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Pediatrics > Peds Infectious Diseases > Flashcards

Peds Infectious Diseases Flashcards

1
Q

Avoid tetracycline and minocycline in kids <____ years old

A

8

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2
Q

Fluoroquinolone ophthalmic solutions not ind. in children <___ years old

A

1

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3
Q

Which layers of the meninges are involved with meningitis?

A

pia and arachnoid

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4
Q

At what age is the greatest chance of getting bacterial meningitis?

A

1st month of life

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5
Q

What are the most common causes of bacterial meningitis in the neonate?

A

Group B strep and E. Coli

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6
Q

Petechiae and purpura are most common with bacterial meningitis d/t what?

A

N. meningitidis

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7
Q

What will the CSF show if a pt has bacterial meningitis?

A

Elev. CSF protein, decreased CSF glucose

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8
Q

Typical empiric abx tx for neonates with meningitis typically includes?

A

ampicillin, gentamycin, +/- cefotaxime

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9
Q

What abx are used to treat bac. meningitis if it is for an infant or child?

A

3rd gen ceph and vanco

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10
Q

If a neonate survives meningitis, what should be evaluated after recovery?

A

hearing

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11
Q

What is the most common cause of viral meningitis?

A

enterovirus

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12
Q

What is the clinical presentation of enterovirus infections?

A

conjunctivitis, pharyngitis, rash, herpangina, hand-foot and mouth disease

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13
Q

What diagnostic study do you want to get if you suspect HSV encephalitis in a kid?

A

MRI

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14
Q

What type of conjunctivitis is more common in kids?

A

Bacterial

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15
Q

Bacterial conjunctivitis in kids is usually caused by what 3 bacteria?

A

H flu, M. catt, strep pneumo

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16
Q

First line therapy for bacterial conjunctivitis?

A

erythromycin ophthalmic ointment or polymyxin/trimethoprim drops

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17
Q

If conjunctive has a “bumpy” appearance, what should you think of?

A

viral conjunctivitis

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18
Q

What sinuses are present at birth?

A

maxillary and ethmoid

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19
Q

By what age do sphenoid sinuses normally develop?

A

5

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20
Q

These sinuses develop by 7-8 years of age

A

frontal

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21
Q

Children <6 have an avg of ?? colds per year with typical symptom duration of 14 days

A

6-8

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22
Q

Is a fever more or less common with school-aged children that have the common cold?

A

LESS

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23
Q

What should you tell parents to avoid when their child has a cold when their child is <12?

A

OTC cough and cold meds

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24
Q

What are the most common pathogens for acute bacterial rhinosinusitis?

A

m. catt, h flu, s. pneumo

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25
Q

When a child has a cold, when should you worry about acute bacterial rhinosinusitis?

A

If symptoms are present for > or equal to 10 days WITHOUT improvement

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26
Q

When is imaging necessary for acute bacterial rhinosinusitis?

A

If complications are suspected

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27
Q

What meds are NOT recommended for acute bacterial rhinosinusitis?

A

antihistamines

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28
Q

Complications of acute bacterial rhinosinusitis?

A

intracranial extension, periorbital and orbital cellulitis, septic cavernous sinus thrombosis, meningitis or brain abscess, osteomyelitis, epidural or subdural abscess

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29
Q

When is it considered chronic rhinosinusitis?

A

complex inflammatory condition of the paranasal sinuses lasting >12 weeks despite medical therapy

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30
Q

What are the most common pathogens of otitis externa?

A

P. aeruginosa, S. epidermidis, and S. aureus

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31
Q

This condition commonly presents with ear pain, pruritis, discharge and hearing loss

A

Otitis externa

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32
Q

With this ear condition, the TM should have NORMAL mobility but have evidence of erythema/edema?

A

Otitis externa

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33
Q

What age group has the peak occurence of otitis media?

A

btw 6-18 mos

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34
Q

When should you worry about eardrum rupture?

A

If sudden drainage occurs from the ear

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35
Q

Bulging TM think?

A

OM

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36
Q

Are decongestants/antihistamines rec. for AOM?

A

NO

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37
Q

When are abx useful with acute otitis media?

A

if the child is 2 with bilateral disease or otorrhea

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38
Q

First line therapy if abx are used for AOM?

A

amoxicillin

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39
Q

What is 2nd line therapy for AOM?

A

augmentin

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40
Q

When is AOM considered recurrent?

A

> or equal to 3 distinct and well documented episodes of AOM within 6 mos or > or equal to 4 episodes or AOM within 12 mos

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41
Q

What are treatment options for recurrent AOM?

A

Abx prophylaxis or refer for tympanostomy tubes

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42
Q

Presence of a middle ear effusion in the absence of acute signs/symptoms of infection is?

A

Serous Otitis Media

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43
Q

Serous Otitis Media is accompanied by ?

A

conductive hearing loss

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44
Q

Treatment options for serous otitis media?

A

referall for surgery or watchful waiting

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45
Q

EBV infection begins with?

A

malaise, HA, low grade fever

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46
Q

What will a PE look like with someone with EBV/Mono?

A

exudative tonsillopharyngitis, posterior cervical LAD, +/-spleno and hepatomegaly, and occ. rash

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47
Q

What is the most common cause of sore throat?

A

Viral tonsillopharyngitis

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48
Q

CBC will reveal what if someone has mono?

A

lymphocytosis

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49
Q

bacterial tonsillopharyngitis is typically d/t ?

A

Group A strep

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50
Q

What are signs/symptoms of group A strep infection?

A

scarlatiniform rash, palatal petechiae, pharyngeal exudate, vomiting, and tender cervical lymph nodes

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51
Q

Common age for bacterial strep?

A

5-12

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52
Q

Bacterial tonsillopharyngitis involves ANT or POST cervical LAD?

A

Anterior

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53
Q

What should you do if you think your patient has bac. strep throat but their rapid strep test is neg?

A

Should get confirmatory throat culture

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54
Q

What is the treatment for bacterial tonsillopharyngitis?

A

PCN V or amoxicillin; erythromycin if PCN allergy

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55
Q

When is strep throat no longer considered contagious?

A

until 24 hours after abx are started

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56
Q

What are Pastia’s lines?

A

bright red color in creases of the underarm of someone who has scarlet fever

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57
Q

What is the treatment for scarlett fever?

A

PCN V or amoxicillin (same as for strep)

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58
Q

This condition typically occurs 14-28 days after strep throat or scarlett fever?

A

Rheumatic Fever

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59
Q

Rheumatic fever most commonly affects kids of what ages?

A

5-15

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60
Q

Pancarditis that results in chest pain and dyspnea is usually?

A

Rheumatic fever

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61
Q

Erythema marginatum and sydenham chorea can be assoc. with what condition?

A

Rheumatic Fever

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62
Q

What condition will you have an elevated or rising antistreptolysin O Ab titer?

A

Rheumatic Fever

63
Q

What may a CBC show with Rheumatic Fever?

A

mild normochromic, normocytic anemia

64
Q

Treatment of Rheumatic Fever?

A

Abx (acute and long term prophylaxis), antiinflammatories, and possibly antiepileptics if sydenham chorea is severe

65
Q

What are the most common VALVULAR complications of Rheumatic Fever?

A

mitral and aortic stenosis

66
Q

This disease is characterized by a thick pharyngeal membrane and marked cervical adenopathy

A

diptheria

67
Q

What are the “3 D’s” assoc. with? (drooling, dysphagia, and distress)?

A

Epiglottitis

68
Q

How is someone’s voice described if they have epiglottitis?

A

“hot potato” voice

69
Q

What is the “classic presentation” of someone with epiglottitis?

A

respiratory distress, anxiety and the characteristic “tripod” or “sniffing” position

70
Q

Thumbprint sign = ?

A

Epiglottitis

71
Q

Treatment of epiglottitis?

A

Admit to hospital (ICU), maintain airway, broad spectrum abx, +/- CS, supportive care

72
Q

Pharyngeal abscesses generally affect kids < what age?

A

<5

73
Q

Symptoms of this disease can include dysphagia, stiff neck, torticollis, changes in voice quality, respiratory distress, neck swelling, trismus, chest pain and often have a fever

A

Pharyngeal abscess

74
Q

Imaging for a potential pharyngeal abscess can include?

A

lateral neck Xray or CT

75
Q

Tx of pharyngeal abscesses include?

A

Hospitalize, maintain airway, may req. surgical drainage, abx, supportive care

76
Q

What are the “more serious” complications of the Mumps?

A

meningitis, encephalitis, and orchitis

77
Q

What is the treatment for mumps?

A

Symptomatic

78
Q

Acute bronchiolitis is usually caused by?

A

RSV

79
Q

This condition usually affects kids <2 and usually occurs in the winter months?

A

Acute bronchiolitis

80
Q

What is the typical course of acute bronchiolitis?

A

typically begins with 1-3 day hx or URI symptoms followed by fever, cough and mild resp. distress

81
Q

Auscultory findings with acute bronchiolitis?

A

exp. wheezing, prolonged exp phase, coarse and fine crackles

82
Q

What treatments are NOT rec. for acute bronchiolitis?

A

GC, Abx, antivirals, hypertonic saline, heliox

83
Q

What meds can you trial with acute bronchiolitis?

A

Inhaled bronchodilators

84
Q

How is a diagnosis of RSV confirmed?

A

analysis of respiratory secretions

85
Q

Treatment of RSV? Infants? Older kids?

A

Supportive, older kids you can trial CS but not in infants

86
Q

This resp. illness is char. by inspiratory stridor, cough, and hoarseness

A

Laryngotracheitis (Croup)

87
Q

What is the hallmark sign of Croup?

A

Barking cough

88
Q

Is croup more common in boys or girls?

A

boys

89
Q

What virus most commonly causes Croup?

A

parainfluenza type 1

90
Q

How long do Croup symptoms usually last?

A

3-7 days

91
Q

The “steeple sign” on Xray indicates what?

A

subglottic narrowing (Croup)

92
Q

What treatment can you possibly consider in Croup?

A

Single dose of CS

93
Q

If patient has Croup with significant stridor, what therapy may you consider?

A

nebulized epi

94
Q

Which pulm disease is assoc. with 3 different stages?

A

Pertussis

95
Q

What is the “catarrhal” stage of pertussis?

A

nonspecific prodrome lasting 1-2 weeks

96
Q

What is the “paroxysmal” stage of pertussis?

A

persistent coughing attacks lasting 2-6 weeks

97
Q

What is the “convalescent” stage of pertussis?

A

cough decreases over several weeks to mos.

98
Q

How do you treat pertussis?

A

abx if early in course (macrolides = 1st line), supportive care, bronchodilator therapy

99
Q

When can kids with pertussis return to school?

A

5 days after Abx therapy

100
Q

Obtain PA/AP view for CXR if child in question of PNA is <4?

A

AP

101
Q

If child you think has PNA is >4, what view CXR should you obtain?

A

PA

102
Q

When should you always hospitalize if a child has PNA?

A

If they are <3-6 months old with suspected bac. PNA

103
Q

What is first line therapy for O/P tx of PNA?

A

amoxicillin

104
Q

What is generally first line tx of PNA if the patient is in the hospital?

A

3rd gen. ceph

105
Q

VIRAL PNA is more likely to occur when child has exposure to ?

A

sick contacts

106
Q

Most common symptoms/signs of this are fever, cough, tachypnea, malaise, emesis, hypoxemia, decreased breath sounds, and crackles

A

bac. PNA

107
Q

Bac. PNA in neonates is usually d/t?

A

Group B strep

108
Q

Infants and children <5, which type of PNA is more common?

A

VIRAL

109
Q

Children >5, what is the most common type of PNA?

A

Bacterial, S. pneumo, M. pneumo, and chlamydophilia pneumo

110
Q

HSV 1 is commonly referred to as?

A

herpes labialis

111
Q

How does HSV 1 usually present in kids?

A

gingivostomatitis

112
Q

What other condition can occur with HSV 1 in kids?

A

keratitis

113
Q

What can in utero transmission of HSV cause?

A

hydrops fetalis and fetal in utero demise

114
Q

This disease affects everywhere on the body EXCEPT the mucous membranes?

A

Roseola Infantum

115
Q

This disease has a course of 3-5 days of high fever followed by a rash

A

Roseola infantum

116
Q

What is roseola infantum usually caused by?

A

herpes virus 6

117
Q

What age is typically affected by roseola infantum?

A

young kids, btw 7-13 months of age

118
Q

What type of rash does someone get with roseola infantum?

A

blanching macular or maculopapular rash

119
Q

How long does the rash of roseola infantum persist usually?

A

1-2 days

120
Q

Treatment of roseola infantum?

A

supportive, typically is self-limiting, can control fever with tylenol

121
Q

Acute febrile illness of unk etiology = ?

A

Kawasaki Disease

122
Q

This disease usually affects kids >5 and affects more boys than girls

A

Kawasaki Disease

123
Q

W/ Kawasaki disease, what do symptoms occur from?

A

they occur as a result of widespread inflamm of medium and small sized blood vessels

124
Q

If you have a kid with a fever that persists 7-10 days and is resistent to antipyretics, what should you think of ?

A

Kawasaki disease

125
Q

Besides fever, what other symptoms are common with Kawasaki disease?

A

mucocutaneous inflamm–bilat. conjunctivitis, erythema of the lips and oral mucosa, rash

126
Q

Conjunctivitis and strawberry tongue….think?

A

kawasaki disease

127
Q

What is the treatment of kawasaki disease?

A

IVIG and ASA

128
Q

What test should a kid with Kawasaki disease have at diagnosis and 6-8 weeks after onset?

A

ECHO

129
Q

Erythema infectiosum is caused by?

A

parvovirus B19

130
Q

What is erythema infectiousum?

A

a viral illness that leads to rash on cheeks, arms and legs

131
Q

Erythema infectiosum occurs most often in what season?

A

Spring

132
Q

With this disease, the kid’s rash fades from the center outwards, giving a lacy appearance and typically resolves within 1-2 weeks

A

Erythema Infectiosum

133
Q

Tx of erythema infectiosum?

A

Self limited, no tx

134
Q

What are other names for erythema infectiosum?

A

Fifth disease, Slapped Cheek

135
Q

How long is someone infected with Measles usually before they have symptoms?

A

8-12 days

136
Q

What does the “prodrome” for measles look like?

A

fever, malaise, anorexia followed by conjunctivitis, coryza, and cough

137
Q

What is the sign that is pathognomic for measles?

A

Koplik’s spots

138
Q

What is rash like assoc. with measles?

A

maculopapular, blanching rash beg. on the face and spreading cephalocaudaly

139
Q

How long does a measles rash typically last? What happens after?

A

3-4 days, followed by fine desquamination

140
Q

Tx of Measles?

A

Supportive

141
Q

With this disease, you worry about congenital infections?

A

Rubella

142
Q

_______= “3 day” or “German” measles

A

Rubella

143
Q

All pregnant women are tested for immunity to this bc of risk of congenital infections?

A

Rubella

144
Q

What is the most frequent defect assoc. with congenital rubella infection?

A

hearing loss, foll. by mental retardation, C/V defects and ocular defects

145
Q

When is antiviral treatment indicated for chickenpox?

A

If the child is >12

146
Q

Hand, foot and mouth disease is caused by ?

A

enteroviruses (coxsackie A16)

147
Q

What age of kids usually get Hand, foot, and mouth disease?

A

<5

148
Q

Rash for this disease are usually on the palms of the hands and soles of the feet?

A

Hand, foot, and mouth disease

149
Q

Is there a vaccine to prevent Hand, foot and mouth disease?

A

No

150
Q

What is the most sig. cause of ped. viral gastroenteritis worldwide?

A

Rotavirus

151
Q

Disease occurence of rotavirus increases in what season(s)?

A

winter and spring

152
Q

Is there a vaccine available for rotavirus?

A

Yes

153
Q

What are RotaTeq and Rotarix vaccines for?

A

Rotavirus

154
Q

What is more common in causing viral gastroenteritis now that there is a vaccine for rotavirus?

A

Norovirus

Pediatrics (3 decks)

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