Peds

Question 1

Epstein Barr Virus (Infectious Mononucleosis

Answer 1

Transmitted via Saliva
HHV 4 is pathgen
Sx: Fever, Sore throat, POSTERIOR cervical lymphadenopathy, myalgias, splenogmegaly, Petechial rash
Dx: Hterophile (Monospot) antibody test, see Atypical Lymphocytes
Tx: Supportive, avoid physical activity if splenomegaly due to risk of splenic rupture

Question 2

What is Rubeola (Measles)
Sx
Dx
Tx

Answer 2

Paramyxovirus
URI prodome with high fever, COUGH, CORYZA, CONJUNCTIVITIS, see KOPLIK SPOTS (small red spots in buccal mucosa with blue/white pale center), over time develop maculopapuarl brick red rash on face that starts at HAIRLINE
Rash lasts 7 days, need to isolate patient for 1 week after onset of rash (still contagious)
Tx: Supportive
Complication is otitis media

Question 3

What is Mumps
Sx
Dx
Tx

Answer 3

Paramyxovirus
Transmitted via respiratory doplots
Low grade fever, myalgias, headache, PAINFUL PARTOID GLAND SWELLING
Complications is orchitis in males, acute pancreatitis
Dx: Serologies
Tx: Supportive, anti-inflammatories
MMR VACCINE GIVEN AT 12-15 MONTHS THEN 4-6 YEARS

Question 4

What is Rubella (German Measles)

Answer 4

Togavirus
Spread via respiratory droplets
Sx: Posterior cervical, posterior auricular lymphadenopathy, fever, cough, pink light red spotted maculopapular rash on face then spreads to extremities
Transient photosensitivity and joint pains
Tx: Anti-inflammatoires, supportive
In 1st trimester canc ause sensorineural deafnes, cataracts, TTP, mental retardation

Question 5

Varicella (chicken pox)

Answer 5

Varicella, incubation is 10-21 days
Widely scattered red macules and papules on face and trunk, dew drops on a rose petal, all different stages
They turn into vesicles on erythematous base then pustules then crusts
Lasts 5-6 days

Question 6

Erythema Infectiosum (Fifths Disease)

Answer 6

SLAPPED CHEECK
Parvovirus B-19
Spread via respiratory droplets
Sx: Slapped cheek, LACY RETICULAR RASH on extremities, spares palsm and soles, arthropathy in older kids
Dx: SErologies
Tx; Supportive
May cause aplastic crisis in sickle cell disease

Question 7

Roseola (Sixths Disease)

Answer 7

HHV6 and HHV7
Spread via respiratory droplets
Sx: High fever for 3-5 days, after fever breaks a rose pink maculopapular blanchable rash appears on trunk/back then the face
THIS IS THEO ONLY EXANTHEM THAT STARTS ON TRUNK
Child appears well during febrile phase
Tx: Supportive

Question 8

Kawasaki Syndrome

Answer 8

Usually in Asian kids
Medium and small vessel vasculitis
Sx: WARM CREAM
Fever
C: Conjunctivitis (bilateral)
R: Rash - Polymorphous
E: Extremity changes - Edema, erythema, desquamation of palms and soles
A: Adenopathy - Cervical lymphadenopathy
M: Mucous Membranes - Lip swelling and fissues, STRAWBERRY TONGUE
Tx: IVIG, high dose ASA

Question 9

Hand, Foot and Mouth Disease

Answer 9

Coxsackie virus A
Usually in late summer/early fall
Sx: Mild fever, URI, decreased appetite, vesicular lesions on reddended base in oral cavity
Tx: Supportive

Question 10

Pinworms

Answer 10

Enterobius Vermicularis
Spread via feco-oral route
Sx: Perianal itching espeically at night (when eggs are laid)
Dx: Scotch tape test
Tx: Albendazole

Question 11

Pertussis (Whooping Cough)

Answer 11

Bordetella Pertussis
Catarrhal Phase: URI sx for 1-2 weeks
Paraoxysmal Phase: Coughing fits with whooping sound during inhalation after cough fit, post coughing emesis
Convalescent: REsolving sx, cough remains
Dx: Nasopharyngeal swab
Tx: Erythromycin to help with spread, doesn’t shorten course in patient

Question 12

Scarlet Fever

Answer 12

Group A Beta Hemolytic Strep (Strep Pyogens)
Erythematous blanching, sandpaper rash that starts on neck/upper trunk then generalizes
Cheecks/forehead flushed with circumoral pallor
Strawberry tongue
Dx: Rapid Strep, Throat Culture is definitive
Tx: Penicillin G or VK
Macrolides if PCN allergy
Complications are Rheumatic Fever and Acute post-strep glomerulonephritis

Question 13

ADHD

Answer 13

Short attention span, easy distractibility, hyperactivity, impulsivity
Sx must occur in more than 1 setting (school and home)
Tx: Stimulant drugs like Methylphenidate, D-amphetamine

Question 14

Conduct Disroder

Answer 14

Social and Academic difficulty, defies authority, sexually uninhibited
Most develop antisocial personality disorder

Question 15

Turner Syndrome

Answer 15

Monosomy X

Short stature, webbed neck, prominent ears and low posterior hairline, broad chest, widely spaced nipples

Question 16

Down Syndrome

Answer 16

Trisomy 21
Hypotonia, poor Moro relfex, hypermobility of joints, flattened facies, excess skin on posterior neck, upward-slanting palpebral fissures, pelvic dysplasia, single transverse palmar crease
Congenital heart disease is comon, usually AV septal defects

Question 17

Marfan Syndrome

Answer 17

Connective tissue disorder
Tall, lanky stature, joint laxity, high arched palate, long digits, myopia
Cardiac: Mitral valve prolapse, aortic root dilation, aortic insuffieincy, aneurysms, spontaenous pneuumothorax

Question 18

Fetal Alcohol Syndrome

Answer 18

Microcephaly, long and smooth philtrum, thin upper lip, small palpebral fissures, small distal phalages