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MS3 > Peds 6 > Flashcards

Peds 6 Flashcards

1
Q

Treating group A strep early will prevent X but not X

(rheumatic fever vs. PSGN)

A

Treating early will treat RF but not PSGN

Recall that PSGN is a Type III hypersensitivity (antigen-antibody complexes will form even if treated early)

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2
Q

Causes of proteinuria that do not include renal disease

A
  • Benign orthostatic proteinuria = just standing; gravity

- Fever

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3
Q

Describe diff in edema in nephritic vs. nephrotic syndrome

A
  • In nephritic, there is increase in actual volume (too much volume everywhere - increase in both intravascular and extravascular) due to damaged kidneys not allowing urine output
  • In nephrotic, there is decreased oncotic pressure, so volume leaves from intravascular space into extravascular space (so fluid is in wrong place, but there is no increase in total volume)
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4
Q

How do you treat edema is nephritic vs. nephrotic syndrome

A
  • Nephritic = treat with diuretics (need to reduce total volume)
  • Nephrotic = treat with albumin (need to increase oncotic pressure)
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5
Q

Where is erythropoeitin made and what does it do

A

Made in the kidney

Stimulates bone marrow to make more RBCs

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6
Q

Describe antalgic limp

A

Spending less time on painful side

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7
Q

Foot drop is caused by what

A

Damage to common peroneal nerve or other neuro disorder

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8
Q

Where is Toddler’s fx

A

spiral fx of distal tibia

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9
Q

What is Legg-Calve-Perthes disease

A

Ischemic necrosis, collapse, and subsequent repair of the femoral head

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10
Q

What part is affected in Osgood Schlatter

A

Reaction of patellar tendon insertion into distal tibia

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11
Q

Tx of developmental dysplasia of hip in different aged infants

A

< 6 months = harness
6-18 mo = closed reduction
> 18 mo = open reduction

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12
Q

How can septic arthritis lead to avascular necrosis

A

increased intracapsular pressure causes tamponade that can interfere with venous return from the femoral head, resulting in AVN

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13
Q

MOA of Chloramphenicol

A

Inhibition of 50S ribosome subunit – bacteriostatic

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14
Q

Uses of Chloramphenicol

A
  • Meningitis (Strep Pneumo, H. Flu, Neisseria Menigitidis)
    • Used as empiric treatment for meningitis in developing countries
  • Rocky Mountain Spotted fever
    • Especially important in pregnancy when Doxycycline is contraindicated
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15
Q

Adverse effects of Chloamphenicol

A

♣ Anemia – Causes dose-related reversible suppression of RBC production
♣ Aplastic anemia – due to irreversible bone marrow suppresion
♣ Grey Baby Syndrome

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16
Q

MOA of Linezolid

A

♣ Inhibits 50S ribosome subunit – bacteriostatic

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17
Q

Uses of Linezolid

A

♣ Gram positive organisms such as Staph, Step, and Enterococcus
♣ MRSA (Treat with Vancomycin, Daptomycin, and Linezolid)
• Useful for nosocomial MRSA infections (e.g. hospital acquired pneumonia)
♣ Vancomycin resistant Enterococcus, VRE (nosocomial UTI and endocarditis)

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18
Q

Adverse effects of Linezolid

A

♣ Thrombocytopenia (decreased platelets)
♣ Optic neuropathy with prolonged treatment
♣ Peripheral neuropathy (glove and stocking sensory impairment)
♣ Serotonin Syndrome
• Linezolid is an inhibitor of monoamine oxidase

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19
Q

MOA of Aminoglycosides

A

♣ Acts on the bacterial ribosome, halting translation

♣ Bind IRREVERSIBLY to the 30S subunit – BACTERICIDAL

20
Q

Example of Aminoglycoside drug names

A

Neomycin, Gentamicin, Streptomycin, Tobramycin, Amikacin, Paramycin

21
Q

Uses of Aminoglycosides

A

♣ Aerobic, gram-negative bacilli
• In order to get past the cell wall they are coupled with cell wall active drugs (e.g. beta-lactams or vancomycin)
• Are transported into bacteria via an oxygen dependent process (hence the activity against aerobic bacteria)
♣ Enterococcus (UTI and endocarditis)

22
Q

Use of Neomycin

A

• When taken orally, remains active in GI tract until excreted in feces– useful in bowel prep before colorectal surgery

23
Q

use of Paramycin

A

• Luminal agent against intestinal parasites such as Entomoeba histolytica

24
Q

Use of Streptomycin

A
  • Treat Tularemia caused by Francisella

* Treats plague caused by Yersinia pestis

25
Q

Use of Gentamicin

A
  • Treats resistant gram negative infections (e.g. Enterobacter, Serratia, Klebsiella)
  • Pseudomonas
26
Q

Use of Tobramycin

A

• Similar spectrum to Gentamicin

o Both treat pseudomonas

27
Q

Use of Amikacin

A
  • Resistant to many of the enzymes that inactivate other aminoglycosides in resistant bacteria
  • Treatment against pseudomonas
28
Q

Describe resistance to Aminoglycosides

A

♣ Enterococcus create resistance by inactivating Aminoglycoside via acetylation enzyme

29
Q

Adverse effects of Aminoglycosides

A
  • Ototoxicity
  • Nephrotoxicity (due to acute tubular necrosis)
  • Neuromuscular blockade (contraindicated in MG)
  • Teratogenic (deafness onn the newborn)
30
Q

Treatment of acute chest syndrome

A

Supplemental O2 and antibiotics

31
Q

What monitoring should be performed in kids with sickle cell in order to prevent stroke

A

Transcranial ultrasound

Should be initially performed at 2 year, and if normal then be repeated annually until 16 y/o

32
Q

Next step in management of sickle cell kid with abnormal transcranial US

A

Transfusion therapy to reduce percentage of sickled cells

33
Q

What is empyema

A

Purulent infection in the pleural space; usually seen with bacterial pneumonia or pulmonary abscess

34
Q

Bacterial causes of pneumonia to consider in a neonate

A

Enterobacteriaceae, Group B strep, Staph aureus, Strep pneumo, Listeria, Chlamydia

35
Q

Viral causes of pneumonia to consider in a neonate

A

HSV, RSV, enterovirus, influenza

36
Q

Common viral causes of pneumonia in infants

A

RSV, adenovirus, rhinovirus, influenza, parainfluenza

37
Q

Most common bacterial cause of pneumonia in pediatric patient > 5 years

A

Mycoplasma

38
Q

Tx of Mycoplasma pneumonia

A

Macrolides (e.g. Azithromycin)

39
Q

3 most common bacterial causes of acute otitis media

A

Strep pneumo, H. flu, Moraxella

40
Q

What is the usual antibiotic used to treat AOM

A

Amoxicillin

41
Q

What do you use to treat if Amoxicillin is not working on AOM

A

Amoxicillin-Clavulanate or Cephalosporin

Tympanocentesis and culture of middle ear fluid if several abx regimen are failed

42
Q

Management of suspected mastoiditis as a result of AOM

A

Myringotomy (TM incision), fluid culture, and parenteral abx

43
Q

Name 3 things that reduce risk of acute otitis media

A

♣ Administration of Pneumococcal and Influenza vaccines
♣ Tobacco smoke avoidance
♣ Increase breast-feeding

44
Q

What is cerebral palsy

A

o Disorder of nonprogressive motor dysfunction that results from an insult to or anomaly of the developing CNS

45
Q

In terms of cerebral palsy, differentiate between:

  • Hemiplegia
  • Diplegia
  • Quadriplegia
A

Hemiplegia = involvement of a single lateral side of the body, with greater impairment of the upper extremities

Diplegia = 4 limb involvement with greater impairment of lower extremities

Quadriplegia = 4 limb involvement with significant impairment of all 4 extremities

MS3 (88 decks)

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