The Sickys Flashcards
OME or AOM: tympanic membranes are a pearly grey and retracted w/decreased mobility
OME: this is likely otitis media with effusion. You would find fever, TM erythema, or retotympanic pus with AOM, not effusion
What are key physical exam findings for AOM?
You would find fever, TM erythema, or retotympanic pus with AOM, not effusion
When is an adenoidetomy warranted in the setting of OME?
Adenoidectomy can be used in conjuction with a tympanostomy for kiddos with persistent OME. It is for the kiddos where its less likely to resolve spontaneously.
A 2 year old firl presented to your clinic 10 days ago for AOM. She compelted a 10 day course of amoxicillin and now deomstrates bilateral effusions behind the TM. What is your managment?
No management indicated at this time; it will likely resolve on its own.
After ordering a CBC and CMP for suspected PSGN, what should you order?
C3
Immune complex deposition within the glomerulus and mesangium leads to decreased seroum C3
When Should a Lumbar Puncture (LP) Be Performed in Young Children with Fever Without a Source?
Infants ≤ 21 days old with fever ≥ 38 C
An LP should be performed for all infants in this age group regardless of appearance.
Infants 22 to 90 days old with fever ≥ 38 C
An LP should be performed for all ill-appearing infants
The decision about when to perform an LP in well-appearing infants in this age group is controversial. Well-appearing infants may not need an LP if inflammatory markers are normal, which include procalcitonin, C-reactive protein, absolute neutrophil count, and fever < 38.5 C. If inflammatory markers are abnormal, an LP would be performed.
Children > 3 months old
An LP is indicated when a child has neurologic symptoms or meningeal signs. Because neurologic signs can sometimes be subtle (such as irritability), a high degree of suspicion should be maintained for any ill-appearing young child.
Unfortunately, there is no guideline that accurately predicts the presence of meningitis in every situation.
What are the typical CSF findings in a patient with bacterial vs viral meningitis?
aquifer case 11 diif dx 1
What are the phases of bordetella pertussis?
Pertussis has a triphasic course:
The initial catarrhal stage lasts 1-2 weeks and is characterized by upper respiratory tract infection symptoms.
The paroxysmal stage that follows lasts 4-6 weeks and is characterized by repetitive, forceful coughing episodes followed by massive inspiratory effort, which results in the characteristic “whoop.” Infants generally do not develop a “whoop” due to relative weakness of their inspiratory effort.
The paroxysms of cough gradually decrease in frequency and severity as the convalescent stage is entered. Episodic cough may persist for months.
These are signs of..
Fever
Stridor
Drooling
Dysphonia
Dysphagia
Respiratory distress
Epiglottitis
The most common cause of pneumonia in children is a respiratory virus, including:
Adenovirus
RSV
Parainfluenza
Influenza
Most common causes of laryngotracheobronchitis
Most cases are due to parainfluenza. Other common viruses such as rhinovirus, RSV, influenza, and adenovirus can also cause croup
Lung exam finding:
due to airway narrowing above the thoracic inlet
usually heard with inspiration but can be biphasic if obstruction is severe
STRIDOR
Lung exam finding:
-typically due to airway narrowing below the thoracic inlet
-often heard only on expiration
Wheezing
Coarse, low-pitched rattling sounds heard best in expiration.
Thought to be due to secretions and narrowing of airways.
Rhonchi
