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3rd Semester Final > Pediatric Infectious Disease Lecture Powerpoint > Flashcards

Pediatric Infectious Disease Lecture Powerpoint Flashcards

1
Q

Most common type of infectious illness in children

A

Upper respiratory infections, common viral colds are common because kids don’t have the acquired immunity, will frequently have 6-10/year

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2
Q

Symptoms of a URI (3)

A
  • Fever, headache, malaise
  • nasal stuffiness, sneezing, sore throat, cough
  • nasal discharge initially clear and watery but soon thick and colored either yellow, white, or green, returns to watery before resolving
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3
Q

Color of snot and pathogen identification

A

Not indicative of anything

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4
Q

Unilateral foul smelling nasal discharge in child should raise suspicion for….

A

….foreign body obstruction

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5
Q

3 distinct criteria in diagnosis of acute bacterial sinusitis (differing it from a URI, only 6-7%)

A
  • persistent symptoms (nasal discharge/congestion and or cough for >10 days without improvement)
  • severe symptoms (temp >38.5 with purulent rhinorrhea for at least 3 days
  • worsening symptoms after initial improvement, (worsening of nasal congestion, rhinorrhea, cough, and fever after a 3-4 improved period
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6
Q

Maxillary and frontal sinuses do not grow in anatomically until…

A

….7-8 years

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7
Q

Acute bacterial sinusitis treatment (1)

A

-amoxicillin with or without clavulanate

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8
Q

Common cold treatment options (2)

A
  • supportive

- ipratroprium bromide (atrovent) may help

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9
Q

Common causes of acute pharyngitis (2)

A
  • viruses (rhinovirus, influenza, etc)

- bacteria (GABHS, niesseria gonorrhoae, diptheria)

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10
Q

Clinical presentation of GABHS pharyngitis (5)

A
  • sudden onset
  • sore throat
  • fever
  • tonsillar hypertrophy
  • strawberry tongue
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11
Q

Lab tests for GABHS (3)

A
  • Rapid strep test (high sensitivity low specificity)
  • throat culture follow up (doesn’t differentiate between acute strep and strep carriers)
  • ASO titer in suspected rheumatic fever or acute glomerulonephritis
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12
Q

Erythromycin resistant GABHS and treatment option in PCN allergic patients (1)

A

Identified in some parts of the world, in patients that cannot tolerate B lactam antibiotics a good choice would be clindamycin

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13
Q

Retropharyngeal abscess definition

A

GABHS infeciton occurs in retropharyngeal space posterior to pharynx and can cause airway /swallow compromise and eventually progression to sepsis if left untreated, most common in 6 months to 6 years

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14
Q

Retropharyngeal abscess diagnostic study (2) and treatment

A
  • x ray or CT

- Drainage and clindamycin (need gram + and - coverage)

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15
Q

Peritonsillar abscess definition

A

GABHS infection located in palatine tonsil, results in fever, dyspnea, trismus, and muffled potato voice, can spread to salivary glands

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16
Q

Peritonsillar abscess diagnostic study and treatment options (3)

A

-CT imaging

  • Drainage
  • PCN oral outpatient or IV
  • alternatively clindamycin
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17
Q

Treatment failure of GABHS (3)

A
  • noncompliant patient
  • previously unknown carrier state
  • inactivation by PCN resistant strain
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18
Q

Are follow up throat cultures necessary in GABHS patients?

A

No, noncontagious 24 hours after initiation of therapy unless continue to be symptomatic

19
Q

2 most common causative pathogens of acute otitis media

A

H influenzae

S pneumoniae

20
Q

Acute otitis media vs otitis media with effusion

A

Collection of fluid in middle ear alone without signs or symptoms of acute infection including changing coloration/opacification is otitis media with effusion, while acute otitis media has bulging** tympanic membrane with color change

21
Q

Tympanography

A

A tool to look for middle ear effusion based on tympanic membrane compliance, in a normal eardrum it is tent shaped and peaks at 0, if the compliance is low and the tent is small this indicates high probability of effusion, if the tent peak is shifted negatively to the left this indicates eustachian tube dysfunction

22
Q

Antibiotic therapy for acute otitis media is only recommended if the patient is ___ or ____

A

under 24 months, if the child worsens or fails to improve

23
Q

1st and 2nd line treatment and 3rd line treatment for acute otitis media

A
  • amoxicillin 80-90mg/kg/day in 2 doses
  • amoxicillin-clavulanate (augmentin) 90mg/kg/day
  • tympanocentesis
24
Q

Croup presentation (3)

A
  • barking cough
  • subglottic narrowing on x ray
  • preceding upper respiratory infection (ecvept in spasmodic croup)
25
Q

epiglottitis

A

More severe emergency than croup and more rare in time sinc HIB vaccine, URI infection that doesn’t have stridor or prodrome, presents with characteristic thumb sign on x ray, progressive swelling (supraglottic stenosis), sore throat, drooling, with airway management being utmost priority

26
Q

croup treatment options (6)

A
  • comfort child - crying will make it worse
  • humidified o2 up to intubation if severe
  • racemic epi
  • nebulized budesonide
  • dexamethasone oral or im
  • admit if moderate to severe
27
Q

Epiglottitis treatment options (2)

A
  • airway preservation

- ceftriaxone

28
Q

Bronchiolitis 3 most common causative agents

A
  • RSV
  • human metapneumovirus
  • parainfluenza virus
29
Q

Bronchiolitis clinical presentation (3)

A
  • chest x ray with lung hyperinflation and flattened diaphragm
  • history of rhinorrhea and cough
  • fine crackles on inspiration indicating lower lung infection
30
Q

Bronchiolitis diagnosis (3)

A
  • clinical diagnosis
  • CXR in severe cases
  • ABG’s to determine severity
31
Q

Bronchiolitis hospitalization treatment options (4) (remember most mild cases can be handled outpatient)

A
  • supportive care including o2
  • nebulized racemic epi (used to be bronchodilators back in the day)
  • ribavirin in severe RSV infection or immunocompromised
  • antibiotics if concomitant otitis media
32
Q

3 common findings of pneumonia

A

Fever, shallow respirations, cough

33
Q

Foreign body aspiration management

A

Endoscopic removal with a rigid bronchoscope followed by corticosteroids if inflammation presents and same day discharge

34
Q

Clinical signs and symptoms of pneumonia in children (6)

A
  • cough day and night, often productive
  • fever
  • tachypnea
  • retractions
  • hypoxia and cyanosis
  • crackles and wheezes
35
Q

Pneumonia diagnostic studies (3)

A
  • x ray in children who do not improve on initial antibiotic therapy (ground glass appearance)
  • cbc with diff
  • first morning sputum and culture
36
Q

Pneumonia treatment options (chidren) (4)

A
  • amoxicillin
  • azithromycin (coverage against mycoplasm and chlamydia pneumoniae in teens!)
  • macrolide or doxy
  • fluorquinolones
37
Q

Blood pressure dropping in a child with dehydration is a…

A

….late stage finding, children have excellent compensatory mechanisms

38
Q

Lab tests for childhood diarrhea (4)

A

Normally not necessary but can get CBC, BMP, urinalysis, stool culture

39
Q

Fluids not recommended for acute diarrhea in kids (7)

A
  • tea
  • juice
  • cola
  • chicken broth (just going to cause hypernatremia)
  • sports drinks such as gatorade and powerade (not ideal, has some k and na+ and lower amount of sugar in it but not good)
  • koolaid
  • water alone!!! (want carb to sodium ratio between 1.2-3.1)
40
Q

Carb to sodium ratio and base levels in commercial oral electrolyte solutions that are best for children and some products that meet this balance (2)

A

1.2-3.1, 30, pedialyte, infalyte,

gatorade gets to 13 CHO-Na, so its closer than not

41
Q

Number 1 cause of viral childhood diarrhea

A

norwalk (norovirus), used to be rotavirus but then we got that sick vaccine yo

42
Q

Degree of dehydration and corresponding signs and symptoms

A

1-3% not noticable
3-5% mild, thirsty and slightly dry
6-9% moderate, blood pressure starts to drop
>10% severe, skin cold clammy, tenting, etc

43
Q

Treatment principles for diarrhea in children (4)

A
  • most is self limiting
  • replace fluid and electrolytes
  • avoid fatty foods or foods high in simple sugars
  • drinks made with unsweetened yogurt, unsweetened juice, mashed bananas, mashed potatoes, soda crackers, pretzels, beans, pastas, chicken, fish, eggs are all foods they can eat (go beyond the brat diet)
  • small portions frequently every 3-4 hours
  • avoid antibiotics, if its vira may cause harm, or may increase risk of hemolytic uremic syndrome

3rd Semester Final (248 decks)

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