Vascular & Infectious Conditions Blueprint

Question 1

What is Kawasaki disease?

Answer 1

An infectious or possibly a toxic trigger that initiates an immune response that affects medium sized arteries → coronary arteries

Inflammatory process that causes thickening & scarring of the vascular walls

Question 2

what is Kawasaki disease also known as?

Answer 2

Mucocutaneous Lymph Node Syndrome

Question 3

how long is the acute stage of Kawasaki disease?

Answer 3

10-14 days

Question 4

What sx occur during acute stage of Kawasaki disease? (hint: 8)

Answer 4

Fever (>5 days)
bilateral non-purulent conjunctivitis
strawberry tongue
swelling of hands & feet with erythema of palms & soles
generalized erythematous rash
enlarged cervical lymph nodes
tachycardia
irritability

Question 5

how long is the subacute stage of Kawasaki disease?

Answer 5

15-25 days

Question 6

What sx occur during the subacute stage of Kawasaki disease? (hint: 6)

Answer 6

Fever gone
anorexia
irritable
desquamation of fingers & toes
arthritis & arthralgia Sx’s
cardiovascular Sx’s (CHF, dysrhythmias, coronary aneurysms)

Question 7

how long is the convalescent stage of Kawasaki disease?

Answer 7

26 days until ESR returns to normal & Sx’s disappear

Question 8

Clinical manifestations of the convalescent stage of Kawasaki disease?

Answer 8

Deep beau lines on nails

All Sx disappear unless irreversible complications

Question 9

What is the goal of tx for Kawasaki disease?

Answer 9

to prevent coronary artery complications

Question 10

List the tx mechanisms for Kawasaki disease (hint: 3)

Answer 10

IVIG (IV immune globulin) and antipyretic therapy

Aspirin therapy: 10-15 mg/kg/dose q4h (max 3.6 g/day)

Corticosteroids can be prescribed

Question 11

regarding tx for Kawasaki disease, what should be taught to parents about future vaccines?

Answer 11

NO live vaccines for at least 11 months after IVIG

Question 12

Diagnosis of acute rheumatic fever requires what?

Answer 12

the presence of either two major jones criteria OR one major plus two minor criteria

Question 13

List the major criteria for rheumatic fever (hint: CASES)

Answer 13

C → carditis
A → arthritis
S → subcutaneous nodules
E → erythema marginatum
S → sydenham’s chorea

Question 14

List the minor criteria for rheumatic fever (hint: FRAPP)

Answer 14

F → fever
R → raised ESR/CRP
A → arthralgia
P → prolonged PR interval
P → previous RF

Question 15

Caution against Ibuprofen use in pregnancy: Why is this important?

Answer 15

exposure to NSAIDs in the 3rd trimester can interfere with the closure of ductus arteriosus (DA)

Premature closure of this blood vessel can cause high BP in the lungs of the developing fetus leading to pulmonary HTN

Question 16

NSAIDs are given to premature infants for what reason?

Answer 16

to induce closure of the ductus arteriosus

Question 17

(From ATI) Low cardiac output results in a reduction of baroreceptor stimulation, leading to the activation what?

How does this affect the heart? (hint: 3)

Answer 17

the sympathetic nervous system

Increases heart rate
Increases contractility
Increases vasoconstriction

Question 18

(From ATI) low cardiac output results in reduced renal perfusion leading to the activation of what?

How does this affect the heart? (hint: 2)

Answer 18

RAAS

increases vasoconstriction
increases sodium & water retention

Question 19

(From ATI) Pts who have heart failure with decreased cardiac output and increased cardiac workload may experience activity intolerance. How might this present in infants?

Answer 19

increased respiratory rate with feeding

Question 20

(From RICCI) List the clinical manifestations of inadequate cardiac output related to structural defect, congenital anomaly, or ineffective heart pumping (hint: 5)

Answer 20

Arrhythmias,
Edema
Murmur
abnormal heart rate
abnormal heart sounds