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Peds 2 > Peds Infectious Dz 1 > Flashcards

Peds Infectious Dz 1 Flashcards

1
Q

Otitis media:

  • presentation
  • peak incidence
  • risk factors
  • MC bugs
  • Tx
  • Complications
A

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

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2
Q

Otitis Externa

  • risk factors
  • MC bugs
  • sx
  • PE findings
  • tx
A

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!
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3
Q

Pharyngitis/Tonsillitis

-MC cause & complications

A

MC cause:

  • viruses***
  • Streptococcus pyogenes (GABHS) = complications are rheumatic heart dz, glomerulonephritis, and scarlet fever.
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4
Q

Viral pharyngitis:

  • sx
  • tx
A

sx: rhinorrhea, cough, fatigue, anorexia, abd pain

Tx: manage sx

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5
Q

GABHS Sore throat

  • signs & sx
  • dx
  • tx
A

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.
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6
Q 
EBV 
-sx 
-whats found on peripheral blood smear?
-Dx
Tx
A

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

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7
Q

Herpangina

  • MC cause
  • sx
  • Tx
  • how is this different from from herpes simplex?
A

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..

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8
Q

WHen you see ulcers and vesicles you should automatically think what?

A

VIRAL CAUSE!!!!!!!!!!!!!

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9
Q

Hand, foot, andd mouth dz

  • cause
  • signs & sx
  • Tx
A

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.

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10
Q

Serious causes of sore throat

A
  • peritonsillar abscess
  • retropharyngeal abscess
  • epiglottitis
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11
Q

Aphthous Stomatitis

  • aka
  • duration of dz
  • management
A

aka: canker sore
- duration: 1-2wks
- management: topical preparations: numbing agent; orajel.

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12
Q

Gingiovstomatitis:

  • cause
  • sx
  • duration of dz
  • tx
A

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
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13
Q

Oral Candidiasis

  • aka
  • affects who
  • sx
  • PE findings
  • Tx
A

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

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14
Q

Sinusitis

  • cause
  • which type is unusual to occur before what age?
  • sx
  • tx
A

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

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15
Q

Croup

  • MC cause
  • MC at what age
  • sx
  • XRay findings
  • Tx
A

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.
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16
Q

Epiglottitis:

  • MC cause
  • sx
  • dx
  • tx
A

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
17
Q

Mumps

  • sx
  • tx
A

sx:
- parotid* gland swelling
- aspetic meningitis
- transient pancreatitis
- orchitis* or oophoritis
- epididymitis*

Tx: supportive

18
Q

Kawasaki Dz:

  • aka
  • what is this?
  • cause
  • common in who?
  • sx
  • Typical labs
  • dx
A

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
19
Q

Kawasaki Dz:

  • complications
  • tx
A

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.
20
Q

Measles

  • aka
  • sx
  • cause
  • what
  • tx
A

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

21
Q

Rubella

  • aka
  • prevention
  • what?
  • MC
  • sx
  • Dx
A

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

22
Q

Roseola

  • aka
  • MC cause
  • MC age of infection
  • transmission
  • sx
  • MC cause of what in infants?
  • tx
A

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

23
Q 
5ths Dz: 
-aka 
-Caused by? 
-sx 
tx
A

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

24
Q

Varicella

  • aka
  • sx
  • lesion description
  • complications
  • contagious
  • Tx
A

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
25
Q

Pityriasis Rosea

  • cause
  • 1st sign of dz
  • sx
  • duration of dz
  • tx
A

Cause: unclear

-1st sign if herald patch

Sx:

  • herald patch at first then smaller satellite lesions that appear on central trunk. (look like inverted christmas trees; ovals that follow the dermatomes)
  • itches
  • lesions resolve in 6-10wks
    tx: supportive, goes away on own.
26
Q

Bronchiolitis

  • MC cause
  • complications
  • sx
  • tx
  • prevention?
A

MC cause: RSV

Complications: respiratory failure

Sx:
-fever, URI sx, tachypnea, wheezing

Tx: supportive care
-Ribavirin for severely ill or immunocompromised.

Prevention: Palivizumab (Synagis) an IM monoclonal Ab that provides passive prophylaxis against RSV.

27
Q

Bronchitis:

  • sx
  • WBC & CXR findings
  • MC cause
A

Sx: URI sx w/ cough and malaise, coarse bronchial sounds
-mucopurulent sputum

WBC: normal
CXR clear

MC cause: viral

28
Q

Pneumonia
-MC cause
-sx of bacterial and viral
tx

A

MC cause: most are viral but unable to predict which are viral so we treat with abx, causes of pneumonia vary with age.

Viral sx:
-rhinorrhea, cough, low grade fever, pharyngitis, tachypnea

Bacterial Sx:

  • more abrupt
  • high fever, cough, chest pain, shaking chills, tachypnea

Tx:

  • abx
  • bronchodilators if wheeze
  • fluids
  • O2
  • if asthma and on steroids
29
Q

Pertussis

  • aka
  • cause
  • duration of dz
  • contagious?
  • sx
  • tx
  • dx
  • tx
A

aka: whooping cough, 100 day cough, BADDDDDDDD!!!!

Cause: bordetella pertussis

Duration of dz: 4-12weeks

-highly communicable

sx:
- URI sx and slight fever
- after 2 weeks cough becomes paroxysmal with classic whoop.
- cough may cause vomiting

dx:
- nasal swab for culture
- nasal swab for PCR (more sensitive)

Tx:
-azithromycin 5-7 days

30
Q

Bronchiectasis

  • what is this?
  • MC on who?
A

What: abnormal dilation and distortion of abnormal bronchial tree, resulting in chronic obstructive lung dz. impaired mucus clearance

MC in CF pts

Peds 2 (8 decks)

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