peds93 Flashcards
parinaud oculoglandular syndrome
conjunctivits, and preauricular lymphadnitis; seen in cat scratch disease
management of cat scratch disease
supportive care; antibiotics reserved for patients with systemic disease (oral azithromycin, TMP/SMX, or ciprofloxacin)
why are kids less than 12 years with TB usually not contagious?
their cough is minimal and their pulm lesions are usually small
extrapulmonary TB disease
cervical lymphadenitis (scrofula), the most common form of extrapulm TB disease in kids; meningitis; abdominal involvemnt; skin and joint involvemnt; skeletal disease; dissem or miliary TB
what kind of skeletal diseae do you get in TB
Pott’s disease, involving the vertebra
Pott’s disease
extrapulm TB involving the vertebra
radiographic features of TB disease
hilar or mediastinal lymphadenopathy; Ghon complex; lobar involvement, pleural effusion, or cavitary disease, which typically affects the upper lung segments
describe the tuberculin skin test
contains 5 tuberculin units of purified protein derivative; becomes pos 2-12 weeks after exposure; pos TB test is read by measuring the area of induration, not erythema
results of TB test
greater than 5 is pos in kids with high risk factors; greater than 10 in kids younger that 4, chronic med condition, or live in endemic area; greater than 15 for rest
definitive diagnosis of TB
pos culture from early morning gastric aspirates obtained by NG tube, pleural fluid, CSF or other body fluid; pos staining for AFB; pos histology
management of latent TB
isoniazid for 9 months; some given daily pyroxidine (vit b6) to prevent neuro complications of INH therapy
management of patients with TB diseae
2 months of INH, rifampin, and pyrazinamide, followed by 4 months of INH and rifampin