Peds Exam 1 Flashcards
A fever is a rectal temperature that exceeds
38 degrees C (100.4 F)
Fever has the GREATEST RISK among infants and children younger than
36 months
Most common eye disorder in children is
Conjunctivitis
Most common bacterial cause of conjunctivitis is
H. influenza
Most common viral cause of conjunctivitis is
Adneoviruses
Treatment of suspected bacterial conjunctivitis is
- Trimethoprim-polymyxin B solution (polytrim) topical drops; 1 drop 4x daily for 7 days
Treatment of suspected bacterial conjunctivitis in babies is
Erythromycin ointment
Blepharitis is treated with
- Cleansing the lid well / warm compresses
- Erythromycin ointment OR Azithromycin drops
______ rhinosinusitis is most common
Viral
diagnosis of acute bacterial rhino sinusitis is made
when a cold does not improve by 10-14 days or worsens at day 5-7
Gold standard diagnostic testing for rhino sinusitis is
Nasal endoscopy (done by ENT and rarely done)
First line treatment of acute bacterial rhinosinusitits is
1st Amoxicillin 80-90 mg/kg/day for 10 days
Second line is Augmentin
The TWO most common causes of periorbital (preseptal) cellulitis is
- Group A strep
- Staph aureus
How does periorbital cellulitis differ in presentation from orbital cellulitis
Periorbital: Visual acuity, eye motility, and pupillary reaction are normal. No pain on eye movement and no proptosis.
Orbital cellulitis: Poor vision, proptosis, poor motility, double and blurry vision, very painful.
Treatment of periorbital cellulitis includes
- PO or IV antibiotics
- Amoxicillin-clavulanate (Augmentin) 80-90 mg/kg/day for 10 days
Orbital cellulitis is more commonly associated with
Rhinosinusitis
the most common cause of URI (common cold) 30-40% of the time is
Rhinovirus
most common viral cause of pharyngitis is
Rhinovirus
Most common bacterial cause of pharyngitis is
Group A strep
Although this is usually not first line dx test, what is the gold standard test to distinguish group A strep pharyngitis from other organisms?
Throat culture
Treatment for Group A beta-hemolytic streptococcal pharyngitis strep throat is
Amoxicillin 50 mg/kg/day once daily for 10 days
if attempting to eradicate strep carrier state, how could you do that?
- Clindamycin for 10 days OR
- Rifampin for 5 days
What vaccination has reduced the incidence of Epiglottis?
H Flu type B (HIB) vaccination
A thumb print sign on X-ray Indicates
Epiglottitis
Definitive dx of epiglottitis is
Nasal fiberoptic endoscope performed in the OR; can see “Cherry red” erythematous and edematous epiglottitis
Treatment of epiglottitis includes
IV antibiotics: Ampicillin/sulbactam, cefotaxime or ceftriaxone for 2-3 days and then change to oral meds to complete a 10 day course
Infectious Mononucleosis is caused by
Epstein-Barr (EBV) virus infection
Diagnosis of Mono can be done via
Serum Monospot test (90% sensitive)
A “hot potato voice”, deviated uvula and soft palate to the contralateral side, and a severe sore throat that is out of proportion to physical findings may suggest
Peritonsillar abscess
Tx of a peritonsillar abscess includes
Referring pt to ENT for incision and drainage and antibiotics
what is type I hypersensitivity
Immediate hypersensitivity (systemic or localized)
what is type II hypersensitivity
Cytotoxic (antibody-dependent)
what is type III hypersensitivity
Immune complex (inflammatory reaction)
what is type IV hypersensitivity
Delayed (cell mediated)
Allergic rhinitis is a type ____ mediated allergic response?
Type I IgE
What is the atopic triad?
Allergic rhinitis, asthma, and atopic dermatitis
The best wat to test for allergies is
Skin testing
Skin testing works by
bioassay that detects the presence of allergen-specific IgE on a pt’s mast cells
Severity classification of allergic rhinitis:
Sx present < 4 days a week or for < 4 weeks
intermittent
Severity classification of allergic rhinitis:
Sx present > 4 days a week and for > 4 weeks
Persistent
Severity classification of allergic rhinitis:
Without impairment or disturbance of sleep, daily activities, work, school, or without troublesome sx
Mild
Severity classification of allergic rhinitis:
Disturbance of sleep, daily activities, leisure, sports, school or work
Moderate-severe
In infancy, atopic dermatitis is found on
Face, scalp, and extensor surfaces
what are Dennie-Morgan folds and what condition are they associated with?
(aka infraorbital folds)
Occurs in 25% of patients with atopic dermatitis
Benign dry rough patches / tiny bumps found on the upper arms, thighs, cheeks or buttocks that are NOT painful or itchy is known as
Keratosis Pilaris
First line pharmacologic therapy for atopic dermatitis is
Topical corticosteroids
what type of hypersensitivity reaction is contact dermatitis
Type IV - delayed (cell mediated)
Urticaria and angioedema are caused by
mast cell deregulation in the skin
there are many causes of urticaria and angioedema some examples include
- VIRAL infections
- Foods/drugs
- Latex
- Serum sickness
- Autoimmunity
Treatment of urticaria/angioedema is
2nd generation H1 antihistamines; Cetirizine is first line
Cetirizine dose to tx urticaria / angioedema in a pt:
6mo-2yrs
2.5 mg
Cetirizine dose to tx urticaria / angioedema in a pt:
2y-5y
5 mg
Cetirizine dose to tx urticaria / angioedema in a pt:
6y-12y
5-10 mg
Cetirizine dose to tx urticaria / angioedema in a pt:
> 12 yrs
10 mg
what type of hypersensitivity reaction is serum sickness
Type III - immune complex
rash, fever, and polyarthralgias or poly arthritis that begin 1-2 wks after the 1st exposure and resolve within a few weeks of discontinuation is cardinal features of
Serum sickness
Anaphylactic reactions are what type of hypersensitivity reaction?
Type I - IgE mediated reaction
Medical management of anaphylaxis includes
Epinephrine 0.01 mg/kg IM repeat q 20 mins prn
medication allergies can occur within
1 hour and up to 72 hrs from the last dose
The most frequent cause of medication allergies are
Antibiotics (amoxicillin, bacterium, and ampicillin)
Treatment of insect bites includes
- Local therapy with cool compress, steroids, NSAIDs, and antihistamine cream
- Epinephrine if needed
- IV antihistamines / corticosteroids if needed
Complications of insect allergies includes
Anaphylaxis
food allergies can occur
minutes up to four hours after ingestion
