Infectious Diseases

Question 1

Reyes Syndrome

Answer 1

Very rare. Now no Aspirin is even prescribed to children to get this in the first place. 30% of kids with this would die. Now no more than 2 kids even get this annually.

Question 2

Tylenol dosing

Answer 2

Acetaminophen 7-15mg/kg every 4 hours do not exceed 5 in 24 hours. Available in liquid, rectal, chewable and melt-a-ways. Dose is different in each form. Do not give extra strength to children

Question 3

Ibuprofen dosing

Answer 3

10mg/kg every 6-8 hours. Maximum of 40mg/kg/day. Available in liquid, chewable, melt-a-way – not rectally like Tylenol.

Question 4

Tylenol and Ibuprofen cause

Answer 4

antipyretic and pain reducing… can alternate depeding on the practice. Ibuprofen at 10, Tylenol at 12, then pick one in 4 hours, can do 3 hour dosing – room for error.

Question 5

Supportive Care means…

Answer 5

Tylenol/Motrin, restful activity, increase fluids, return to office if symptoms increase or worsen

Question 6

Erythema Infectiosum caused by

Answer 6

Fifths disease. Etiology: exposure to parovirus B19

Question 7

Erythema Infectiosum transmission, contagious?

Answer 7

Contact with respiratory droplets. Contact precaution. Mildly contagious, NOT contagious after rash appears.

Question 8

Erythema Infectiosum

Answer 8

4-14 days, up to 21 days

Question 9

Erthema Infectiosum s/s

Answer 9

Prodromal low fever, 99 may not even notice it. Not really feeling well, cranky, whiny, not feeling well for a few days then bam rosy cheeks

Question 10

Erythema Infectiousum children may develop persistent

Answer 10

arthritis

Question 11

Rash of E.I stage 1

Answer 11

Intensely red, maculopapular lesion on face – looks like slapped cheeks. Can return to class when rash appears as they are no longer contagious.

Question 12

Stage 2

Answer 12

Rash appears on trunk, arms and legs that can last a week or so up to 6 weeks

Question 13

Stage 3

Answer 13

Rash fades from the center outward, lacelike appearance to rash, may look lavender color, fine desquamation may occur. Can be precipitated by trauma, sunlight, hot or cold.

Question 14

Erythema Infectiousum treatment

Answer 14

Complications are rare – includes arthralgias and joint pain – can give Ibuprofen. Treatment for E.I includes supportive care, avoid contact w pregnant women as it is teratogenic, returns to school when rash appears. Can get this again, no immunity once get it.

Question 15

Coxsackie Disease s/s

Answer 15

ABRUPT fever, high 101/102, malaise. Sore throat, anorexia, drooling, abdominal pain since it is viral can lead to soft stool. Dont want to eat anything, hurts to swallow so they drool, even in older kids. Rash: vescles or papules on the tongue, mucosa, hands and feet. Look everywhere in mouth. Also on feet, raised, hard lesions.

Question 16

Treatment Coxsackie

Answer 16

Symptomatic no abx. Prevent dehydration high fever will also not want to eat. Tylenol q4h 20 minutes after it will peak have them eat ice cream yogurt something they like, can freeze bread soothing.

Question 17

1 Complication Coxsackie

Answer 17

dehydration

Question 18

Magic Mouthwash

Answer 18

1 part lidocaine 2%. 1 part maalox. 1 part benadryl 12.5 per 5ml. 120ml. Swish, gargle and spit one to two teaspoons every 6 hours as needed. Can swallow if esophageal involvement. Shake well.

Question 19

Roseola cause

Answer 19

By herpesvirus 6. Most often occurs in childhood. Seasonal when it is warmer in the spring and fall. Unknown transmission. Will transmit when febrile. Icubation 10-14 days

Question 20

Symptoms Roseola

Answer 20

First is a VERY HIGH fever 104-105, infants may be irritable and anorexia but not ill appearing. Slightly inflammed pharynx. Lymphadenopathy. After 3-4 days of high fever the fever will suddenly vanish. Eating drinking sleeping is all ok except for fever. High fever may cause seizures. When blotchy, nonitchy rash comes then no longer contagious

Question 21

Scarlet Fever

Answer 21

GABHS. Fever, chills, lethargy. Sore throat. They look and feel sick.Pallor and circumoral cyanosis. Rash - pinpoint/sandpaper, after 1 week desquamates.

Question 22

Scarlet Fever treatment

Answer 22

Pen V 12 125-500mcg q6-8 hours. Augmentin if Amoxil already. If allergy to PCN can do Clarithromycin 15mg/kg/day q12h x 10 days or Zithromax 12mg/kg/day x 5 days. Antihistamine for rash. Analgesic, antipyretics