julia specific notes for midtermn Flashcards
MCC of
Epiglottitis
laryngomalacia
Croup
Bronchiolitis
Influenza
Pertussis (Whooping Cough)
Viral Pneumonia
epiglottitis:
- Haemophilus influenzae (MC)
- Streptococcal species in immunized patients
laryngomalacia: congenital
croup: Parainfluenza VIRUS
bronchiolitis: RSV
influenza: Influenza A/H1N1, A/H2N2
pertussis: Bordetella pertussis (bacterial infection)
viral PNA:
- Human rhinovirus
- adenovirus
- parainfluenza
- influenza
- coronavirus
Disease - etiology and appearance of rash
Measles (Rubeola)
Rubella (German Measles)
Erythema Infectiosum (5th Disease)
Roseola Infantum (6th Disease)
Varicella (Chickenpox)
Hand-Foot-Mouth Disease
Disease
Cause
Appearance of Rash
Measles (Rubeola): Paramyxovirus
- Prodrome: CCC + kolpik spots
- Rash: Maculopapular, starts on face → spreads downward
Rubella (German Measles)
- Togavirus
- Maculopapular, face → trunk, disappears in 3 days
Erythema Infectiosum (5th Disease)
- Parvovirus B19
- Low grade illness: fever, myalgia, headache -> rash
3 stages:
- “Slapped Cheek” rash, lacy, reticulated on trunk
- 1-4 days later: erythematous symmetric maculopapular rash on TRUNK
- Central clearing of rash
Roseola Infantum (6th Disease)
- HHV-6
- High fever resolves→ Rash - maculopapular rose-colored rash
- Varicella (Chickenpox)
Varicella-Zoster (VZV) double stranded DNA virus
- Prodrome: fever, malaise for 1 day before rash
Rash: Dew drop on a rose petal, vesicular, lesions at different stages
- Small red papules, non-umbilicated
- Start on trunk then head and extremities
Hand-Foot-Mouth Disease
- Coxsackievirus A5, 10, 16
- Vesicles/ red papules on palms, soles, oral mucosa
Disease - lab findings
Measles (Rubeola)
Rubella (German Measles)
Erythema Infectiosum (5th Disease)
Roseola Infantum (6th Disease)
Varicella (Chickenpox)
Hand-Foot-Mouth Disease
Measles:
- Serology: IgM appears 1-2 into rash
Rubella:
- IgM 5 days after onset
- 4x rise in IgG during acute phase
5th disease:
- Reticulocytopenia
- Thrombocytopenia
- Lymphopenia
- neutropenia
- Parvovirus B19 IgM
- PCR: erythroid precursors in bone marrow
roseola:
- PCR for HHV-6
chickenpox:
- PCR of vesicular fluid - VZV
HFM disease: Clinical Dx
epiglottitis vs croup tx
Epiglottitis : Haemophilus influenzae (MC)
* ET intubation for airway and extubation within 1-2 days when epiglottis reduced in size
* Blood and epiglottis culture
* IV ceftriaxone x2-3 days; followed by PO ab x 10 days
Croup: Parainfluenza
* Mild: supportive, hydrate, dexamethasone
* Severe (stridor at rest): nebulized racemic epinephrine diluted in sterile saline (refrigerated)
* - observe for 3-4 hrs -> discharge w no sx
* - Recurrent epi doses required -> admission for observation
* Impending respiratory failure: intubation with ET tube, extubation in 2-3 days
tx of bronchiolitis and influenza and viral PNA
Bronchiolitis:
- RSV
- supportive tx
- Hospitalize if respiratory distress, apnea, cannot tolerate oral feeding
Influenza:
- Supportive, Antivirals (Oseltamivir) if started within 48 hours
viral PNA:
- Supportive care; no antibiotics needed
- Human rhinovirus, adenovirus, parainfluenza, influenza, coronavirus
tx of pertussis and mycoplasma PNA
Pertussis :
- Bordetella pertussis
- Macrolide antibiotics (Azithromycin, Clarithromycin, Erythromycin)
mycoplasma:
- mycoplasma pneumoniae
- Macrolide antibiotics x 5-10 days
tx of bacterial and mycoplasma PNA
bacterial
- Under 4 wks old: ampicillin + aminoglycosides
- 4 wks - 6 months: IV ampicillin x 7-10 days
- Over 6 months: high dose amoxicillin TID x 7 days
mycoplasma
- Macrolide antibiotics x 5-10 days
fb aspiration tx
Prevention - counsel pts parents
Upper airway obstruction:
- Partial: cough reflex
- Complete: BLS protocol - 5 back sweeps and sternum presses, CPR if unresponsive
Lower airway:
- Rigid bronchoscopy under general anesthesia
- Beta neb tx
