash subsides. can recur with trauma, heat, exercise, stress, sunlight, cold. Arthralgia (rarer) resolves in 2-4 weeks.

40
Q

Fifth disease diagnostics

A

clinical diagnosis. IgM antibody. anti IgG shows past infection. PCR for immunocompromised. Differential: rubella, entero, lupus, atypical measles, drug rashes. no treatment minus transfusion for hemolytic anemia. IVIG for immunocompromised. can go to school in rash stage.

41
Q

parainfluenza virus

A

a paramyxovirus, similar to flu/mumps, big cause of croup, bronchitis, bronchiolitis, and pneumonia. types 1/2 get kids up to 5 years. type 3 in <1 year. from NP secretions or famine. incubation 2-6 days. shed virus for 4-7 days before s/s and up to 21 days after.

42
Q

para-flu virus s/s

A

mild fever, sore throat, hoarseness, cough, croup cough, dyspnea, crackles, wheezing, hyper aeration. doesn’t need routine testing but can be gotten on PCR. NP cultures. differentials: URIs, allergic croup, abscess, epiglottis, foreign body, reflux. Treatment is supportive. antibiotics if suspecting superinfection

43
Q

Rubella

A

rubivirus. NP secretions or transplacental transmission. in blood, EBM, conjunctival sac, urine. need prolonged/repeated contact to be infected. incubation: 14-21 days. max viral shedding 5 days pre rash to 6 days post rash appearance. winter/spring month peak. risk immigrants and unvaccinated. if primary rubella in first 12weeks pregnancy, 61% chance congenital defects.

44
Q

Rubella s/s

A

prodrome: fever, lower GI upset, sore throat, eye pain, arthralgia, malaise, headache 1-5 days before stage3. then lymphadenopathy within 24 hours of rash usually, lasts 1 week. then Rash with enanthem first. rose to red spots on soft palate. rash face then spreads caudally, gone by 3rd day. can be itching, desquamation.

45
Q

Rubella diagnosis

A

clinical diagnosis. PCR. IgM after 5th day post rash. differentials: scarlet fever, mono, entero, roseola, rubeola, fifth disease, EBV, drug eruptions. treatment: supportive; stay at home for 1 week after rash.

46
Q

Lyme disease

A

borrelia burgdorferi, spirochete, cause. most common vector borne infection in US/europe. host is mouse, deer, squirrel, lizard. sesame seed size. boys 5-9 highest risk. ticks feed for 36-48 hours and adult for 2-3 days before risk of transmission of Bb.

47
Q

Lyme disease s/s

A

stage1: 1-2 weeks post bite, rash at site. annular > clear ring bull’s eye, at least 5cm for diagnostic criteria. warm, pruritic, not painful, can fade. has rapid enlargement. fever, malaise, headache, arthralgia, myalgia, stiff neck. stage 2: secondary annular lesions 1-3cm, neuro complaints, paresthesias, neuropathies, can last up to 2 years without treatment. stage 3: pauciarticular arthritis. chronic neurological issues. knees most common. joints hot, red, edematous, but not as painful. recurrent, migratory.

48
Q

Lyme disease diagnostics

A

presence of EM is diagnostic. IgM 2-4 weeks after a bite. can be positive for old infections. ELISA, western blot. after 4 weeks, IgG. Differentials: eczema, tines, granuloma annular, cellulitis, insect bite, WNV, Parvo, arthritis, hepatitis, meningitis, etc.

49
Q

Lyme disease treatment

A

doxycycline, amoxicillin, cefuroxime, and prophylaxis for a tick that was attached 36-72 hours and in endemic area, or if tick can’t be identified. In early disease <8 years: amoxicillin. >8y: doxycycline. use DEET to prevent, permethrin on clothing, long sleeves, hat, remove safely.

50
Q

Rocky Mountain spotted fever

A

rickettsia rickettsii, coccobacillus. vectors: American dog tick, Rocky Mountain wood tick, brown dog tick. spring/summer months. incubation 2-14 days. remove promptly.

51
Q

Rocky Mountain s/s

A

fever, chills, severe headache, myalgia, malaise, GI upset/tenderness, diarrhea, cough, conjunctival injection, photophobia, altered mental status. focal neurological deficits with progression. maculopapular rash 2-5 days after fever onset. flat, nonpruritic, faintly pink spots on wrists, forearms, ankles, then to trunk. on day 6, petechial rash.

52
Q

Rocky Mountain diagnostics

A

immunohistochemical staining or PCR; gold standard IFA. IgG. thrombocytopenia, moderate hyponatremia, leukocytosis, anemia. Differentials: enteroviral, adenovirus, flu, sepsis, TSS, measles, rubella, syphilis, typhoid, gonococcal infection, ITP, TTP, mono

53
Q

Rocky Mountain management

A

antibiotics prior to rash and within 5 days. if summer in endemic area with acute fever <2 days without profound malaise/myalgia/headache, do CBC/chem profile and monitor. If fever progresses to 3rd day and labs suggest RMSF or kid appears toxic, do antibiotics. doxycycline all ages 7-10 days.

54
Q

MRSA

A

altered PBP so less sensitivity to B-lactam antibiotics minus ceftaroline. risk for MRSA: boil, furuncle, abscess without draining puss that is red, warm painful; treatment failure with B-lactam agent, recent skin infection, family members with similar infection, neonate with skin/soft tissue infection; spider bite lesion or larger ones, pus present; history small, contender, nonpruritic maculopapular lesions that become pruritic or painful. contact sports, ethnic minority, woman with breast abscess, in last year: hospital, surgery, indwelling device, child care, CF, head/neck infection.

55
Q

MRSA treatment

A

treat skin infections topical bacitracin/mupirocin. assess for lack of response to treatment. select MRSA med if community prevalence, nosocomial infection, or severe. recommend I&D with culture, then empiric treatment. no fluid fluctuation or signs of bacteria, use warm compresses and oral antibiotics. reveal in 24-36 hours post I&D. MRSA drugs if multiple abscesses, cellulitis developing, systemic s/s, comorbid/immunosupressed, no response to I&D.

56
Q

Cat scratch disease

A

B. Henselae gram negative bacillus. common cause of >3 weeks lymphadenopathy. usually a cat involved. incubation 7-12 days. symptoms: in 1/3. erythematous papule in linear pattern paralleling scratch, heal spontaneously. 4 weeks post inoculation, swollen lymph nodes. warm, tender, indurated, red. lasts 4-6 weeks. mucous membrane ulcers, fever, malaise, fatigue, anorexia, headache. Spontaneous recovery in 2-4 months.

57
Q

cat scratch diagnostics

A

IFA. cultures, bortonella PCR. differentials: bacterial/viral infections, neck masses, malignancy. Treat with antipyretics, moist wraps or aspiration for painful nodes. No I&D. no antibiotics unless systemic or superinfection. azithromycin may speed recovery. treat for immunocompromised. don’t play rough with cats, wash scratches. avoid young cats or strays.

58
Q

meningococcal disease

A

commonly N. Meningitidis, listeria, E. coli, etc. incubation 1-14 days. contagious until 24 post initiation of treatment. s/s: occult bacteremia, febrile kid with URI or GI symptoms. maybe rash. 2/3 go to meningitis, progresses rapidly, fever, septic shock, fever, headache, myalgia, chills, cold hands/feet, flu s/s, vomiting, abdominal pain, petechiae > purpura, maybe low BP, DIC, acidosis, hemorrhage, renal failure, heart failure, coma. Stiff neck, irritability.

59
Q

meningococcal disease diagnostics

A

blood, CSF, sputum, lesion scraping cultures. PCR. hypoalbuminemia, hypocalcemia, increased lactate, low platelets, elevated ESR/CRP, decreased PT, fibrinogen, prolonged coag times with DIC. differentials: septicemia by other bacteria, viral meningitis, brain abscess, sinusitis, h/o disease, RMSF, lead, rubella/rubeola, ITP, typhoid, TSS, Kawasaki

60
Q

meningococcal disease treatment

A

hospitalization mandatory with IV antibiotics 5-7 day course. evaluate contacts. Chemoprophylaxis within 24 hours regardless of immune status. If contact in week prior to s/s, high risk invasive disease and should get meds. airline travel >8 hours by individual, medical staff if mouth to mouth, intubation, suction prior to antibiotics. Rifampin or ciprofloxacin for infants/children.

61
Q

group A streptococcus

A

if M protein, can resist phagocytosis, if not then avirulent. many toxins. often d/t overcrowding. winter/spring, temperate climates, >3 years old generally. risk: VCV, IV drug use, HIV, DM, chronic heart or lung disease, infants, older adults. incubation 2-5 days for pharyngitis and 7-10 days skin infection. non infectious after 24 post antibiotic start.

62
Q

GAS s/s

A

abscesses, otitis media, sinusitis, scarlet fever: 3 day incubation with sore throat, vomiting, headache, chills, malaise, exudative red tonsils that swell, grey-white exudate on pharynx. petechiae. strawberry tongue, scarlatina rash, blanches to pressure, finely papular starting on neck and going down, can desquamate for up to 6 weeks). bacteria. joint infections, arthritis, cellulitis, rheumatic heart disease, necrotizing fasciitis.

63
Q

GAS diagnostics

A

differentials: flu, parable, rhino, corona, EBV, bacterial URI, impetigo, meningitis, etc. Treatment: antibiotics to prevent risk for rheumatic fever.

64
Q

Tuberculosis

A

M. Tuberculosis, slow growing; transmits by droplets. can be latent or active. high risk are immigrants, travelers, IV drug users, alcoholics, homeless, closed communities. Detected by Mantoux TST or positive interferon y release assay. reactive within 2-10 weeks after initial exposure. high risk progression in 6 months after infection and stays high after 2 years, but can be latent. most infections from adults. high risk to a active disease in infants, 15-25years, older adults. especially if immunocompromised, chronic diseases, receiving TNF-a antagonists, having had TB.

65
Q

TB s/s

A

hilar lymphadenopathy, then focal hyperinflation and atelectasis; low grade fever, cough, dyspnea, malaise, decreased appetite, weight loss, night sweats, chills, erythema nodusum, keratoconjunctivitis. can have airway obstruction from enlarged lymph nodes. (See ch, extended info)

66
Q

TB diagnostics

A

Mantoux is PPD skin test. can read 4-8weeks after exposure. prior BCG can cause positive results. Test positive: induration >5mm in close contacts, consistent CXR, immunosuppressed or HIV; induration >10mm for those <4 years without risk factors; induration >15mm in >4years no risk factors. TST preferred for those <5 years. IGRA recommended for confirmation for immunocompetent >5 years, those who got BCG vaccine, unlikely to return for reading, if initial is positive in a kid who had BCG. Hallmark enlarged regional lymph nodes with small pleural focus on CXR; pneumonitis.

67
Q

TB differentials

A

mycotic infections, staph pneumonia, sarcoidosis, chronic pneumonia, Hodgkin lymphoma, toxoplasmosis, etc. Treatment: consult a specialist. DOT treatment. prophylaxis: INH 4-6 months; rifampin 3 months; or INH and rifapentine 12 weeks. For disease: all four drugs for 2 months, then INH/RIF for another 4 months. If HIV or bone/joint/disseminated, then 6-9 months of treatment. meningitis 9-12 months. exclusively breastfed infant getting ISH should get pyridoxine.

68
Q

Tetanus

A

C. tetani bacteria releases neurotoxic exotoxin. Gram + rod. resistant to heat/antiseptics. Inoculated through contaminated dirt/soil. or via umbilical stump with unclean instruments, soiled dressings, mud or dung on stump. Incubation 3 days to 2 weeks. s/s a week post delivery.

69
Q

tetanus s/s

A

lockjaw trismus, dysphagia with drooling, noisy respirations, neck/back/shoulder stiffness, cephalocaudal progression of rigidity, spasms, fever, painful contractions, respiratory compromise, autonomic disinhibition excessive sweating, HTN, tachycardia, arrhythmias. Can cause fractures, respiratory arrest, aspiration, etc. resolution gradual over 6 weeks.

70
Q

tetanus treatment

A

tetanus IVIG, wound care, metronidazole, ICU, paralytic and sedation, intubation as needed. Get vaccine! prophylactically

71
Q

Pertussis

A

Gram - bordetella pertussis. whooping cough. major inflammation, irritation > epithelial cell damage. cause whooping cough for attempt to clear necrotic epithelial tissue/mucus and trying to inspire oxygen after. respiratory/airborne transmission. incubation 7-10 days. most contagious in catarrhal stage.

72
Q

pertussis s/s

A

Catarrhal (URI, low grade fever) > paroxysmal (intense coughing)> convalescent (recovery) phases lasting 1-3 weeks each and complete recovery 2-3 months. infants can have apnea, cough, poor feeding, leukocytosis with lymphocytosis. diagnosed with PCR. DFA. culture gold standard. Differentials: other viruses, Gerd, CF, sinusitis, asthma, FBs.

73
Q

pertussis treatment

A

antibiotics within 6 weeks of disease in infants and in children/adults within 21 days. macrolides except EES infants <1 month d/t risk pyloric stenosis. Azithromycin. Bactrim as alternative. prophylaxis of exposure with macrolide.

74
Q

botulism

A

from C. Botulinum, spreads by soil/water, food borne, or via wounds. Leads to weakness, blurred vision, tired, trouble speaking > vomiting, weakness, diarrhea. Don’t give honey to kids <12 months! properly store food, heat it properly. treat with antitoxin. may need antibiotics or mechanical ventilation

75
Q

Malaria

A

spread by anopheles female mosquito. relapses can occur d/t dormant liver stage parasites. febrile nonspecific illness from 7-30 days after exposure. then high fever/chills, rigor, sweats, headache appearing cyclicly in 2-3 day pattern. n/v/d, cough, pallor, jaundice, tachypnea, arthralgia, myalgia, abdominal/back pain, hepatosplenomegaly. anemia, thrombocytopenia, elevated bilirubin and liver enzymes.

76
Q

Malaria diagnostics

A

PCR, DNA probes, smears. treated with imidazopyrazine, vaccines being developed. case management, insecticide-treated nets, intermittent preventative treatment in pregnant women and infants, and indoor residual spraying. prophylaxis for travelers to high risk areas.

Pediatric Primary (10 decks)

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