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Pediatrics > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What is the gold standard method to take neonate/infant temps?

A

rectal

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2
Q

all infants 0-29d with possible infection get what diagnostics (hint: think three locations)?

A

Urinalysis and urine culture
CBC, +/- inflammatory markers (PCT, CRP) and blood culture
Lumbar puncture and CSF culture

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3
Q

Infants 30-59d get what diagnostics?

A

Can depend on institutional guidelines
Minimum urine and blood evaluation
Based on those results and clinical presentation, consider LP

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4
Q

Infants 60-90d get what diagnostics?

A

Can depend on institutional guidelines
Minimum urine evaluation
Consider blood evaluation (10% of pyelo will have bacteremia)
Based on those results and clinical presentation, consider LP

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5
Q

under 3 months of age, who has a higher incidence of UTIs, boys or girls?

A

Boys, particularly those who are uncircumcised.

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6
Q

Risk Factors for UTI

A

Urologic abnormalities (hypospadias, vesicoureteral reflux)

Neurologic abnormalities (tethered cord, spina bifida, neurogenic bladder)

Poor hygeine (front to back!)

Sexual activity

Behavioral dysfunctional voiding

Constipation

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7
Q

What is the gold standard to Dx UTI? and what is the criteria for Dx?

A

Urine Culture

PYURIA/BACTERIURIA AND >50K COLONIES OF A SINGLE ORGANISM

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8
Q

Early UTI can suggest?

A 
A GU abnormality:
Vesicoureteral reflux
Posterior urethral valves
Single/horseshoe kidney
Duplex collecting system
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9
Q

Under 2 mos of age with UTI warrants what diagnostics to be performed?

A

Renal ultrasound

Consider voiding cystourethrogram

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10
Q

2 mos to 2 years with UTI, diagnostic consideration?

A

Free pass for first UTI, then ultrasound

VCUG if ultrasound abnormal or recurrent UTIs

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11
Q

What are the most common infections in infants under 90d?

A

10% urinary tract infections/pyelonephritis
2% bacteremia
1% meningitis

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12
Q

What are the most common bacterial pathogens associated with acute otitis media?

A

SHM

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis

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13
Q

Otitis Media Tx

A 
Watchful waiting (could be viral)
Pain control
1st line- Amoxicillin
2nd line- Augmentin (Amoxicillin/Clavulanic Acid)
3rd line- Ceftriaxone IM
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14
Q

Tx for frequent/persistent otitis media infections?

A

Tympanocentesis

Myringotomy tube placement

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15
Q

Bacterial sinusitis symptoms

A

Severe nasal discharge
Persistent respiratory symptoms (>2wks)
Cough, headache, facial pressure, tooth pain, halitosis

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16
Q

Bacterial sinusitis treatment

A

watchful waiting

amoxicillin

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17
Q

which sinuses are present at birth?

A

maxillary sinus and ethmoid sinus

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18
Q

Classic symptoms of Strep Pyogenes?

A 
Fever
Pharyngitis (Palatal petichiae, Tonsillar exudate, Strawberry tongue)
Tender cervical lymphadenopathy
Headache
Abdominal pain +/- vomiting
Rash
Absence of cough
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19
Q

S. Pyogenes Tx?

A

Penicillin/amoxicillin

20
Q

Bacterial Gastroenteritis Tx?

A

Rarely treated, tends to resolve without antibiotics

Antibiotics must be used cautiously, many strains can cause Hemolyic Uremic Syndrome

21
Q

S/sx of bacterial meningitis

A 
Fever
Lethargy
Headache
Neck stiffness
Irritability
Vomiting
Bulging fontanelle
Petechiae
22
Q

What pathogens most commonly cause bacterial meningitis in infants <3mos.

A

E. Coli
GBS
Listeria

23
Q

What pathogens most commonly cause bacterial meningitis in older infants/children

A

Strep pneumo, Neisseria meningitis, H. Flu

24
Q

early complications of bacterial meningitis

A 
Brain abscess
Subdural empyema
Seizures
SIADH
Sensorineural deafness
25
Q

Late complications of bacterial meningitis?

A

developmental delay
hydrocephalus
epilepsy

26
Q

URI Tx

A

Fluids (to prevent dehydration)
Antipyretics (no ibuprofen under 6 months, no aspirin under 18 years)
Nasal bulb suction or wash

No definitive proof of efficacy for decongestants, expectorants, cough suppressants, against use in those <6yo.
Antihistamine may give slight benefit in those over 12 months

zinc, vitamin C and echinacea have limited data regarding efficacy in children; honey (>1 year) can help cough

27
Q

hand foot mouth can sometimes also affect what area?`

A

diaper area

28
Q

Roseola symptoms

A

Fever alone, often high, for 3-5 days

Followed by eruption of full body rash after fever gone

29
Q

Warts Tx Options

A 
salicylic acid
duct tape
tretinoin cream
liquid nitrogen
canthradin
imiquimod (podophyllin)
30
Q

What causes molluscum contagiosum

A

pox virus

31
Q

what is the most common cause of viral encephalitis/meningitis? and which is the most serious?

A

most common: enterovirus

most serious: HSV

32
Q

How is HSV testing done?

A

by surface culture and PCR of blood/CSF

33
Q

3 categories of HSV?

A

skin-eye-mouth
disseminated (bloodstream, liver)
CNS (meningitis, encephalitis)

34
Q

workup for HSV meningoencephalitis?

A

CSF studies, includes HSV PCR vs. culture
MRI
EEG

35
Q

Tx for HSV meningoencephalitis

A

IV acyclovir for 21 days

36
Q

What type of HSV infection is often primary?

A

HSV gingivostomatitis

37
Q

What is the cause of herpetic whitlow?

A

primary or recurrent HSV on the finger.

Can arise after autoinoculation due to gingivostomatitis.

38
Q

Herpetic Whitlow Sx

A

pain, swelling, erythema and vesicles

39
Q

Cause of eczema herpeticum

A

Eczema causes weakening of the skin barrier

HSV vesicles spread rapidly and diffusely

40
Q

Complication of eczema herpeticum

A

herpes keratitis

41
Q

Treatment for Influenza

A

Oseltamivir = mediocre, upset stomach, use only in severe cases or hospitalized patients

42
Q

Signs and Sx of EBV (Mono)

A

fever, sore throat, LAD, fatigue, splenomegaly

infants-asymptomatic

43
Q

EBV Tx

A

supportive, steroids if airway concern

44
Q

All tineas can be treated topically except?

A

tinea capitis

45
Q

How to treat tinea versicolor?

A

miconazole, clotrimazole, selenium

46
Q

Scabies treatment

A

permethrin

47
Q

Lice Tx

A

Permethrin shampoo for all

Mayonnaise/vaseline method

Pediatrics (8 decks)

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