Peds Infectious Dz 1 Flashcards
Otitis media:
- presentation
- peak incidence
- risk factors
- MC bugs
- Tx
- Complications
Presentation: pulling at ears, pain, fever, sinus congestion, etc.
Peak incidence: 6-36mo.
Risk factors:
-caretaker smoking, bottle propping, daycare
MC bugs: Strep Pneumonia, H. Flu, M. Cat
Tx: Amoxicillin 1st line, can do azithromycin in place of augmentin b/c it tastes good and wont gie the kiddo bad diarrhea.
Complications:
-mastoiditis, venous sinus thrombosis, brain abscess
Otitis Externa
- risk factors
- MC bugs
- sx
- PE findings
- tx
Risk factors:
-swimming, humid environments, qtips, immunocompromised
MC bug:
- staph aureus*
- PSEUDOMONAS*
- Proteus
Sx:
- otalgia
- pain at tragus
- pruritis
- discharge
- hearing loss
- inflamed regional LN
PE findings:
- edematous and erythematous ear canal
- yellow, brown, or white/grey debris
- no middle ear fluid, mobile TM.
Tx:
- clean ear canal
- protect ear from water
- Ofloxacin if TM perforation
- Cortisporin, Cipro HC, tobradex if TM INTACT!
Pharyngitis/Tonsillitis
-MC cause & complications
MC cause:
- viruses***
- Streptococcus pyogenes (GABHS) = complications are rheumatic heart dz, glomerulonephritis, and scarlet fever.
Viral pharyngitis:
- sx
- tx
sx: rhinorrhea, cough, fatigue, anorexia, abd pain
Tx: manage sx
GABHS Sore throat
- signs & sx
- dx
- tx
Signs and Sx:
- beefy red tonsils w/ exudate*
- strawberry tongue*
- petechiae*
- tender anterior cervical LN*
- HA, Abd pain
- high fever!*
- severe sore throat*
- absence of URI
Dx; -throat culture** (gold standard) -rapid strep Tx: -PCN VK 1st choice -amoxicillin -if pcn allergic give azithromycin or 3rd gen cephalosporin, ENT use clindamycin.
EBV -sx -whats found on peripheral blood smear? -Dx Tx
Sx:
- beefy red tonsils and exudate
- diffuse lymphadenopathy
- fatigue/malaise
- splenomegaly
- afebrile
Peripheral blood smear: atypical lymphocytosis
Dx:
- Monspot test (Heterophile aby testing)
- IgG and IgM testing if monospot negative.
Tx: education, no contact sports for 6-8wks
Herpangina
- MC cause
- sx
- Tx
- how is this different from from herpes simplex?
MC cause is enterovirus
Sx:
- high fever
- small ulcers on tonsillar pillars, soft palate, and uvula
Tx: acyclovir
Diff from herpes simplex because its not caused by herpes simplex virus and herpes likes to attack vermillion border of the mouth..
WHen you see ulcers and vesicles you should automatically think what?
VIRAL CAUSE!!!!!!!!!!!!!
Hand, foot, andd mouth dz
- cause
- signs & sx
- Tx
Cause: coxsackie virus
Signs an Sx: vesicles or red papules found on the tongue, oral mucosa, hands, and feet
*nodules are hard and non-blanching.
Fever, malaise
Tx: no tx, sometimes lozenges to help with swallowing.
Serious causes of sore throat
- peritonsillar abscess
- retropharyngeal abscess
- epiglottitis
Aphthous Stomatitis
- aka
- duration of dz
- management
aka: canker sore
- duration: 1-2wks
- management: topical preparations: numbing agent; orajel.
Gingiovstomatitis:
- cause
- sx
- duration of dz
- tx
cause: herpes simplex
sx:
- ulcers can develop on buccal mucosa, anterior pillars, inner lips,, tongue, and gingiva
- fever
- tender cervical lymphadenopathy
Duration: 7-10days
Tx:
- topical preparations (BUT NO STEROIDS)
- Acyclovir
Oral Candidiasis
- aka
- affects who
- sx
- PE findings
- Tx
Aka: thrush
affects infants and older children in debilitated state, also those taking abx or steroids.
Sx: mouth soreness, refusal of feedings
PE: white-curd like plaques predominantely on buccal mucosa
Tx: nystatin oral suspension
Sinusitis
- cause
- which type is unusual to occur before what age?
- sx
- tx
Cause: possibility when standard viral URI sx persist beyond 10-14 days.
Frontal sinusitis unusual before age 10 years.
Sx:
- facial pain, maxillary teeth pain, malodorous breath, congestion
- more likely if persistent and worsening sx
Tx: amoxicillin or augmentin
Croup
- MC cause
- MC at what age
- sx
- XRay findings
- Tx
MC cause: parainfluenza virus*, May also be caused by RSV, influenza, and adenovirus
MC at ages 6mo to 3 years
Sx:
- barking cough and stridor
- occurs at night, like 2-3AM, winter months
- URI sx
Xray: steeple sign
Tx:
- take out onto porch
- nebulized racemic epi
- dexamethasone IM if stridor
- observe for 3 hrs, if okay D/C.
- if see them in clinic and hear their croupy cough but they arent that sick you send them home with steroids.
Epiglottitis:
- MC cause
- sx
- dx
- tx
MC cause: H flu type B
SX:
- sudden
- fever
- dysphagia
- drooling*
- hot potato voice*
- inspiratory retractions
- stridor
Dx: Stat Xray: thumb print sign
laryngoscopy: red cherry spot
Tx:
- prepare to intubate
- call peds anesthesia folks
- emperic abx (Ceftriaxone)
- culture to cater abx
Mumps
- sx
- tx
sx:
- parotid* gland swelling
- aspetic meningitis
- transient pancreatitis
- orchitis* or oophoritis
- epididymitis*
Tx: supportive
Kawasaki Dz:
- aka
- what is this?
- cause
- common in who?
- sx
- Typical labs
- dx
aka: mucocutaneous lymph node syndrome
What: vasculitis of unknown etiology affecting medium sized arteries
Common in pediatric population
Sx: must include 4 of following sx + -fever* greater than 5 days:
- rash on palms
- unilateral cervical lymphadenopathy
- nonpurulent conjunctivitis*
- swollen hands and feet*
- mucous membrane involvement.
Typical Labs:
- hypoalbuminemia
- thrombocytosis
- elevated ESR
Kawasaki Dz:
- complications
- tx
Complications:
-cardiac: coronary vasculitis, aneurysm formation leading to arrhythmias, infarction, CHF, even death.
Tx:
- high dose aspirin and 2 days of IV immunoglobulin
- every 3 mo after dx they are monitored with EKG, echo, and CXR.
Measles
- aka
- sx
- cause
- what
- tx
aka: rubeola
sx:
-high fever*
-dry cough
-rhinitis
-conjunctivitis
-koplik spots (appear 1-2days prior to rash)*
-Rash* = dark red raised*, begins at hairline and spreads to trunk, arms, legs, hands and feet, leaves the same way it came.
rash is morbiliform = measle like rash?
Cause: virus
What: infection of epidermis
Tx: supportive
Rubella
- aka
- prevention
- what?
- MC
- sx
- Dx
aka: German Measles or congenital rubella syndrome
prevention: MMR vaccine to prevent spread to avoid congenital rubella syndrome
What: infection of the dermis
MC complication: arthritis and arthralgia
Sx:
- rash begins on face and progresses caudally, does not coalesce & fainter in color than measles.
- rash preceeded by low grade fever*, malaise, and URI
- lymphadenopathy of post auricular, suboccipital, and posterior cervical LN
Dx: serum IgM
Tx: supportive
Roseola
- aka
- MC cause
- MC age of infection
- transmission
- sx
- MC cause of what in infants?
- tx
aka: 6th dz
MC cause: HHV-6
MC age: 6-36mo
Transmission: virus acquired from close contact with saliva from parents or siblings
sx:
- abrupt onset of high fever lasting 3-7days
- rash on torso only!
- resolution of fever followed by development of erythematous maculopapular rash that spontaneously resolves
MC cause of infantile sz d/t high fever.
Tx: supportive
5ths Dz: -aka -Caused by? -sx tx
aka: slapped cheek, erythema infectiosum
Caused by parvovirus B-19
Sx: illness mild and includes:
- fever
- URI sx
- mild malaise
- rash is flat, lacey, pruritic, located on cheeks, trunk, and extremities
Tx: supportive
Varicella
- aka
- sx
- lesion description
- complications
- contagious
- Tx
aka: chickenpox
sx:
- pruritic vesicular rash beginning on face, neck, or upper trunk and spreads outward
- fever
- malaise
Lesion description: dew drop on rose petal, all are in different stages.
Complications: encephalitis and shingles later in life.
Contagious: 1-2days, until lesions
Tx:
- supportive
- acyclovir in immunocompromised
- immune globulin for those at risk for severe dz
