Peds Infectious Diseases Flashcards
1
Q
Avoid tetracycline and minocycline in kids <____ years old
A
8
2
Q
Fluoroquinolone ophthalmic solutions not ind. in children <___ years old
A
1
3
Q
Which layers of the meninges are involved with meningitis?
A
pia and arachnoid
4
Q
At what age is the greatest chance of getting bacterial meningitis?
A
1st month of life
5
Q
What are the most common causes of bacterial meningitis in the neonate?
A
Group B strep and E. Coli
6
Q
Petechiae and purpura are most common with bacterial meningitis d/t what?
A
N. meningitidis
7
Q
What will the CSF show if a pt has bacterial meningitis?
A
Elev. CSF protein, decreased CSF glucose
8
Q
Typical empiric abx tx for neonates with meningitis typically includes?
A
ampicillin, gentamycin, +/- cefotaxime
9
Q
What abx are used to treat bac. meningitis if it is for an infant or child?
A
3rd gen ceph and vanco
10
Q
If a neonate survives meningitis, what should be evaluated after recovery?
A
hearing
11
Q
What is the most common cause of viral meningitis?
A
enterovirus
12
Q
What is the clinical presentation of enterovirus infections?
A
conjunctivitis, pharyngitis, rash, herpangina, hand-foot and mouth disease
13
Q
What diagnostic study do you want to get if you suspect HSV encephalitis in a kid?
A
MRI
14
Q
What type of conjunctivitis is more common in kids?
A
Bacterial
15
Q
Bacterial conjunctivitis in kids is usually caused by what 3 bacteria?
A
H flu, M. catt, strep pneumo
16
Q
First line therapy for bacterial conjunctivitis?
A
erythromycin ophthalmic ointment or polymyxin/trimethoprim drops
17
Q
If conjunctive has a “bumpy” appearance, what should you think of?
A
viral conjunctivitis
18
Q
What sinuses are present at birth?
A
maxillary and ethmoid
19
Q
By what age do sphenoid sinuses normally develop?
A
5
20
Q
These sinuses develop by 7-8 years of age
A
frontal
21
Q
Children <6 have an avg of ?? colds per year with typical symptom duration of 14 days
A
6-8
22
Q
Is a fever more or less common with school-aged children that have the common cold?
A
LESS
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
24
Q
What are the most common pathogens for acute bacterial rhinosinusitis?
A
m. catt, h flu, s. pneumo
25
When a child has a cold, when should you worry about acute bacterial rhinosinusitis?
If symptoms are present for > or equal to 10 days WITHOUT improvement
26
When is imaging necessary for acute bacterial rhinosinusitis?
If complications are suspected
27
What meds are NOT recommended for acute bacterial rhinosinusitis?
antihistamines
28
Complications of acute bacterial rhinosinusitis?
intracranial extension, periorbital and orbital cellulitis, septic cavernous sinus thrombosis, meningitis or brain abscess, osteomyelitis, epidural or subdural abscess
29
When is it considered chronic rhinosinusitis?
complex inflammatory condition of the paranasal sinuses lasting >12 weeks despite medical therapy
30
What are the most common pathogens of otitis externa?
P. aeruginosa, S. epidermidis, and S. aureus
31
This condition commonly presents with ear pain, pruritis, discharge and hearing loss
Otitis externa
32
With this ear condition, the TM should have NORMAL mobility but have evidence of erythema/edema?
Otitis externa
33
What age group has the peak occurence of otitis media?
btw 6-18 mos
34
When should you worry about eardrum rupture?
If sudden drainage occurs from the ear
35
Bulging TM think?
OM
36
Are decongestants/antihistamines rec. for AOM?
NO
37
When are abx useful with acute otitis media?
if the child is 2 with bilateral disease or otorrhea
38
First line therapy if abx are used for AOM?
amoxicillin
39
What is 2nd line therapy for AOM?
augmentin
40
When is AOM considered recurrent?
> 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
41
What are treatment options for recurrent AOM?
Abx prophylaxis or refer for tympanostomy tubes
42
Presence of a middle ear effusion in the absence of acute signs/symptoms of infection is?
Serous Otitis Media
43
Serous Otitis Media is accompanied by ?
conductive hearing loss
44
Treatment options for serous otitis media?
referall for surgery or watchful waiting
45
EBV infection begins with?
malaise, HA, low grade fever
46
What will a PE look like with someone with EBV/Mono?
exudative tonsillopharyngitis, posterior cervical LAD, +/-spleno and hepatomegaly, and occ. rash
47
What is the most common cause of sore throat?
Viral tonsillopharyngitis
48
CBC will reveal what if someone has mono?
lymphocytosis
49
bacterial tonsillopharyngitis is typically d/t ?
Group A strep
50
What are signs/symptoms of group A strep infection?
scarlatiniform rash, palatal petechiae, pharyngeal exudate, vomiting, and tender cervical lymph nodes
51
Common age for bacterial strep?
5-12
52
Bacterial tonsillopharyngitis involves ANT or POST cervical LAD?
Anterior
53
What should you do if you think your patient has bac. strep throat but their rapid strep test is neg?
Should get confirmatory throat culture
54
What is the treatment for bacterial tonsillopharyngitis?
PCN V or amoxicillin; erythromycin if PCN allergy
55
When is strep throat no longer considered contagious?
until 24 hours after abx are started
56
What are Pastia's lines?
bright red color in creases of the underarm of someone who has scarlet fever
57
What is the treatment for scarlett fever?
PCN V or amoxicillin (same as for strep)
58
This condition typically occurs 14-28 days after strep throat or scarlett fever?
Rheumatic Fever
59
Rheumatic fever most commonly affects kids of what ages?
5-15
60
Pancarditis that results in chest pain and dyspnea is usually?
Rheumatic fever
61
Erythema marginatum and sydenham chorea can be assoc. with what condition?
Rheumatic Fever
62
What condition will you have an elevated or rising antistreptolysin O Ab titer?
Rheumatic Fever
63
What may a CBC show with Rheumatic Fever?
mild normochromic, normocytic anemia
64
Treatment of Rheumatic Fever?
Abx (acute and long term prophylaxis), antiinflammatories, and possibly antiepileptics if sydenham chorea is severe
65
What are the most common VALVULAR complications of Rheumatic Fever?
mitral and aortic stenosis
66
This disease is characterized by a thick pharyngeal membrane and marked cervical adenopathy
diptheria
67
What are the "3 D's" assoc. with? (drooling, dysphagia, and distress)?
Epiglottitis
68
How is someone's voice described if they have epiglottitis?
"hot potato" voice
69
What is the "classic presentation" of someone with epiglottitis?
respiratory distress, anxiety and the characteristic "tripod" or "sniffing" position
70
Thumbprint sign = ?
Epiglottitis
71
Treatment of epiglottitis?
Admit to hospital (ICU), maintain airway, broad spectrum abx, +/- CS, supportive care
72
Pharyngeal abscesses generally affect kids < what age?
<5
73
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
Pharyngeal abscess
74
Imaging for a potential pharyngeal abscess can include?
lateral neck Xray or CT
75
Tx of pharyngeal abscesses include?
Hospitalize, maintain airway, may req. surgical drainage, abx, supportive care
76
What are the "more serious" complications of the Mumps?
meningitis, encephalitis, and orchitis
77
What is the treatment for mumps?
Symptomatic
78
Acute bronchiolitis is usually caused by?
RSV
79
This condition usually affects kids <2 and usually occurs in the winter months?
Acute bronchiolitis
80
What is the typical course of acute bronchiolitis?
typically begins with 1-3 day hx or URI symptoms followed by fever, cough and mild resp. distress
81
Auscultory findings with acute bronchiolitis?
exp. wheezing, prolonged exp phase, coarse and fine crackles
82
What treatments are NOT rec. for acute bronchiolitis?
GC, Abx, antivirals, hypertonic saline, heliox
83
What meds can you trial with acute bronchiolitis?
Inhaled bronchodilators
84
How is a diagnosis of RSV confirmed?
analysis of respiratory secretions
85
Treatment of RSV? Infants? Older kids?
Supportive, older kids you can trial CS but not in infants
86
This resp. illness is char. by inspiratory stridor, cough, and hoarseness
Laryngotracheitis (Croup)
87
What is the hallmark sign of Croup?
Barking cough
88
Is croup more common in boys or girls?
boys
89
What virus most commonly causes Croup?
parainfluenza type 1
90
How long do Croup symptoms usually last?
3-7 days
91
The "steeple sign" on Xray indicates what?
subglottic narrowing (Croup)
92
What treatment can you possibly consider in Croup?
Single dose of CS
93
If patient has Croup with significant stridor, what therapy may you consider?
nebulized epi
94
Which pulm disease is assoc. with 3 different stages?
Pertussis
95
What is the "catarrhal" stage of pertussis?
nonspecific prodrome lasting 1-2 weeks
96
What is the "paroxysmal" stage of pertussis?
persistent coughing attacks lasting 2-6 weeks
97
What is the "convalescent" stage of pertussis?
cough decreases over several weeks to mos.
98
How do you treat pertussis?
abx if early in course (macrolides = 1st line), supportive care, bronchodilator therapy
99
When can kids with pertussis return to school?
5 days after Abx therapy
100
Obtain PA/AP view for CXR if child in question of PNA is <4?
AP
101
If child you think has PNA is >4, what view CXR should you obtain?
PA
102
When should you always hospitalize if a child has PNA?
If they are <3-6 months old with suspected bac. PNA
103
What is first line therapy for O/P tx of PNA?
amoxicillin
104
What is generally first line tx of PNA if the patient is in the hospital?
3rd gen. ceph
105
VIRAL PNA is more likely to occur when child has exposure to ?
sick contacts
106
Most common symptoms/signs of this are fever, cough, tachypnea, malaise, emesis, hypoxemia, decreased breath sounds, and crackles
bac. PNA
107
Bac. PNA in neonates is usually d/t?
Group B strep
108
Infants and children <5, which type of PNA is more common?
VIRAL
109
Children >5, what is the most common type of PNA?
Bacterial, S. pneumo, M. pneumo, and chlamydophilia pneumo
110
HSV 1 is commonly referred to as?
herpes labialis
111
How does HSV 1 usually present in kids?
gingivostomatitis
112
What other condition can occur with HSV 1 in kids?
keratitis
113
What can in utero transmission of HSV cause?
hydrops fetalis and fetal in utero demise
114
This disease affects everywhere on the body EXCEPT the mucous membranes?
Roseola Infantum
115
This disease has a course of 3-5 days of high fever followed by a rash
Roseola infantum
116
What is roseola infantum usually caused by?
herpes virus 6
117
What age is typically affected by roseola infantum?
young kids, btw 7-13 months of age
118
What type of rash does someone get with roseola infantum?
blanching macular or maculopapular rash
119
How long does the rash of roseola infantum persist usually?
1-2 days
120
Treatment of roseola infantum?
supportive, typically is self-limiting, can control fever with tylenol
121
Acute febrile illness of unk etiology = ?
Kawasaki Disease
122
This disease usually affects kids >5 and affects more boys than girls
Kawasaki Disease
123
W/ Kawasaki disease, what do symptoms occur from?
they occur as a result of widespread inflamm of medium and small sized blood vessels
124
If you have a kid with a fever that persists 7-10 days and is resistent to antipyretics, what should you think of ?
Kawasaki disease
125
Besides fever, what other symptoms are common with Kawasaki disease?
mucocutaneous inflamm--bilat. conjunctivitis, erythema of the lips and oral mucosa, rash
126
Conjunctivitis and strawberry tongue....think?
kawasaki disease
127
What is the treatment of kawasaki disease?
IVIG and ASA
128
What test should a kid with Kawasaki disease have at diagnosis and 6-8 weeks after onset?
ECHO
129
Erythema infectiosum is caused by?
parvovirus B19
130
What is erythema infectiousum?
a viral illness that leads to rash on cheeks, arms and legs
131
Erythema infectiosum occurs most often in what season?
Spring
132
With this disease, the kid's rash fades from the center outwards, giving a lacy appearance and typically resolves within 1-2 weeks
Erythema Infectiosum
133
Tx of erythema infectiosum?
Self limited, no tx
134
What are other names for erythema infectiosum?
Fifth disease, Slapped Cheek
135
How long is someone infected with Measles usually before they have symptoms?
8-12 days
136
What does the "prodrome" for measles look like?
fever, malaise, anorexia followed by conjunctivitis, coryza, and cough
137
What is the sign that is pathognomic for measles?
Koplik's spots
138
What is rash like assoc. with measles?
maculopapular, blanching rash beg. on the face and spreading cephalocaudaly
139
How long does a measles rash typically last? What happens after?
3-4 days, followed by fine desquamination
140
Tx of Measles?
Supportive
141
With this disease, you worry about congenital infections?
Rubella
142
_______= "3 day" or "German" measles
Rubella
143
All pregnant women are tested for immunity to this bc of risk of congenital infections?
Rubella
144
What is the most frequent defect assoc. with congenital rubella infection?
hearing loss, foll. by mental retardation, C/V defects and ocular defects
145
When is antiviral treatment indicated for chickenpox?
If the child is >12
146
Hand, foot and mouth disease is caused by ?
enteroviruses (coxsackie A16)
147
What age of kids usually get Hand, foot, and mouth disease?
<5
148
Rash for this disease are usually on the palms of the hands and soles of the feet?
Hand, foot, and mouth disease
149
Is there a vaccine to prevent Hand, foot and mouth disease?
No
150
What is the most sig. cause of ped. viral gastroenteritis worldwide?
Rotavirus
151
Disease occurence of rotavirus increases in what season(s)?
winter and spring
152
Is there a vaccine available for rotavirus?
Yes
153
What are RotaTeq and Rotarix vaccines for?
Rotavirus
154
What is more common in causing viral gastroenteritis now that there is a vaccine for rotavirus?
Norovirus
