Pediatrics- Fever and Rheum Flashcards
fever differential
infections
inflammatory
malignant
miscellaneous
what are the components of a full septic workup and when should you do a full septic workup
CBC and differential
Blood culture and smear
Urinanalysis and culture
LP-CSF
CRP
+/- CXR
+/- stool microscopy
+/- resp viruses swab
perform in any infant under 28 days with a fever OR toxic sick child with no obvious cause, irritable, altered
What are the components of a partial septic workup
CBC with differential
blood culture
urinalysis and culture
CRP
LP if unwell, elevated CRP, white count
describe the signs and symptoms of mild, moderate, and severe dehydration
What are red flags for abdominal pain
features of classic Kawasaki
Remember it is a medium vessel vasculitis:
That means lots of inflammation- fever and mucous membrane involvement
fever over 5 days and 4/5 of the following
-bilateral conjunctivitis without exudate
-mucous membrane changes (strawberry tongue, fissured lips, erythema)
-polymorphous rash
-changes in hands and feet- erythema and desquamation
-cervical lymphadenopathy > 1.5cm
what testing should be done for atypical kawasaki’s
first, ESR and CRP
if high then
anemia
thrombocytosis
albumin
ALT
WBC count
urine WBC
OR echo
what is the most important test to conduct if there is a suspicion for kawasaki
ECHO
you want to see heart function because there are acute changes
and there may be cardiac complications
what is the initial management of kawasaki disease
IVIG and ASA for 6 weeks
if refractory to this for two doses (ie still febrile), give steroids
what the outpatient (non-immediate) treatment steps of Kawasaki disease
outpatient ECHO 6-8 weeks
NO live vaccines for 1 year after IVIG
possibly cardiology follow up if damage occurred
What is SLE and the features?
SLE is an autoimmune disease
- What is Henoch Schonlein purpura
IgA mediated vasculitis
Small vessel
Can have renal, GI, pulmonary, CNS, GU complications
