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Clin Med IV: Pediatrics > Pediatric Infectious Disease > Flashcards

Pediatric Infectious Disease Flashcards

1
Q

What is the clinical manifestation of conjunctivitis

A

Bacterial
viral
or allergic

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2
Q

what is the presentation of bacterial conjunctivitis

A

erythema, cehmosis, itching, burning, mucopurulent exudate, matter in eyelashes

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3
Q
A
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4
Q

what is the presentation of viral conjunctivitis

A

erythema, chemosis, tearing (bilateral); HSV unilateral photophobia, fever, nose lesions

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5
Q

What is the presentation of allergic conjunctivitis

A

stringy mucoid exudate, swollen eyelids and conjunctiva, itching, tearing, headache, rhinitis

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6
Q

what is the treatment of bacterial conjunctivitis

A

erythromycin ointment or polymixin B/trimethorpim
warm soaks, no sharing towels or pillows/stress hygiene

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7
Q

What is the treatment of viral conjunctivitis

A

refer to ophthalmologist if HSV, otherwise cool compressess, supportive, hygiene

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8
Q

what is the treatment of allergic conjunctivitis

A

allergy referral if needed

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9
Q

What is the presentation of peri/orbital cellulitis

A

fever, swelling and erythema of surrounding tissues, deep red color of eyelid
proptosis, eye pain, decreased visition, limited extraocular motility think orbital cellulitis

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10
Q

what is the etiology of peri/orbital cellulitis

A

S. aureus
H. influenza
m. catarrhalis

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11
Q

What is the treatment of peri/orbital cellulitis

A

CBC with diff, EOMI, PERRLA
if even remotely thinking orbital cellulitis: CT scan
admission and IV antibiotics
if periorbital: augmentin (90mg/kg/day, BID)

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12
Q

What can cause otitis externa

A

retained moisure: penduomonas, s. aureus, eczema, weborrhea, psoriasis

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13
Q

What is the treatment of otitits externa

A

antimicrobial +/- steroid
cortisporin 2gtts in ear every 3-4 hours for 5-7 days
Floxin 5gtts in affected ear BID for 7 days

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14
Q

what is the etiology of otitis media

A

S.pneumonia, H. infleunza, M. catarrhalis

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15
Q

What are the causes of otitis media

A

Virual URI
Bacterial URI
allergic rhinitis
Eustachian tube dysfunction/anatomic

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16
Q

what are the symptoms of otitis media

A

ear pain
hearing loss
fever?
drainage?

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17
Q

What is the treatment of otitis media

A

pain management
watchful waiting?
antibacterial therapy: amox 90mg/kg/day, BID

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18
Q

What is the treatment of non-allergic rhinitis

A

nasal sprays

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19
Q

what is the treatment of viral rhinitis

A

nasal saline, steam?

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20
Q

What are the clinical findings with influenza

A

sudden onset high fever (102-106)
headache, chills, coryxa
vertigo, sore throat, body aches, cough

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21
Q

what is the treatment of influenza

A

supportive, treat high risk with anti-virals (immunocompromised, asthmatic, chronic illness, age 6mo - 6 years)
-tamiflu

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22
Q

What is the clinical manifestation of sinusitis

A

persistent nasal congestion, without improvemement after 10 days
severe and worsening symptoms

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23
Q

what is the etiology of sinusitis

A

98% is viral
10 days
fever
unremitting headache
gravity tests

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24
Q

What is the treatment of sinusitis

A

amoxicillin/amoxicillin-clavulanate 90mg/kg/day, usually BID

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25
Q

what are risk factors for thrush

A

common in first weeks of life, inhaled steroids, HIV infection, recent abx

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26
Q

What is the treatment of thrush

A

oral nystatin
(sterilize pacifiers, nipples, toys, etc)

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27
Q

what is the etiology of gingivostomatitis

A

herpes virus - 1

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28
Q

what is the clinical manifestation of gingivostomatitis

A

very sick, highly infectious
10+ ulcers of bucal mucoas, lips, tongue
may have fever, tender cervical nodes, inflammation

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29
Q

what is the treatment of gingivostomatitis

A

symtpomatic
if seen within 72 hours of onset: acyclovir, “magic mouthwash”

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30
Q

What is the etiology of bacterial pharyngitis

A

GAS
mycoplasma pneumonia
chlamydia pneumoia, groups C and G strep

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31
Q
A
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32
Q

what is the clinical manifestation of bacterial pharyngitis

A

tender anterior cervical nodes, palatial petechiae, beefy-red uvula, tonsillar exudate

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33
Q

what is the treatment of bacterial pharyngitis

A

amox 90mg/day BID/TID x 10 days

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34
Q

What is the centor criteria

A

used for bacterial pharyngitis
-adenopathy, tonsillar exudates, absence of cough, fever

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35
Q
A
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36
Q

What are complications of bacterial pharyngitis

A

rheumatic fever
glomerulonephritis
lemierre syndrome
tonsillar abscess

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37
Q

What is the etiology of peritonsillar cellulitis/tonsillitis

A

GAS
S.pneumo
h.flu
m.cat

38
Q

what is the clinical manifestation of peritonsillar cellulitis/tonsillitis

A

high fever, unilateral, tonsil bulges medially, soft palate and uvula edematous, displaced toward involved side, possible trismus

39
Q

what is the treatment of peritonsillar cellulitis/tonsillitis

A

usually start with IV or oral abx for 12-24 hours
EENT or ED referral for drainage if no improvement or worse

40
Q

what is the cause of mononucleuosis

A

epstein-Barr virus (EBV)

41
Q

what is the highest incidence population for mono

A

15yo - 25 yo

42
Q

what is the complications of mono

A

splenic rupture, hepatitis

43
Q

what is the treatment of mono

A

supportive: ibuprofen/acetaminophen for fevers
steroids (controversal)
soft diet, liquids
no contact sports or activites
rest

44
Q

what is croup

A

acute inflammaotry disease of larynx
-viral (RSV, influenza, adenovirus, mycoplasma pneumonia)

45
Q
A
46
Q

what are the clinical findings of Croup

A

barking cough, stridor, low grade fever, cough, drooling

47
Q

what is the treatment of Croup

A

dexamethasone 0.15-0.6 mg/kg PO max 10mg as one-time dose
nebulized racemic epinepherine
fluids, warm, moist air

48
Q

What are the 4D’s of epiglottitis

A

Drooling - Dysphagia- Dysphonia - Distressed Respiratory efforts

49
Q

what is the treatment of epiglottitis

A

Intubation, IV antibiotics

50
Q

what is “hands, foot and mouth disease”

A

Coxackie virus

51
Q
A
52
Q

what is the treatment of coxsackie

A

supportive

53
Q

what is the prodrome for rubeola (measles)

A

fever
malaise
and anorexia; followe by cough, coryza and conjunctivitis

54
Q

What is the treatment of rubeola (measles)

A

supportive
control of spread (vaccinate)

55
Q

what is the vaccination for rubeola (measles)

A

2 shot series (MMR)
12-15 months
before school (4-6 years old)

56
Q

what is the presentation of mumps

A

low grade fever
malaise
headache
anorexia
myalgia
parotitis 48 hours later

57
Q

what are the complications of mumps

A

meningitis
encephalitis
orchitits

58
Q

what is the treatment of mumps

A

supportive, analgesic, bed rest for orchitis
isolate until parotitis is gone
vaccinate

59
Q

What is the presentation of rubella (german measles)

A

acute onset maculopapular rash on face. spreads rapidly down body
may have fever, lymphadenopathy 1-5 days prior

60
Q

what is the treatment of rubella (german measles)

A

supportive

61
Q

what is the presentation of roseola infantum

A

presents in 3-5 days of high fever followed by maculopapular rash on trunk, spreading to extremities, neck and face as fever resolves
may have associated febrile seizures

62
Q

how is rotavirus transmitted

A

fecal-oral route
peaks in winter months, 3-15 months of age

63
Q

what is the presentation of rotavirus

A

vomiting followed by diarrhea that lasts about 4-8 days

64
Q

what is the treatment of rotavirus

A

fluid replacement, anti-diarrheal meds are ineffective

65
Q

how is rotavirus prevented

A

hygiene, vaccination

66
Q

what is the presentation of viral gastroenteritis

A

like rotavirus, but not seasonal, duration may be longer
abdominal findings mostely benign; ~hyperactivity but no tenderness, no HSM
norwalk causes more vomitting than diarrhea

67
Q

what is the treatment of viral gastroenteritis

A

supportive esp fluids

68
Q
A
69
Q

what is the presentation of Hep A

A

significant GI upset (anorexia, v/d)
jaundice
liver tenderness and enlargement
incubation period 15-40 days, jaundice 5-10 days after initial symptoms

70
Q

what is the treatment of Hep A

A

supportive

71
Q

what is the prevention of Hep A

A

immunization, immune globulin if given within 1-2 weeks of exposure

72
Q

what is the presentation of pinworms

A

intense perianal itching overnight

73
Q

what is the diagnostic test for pinworms

A

“scotch tape test” in the morning before defecation/washing

74
Q

what is the treatment of pinworms

A

mebendazole 100mg once PO, repeat in 2 weeks
wash linens
Treat entire house

75
Q

what is the presentation Kawasaki disease

A

high fever, conjunctivitis, mucositis, rash, extremity changes, lymphadenopathy, cardiovascular inflammation

76
Q

what is the treatment of Kawasaki disease

A

IV IG and aspirin

echocardiogram: done early acute phase and again 6-8weeks later

77
Q

what is the presentation of rabies

A

drooling, seizures, signs of CNS dysfunction
universally fatal once symptoms occur

78
Q

what is the treatment of a suspected contact with rabies

A

one dose immune globulin, series of rabies vaccine over a 2 week period (Pediatric ID)

79
Q

what is Varicella

A

highly contageous herpes family virus
chickenpox is the primary illness (globar rash vs dermatomal)

80
Q

what is the presentation of varicella

A

prodrome: low grade fever, HA, bachache, URI; 1-2 days prior to onset of rash
Rash: begins on face, scalp or trunk, scabs from 5-20 days

81
Q

what is the treatment of varicella

A

supportive, PCN for bacterial superinfection, VZ IG if immunocompromised

82
Q

what is erythmea infectiosum

A

parvovirus B19
mild flu-like symptoms followed by rash 10 days later
“slapped-cheek”, lacey-like pattern

83
Q

what is the treatment of erythema infectiosum

A

supportive
avoid pregnant females

84
Q

what is molluscum

A

poxavirus (soil virus)
umbilicated, white or whitish-yellow papules in groups

85
Q

what is the treatment of molluscum

A

imiquimod, cantharidin, curettage, oral cimetidine, liquid nitrogen

86
Q

what is christmas tree with preceding herald patch

A

pityriasis rosea

87
Q

what is a fungus on head, groin, body or feet

A

tinea (“ringworm”)

88
Q

What is Henoch-Schonlein purpura (igA vasculitis)

A

inflammation and bleeding of small vessels in joints, intestine and kidneys
usually resulting form autoimmune response - preceding URI, allergic reaction, med, injury or cold weather response

89
Q

what is the treatment of Henoch-Schonlein purpura

A

steroids (heme consult)

90
Q

What is ITP

A

idiopathic thrombocytopenia purpura
usual preceding viral illness; immune system now attacks own plateelts

91
Q

what is the treatment of ITP

A

usu. resolves spontaneously, may need steroids, rare splenecomy; heme consult

Clin Med IV: Pediatrics (16 decks)

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