UW pediatrics Flashcards
Preseptal vs orbital cellulitis regarding clinical features
preseptal: eylid erythema + swelling + chemosis (edema of conjuctiva)
orbital: same symptoms PLUS proptosis +/or opthaloplegia with diplopia
preseptal vs orbital cellulitis regarding treatment
preseptal: oral antibiotics
orbital: IV antibiotics +/- surgery
Herpangina vs herpetic gingivostomatitis regarding etiology / age / season
herpangina: Cox A, 3-10 years, summer/early fall
Herpetic: HSV1, 6months - 5 years, no season
herpangina vs herpetiv gingivostomatitis regarding clinical features / treatment
- herpangina: fever, pharyngitis, GRAY vesivles/ulcers on POSTERIOR oropharynx –> supportive management
- Herpetic: fever pharyngitis, erythematous gingiva, Clusters of small vesicles on ANTERIOR oropharynx and LIPS –> oral acyclovir
perinatal transmission of HCV - ways of transmission
- perinatal exposure to genital secretion (MC)
- transplacental (rare)
NOT FROM BREASTFEEDING
impetigo - types and microbiology / treatment
- non-bullous: S. aureus, S. pyogenes
- boullou: S. aureus
treatment: limited skin: topical antibiotics (mucirocin)
extensive skin involvemnt: oral antibiotics (cephalexin, dicloxacillin, clindamycin)
rubella immunization during pregnancy
contraindicated
nonbulous impetigo - treatment
topical antibiotics (eg. mupirocin)
Rubella - clinical manifestations
children: fever, cephalocaudal spread of maculopapular rash (SPREADS IN 24 HOURS)
adolsescents/adults: same + arhtralgias/arthritis
how to diagnose measles instead of rubella
higher fever more than 40), rash ospread over multiple days, cervical lymphadenopathy rather than posterior auricular or suboccipital
NOT ARTHRITIS
congenital varicella is characterised by
limb hypoplasia, cataracts, distintive skin lesion (eg. scarring)
maternal - fetal transmission is more teratogenic during (time)
1st trimester
pertusis prophylaxis
all close contacts should be given a macrolide antibiotic REGARDLESS OF AGE, IMMUNISATION STATUS, OR SYMPTOMS
MCC of viral meningitis
non-polio enterovirus such as exchovirus and cox
Measles virus (rubeola) - clinical manifestation and treatment
prodrome (cough, coryza, conjunctivitis, fever (more than 40), koplik spots)
maculopapular exanthem: cephalocaudal + centrifugal spread, spares palms and soles
treatmetn: supportive, vit A for hospitalized patients
retropharyngeal abcess - presentation
fever, dysphagua, inability to extend neck, muffled voic,
LATERAL X-RAY showing widened prevertbral space
suspect of retropharyngeal abcess - next step
if no resp compromise –> CT scan
polymicrobial
FIRST step in treatmetn of septic athrtitis
atrhocentesis
complications of malaria in children vs adults
children: seizure, coma, hypoglycemia, met acidosis
adults: jaundice, acute renal failure, acute pulm edema
protective factors for severe malaria
- SC trait
2. past history of malaria partial immunity
Mump virus - etiology / presenation
paramyxovirus
presentation: fever and parotitis
complications: orchitis, aseptic meningitis, pancreatitis (can cause sterility esp after puberty
sore throat - evidence for strep - evaluation
rapid strep test –> if positive treat it –> if negative make a throat culture –> if positive treat it, if negative is viral
unlike adults, in children must be confirm the strep before treat it
(MAKE ALWAYS TESTS BEFORE TREATMENT)
Varicella infection - treatmetn / prognosis
prodrome (fever malaise)
maculopapular rash follwed by successive crops of vesicles
self limited
varicella - prevention
2 doses of VZV (age 1 + 4 years old)
breakthrough are still possible, esp if only 1 dose
eczema hepreticum
HSV on atopic dermatitis –> vesicular rash, fever, possible dissaminated virus
Varicella post exposure prophylaxis
received 2 doses (1 + 4)?
yes –> observation
no –> vaccine if immunocompoment, IVIG if low immune
IF YOUNGER THAN 1 –> NOTHING
MC source of rabies in US vs developing world
USA: bat
Developing: dogs
exposure to rabies –>
vaccination + IVIG
Scarlet fever - etiology clinical
S. pyogenes
Clinical: fever + pharyngitis, STRABERRY TONGUE, anterior cervical nodes, sanpaper rash
IM –> acute airway obstruction ?
rare complication –> give corticosteroids
pertusis in infnats under 6 months
life threatening death and apnea
foodborne disease with vomiting predominant
Vomiting predominant: B. cereus, S. aureus, Norwalk
empiric treatment for suscpetect meningitis
3rd generation ceph (eg. ceftriaxone) + vancomycin
infectious complications of atopic dermatitis - types (and pathogens)
- impetigo (S. aureus, S pyogenes)
- Eczema herpeticum (HSV1)
- Molluscum contagiosum (Poxvirus)
- Tinea corporis (Trichphyton)
HBV transmission to neonatal - ways
perinatal exposure to genital secretions (MC)
- Transplacental (rare)
- not by breastfeefing)
prevention of early onset GBS infection inclide maternal screening - prevent sepsis?
NO
difference in gonoc vs chlamydial conjuctiva exvcept the days
- gonoco: marked eyelid swelling, profuse purulent discharge, corneal edema/ulceration
- chlamydial: mild eyelid swelling watery serosanguineous or mucopurulent eye discharge
pediatric septic arthritis - organisms and treatment
- 0-3 momths:staph, agalacte, gram (-) bacilli): antistaphylococcal + GEentamicin or cefotamice
- older than 33 months: staph, Strep pyogenus, strep pneumoneia: nafcillin, clindamycin, cefazolin or vancom
clinical features of rabies
- encephalitic: hydrophobia, aerophobia, spastic paralysis of pharynx, agitation
- paralytic: ascending flaccid paralysis
