Peds Syllabus Flashcards
What are the absolute c/i for breast feeding
What two pediatric metabolic d/os are c/i for breast feeding
? is the MC type of abuse, ? is the down side to this MC, and what are the 3 forms
Antineoplastic/ImmSupp agents HIV TB Varicella H1N1 HSV on breast Alcohol: limit <0.5mg/day Radiopharmaceutical PCP Amphetamine Cocaine
Galactosemia, Phenylketonuria
Neglect- failure to provide for child’s needs;
Hardest to document/prove;
Physical Medical Emotional
How does Pt w/ neglect abuse present to clinic
What are 6 indicators neglect is occurring
? is the MC form of emotional abuse but this form also includes ? form of abuse
Type 1 growth deficiency: normal length/head, low weight
Begging/stealing food Assuming adult role Self-destructive behavior States no adult at home Inattentive adult Fatigue
Verbal- witnessing abuse
How is lice Tx first/second line
Launder anything worn/slept on in past ? long and how are items non-washable Tx
How are brush/combs cleaned
1st: Permethrin 1% 2nd, resistant: Mathalion 0.5% Ivermectin 0.5% Benzoyl 5% Spinosad 0.9% Retreat in 9-10 days since eggs can survie
Past 2days;
Air tight bag x 2wks
Detergent/rubbing alcohol soak x 1hr
How does scabies infection start
How can it present in infants
How can it present differently in adolescents
Sarcoptes burrows into dermis, lays eggs and dies, eggs hatch 3-4d
Sxs 3-4wks after infestation w/ bullae, pustules, eczematous eruption on neck/higher w/out burrows
Head, neck, palms spared
What causes Molluscum Contagiosum and how does this present
Where is the MC and rarely found on body
How is it Tx
Poxvirus in epithelial cells= smooth, dome shaped papule w/ central umbillication
MC: neck, axilla, thigh
Rare: face, periocular
Self-resolves in 6-9mon;
Extensive- cryo, Cantharidin 0.9% not face
Avoid sharing baths/towels
MC complication from measles
Two rare but possible outcomes
When is the MMR vaccine given
Otitis media
Encephalomyelitis, Sclerosing panencephalitis
12-15mon, 4-6yrs
Combo w/ MMRV at 4-6y/o only d/t febrile seizure risk
Post-exposure prophylaxis for measles
German Measles is AKA ? and causes ? in kids
IFetus acquires transplacental Abs and is protected x ? long
<72hrs: Vaccine
<6d: Immunoglobulin
Rubella; exanthematous dz in Peds; Blueberry muffin babies
First 6mon
Rubella microbe is sensitive to ? but stable in ? environment
How does virus cause infection
How is this passed/how long are Pts infectious
Heat, UV, pH; Stable: cold
Invades respiratory epithelium, spreads to nodes
Direct/droplet contact w/ secretions;
2d before and up to 7d after rash onset (virus found in secretions 7d before, 14d after rash)
When is Rubella Congenital infections the highest
How does post-natal infection present
What does this rash look like and present as
1st trimester, rare after 16wks
2-3wk incubation, mild prodrome w/ occipital, auricular, anterior cervical adenopathy
Face/neck to torso and fades w/ migration, lasts 3d
What spots may be seen during Rubella infections
What are 3 possible complications that can arise
How is this Dx confirmed
Forchheimer- rose colored petechiae in oropharynx
Thrombocytopenia Encephalitis Arthritis
Serological IgM or IgG w/ 4x increase
What are the adverse outcomes for Blueberry Muffin Babies
How long are these Pts infectious
How is post-exposure prophylaxis managed
Deaf Cataract Congenital heart dz
Secrete virus in secretions x12mon
Live vaccine <3d of exposure unless;
ImmSupp/Comp, Pregnant, Immunoblobulin <11mon
Roseola Infantum can AKA ? three names
What virus causes this
How is this infection spread
Exanthem Subitum; fever that precedes rash; 6th Dz
HHV 6/7
Salivary/Respiratory droplets of ASx adults/infants
How does Roseola present
What type of rash is present
? rare presentation can occur in 12-15mon old Pts
Abrupt onset of high fever x 3-5d
Maculopapular, rose colored AFTER fever resolves, move from trunk, to face, to extremities
Febrile seizures
How is Roseola Dx
How is it Tx if Pt is ImmComp
Two rare but possible complications
Viral culture- gold standard
Ganciclovir w/ hydration and antipyretics
Encephalitis
Virus associated hemophagocytosis syndrome
What is 5th Disease AKA and what causes this
Although an overall benign viral exanthema for healthy Pts, this microbe has a high affinity for ? part of the body that can cause ?
This microbe has the greatest overall risk to ? Pts and can cause ?
Erythema Infectiosum; Parvovirus B19
RBC progenitor cells;
Aplastic crisis/hemolytic anemia
2nd Trimester pregnancy:
HF Anemia Hydrops
How is 5ths Dz transmitted
How long does this incubate for and how does it present
When/How does the rash appear for this infection
Respiratory secretions
Blood product transfusions
4-14 days; HA w/ URI Sxs
7-10d later in three stages:
1: slapped cheek w/ circumoral pallor
2: erythematous, maculopapular trunk rash
3: central clearing leaving reticulated, lacy and pruritic rash w/out desquamation and spares palms/soles
How is Varicella transmitted
Where does the virus replicated and for how long
When are Pts infectious and when are they considered non-infectious
Airborne
Contact w/ conjunctiva or respiratory tract
Nasopharynx, Upper respiratory tract x 14-16d
2d before through 7d after rash
Once all lesions crusted= non-infectious
MC and 2nd MCC of fever/meningitis in infants
What are the 3 causes of pneumonia is 0-1mon olds
What is the MCC of early onset neonatal sepsis
1st: E Coli; 2nd: GBS
GBS, EColi, Strep pneumo
GBS
What causes Rheumatic Fever
This can affect all valves but ?
What lab is drawn for Dx using ? criteria
GABHS 2-6wks prior- Abs cross react w/ cardiac Ags causing damage/scars
Tricuspid
Anti-streptolysin O titer; strep Ab test;
Revised Jones w/ 2 major or 1 major and two minor
What are the Major Jones Criteria
What are the Minor Jones Criteria
Carditis Polyarthritis Sydenhames chorea Erythema marginatum Nodules, subcutaneous
Prolonged PR/heart block Arthralgia Fever inc ESR/CRP Leukocytosis Prior Hx of RF/RHDz
How is Rheumatic Fever Tx
What is added to Tx if severe carditis is present
What is done for long term Tx
Cards consult
ABX: Benzathin PCN G or PO Amoxicillin
PCN allergy: Erythromcyin
Salicylates: ASA, NSAID as alternative
PO CCS
PCN prophylaxis w/ PCN-G 1.2M units q28d
If myocardial/valvular defects- lifelong prophylaxis
Impetigo is a possible mild complication from ? Dz process
Secondary Impetigo is MC caused by ? two microbes and is Tx w/ ?
How does Impetigo appear on PE
Varicella
MC: Staph A, then GAS
Tx: Topical mupirocin
Wide/Generalized lesions: PO 1st gen cephalosporin (Cephalexin)
Single erythematous papulovesicle w/ honey colored crust MC on face or extremity
Exanthem numbering of Dzs
What causes Scarlet Fever
How does the rash present
1st: Measles (Rubeola)
2nd: Scarlet
3rd: German measles (Rubella)
4th: Staphylococcal
5th: Erythema infectiosum
6th: Roseola
GAS pharyngitis
24-48hrs later w/ rash on neck, spreads to extremities;
Finely papular, erythematous eruption feeling like sandpaper, that blanches w/ pressure and leads to desquamation in 3-4days
Scarlet fever can have ? presentation mimicking Kawasaki’s and how are they differentiated
Scarlet fever is a potential systemic complication from ? Dx
Strep pharyngitis is uncommon prior to ? age and most importantly w/out ? Sx
Strawberry tongue: GAS isolated from pharynx
Pharyngitis/Tonsillitis
<3y/o; no cough