Peds Flashcards
HSP
IgA Vasculitis
Purpura — All patients developed palpable purpura. This may be an overestimation as it is most likely that patients would not be considered for inclusion in these case series without characteristic skin findings.
Arthralgia/arthritis — 43-75% of patients.
Abdominal pain — Colicky pain occurred in ~50% of patients & GI bleeding in ~20-30% of patients
Renal disease — Seen in 21-54%
Mesenteric adenitis
Can mimic appendicitis if nodes in RLQ
Abdominal LNs >10 mm
neonatal conjunctivitis occurring on day 3-5 of life?
gonococcal conjunctivitis
can present as typical bacterial conjunctivitis
to hyperacute conjunctivitis with profuse discharge
severe edema of both lids
has the capacity to invade superficial layers of the conjunctiva, causing ulceration of the cornea - if not tx’d can result in permanent blindness from corneal ulcer
irrigate eyes with saline fln immediately and at frequent intervals until the discharge is eliminated
tx: cefotaxime 100 mg/kg IV or IM or
or ceftriaxone 25-50mg/kg/d IV or IM not to exceed 125 mg given once
diseminated disease should be suspected until CSR cx’s are negative
admission necessary
optho consult necessary
neonatal conjunctivitis occurring on day 2-7 of life?
gonococcal conjunctivitis
can present as typical bacterial conjunctivitis
to hyperacute conjunctivitis with profuse discharge
severe edema of both lids
has the capacity to invade superficial layers of the conjunctiva, causing ulceration of the cornea - if not tx’d can result in permanent blindness from corneal ulcer
irrigate eyes with saline fln immediately and at frequent intervals until the discharge is eliminated
tx: in isolated conjunctivitis in neonate without hyperbilirubinemia - single dose ceftriaxone 50mg/kg IV or IM not to exceed 125 mg
or cefotaxime 50 mg/kg IV or IM q8H
diseminated disease should be suspected until CSR cx’s are negative
admission necessary
optho consult necessary
neonatal conjunctivitis
a gram stain and culture should always be obtained to look for N. gonorrhea
chlamydial conjunctivitis
usually on days 5-14 of life
mild to severe hyperemia
thick mucopurulent discharge
pseudo membranous formation
and pneumonia tx in neonates with oral erythromycin 50 mg/kg PO per day divided in 4 doses, x14 days
efficacy of erythromycin tx is 80%, may req an additional dose of tx
tx mother & sexual partner
ceftriaxone in neonates
cefotaxime preferred as
ceftriaxone can displace bilirubin in kids and cause kernicterus
early onset neonatal sepsis
seen in the first few days of life
fulminant, assoc w/ maternal or perinatal risk factors eg maternal fever, prolonged rupture of membranes and fetal distress
septic shock and neurtopenia more common with early onset dz
late onset neonatal sepsis
occurs after 1 week of age
develops more gradually than early onset dz
less likely to be assosc w/ risk facotrs
meningitis is more common in late onset dz
initial tx of a neonate with suspected bacterial septicemia or miningitis
ampicillin 50 mgs/kg to cover group B strep and listeria
gentamycin 2.5 mg/kg to cover E. coli and gram neg org’s
if gram neg meningitis strongly suspected switch to cefotaxime 50 mg/kg which have better CNS penetration
acetaminophen: kids
15 mg/kg
ibuprofen: kids
10 mg/kg
Reye’s syndrome
ASA admin to kids with viral infxns
encephalopathy and acute liver failure
mortality 20-40%
febrile seizures
incidence 4%
generalized tonic clonic sz does not return in 24 hours is assoc w/ fever lasts longer than 15 mins occurs in an otherwise neurologically normal child age 3 mos to 5 yrs
dacroadenitis: tx
keflex mild cases
suspect mrsa - bactrim vs linezolid
severe - iv nafcillin or vancomycin if mrsa suspect
