peds82

Question 1

reactive lymphadenitis

Answer 1

occurs in response to infections in the pharynx, teeth, and soft tissues of the head and neck

Question 2

viral infections that can cause cervical lymphadenitis

Answer 2

EBV, CMV, and HIV, among others

Question 3

kawasaki disease and cervical lymphadenitis

Answer 3

may present with cervical lymphadenitis (in fact, enlarged cervical lymph node is one of the diagnostic criteria)

Question 4

toxoplasma gondii and cervical lymphadenitis

Answer 4

can cause a mono-like disease with cervical lymphadenopathy

Question 5

how can structural lesions in the neck cause a cervical lymphadenitis

Answer 5

can become infected and drain to the lymph nodes in the neck

Question 6

what do the lymph nodes in cervical lymphadenitis look like?

Answer 6

mobile, tender, warm, and enlarged, and the overlying skin is erythematous. Fluctuance may be present

Question 7

management of cervical lymphadenitis

Answer 7

empiric antibiotics directed at strep and staph; initial treatment may include a first gen cephalosporin or an anti-steph penicillin for 7-10 days

Question 8

parotitis

Answer 8

inflamm of the parotid salivary glands

Question 9

etiology of parotitis

Answer 9

mumps and other viruses; bacterial parotitis

Question 10

difference in presentation between bacterial and viral parotitis

Answer 10

viral has bilateral involvement; bacterial is unilateral

Question 11

causes of bacterial parotitis

Answer 11

aka acute suppurative parotitis; caused by staph aureus, strep pyogenes, and M tuberculosis

Question 12

clincial features of parotitis

Answer 12

swelling centered above the angle of the jaw and fever; exam of the pharynx may reveal pus expressed from stenson’s duct

Question 13

most common cause of viral parotitis

Answer 13

mumps (before vaccination)

Question 14

complications of acute suppurative parotitis

Answer 14

formation of an abscess anad osteomyelitis of the jaw

Question 15

impetigo

Answer 15

superficial skin infection involving the upper dermis

Question 16

causative organisms in impetigo

Answer 16

stap aureus and GABHS or strep pyogenes

Question 17

clinical features of impetigo

Answer 17

honey colored crusted or bullous lesions are present, commonly on the face, esp around the nares; fever usually absent; infection is easily transmitted

Question 18

management of impetigo

Answer 18

treatment may include topical mupirocin or oral antibiotics like dicloxacillin, cephalexin, or clindamycin

Question 19

complications of impetigo

Answer 19

bacteremia, post-strep glomerulonephritis (tx of impetigo does not prevent this), and staph scalded skin syndrome (SSSS)

Question 20

erysipelas

Answer 20

skin infection that involves the dermal lymphatics

Question 21

causative organism in erysipelas

Answer 21

GABHS

Question 22

clinical features of erysipelas

Answer 22

tender, erythematous skin with a distinct border. Face and scalp are common locations

Question 23

management of erysipelas

Answer 23

systemic abx aganst GABHS

Question 24

complications of erysipelas

Answer 24

bacteremia, post-strep glomerulonephritis, and necrotizing fasciitis

Question 25

cellulitis

Answer 25

skin infection within the dermis

Question 26

causes of cellulitis

Answer 26

staph aureus and GABHS

Question 27

infected skin border in erysipelas vs cellulitis

Answer 27

in cellulitis border is indistinct

Question 28

management of cellulitis

Answer 28

oral or IV abx (first gen cef or anti staph penicillins)

Question 29

buccal cellulitis

Answer 29

unilateral bluish discoloration of the cheek of a young immunized child

Question 30

causative agent in buccal cellulitis

Answer 30

HIB

Question 31

what does a child with buccal cellulitis look like?

Answer 31

toxic, and blood cultures usually pos

Question 32

management of buccal cellulitis

Answer 32

IV antibiotics against H influenza, usually a second or third gen cephalosporin; perform LP

Question 33

perianal cellulitis

Answer 33

well-demarcated erythema involveing the skin around the anus

Question 34

how might kids with perianal cellulitis present

Answer 34

constipation

Question 35

cause of perianal cellulitis

Answer 35

GABHS

Question 36

managmenet of perianal cellulitis

Answer 36

oral antibiotics (cephalaxin, dicloxacillin)

Question 37

necrotizing fasciitis

Answer 37

potentially fatal form of deep cellulitis that extends into the muscle; pain and systemic findings out of proportion to physical findings;

Question 38

causative organisms in necrotizing fasciitis

Answer 38

polymicrobial; may involve GABHS and anaerobic bacteria

Question 39

therapy for necrotizing fasciitis

Answer 39

IV antibiotics and surgical debridement are essential components of therapy

Question 40

staph scalded skin syndrome

Answer 40

staph aureus produces a toxin that caues fever, tender skin, and bullae; large sheets of skin slough off; Nikolsky sign is present

Question 41

Nikolsky sign

Answer 41

extension of bullae when pressure is applied to the skin (skin pulls away w lateral pressure)

Question 42

management of SSSS

Answer 42

good wound care and IV antibiotics against Staph aureus

Question 43

scarlet fever

Answer 43

toxin-mediated bacterial illness that results in a characteristic skin rash

Question 44

cause of scarlet fever

Answer 44

GABHS that produces an erythrogenic toxin

Question 45

transmission of scarlet fever

Answer 45

large respiratory droplets or by infected nasal secretions

Question 46

clinical features of scarlet fever

Answer 46

exanthem tha develops during any GABHS infection (impetigo, cellulitis, pharyngitis); before or during exanthem, fever, chills, often exudative pharyngitis

Question 47

what does the exanthem of scarlet fever look/feel like?

Answer 47

begins on trunk and moves peripherally; skin is erythematous with tiny skin colored papules (“scarlitiniform”) and has texture of sandpaper; rash blanches; petechiae localized within skin creases in a linear distrib (Pastias lines)

Question 48

pastia’s lines

Answer 48

petechiae are often localized within skin creases in a linear distribution; seen in scarlet fever;

Question 49

desquamation of dry skin occurs as scarlet fever rash resolves

Answer 49

right; so do not worry if you see it