Infectious Disease Flashcards
Rheumatic Fever treatment
anti-inflammatory medication (aspirin), eradication of the streptococcal infection (penicillin), and treatment of carditis or heart failure. There is no role for intravenous immunoglobulin in ARF. In cases of severe rheumatic carditis, the addition of glucocorticoids is believed to have therapeutic benefit, but contemporary studies are lacking, and it is not the current standard of care.
Most accurate ways to take temperature
rectal> oral >axillary
Problematic fever
greater than 41.7C
OI
OI = (FiO2 × mean airway pressure × 100)/PaO2. In the PALICC definition, mild ARDS is defined as an OI of 4 to 8, moderate as 8 to 16, and severe as greater than 16
Organism most likely to cause Lemierre syndrome
Fusobacterium Necrophorum
Hib vaccination schedule
2.4.6 months and booster at 12-15 months
Repeat series for any child who has undergone BMT, 6 months after treatment complete
Subdural hemorrhages
- crescent shaped
- associated with tears of bridging veins
- trauma: shaken baby
Epidural Hemerrhages
- lenticular (oval) lesion on CT
- associated with middle me I’ve always artery tear
- associated with temporal bone trauma
- period of Lucidity before LOC
- can lead to uncal herniation and 3rd nerve palsy- marked by ipsilateral dilated and in reactive pupil
Goal caloric intake for infant with congestive heart failure
140 kcal/kg/d
Puberty courses
Girls 8-12 years old
Breast development- pubic hair- peak height velocity- menarche
- menarche typically occurs 2-2.5 years after breast development (between SMR 3-4)
- precocious puberty : before 8 years old in girls
- delayed puberty: no breast development by 13 or no menarche by 16
Boys 9-13 years old
Testicular enlargement- pubic hair- inc penile length- peak height velocity
- delayed puberty: no testicular enlargement by 14
- precocious puberty: before age 9
Type 2 diabetes management
Initiate insulin therapy with blood glucose over 250 or HgA1c greater than 8.5 at diagnosis . Also consider with ketosis
Consider metformin if below insulin thresholds
Features of Guillan-Barre Syndrome
symmetric ascending paralysis that can evolve over hours to weeks and at times is preceded by nonspecific reports of back and leg pain. Patients will have weakness with areflexia and lack of a sensory level (distinguishing it clinically from other postinfectious autoimmune processes such as transverse myelitis)
- treat with IvIg or plasmapheresis
Parkland formula for fluid replacement after burns
4 mL/kg × weight (kg) × body surface area affected (%)
The rule of nines divides the body into multiples of 9% as follows:
Abdomen/chest and back, 18% each
Anterior and posterior lower extremities, 9% each
Anterior and posterior upper extremities, 4.5% each
Anterior and posterior head, 4.5% each
Genitals, 1%
True/ False: Florinated toothpaste is not recommended
True. Patients should begin brushing with fluorinated toothpaste at first tooth eruption
hemoptysis plus other system findings
think systemic vasculitis (eg. Wegners with hemoptysis plus renal findings plus anemia and thrombocytopenia)
Lab diagnosis of West Nile Virus
Serology for IgM antibodies on CSF or blood
ADHD meds that can cause hypertension
Stimulants and atomoxetine
Wolf-Hirschhorn Syndrome
4p deletion
commonly presents with unusual facies, prenatal and postnatal growth deficiency, significant developmental delays, hypotonia, hearing loss, antibody deficiencies, cardiac defects, urinary tract anomalies, central nervous system malformations, and epilepsy or electroencephalographic abnormalities.
“Greek warrior helmet nose”
Typical craniofacial dysmorphology seen in 4p− deletion includes microcephaly, “Greek warrior” helmet nose, high anterior hairline with prominent glabella, hypertelorism, epicanthus, high-arched eyebrows, downturned mouth, small jaw, and small ears with bilateral ear pits.
Who should be screened for ROP
born less than 30 weeks or less than 1500 grams
Begin screening at 31 weeks CGA or 4 weeks chronologic age
spasmus nutans
characterized by a clinical triad of dysconjugate pendular nystagmus, torticollis, and head bobbing.
skin lesion that can complicated severe protein- energy malnutrition
ecthyma gangrenous- primary pathogen pseudomonas gangrenosum
toxo infection treatment
do not need to treat healthy, asympotommatic patient but may require treatment in future if they become immunocompromised
MELAS
(mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes) is a mitochondrial disorder that presents with childhood onset of myopathy, seizures, recurrent headaches and vomiting, sensorineural hearing loss, early signs of diabetes mellitus, stroke-like episodes associated with periods of regression, and laboratory evidence of lactic acidosis both in serum and cerebrospinal fluid.
DTAP/ Tdap schedule
DTaP contains several diphtheria and tetanus toxoids as well as acellular pertussis. Children should receive 5 doses of DTaP prior to the age of 7 years. Typically the first dose is given at 2 months but can be given as early as 6 weeks. The following doses are typically given at 4 months, 6 months, 15 months, 18 months, and between 4 and 6 years of age. If a child does not receive vaccines on a typical schedule, the minimum intervals between doses are as follows:
Between first and second doses: 4 weeks Between second and third doses: 4 weeks Between third and fourth doses: 6 months Between fourth and fifth doses: 6 months Tdap, which should be used for children aged 7 years and older, contains 2 tetanus toxoids, a reduced amount of diphtheria toxoid, and acellular pertussis. It is recommended that children receive 1 dose as a booster between 11 and 12 years of age.
