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11 Cards in this Set
- Front
- Back
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(RCH)
In regards to fever in the infant < 28 days, which of the following is incorrect? A. SBI (Serious bacterial infection) is present in 12% of presentations. B. The full Septic workup involves FBC / BC / Urine and LP +/- CXR C. If the infant looks and feeds well, they can be considered for discharge. D. Axillary +/- rectal temperature can be taken. |
C. They all get admitted.
** D. Rectal is most reliable and most commonly used for this age group; but temperature taking can begin with axillary probe. |
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(RCH)
In regards to Paediatric fever, which of the following is incorrect ? A. Since the pneumococcal vaccine, E coli and Staphylococcus aureus are isolated more than Streptoccoccus pneumonia-as a cause of bacteraemia. B. In age < 3 months, urine infections account for 15% bacterial infections. C. History and examination are unreliable in ruling out SBI in age 29 days to 3 months. D. Bacteraemia accounts for 0.1% of SBI in the 29 days - 3 months age group. |
D.
Bacteraemia : 1 % Meninigitis : 0.2 % |
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(RCH)
In regards to paediatric fever, which of the following is incorrect? A. General aspects of the child's behaviour and appearance provide the best indication of whether a serious infection is likely. B. Pathogens to consider in age > 3 months include Group B Streptococcus and Listeria. C. Septic joints and Osteomyelitis are important sources of fever to consider. D. Meningitis accounts for 0.2% of Serious bacterial infections in age < 3 months. |
B. Age < 3 months
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(RCH)
Which of the following is incorrect regarding Paediatric fever and the Rochester, Philadelphia and Boston rules? A. The rules are criteria for the "Low risk infant" in the Age < 12 months group. B. The above criteria include factors on History, Examination and Laboratory tests. C. If an infant fails the above criteria, they get admitted +/- antibiotics. D. The urine result is negative if there are < 10 white cells per hpf. |
A. 29 days - 3 months.
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(RCH)
Which of the following is correct regarding Paediatric fever? A. CXR is usually performed in febrile infants < 3 months. B. A lumbar puncture is performed in most febrile infants < 3 months. C. Blood cultures and FBC are not always performed in febrile infants < 3 months. D. It is important to "correct" for age when using the RCH / Rochester /Philadelphia or Boston Rules for the low risk infant. |
D.
A = "If respiratory symptoms" B = No : if clinically indicated in the febrile infant 29 days - 3 months with no focus/source and is Clinically unwell. C = Usually they are performed. |
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(Rch)
Which is incorrect regarding when lumbar puncture should not be done emergently in the sick infant ? A. Coma B. Bulging fontanelle. C. Presence of purpura. D. Cardiovascular or respiratory compromise. |
B.
A bulging fontanelle, in the absence of other signs of increased intracranial pressure, is not a contraindication for LP. |
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(Rch)
List the Clinical findings that suggest antibiotics and dexamethasone should be given , AND LP should be delayed until the infant improves. |
1. Coma
2. Signs of Increased ICP 3. Cardiovascular compromise 4. Respiratory compromise 5. Focal Neurology 6. Seizures ( focal or recent ) 7. Coagulopathy / thrombocytopenia 8. local infection over LP site 9. Purpura (suggestive of meningococcal sepsis) |
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(Rch)
List the Clinical signs of increased intracranial pressure. |
1. Drowsiness
2. Diplopia 3. Abnormal pupillary responses. 4. Posturing (Unilateral or bilateral ) 5. Papilloedema 6. Bulging fontanelle ** ( if isolated- not a reliable sign of increased ICP ) |
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(Rch)
In regards to Paediatric fever, which of the following is incorrect ? A. SPA can be performed on age <12 months B. CLean catch / SPA Urine is sought on febrile children - particularly boys age < 12 months and Girls age < 24 months. C. CSF is considered abnormal if there are lymphocytes present. D. ANY neutrophils in the CSF of a febrile child is abnormal. |
C. In age < 1 month, there can be up to 20 Lymphocytes per hpf.
In age > 1 month, there can be up to 5 lymphocytes per hpf. |
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(Rosens)
In regards to the aetiology for SBI in Children, which of the following links is least correct /likely? A. < 28 days -- Group B streptococcus. B. 1-3 months -- Neisseria gonorrhoea. C. 3-36 months - E coli. D. < 28 days -- Listeria monocytogenes |
B. Neisseria gonorrhoea in age < 28 days
Neisseria meningiditis in age > 29 days |
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(Rosens)
Which of the following links is incorrect regarding Paediatric fever and Viral causes ? A. 1-3 months -- Roseola and Coxsackie viruses. B. < 28 days -- Herpes Simplex C. 3 - 36 months -- Coxsackie and Respiratory Syncytial viruses. D. < 28 days -- Varicella and RSV. |
A. Both are in age > 3 months
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