Brainscape's Knowledge GenomeTM

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


See full index

Pediatrics > Manolya > Flashcards

Manolya Flashcards

1
Q

Rash types, classification, on epidermis

A

Less than 1 cm:
Macule:Not raised,faded on pressure( vasodilatation)
Papule: Raised, firm, inflammatory cell aggregation
>1 cm:
Nodule: palpable solid/cystic
Plaque: elevated, psoriasis, mantar enfeksiyonu

Vesicle: içi su dolu, <5mm
Bula: vesicle >5mm
Pustule: Vesicle containing infection, purulent

Petechiae: pinpoint red spots, doesnt fade
Purpura

Differential of:
1.Vesicular:
Coxackievirus
Echovirus
Varicella
Herpes
M-pox
2.petechiae:
Meningococcemia!!
3.Maculopapular: many things

Widespread erythema: strep group A, staph aureus

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

For history and examination think about

A

Age, season,geolocation,travel history, exposure to insects, animals, ptx, history of vaccines and childhood diseases, immune status of host, medicines

Rash characteristics, distrubiton and progress,, change in morphology, accompanying symptoms, timing w/ fever

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

1st disease: Measles/Rubella/ kızamık

A

Single strand RNA virus (paramyxovirus)
Late winter, spring
Transmission by droplet and air, very contagious
Rash during viremia

Resp epithelium: primary viremia
Lymphatic tissue: secondary viremia

Signs:
Rhinorrhea
-conjunctivitis(+photophobia)
Dry cough
Fever(peaks at 3 days, subsides after 4 days)
Koplil spots( pathogonomonic): white spots, molar dişler yanı,yanakta, 48 hours before the rash, disappears 2nd day of rash, lymphatic aggregant)
Rash:3-7. day erythematous maculopaular rash, ear-hairline-nape, forehead to trunk and extremities, fades with brown pigmentation)

Lifelong immunity
Transient immunosupression during infection: 1.otitis media 2.pneumonia(mortality 01-03 !)

Hemorhagic measles: hemorhagic rashes that can be fatal, convulsions coma

Risk factors:
Vit A deficiency
Immune deficiency
Malnutrition

DGX:
Clinical findings+(prodromes,fever, rash koplik)
Positive measles IgM/ IgG serology(4 hafta arayla 4 kat artış) or RT-PCR

Differential: kawasaki, kızamıkçık, 5. 6. Disease,ebv, kızıl, adenovirus, mycoplasma
İlaç erupsiyonları? steven johnson toxic epidermal necrolis !?

Treatment: Vit A tedavisi (özellikle 2 yaş altı)

Korunma: kkk aşısı, 1 yaş, 4 yaş 2 doz
Ama vakaların görüldüğü zamanlar 9. Ayda ilave doz
Anneden geçen antikorlar ilk 6-9ay koruyor, aşının etkisini de engelliyor
Canlı aşı olduğu için 6 aydan önce yapılmaz

Post exposure immunuzation: anyone over 6 months for contact
Aşı durumu bilmiyorsan, kızamık şüpheliyle temas: 72 saat içinde aşı

Post exposure IG: <6 months, pregnant, immunosupressed

Subacute sclerosing panencephalitis(SSPE):
Progressive degenerative disorder of CNS 7-10 years after measles

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

Rubella( kızamıkcık)

A

5-9 yaş grubu
Hafif seyreder. Anne hamileyse congenital rubelladan korkarız
Cervical, suboccipital LAP
Maculopapular rash
Ateş prodromal dönemde, bulaşıcılık 2 hafta devam ediyor
Thrombocytopenia
Arthritis, eklem ağrısı
Encephalitis

People are only resource. Droplet, direct contact, late winter early spring, ıncubation 14-21 days, infectious from 2 days before rash to 7 days after, lifelong immunity. Forscheimer spots. Rash spreads from fave to body in 24 hours. 2nd day quickly fades, rarely 3 days.

Congenital rubella: first trimester:%50-80 infected baby
Cataract, cardiac anomaly, deafness,red purple blueberry muffin spots, meningoencephalitis, low birth weight, newborn IgM +, Ig titer increase, virus isolation

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

5th disease: Erythema Infectiosum

A

Parvovirus B19
Hafif seyreder
Hemolytic anemia, HIV, kemik iliği nakli durumlarında: aplastic anemia/ krize sebep olur
Pregnancy :hydrops fetalis
Ateş, burun akıntısı, öksürük, YANAKLAR KIPKIRMIZI , okul çağı çocukları, gövdesinde oya şeklinde rash
Döküntü en uzun süren hastalık

Spring,5-15y, respiratory tract and blood, ıncubation 4-14 days, prodrome 2-3 dys, fever, headache, weakness, many are asymptomatic
Rash:macular, plaques, SLAPPED CHEEK, PERORAL PALE, widespread in 1-4 days
Lace like rash on trunk and extremities, for 10-15 days. The rash may recur postinfection with exercise,temperature, stress. Itching, arthritis, arthralgia
Not contagious from onset of rash

yetişkinlerde :Gloves socks appearance: el ayak maculopapular purpuric döküntü, rash

Kızamık döküntüden 4 sonrası 5 gün
Su çiçeği kabuklanana kadar
Parvo döküntü çıktığında bulaştırıcılık kalkar

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

Infectious mononucleosis

A

EBV!
+CMV, hiv erken tablo
!Membranous Tonsilit, ağrılı cervical LAP, organomegaly, uzamış ateş, maculopapular rash after amoxicillin/ampicillin!
EBV VCA IgM +
Supportive treatment
Relaps edebilir gelecekte

Older children, adolescents
Fever,chills,sweats,,nausea, anorexia,sore throat, post, cervical lymphadenopathy,splenomegaly, malaise
Rash over trunk, extremities, hands, feet

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

Scarlet fever- kızıl

A

Group A streptococci( faranjit)
3 yaştan sonra görülür
Membranous tonsillit( white exudate like infectious mononucleosis)
White/red strawberry tongue
Petechie on soft palate
Suddenly starts with fever
rash: zımpara gibi, pürüzlü, covers entire body except face in 24 hours, face: forehead and cheeks red,flash like rash
Pallor atound mouth
No constitutional symptoms like kızamık(burun akıntısı gibi)
Pastia sign: linear pigmentation at kıvrım bölgeleri
Treatment: penicillin, 10 gün

Transmission respiratory secretion
İncubation 1-7 days
Sudden fever chills
Vomiting, headache, toxic appearance
Cervical lymphadenopathy
Petechia on palate
Exudative tonsillit

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

Kawasaki

A

> 5 days fever
+ 4 of these:
Conjunctivit, red tongue-cracked lips, el ayak ödem-erythema of palms, polymorph rash( mostly maculopapular), cervical lenfadenopati

Myocardit peicardit coroner arter genişlemesi, aneurysm
Thrombocytosis at 3 weeks.
A vasculitis

İlk 10 gün ivig, Echo yap

+
Acute period:high fever, conjunctivit,uveit, perianal erythema,strawberry tongue, lip fissure, myocardit, perşcardiy,lymphadenopathy

Subacute(11-30): conjunctivit, fever subsides, thrombocytosis, aneurysm, acral desquamation

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

6th disease: roseola infantum( gül hastalığı)
/ exanthema subitum

A

Hsv 6/7
Infants
3-5 gün yüksek ateş 39-40
Ateş düştükten sonra döküntü çıkarsa
Birkaç gün içinde kendi iyleşiyor
+occipital adenopathy

Neurotropic virus: febrile convulsion!
İmmunosupressed ptx: dissemine enfeksiyon
encephalopathyi
hemophagocytic syndrome

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

Chickenpox/ varicella zoster

A

Direct contact, droplet, air!
3 hafta incubation
Hafif ateş, baş ağrısı, soğuk algınlığı sonrası
Vesiculer lezyonlar, içi su dolu, kaşıntılı
Vesiculler farklı evrelerde, hepsi kabuklanana kadar bulaştırıcı(7-10 gün)
İtchy papulles

Complications:
pneumonia
Menengitis, cerebellitis
Myocardit
Reye sendromu
Seconder bacterial cilt enfeksiyonu ! (en sık)
Aplastic crisis
Wegener
Hemorrhagic su çiçeği
+fetal anemic hydrops

Congenital chickenpox:
First 20 week: embryopathy
Last 20 weeks: herpes zoster :)
5d before birth, 2 days after birth: en çok bundan korkarlar

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

Zona zoster

A

Varicella reaktivasyonu
İmmun sistem zayıflayınca, dermatomal lineda rash( shingles)

Acyclovir/ valacyclovir given to:

immunosupressed patients,
inhale steroid use,
yaşı >13
chronic cilt hastalığı varsa altta yatan,
su çiçeği +aspirin=reyes syndrome( chronic salicylate alan hastalar)
+ unvaccinated adolescents, malignancy, hiv, secondary cases in household contacts, high dose corticosteroid >14 days

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

Hand foot mouth disease

A

Conxsackie, enterovirus, echovirus
Çocuklarda yaygın, çok bulaşıcı, bir kere geçirince tekrar geçilir
Vesiculer lezyonlar, kaşınır
Direct temas, fecal oral route
Genital, anal lezyonlar da var
Kendi kendine geçiyor
Very contagious for 2 weeks

Complications:
Myocardit, pericardit, meningoencephalit, sudden death

Atypical HFMD: yetişkinde, ağır
Egzema consackium: daha atipik lezyonlar
Generalized HFMD: disseminated, tüm vücutta

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

Herpes simplex

A

Herpes 1/2

Primary infection: herpetic gingivoSTOMATİTİD: ağız içi beyaz +vesicles, fever, LAP

Neonatal herpes:
Scalp/ neck/ eye Vesicles
Dissemine neonatal herpes( adrenals, liver)
Intracranial, CNS
Encephalit
Herpes 1 by contact, herpes 2 vajinal kanal
Mortal

Intrauterine herpes:
yaygın cilt döküntüleri( hypopigmented, scaling, crusted erosions)

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

Meningococcemia (purpura fulminans)

A

Fever
Petechiae

En korktukları

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

Bacterial Meningitis causative organisms

A

Infants <3 months: Group B streptococcus, E.coli
Older infants children: S.pneumonia( pneumococ), N. Meningitis
Adolescents: N. Meningitis

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

Mechanism of infection for meningitis

A

Nasopharynx colonization

Direct entry( komşu enfeksiyon, trauma, medical device)

Invasion of CNS following bacteremia( infective endocarditis)

17
Q

Predisposimg factors to meningitis

A

Immunodeficiency( asplenia,complement def. Hypogammaglobulinemia,hiv,steroid use, dm)
Anatomic defects(dermal sinus)
Acquired cranial defects( fracture)
Medical device
Parameningeal infections
Recent infection
Recent exposure
Recent travel

18
Q

Presentation, clinical of meningitis

A

Fulminant or grafually progressive

Triad: Fever, neck stifness, abnormal mental status
+ headache, photophobia, nausea/vomiting, Tachycardia, tacyhpnea,hypotension, shock
Petechiae, purpura!
Focal neurologic findings
Seizures
Abnormal mental status
Increased ICP
Systemic findings

INFANTS:
Fever or hypothermia
Bulging fontanelle
Seizures
Jaundice
Respiratory distress
Poor feeding, vomiting, diarhhea
Lethargy, irritability

Meningeal signs:
Nuchal rigidity, headache, photophobia, irritsbility
Nuchal rigidity: limitation of neck flexion, kernig, brudzinski sign

19
Q

N meningitidis

A

Only human nasopharynx
Nasal carriage esp adolescents
Gram - diplococcus, aerobic/ facultative anaerobic
Polysacharide capsule inhibits opsonization and phagoctyosis
6 subgroup causes disease

20
Q

Progession of meningitis - hours

A

0-8h: nonspecific eatly signs like fever sore theoat nausea
9-15hr: classic meningitis signs
16-24: end stage signs like shock and multiple orgn involvemnet

Myalgia higher in bacterial meningitis
Infants at highest risk, then adolescents

21
Q

PE of meningitis

A

Hypotension, tachycardia most common
Petechiae echymosis
Kernig brudzinski
Cold sweats
Partiak clinical response after iv fluids

22
Q

Shock and multisystem involvement in meningitis

A

Peripheral vasoconstriction
Acidosis, hypoxia
Hypotension
Purpura fulminans: low protein C, from meningococcal inf, hemorrhage, necrosis, gangrene( DIC, thrombosis)
(DIC in sepsis)

Focal neurologic signs
Convulsions
Cerebral edema
Myocarditis
Acute abdomen

23
Q

Main toxin in meningitis

A

LOS

High LOS, low plasma in meningitis
Vice versa in meningococcemia

24
Q

Treatment of meningitis

A

4 adet 3rd gen cephalosporins:
1.ceftriaxone
2.cephotaxime
3. Vancomycin
4.penicilline

25
Q

Long term effects of meningitis in surviving patients

A

Neurologic dysfunction
Hearing loss
Scars
Extremity amputation and growth failure
Motor disabilities
Cardiovascular, renal problems

26
Q

Prevention of meningitis

A

Droplet precautions until 24h after antibiyotiks

Post exposure prophylaxis:
(Contact in 7 days before symptoms appear or in 24 hours after antibiotics)
(Ideally İn 24 hours, not after 14 days)
1. Rifampin
2.ciprofloxacin (not before 1 month)
3.ceftriaxone
Alternative: azithromycin

Immunization: conjugated vaccine+ MEN B

MenACWY, Men B vaccines

27
Q

Sepsis

A

Systemic inflammatory response syndrome (SIRS), immune dysregulation, circulation deramgment, end organ dysfunction

SEPSİS: İnfection+ SIRS
Severe sepsis: cardiovascular dysfunction, ARDS, or >2 organ systems dysfunctions
Septic shock: sepsis+ cardiovascular dysfunction
Refractory septic shock: 1.fluid refractory septic shock 2. Catecholamine resistant septic shock

28
Q

Sepsis risk factors and treatment

A

Immunodef. ,Asplenia, bone marrow/ solid organ transplant, cathether, malignancy, severe intellectual disability with cerebral palsy

Sources: respiratory, urinary, gi, ıntra abdominal,genital, bone, joint, cns, skin, burn, cathethers

Treatment:
INFANTS <28d:
1. Ampicillin ( +vancomycin)
2. 3rd gen Cephalosporin/ Meropenem
3.gentamicin( +acyclovir for HSV)
CHİLDREN:
1.Cefotaxime/ ceftriaxone ( +vancomycin)
2.Gentamicin(genitourinary)
3.Anaerobic coverage (gis source)

Immunsupresive children/ pseudomanas risk: Cefepim/ carbapenem

29
Q

Hepatitis A

A

Self limited ilness.
Fecal-oral route, contaminated water/food
Comtagious Until 1 week before , 33 days after viremia
İnactivated by high temp, chlorine, formalin

Noncytopathic stage: viral replication, fecal shedding( HAV into bile)
Cytopathic stage:portal zone infiltration, necrosis, elevated ALT, liver injury. Excessive host response causes fulminant course.

Clinic
nonspecific : fever malaise nausea vomiting anorexia, abd discomfort and pain,diarrhea

Prodromal: elevated transaminases, hepstomegaly, bilirubin in urine, jaundice
Symptomatic: jaundice, lab returns to normal 2-3 months
Acute liver failure: <%1

Extrahepatic: maculopapular rash, arthralgia
+vasculit,arthrit,encephalit, myelitis, bm suppression, may trigger autoimmune hepatit, rarely relapses so no relapse

30
Q

Hep A dgx and treatment

A

Diagnosis:
Clinical:
fever, malaise,diarhea, vomiting, abdominal pain, anorexia, jaundice
Elevated transaminases and bilirubin
Anti HAV IgM: gold standard for acute infection( remains positive for 6 months)
Anti HAV IgG: appears in healing phase and detactable for decades

Prevetnion:
Routine vaccination: 18m, 24m(1.5, 2 yaş)
Hand hygine

Pre/post exposure prophylaxis:
<2 weeks: hep A vaccine, if <1y only IGIM

Treatment: supportive care, self limited: full recovery in 3- 6 months
Fulminant hepatic failure: liver transplant

Pediatrics (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions