Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Learning Objectives > Kiddo with Fever > Flashcards

Kiddo with Fever Flashcards

1
Q

When is a fever in an infant serious?

A

Under 3 months full septic work-up!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are complications from a fever?

A

Seizure, direct cellular effect (damage to DNA), inflammation, systemic effects (gut bacteria translocation), liver failure, AKI, sepsis, organ failure, loss of function of BBB, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most common causes of fever in neonates

A

Listeria
Group B streptococci
HSV

Viral infection is the most common cause of fever without obvious source

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

High risk neonates for serious bacterial illness (and maternal risk factors)

A

Maternal risk factors: Group B strep, HIV, active herpes simplex

Prematurity, Autoimmune , factitious fever (overbundling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Workup for child < 3 weeks

A

0-28 days:
Admit to hospital
Blood, urine, CSF culture
Emperric Abx treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Workup for child 1 month- 3 months

A

If appear well w/ no complications in PMH:
- CBC, blood culture, urinalysis and culture +/- CXR, lumbar puncture, stool studies depending on CC

Based on test results: can decide on empiric abx +/-hospital admission; must FU in 24 hours

If sick appearing – ADMIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Workup for child >3 year

A

If sick appearing - workup

Fever < 39 and well appearing - Nothing

> 39 and well appearing consider: urine analysis and culture, ensure up to date w/ immunizations

Consider treating empirically – if elevated WBC, not up to date w/ immunization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the thermoregulation centre?

A

Hypothalamus (35.6-37.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are infants less able to maintain body temperature?

A

High surface area/ mass ratio

Do not shiver or sweat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do we sense changes in temp

A

Thermoreceptors on skin: free never endings
2 types:
- Warm receptors (increase firing 32-45)
- Cold receptors (increase firing 40-26)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Body Reaction to Cold:

A

Shivering, piloerection, vasoconstriction (sympathetic activation), increase heat production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Body reaction to Heat

A

Vasodilation (heat loss), sweating, decreased metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathophysiology in fever

A

Pathogens release pyrogens –> inc production of IL in phagocytic cells –> IL signals anterior hypothalamus to increase PG production –> PGE2 inc the set point temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the role of PGE2

A

Set point of temperature

- peripheral vasoconstriction, increased metabolic heat production, shivering, behavioural changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benefits of a fever

A

Inhibit bacterial growth
Inc efficiency of immune cells
Inc chemotaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mediators of inflammation response

A

Histamine - increased permeability of blood vessels

Prostaglandin - intensify the effects of histamine and kinins

Leukotrienes - increased permeability and attract phagocytes

Complement - stimulate histamine release, attack neutrophils by chemotaxis, promotes phagocytosis

17
Q

Common cause of fever in infants (1-3 months)

A 
E.coli
H. influenza
Varicella
Enterococci
Streptococcus pneumoniae
N. meningitis
18
Q

3 months- 36 months

A

Streptococcus pneumoniae
N. meningitis
E.coli
Viruses

19
Q

> 3 mo

A

Streptococcus pneumoniae
N. meningitis
Viral
Leukemia,Lymphoma

20
Q

Initial resuscitation measures for an infant with sepsis.

A

First hour of resuscitation:
Obtain rapid peripheral IV access, push isotonic crystalloids (normal saline or lactated ringers)
Begin maintenance 10% dextrose if necessary
Begin antibiotics as soon as possible

21
Q

Indications for lumbar puncture

A

Indications:

  • Infants younger than 1 month
  • All infants 1-3 months who appear unwell
  • Infants 1-3 months with a WBC less than 5 x10^9 or greater than 15x10^9
22
Q

Contraindications for lumbar puncture

A 
Increased ICP
Respiratory insufficiency
Local infection at LP site 
Shock (unusual skin colour, tachycardia/ hypotension, cold hands/ feet, alerted mental state, poor urine output) 
Extensive or spreading purpura 
Coagulation abnormalities
23
Q

Reye’s syndrome

A 
Disease affects mitochondrial function, causing disturbance in fatty acid 
- Rare form of acute encephalopathy and fatty infiltration of the liver 
Using salicylates (generally aspirin) during such illness increases the risk by much as 35 fold
24
Q

Simple Febrile Seizures

A

last < 15 minutes, have no focal features, and do not recur within a 24 hour period

Most, > 90%, febrile seizures are simple

25
Q

Complex Febrile Seizures

A

last > 15 minutes continuously or with pauses, or have focal features (i.e. affects specific body parts the corresponds with specific area of the brain), or recur within 24 hours

26
Q

Kawasaki Disease

A

Fever > 5 days
Changes in lips and oral cavity (erythema, dryness, fissuring, bleeding) STRAWBERRY TONGUE
Bilateral conjunctival infection
Erythematous polymorphous rash
Changes in extremities (erythema and/or induration of palms and soles)
Cervical lymphadenopathy, often unilateral

Learning Objectives (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions