Pediatric Infectious Disease Flashcards

1
Q

What is the primary prevention for infectious diseases?

A

Immunizations

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2
Q

What is important when an infectious disease outbreak occurs?

A

Identify it quickly and attempt to prevent the spread

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3
Q

What are 5 things to assess when a child is admitted with an illness that could be an infectious disease?

A

Recent exposure to known case
Prodromal symptoms- Symptoms that occur as early manifestation
Constitutional symptoms- Fever or rash
Immunization history
History of disease

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4
Q

What is the goal of controlling the spread of an infectious disease?

A

prevent cross-contamination between patients and to healthcare workers

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5
Q

What is the most important step in preventing the spread of illness?

A

handwashing

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6
Q

What are 4 general hygiene measures?

A

bathing, linen changes, cleaning patient rooms, universal precautions

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7
Q

What are 4 reasons that someone may be immunocompromised?

A

steroid therapy, immunosuppresive therapy, cancer, immune disorder

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8
Q

If a patient presents to the ER with an itchy rash, what are comfort measures that the parents should be aware of when caring for the child?

A

the patient should be taking cool baths, avoiding overheating, wear loose, non-irritating clothing, and use anti-itch medications and lotions

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9
Q

If a child has an itchy rash, and the parent wants to give the child a bath, is it okay to give the child a warm, soapy bath?

A

No. The child needs to have a cool bath and cannot use soap

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10
Q

What are two medications that can be used to relieve itching for rashes?

A

diphenhydramine (benadryl) and hydroxyzine (atarax)

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11
Q

What drug may be administered for daytime urticaria?

A

loratadine, cetirizine, and fexofenadine

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12
Q

A child with an illness that has an itchy rash is being discharged, the mother explains to you that she understands that the child should take cool baths, wear long sleeves, be on strict bed rest, and take diphenhydramine during the day if the itching gets too severe. What does this mother need additional teaching on?

A

the child needs to take cool baths and diphenhydramine is not the first choice of antihistamine during the day, because it may make the child drowsy

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13
Q

What are the six diseases of childhood?

A

1 measles, #2 scarlet fever, #3 rubella, #5 erythema infectiosum, and #6 roseola infantum

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14
Q

What are the communicable diseases of childhood?

A

Chickenpox (Varicella)
Diphtheria
Erythema Infectiosum (Fifth Disease)
Exanthem Subitum (Roseola Infantum)
Mumps
Measles (Rubeola)
Pertussis (Whooping Cough)
Poliomyelitis
Rubella (German Measles)
Scarlet Fever

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15
Q

How is measles transmitted?

A

enters body by direct contact of respiratory droplets into the mucous membranes

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16
Q

When should the MMR vaccine series begin?

A

12 months

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17
Q

When was the first MMR vaccine available?

A

1963

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18
Q

What are koplik spots associated with?

A

measles

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19
Q

A patient presents to the ER with fever and malaise along with small, irregular red spots with minute bluish white centers on the buccal mucosa. What is an initial assessment that needs to be done when these findings are seen? Why?

A

Check MMR vaccination status, as these are classic symptoms of measles

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20
Q

When will a rash appear when a patient contracts measles?

A

3-4 days after the onset of the prodromal stage

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21
Q

Where does exanthem begin in a patient that contracts measles?

A

starts on the face and spreads down the body

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22
Q

What medication is used to treat measles?

A

there is no medication that will cure measles

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23
Q

How long must isolation be maintained in a measles patient?

A

until the fifth day of the rash

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24
Q

What is used to clean eyelids on a patient with measles?

A

A warm saline solution to remove secretions or crusts

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25
What can be used to manage a cough that accompanies measles?
cool-mist vaporizer
26
What is the treatment plan for a patient with measles?
Symptomatic and supportive Airborne isolation precautions Bed rest Antipyretics Eye care Cough Skin care
27
What is the causative agent of scarlet fever?
group a beta-hemolytic streptococci
28
How is scarlet fever transmitted?
direct contact with an infected person or droplet spread indirectly by contact with contaminated articles or ingestion of contaminated milk or other food.
29
What is a white strawberry tongue associated with?
Scarlet fever
30
What are the symptoms of scarlet fever?
Abrupt high fever Enlarged tonsils White strawberry tongue-->red strawberry tongue Exanthem known as scarlatina
31
What medications are administered for scarlet fever?
penicillin, erythromycin, or oral cephalosporin
32
Complications of scarlet fever
peritonsillar and retropharyngeal abscess, sinusitis, otitis media, acute glomerulonephritis, acute rheumatic fever, polyarthritis
33
How is rubella spread?
respiratory droplets or direct contact
34
Why is it important to receive the MMR either before or after pregnancy, but not during?
rubella is teratogenic to the fetus
35
What birth defects can rubella cause?
deafness, cataracts, heart defects, mental deficit, and liver and spleen damage
36
Classic symptoms of rubella
rash that spreads from face to the rest of the body accompanied by a low-grade fever
37
How long is the incubation period of rubella?
2-3 weeks
38
How often does rubella manifest when it has been contracted?
~50% of the time
39
Hallmark symptom of rubella
symmetrical lymphadenopathy, mainly occipital or postauricular
40
How is rubella treated?
antipyretics and analgesics
41
What is erythema infectiosum also known as?
5ths disease
42
What is the causative agent of erythema infectiosum?
Human parovirus B19
43
How is erythema infectiosum spread?
contact and respiratory droplets, mainly respiratory secretions
44
When is a person no longer infected after contracting erythema infectiosum?
after the onset of the rash
45
What kind of symptoms are seen with erythema infectiosum?
flu-like symptoms
46
Where will exanthum be found with erythema infectiosum?
proximal extremities and has a "slapped cheek" appearance
47
What is the treatment for erythema infectiosum?
Symptomatic and supportive Analgesics Antipyretics
48
What disease presents with a 3 phase exanthem?
erythema infectiosum
49
What is another name for roseola infantum?
the 3-day fever
50
What is the causative agent of roseola infantum?
human herpes type 6 or 7; HHV-6 or HHV-7
51
How is roseola infantum spread?
unknown causes
52
Of children with HHV-6, how many cases manifest to roseola?
20%
53
What are the symptoms of roseola infantum?
Persistent high fever 3-4 days Otherwise well appearing Fever breaks and rash occurs Discrete macular and maculopapular rash Rash starts on trunk and spreads to neck, face, and extremities
54
What is the treatment for roseola infantum?
antipyretics to treat fever
55
What is the causative agent of chickenpox?
Varicella-zoster virus (VZV); Human herpes type 3 (HHV-3)
56
How is chickenpox spread?
direct contact, airborne, and contaminated objects
57
What happens during the prodromal phase of varicella?
fever, malaise, anorexia
58
Rash phases for varicella
macule--> papule--> vesicle--> crust
59
When is someone with varicella contagious?
1-2 days prior to the onset of symptoms
60
How do varicella lesions typically spread?
appear first at the hairline and spread cranial to caudal
61
What are complications associated with varicella?
secondary infection, encephalitis, pneumonia, Hemorrhagic varicella, Chronic or transient thrombocytopenia
62
What is the treatment for varicella?
antiviral and supportive (relieve itching, skin care, and antipyretics)
63
What is pertussis?
Whooping cough
64
What is the causative agent of pertussis?
bordetella pertussis
65
What are complications associated with pertussis?
Pneumonia Otitis media Apnea Hemorrhage Weight loss and dehydration Hernias (inguinal or umbilical) Prolapsed rectum Syncope Rib fractures
66
How is pertussis spread?
droplet or direct contact
67
When is pertussis most dangerous?
in babies, as it can cause apnea and lead to hospitalization
68
What are the symptoms of pertussis?
Begin like URI, continues for 1-2 weeks and cough progresses Fever Classic high-pitched “whoop” sounding cough Post-tussive emesis common
69
How is pertussis treated?
antibiotic therapy, supportive cares (fluids/oxygen), and mechanical ventilation
70
What causes intestinal parasites?
helminths (pinworms) or protozoa (giardiasis)
71
What increases the risk for intestinal parasites in children?
attending daycare
72
Why are young children especially at risk for intestinal parasites?
hand-mouth activity and uncontrolled fecal activity
73
What is the most common helminthic infection in the United States?
enterobiasis pinworms
74
Where do enterobiasis pinworms eggs hatch?
in the upper intestine
75
Where do female enterobiasis pinworms lay eggs?
around the anus
76
What are the symptoms of enterobiasis pinworms?
intense anal itching
77
How are enterobiasis pinworms diagnosed?
tape test
78
How long can pinworm eggs live for?
2-3 weeks
79
What is the medication of choice to treat pinworms?
mebendazole (vermox)
80
What are things to consider when educated parents on how to prevent reinfection of pinworms?
wash all clothes and bed linens in hot water, vacuum house, hand washing, short nails, dress in one-piece sleepwear, and shower instead of taking a bath
81
What is the most common parasitic pathogen in the United States?
giardiasis
82
How is giardiasis transmitted?
person to person, water and food, animals
83
How is giardiasis diagnosed?
microscopic examination of stool sample
84
What are common sites for urban giardiasis?
child care centers and institutions providing care for persons with developmental disabilities
85
Common symptoms of giardiasis in infants and yound children
diarrhea, vomiting, anorexia, failure to thrive
86
What are the symptoms of giardiasis in children older than 5?
abdominal cramps, intermittent loose stools, constipation
87
What is the treatment for giardiasis?
Several “zole” medications available – metronidazole (Flagyl), tinidazole (Tindamax), nitazoxanide (Alinia) Hand washing Very important to educate parents and care givers about sanitary practices, especially during diaper changes.