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Pediatrics > Peds: ID > Flashcards

Peds: ID Flashcards

1
Q

Most common cause of Stridor in Children. Fever, runny nose, coryza. Barking cough, stridor on inspiration, respiratory distress. Dx Test? Rx?

A

Croup. Infection of the Subglottic space caused by parainfluenza. Test: Clinical diagnosis can see Steeple sign on CXR. Rx: Racemic nebulized epinephrine.

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2
Q

Pt has fever, drooling (hurts to swallow) and refuses to lean back (hurts to lean back), speaks in muffled sounds. CXF there is thumb print sign. Dx? Next step in management? Rx?

A

Epiglottis. Ceftriaxone/Cefuroxime.

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3
Q

Allergic Shiners, Dennie Lines, Transverse nasal crease, pale nasal mucousa, turbinate hypertrophy. Dx? Test? Rx?

A

Allergic rhinitis. Clinical Diagnosis. IgE levels and skin testing can be done. Rx: 1. Avoid triggers 2. Antihistamines first line (diphenhydramine (benadryl) And second generations: Certerizine (Zyrtec), fexofenadine (Allegra), loratidine (Claritin)) 3. Nasal steroid with high dose antihistamine)

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4
Q

Pt gets stung and develops swelling of area over hours to days. Urticaria and angioedema. Dx? Test? Rx? What is the management if pt develops anaphylaxis.

A

Insect Venom Allergy. Clinical Diagnosis can do skin testing. Rx: Apply cold compress, topical antitch cream, pain meds, antihistamine. If anaphylaxis then carry Epi pen and ID bracelet.

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5
Q

Pt can present with urticario/angioedema and atopic dermatitis or vomiting and diarrhea after ingestion of milk, egg, nut or drug. Dx? Test? Rx?

A

Food Reaction/ Food Allergy. Clinical Diagnosis. Must establish food amount, timing and nature of reaction. Can do skin test or test of IgE in blood. Rx: Elimination of food. Carry Epi pen if anaphylaxis develops.

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6
Q

Acute Management of Anaphylaxis? (Latex, antibiotics, Peanuts)

A

Patient should take Epi IM, Oral Antihistamine and go to ER. Doc should establish airway, give Epi IM, fluids, and Drugs : (Antihistamine, B2, Nebulizer, Steroids)

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7
Q

Cause by RSV in the winter months. Infants

A

Bronchiolitis. Clinical Diagnosis. Most accurate test: NP rapid test or PCR for organism. Rx is Supportive: 02, Albuterol, CPT. Ribavrin in the immunocompromised. - Pts should get RSV prophylaxis.

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8
Q

A common cause of Stridor in Infants. Collapse of the supraglottic structures inward during inpiration. Less in prone position Dx? Test? Rx?

A

Laryngomalacia (starts in first 2 weeks of life and then symptoms increase up to 6 months). Clinical suspicion confirmed with Laryngoscopy. Supportive care issues resolves on its own.

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9
Q

A common cause of Stridor in Infants that is associated with meningomyelocele, chiari malformation and hydrocephalus. Bilateral causes airway obstruction and unilateral causes aspiration, cough and choking. Dx? Test? Rx?

A

Vocal Cord paralysis. Flexible bronchoscopy to assess paralysis. Rx: Resolves in 6-12 months. May require temporary tracheotomy.

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10
Q

Toddler choked on some coins. Pt is drooling and is in respiratory distress. Decreased breath sounds on the R with intercostal retractions. Dx? Test? Rx?

A

Foreign Body in airway. CXR then bronchoscopy for definiitve diagnosis. Rigid Bronchoscopy removes foreign object. Unless it’s GI then do flexible endoscope down esophagus- ingestion of foreign body.

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11
Q

After having Bronchiolitis caused by RSV, what is the pt prone to developing?

A

Asthma. Bronchiolitis increases risk of developing asthma.

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12
Q

Rx for inpatient child pneumonia? Rx for out patient child pneumonia.

A

Inpatient - Ceftriaxone or (Azthro/Erythromycin for 1-3 month) olds Outpatient - Ampicillin, Amoxicillin or Azithro/Erythromycin

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13
Q

Fever > 104, Cough, Coryza, Conjunctivityis, Kpolik spots in mouth (whitish spots on buccal mucousa) Dx? Test? Rx?

A

Rubeola (Measles). Clinical Diagnosis. Supportive

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14
Q

Fever and URI symptoms, Slapped Cheek Rash. Dx? Test? Rx?

A

Fiths Disease (parvovirus b19) . Clinical Diagnosis. Supportive

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15
Q

Fever and URI progressing then develops diffuse rash. Dx? Test? Rx?

A

Roseola (6th) caused by HHV-6. Pts get better than break out in rash- Parents think its related to abx allergic reaction but its not. Clinical Diagnosis. Supportive.

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16
Q

Fever precedes classic gland swelling with possible orchitis. Dx? Test? Rx?

A

Mumps. Clinical Diagnosis. Supportive.

17
Q

Baby presents with Hypotonia, Decreased Movements, Poor feeding and mom has started him on new home remedy. There is eye involvement. Dx? DDx(2)? Rx?

A

Botulism toxin. Rx: BIG-IV DDx includes SMA (Wernig Hoffman which does not have eye involvment more lower extremity weakness since it affects the anterior horn.) Botulinism spores are present in the California Soil so honey, not the only reason, ask if the pt has moved or visited Cali.

18
Q

Septick Shock, DIC, Adrenal Hemorrahge, Renal and heart failure with petechiea and purpura present on child. Dx? Rx?

A

Acute Meningoccocemia. IV Penicillin STAT.

19
Q

Delayed immunizations, paroxysmal cough, facial petechiae, conjunctival hemorrahages, post-tussive emesis. Dx? Test? Rx?

A

Whooping cough by Bordetella Pertussis. Test: Clinical Diagnosis and PCR can confirm. Rx: PO Erythromycin for 14 days - helps shorten the course of the illness during the infectious stage and Treat Family members (very contagious) and vaccinate anyone who has not been vaccinated yet.

20
Q

3X5cm tender, erythematous, anterior cervical neck node. No hx of fever, weightloss, chills, night sweats or sore throat. Pt has a cat. Dx? Test? Rx?

A

Bartonella by Bartonella Henselae. Most common cause of lymphadenitis. Test: Clinical and PCR. Rx: Abx only if hospitalized.

21
Q
  1. What to do if mother has positive PPD and just delivered baby? 2. What if she has suspected TB at delivery?
A
  1. Obtain CXR. 2. Separate mother (Put mom in negative Pressure Room and child until CXR is Confirmed.
22
Q

White Plaques that Bleed when Scraped off. Pt jus received course of empiric ab. Dx? Test? Rx for all 3 types.

A

Oral thrush. Test: Bleeds with Scraping. Rx: Oral nystatin swish and swallow. If Diaper rash then give Topical nystatin. With Catheter related fungemia - remove all catheters and give Amp B (Systemic Coverage.)

23
Q

Pt presents with vesicular rash of the mouth, foot and hands. Dx? Test? Rx?

A

Coxsackie A. Clinical. Supportive.

24
Q

Follicular Conjunctivitis, Fever, Diarrhea. Dx? Test? Rx?

A

Adenovirus. Clinical (can do Serology, Viral culture and PCR to Confirm.) Supportive.

25
Q

Lives in GI track and causes Asymetric Flaccid Paralysis. Dx? Test? Rx?

A

Polio. Clinical. Prevent with vaccination.

26
Q

Pt has Cough and Worm was found in diaper. Dx? Test? Rx?

A

Ascariasis causes Loeffler Syndrome (Cough and hemoptysis due to invasion of worm in lungs from GI tract) CBC shows significant Eosinophilia 20%. Rx: Albendazole

27
Q

Pt presents with lack of appeitite, abdominal pain and diarrhea. Also has yellow-green pallor. Dx? Etiology? Test? Rx?

A

Ancylotoma penetrates skin and hooks on to GI mucousa. There is Significant Eosinophilia 20%. Rx with Albendazole.

28
Q

Mother states daughter is scratching her anus and sometimes scratches her vuvula. Pt loves to play in Sandbox. Dx? Test? Rx?

A

Enterobiasis. No eosinophilia- only worm with no eosinophilia. Rx: Albendazole.

29
Q

Name 4 Contraindications to breast feeding.

A
  1. Active TB, 2. HIV (Except in foreign countries) 3. HSV - lesions on breast and substance abuse
30
Q

What is the abx for cat scratch?

A

Augmentin/Clavaunate

31
Q

Baby presents with Spasms and Poor Sucking Reflex. Baby was delivered by untrained person and there was no prenatal or antenal care. The umbilical cord smells foul. Dx?

A

Neonatal Tetanus. Comes from the umbilical stump infection 2/2 improper obsteric procedures in foreign countries and mothers are not immunized.

32
Q

This presents in >12 year olds. Pt presents with Hot Potato Voice/Muffled Voice and the Uvula is displaced midline. Clinical diagnosis. Dx? Rx?

A

Peritonsillar Abscess. I and D and abx.

33
Q

Presents with erythematous tender maculopapular rash that also starts on face and spreads down. Children with this disease have low grade fever and do not appear ill in contrast to Measles. Fever

A

Rubella. Clinical Diagnosis. Supportive.

Pediatrics (13 decks)

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