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Pediatrics > Kawasaki Disease > Flashcards

Kawasaki Disease Flashcards

1
Q

Irritability in a child may mean?

A

irritability may be only way child can express pain or discomfort

  • meningeal irritation
  • headache from intracranial irritation
  • exhaustion
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2
Q

Rashes in kids with fever

A 
Enterovirus
Erythema infectiosum
Measles
Meningococcemia
Roseola
Scarlet Fever
Varicella
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3
Q

Enterovirus

A

erythematous maculopapular rash (palms and soles)

  • hand-foot-and-mouth
  • late summer, early fall
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4
Q

Erythema infectiosum

A

5th disease, parvovirus B19 (slapped cheek disease)

  • low grade fever with rash 7-10 days later
  • can spread from cheeks to trunk
  • polyarthropathy
  • aplastic anemia possible
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5
Q

Measles

A

prodrome of low grade fever, courgh, conjunctivitis –> maculopapular rash appears on neck, ears, and hairline

  • rash spreads downward
  • Koplik spots on buccal mucosa
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6
Q

Meningococcemia

A

Neisseria meningitidis –> abrupt onset

  • fever, chills, malaise, prostration
  • urticarial rash petechial
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7
Q

Roseola

A

maculopapular rash (exanthem subitum)

  • starts on trunk and spreads to extremities
  • preceded by 3-4 days of high fevers ending with rash
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8
Q

Scarlet Fever

A

GAS –> fine papules (sand paper like)
erythematous but blanches
- starts in groin, axilla, or neck and spreads rapidly
- self limiting disease
- treat with antibiotics because of rheumatic fever

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9
Q

Varicella

A

rash starts on trunk and spreads to extremities

  • each lesion progresses from erythematous macule to papule to vesicle to pustule
  • mild fever, self-limiting disease
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10
Q

Lymphadenopathy

A

diffuse adenopathy is more concerning that isolated node

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11
Q

Infectious causes of lymphadenpathy

A

measles, mono, HIV, histoplasmosis, toxoplasmosis, mycobacterium

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12
Q

Non-infectious causes of lymphadenopathy

A

lymphoma, leukemia, histiocytosis, neuroblastoma, rhabdomyosarcoma

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13
Q

Unilateral cervical lymphadenopathy

A

Kawasaki Disease
Bacterical cervical adenitis - staph or strep pyogenes
Cat scratch disease - bartonella
Mycobacterial infection

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14
Q

Strawberry tongue

A

erythematous tongue with prominent papillae

  • strep pharyngitis
  • kawasaki disease
  • toxic shock syndrome
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15
Q

Diagnostic criteria for Kawasaki Disease

A 
High fever for >5 days
- changes in oral mucosa
- extremity changes (redness/swelling)
- unilateral cervical lymphadenopathy
- rash
- conjunctivitis
FINAL - no other cause for symptoms (diagnosis of exclusion)
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16
Q

Complications of Kawasaki Disease

A

CNS manifestation - irritation, lethargy, aseptic meningitis
Coronaries - aneurysms
Liver dysfunction
Arthritis
Hydrops of gallbladder
all patients should receive echo in acute phase

17
Q

Derm nomenclature

A

Macule - flat, discolor spot
Papule - small, well-defined lump
Vesicle - small, well-defined fluid containing bump
Pusutle - small well defined purulent containing bump
Plaque - small, raise differentiated patch
Desquamation - shedding outer layer of skin

18
Q

DDx for child with fever and rash (fully immunized)

A 
Systemic-onset juvenile idiopathic arthritis
Kawasaki Disease
Osteomyelitis
RMSF
Scarlet Fever
SJS
Viral syndrome
19
Q

Juvenile idiopathic arthritis

A

prolonged fever, rash, arthritis, visceral involvement

20
Q

Kawasaki disease

A

fever >5 days, nonpurulent conjunctivitis, rash, swelling and erythema of extremities

21
Q

Osteomyelitis

A

bacterial infection, low-grade fever, painful walking

22
Q

RMSF

A

tick-borne infection

fever, headache, rash, myalgias

23
Q

SJS

A

mucocutaneous disorder caused by hypersensitivity rxn to meds, infection or illness
- severe pruritic rash, fever, mucosal changes

24
Q

Viral Syndrome

A

enterovirus

- fever (3-5 days), non-descript rash

25
Q

DDx for erythema, pain, and extremity swelling

A

arthritis (joint)
cellulitis
Kawasaki

26
Q

Evaluation of Kawasaki

A
  1. CBC w diff - infection/inflammatory response (elevated neutrophils and platelets possible)
  2. Blood culture - no growth
  3. Liver enzymes - can be elevated w/ low albumin
  4. Acute phase reactants - CRP and ESR elevated
  5. UA - sterile pyuria
27
Q

Diagnosis and Tx of strep pharyngitis

A
  • Rapid strep test (highly specific but low sensitivity)
  • should follow with culture if negative
    Treat with amoxicillin to prevent rheumatic fever
28
Q

Tx of KD

A

Aspirin - anti-inflammatory, shortens febrile course, anti-platelet (keep in mind Reye syndrome)
IVIG - decreases aneurysms incidence greatly, given over 12 hours

29
Q

Follow-up care of KD

A

Echo during acute phase –> follow up echo around 3-6 weeks

30
Q

Anticipatory guidelines for KD

A

Aspirin - 6-8 weeks if no aneurysm, indefinitely with aneurysm
Flu vaccine EVERY YEAR

Pediatrics (36 decks)

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