Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
65 Cards in this Set
- Front
- Back
|
Common pathogens for infection
AGE < 1 month old? Empiric Treatment? |
Group B Strep
E. COLI Listeria Viral (herpes) COAG (-) staph Gram (-) nosocomial bugs Tx: Amp + (gent or cefotaxime) |
|
|
Common pathogens for infection
AGE 1-3 months? Empiric Treatment? |
Same as < 1 month olds (plus)
H. influenzae B Neisseria Meningitidis Strept. Pneumo Tx: Amp+(cefotaxime/ceftriaxone) |
|
|
Common pathogens for infection
AGE 3 months - 12 years? Empiric Treatment? |
H. influenzae B
Neisseria Meningitidis Strept. Pneumo Tx: Ceftriaxone +/- vanco |
|
|
Common pathogens for infection
AGE > 12 years? Empiric Treatment? |
Neisseria Meningitidis
Strept. Pneumo Tx: Ceftriaxone +/- vanco |
|
|
Who gets drug treatment for Bacterial meningitis Prophylaxis?
Whats the drug and dose? |
Household contacts, nursery centers, direct contact with secretions
regimen: rifampin for either neisseria or haemophilus ceftriaxone IM for only haemophilus |
|
|
Respiratory syncytail virus (RSV)
Treatment? |
Supportive care
|
|
|
Respiratory syncytail virus (RSV)
Prophylaxis (Synagis) |
Synagis (Palivizumab) 15 mg/kg/dose IM given monthly
reduction in hospitalizations but not mortality. wont prevent nosocomial infections |
|
|
Indications for Synagis (palivizumab)
|
< 32 weeks GA who are < 6 MO
at start of RSV season 5 dose max must repeat dose if Cardiac surgery patient |
|
|
Extra risk factors for RSV and need Synagis
|
*32-35 Week GA < 3 MO during season + daycare/ smoking parents or has young siblings.
*kids< 2 yo with heart disease *Kids < 1yo with lung /muscle/neurologic diseases |
|
|
Ribavirin, corticosteroids, B2 agonists and antibiotics for RSV?
|
Not considered standards of care or reduce mortality or vent days. except maybe with lung / heart disease patients.
|
|
|
Otitis Media
Common pathogens? |
Viral,
S. Pneumo, Non-type H. Influenae Moraxella Catarrhalis |
|
|
Otitis Media
Treatment? |
Not warranted unless both ears for greater than 72 hours
Tx: Amox, Augmentin, Cefuroxime, cefdinir, cefpodoxime 5-10 days Prophylaxis not recommended |
|
|
Immunizations
Whats are the new vaccines added to the most recent guidelines? |
HepA, meningococcal conjugate, pertussis booster, rotavirus and human papillomavirus
|
|
|
What are the latest Recommendations for influenza vaccination?
|
Vaccinate all children 6 month to 18 years old
|
|
|
What is the concern with IVIG and vaccinations?
|
Unable to give live vaccines b/c they wont work.
|
|
|
DTaP-Hib (TriHIBit)
combo vaccine effectiveness? |
Not as effective as individual products
|
|
|
DTaP-IPV (Kinrix)
effectiveness? |
No consistent effects
Inactivate Polio virus |
|
|
DTaP-HepB-Hib combos
|
Not as effective as separate vaccines
|
|
|
DTaP-HepB-IPV (Pediarix)
|
Good TO GO. at least as effective as individual products.
Give at 2,4 and 6 month |
|
|
HepB-Hib (Comvax)
|
Not for those < 6 weeks b/c it wont work as well
|
|
|
Hib-DTaP-IPV (Pentacel)
|
ok for 6 wk to 4 yrs old
|
|
|
HepA-HepB (Twinrix)
|
ok for 18+ yo
|
|
|
MMR and varicella vaccine
(Proquad) ADR? |
More febrile seizures in 1-2 year olds. not recommended
|
|
|
ENGERIX-B and
RECOMBIVAX HB Equivalent? |
HepB vaccines that are interchangeable
|
|
|
Polio Vaccine issues
|
Live and inactivated are equally effective, but live vaccines associated with higher poliomyelitis and oral polio is therefore not recommended
|
|
|
What are the Barriers to immunizations?
|
*allergy
*Acute"mod-severe"febrile illness *Immunodef. and live vaccines |
|
|
Who can't get live vaccines?
|
Immunodeficient patients
Pregnant Recent IVIG |
|
|
Examples of LIVE vaccines
|
MMR, Varicella, oral polio, nasal influenza
|
|
|
What are the important allergies with regard to vaccines?
|
Egg proteins (MMR and influenza)
Neomycin (polio, MMR, varicella) |
|
|
Immunize based on which age, GA or chronological age?
|
Chronological age
except with HepB and Premature babies < 2kg or 30 days old |
|
|
Ok to give live vaccines to those taking low to moderate dosed steroids?
|
Yes if < 2 mg/kg of prednisone equivalent
wait 1 month if giving high dose steroids and live vaccines |
|
|
HIV patient's and vaccinations
|
Ok to give if patient not severely immunocompromised (look at CD4 count)
inactivated should be given regardless |
|
|
(3 series) vaccine recommended at 2,4 and 6 months of age
|
Rotavirus (RV)
|
|
|
(4 series) vaccine recommended at 2,4, 6-18 months and 4 of age
|
Inactivated poliovirus (IPV)
|
|
|
(3 series) vaccine recommended for birth, 1-2, 6-18 months
|
HepB
|
|
|
(5 series) vaccine recommended for 2,4,6,15-18 months and again at 4-6 years old
|
Diphtheria, Tetanus, Pertus
(DTaP) |
|
|
(4 series) vaccines recommended for 2,4,6 and 12-15 months old
|
Haemophilus influenzae B (Hib)
Pneumococcal (PCV) |
|
|
When to give influenza vaccine?
|
yearly after 6 months old
|
|
|
When to give MMR?
|
12-15 months old and again at 4-6 years old
|
|
|
When to give Varicella?
|
12-15 months old and again at 4-6 years old
|
|
|
When to give HepA?
|
2 doses (12-23 months old) and again between 2-6 years old
|
|
|
When to give MCV meningocccal?
|
High risk groups only
once (2-6 years old) all others (11-12 years old) |
|
|
When to give Tdap?
tetanus diphtheria, pertussis |
11-12 years old
|
|
|
When to give HPV?
Human papillomavirus |
3 doses (11-12 years old)
|
|
|
Drugs of choice for
Partial seizures? |
Valproic acid
carbamazepine Phenytoin |
|
|
Alternative drugs for Partial seizures?
|
any of them
|
|
|
Drugs of choice for
Tonic-clonic seizures? |
Valproic acid
carbamazepine Phenytoin |
|
|
Alternative drugs for
Tonic-clonic seizures? |
Lamotrigine
topiramate zonisamide Levetiracetam |
|
|
Drugs of choice for
Myoclonic seizures? |
Valproic Acid
|
|
|
Alternative drugs for
myoclonic seizures? |
Topiramate
zonisamide levetiracetam |
|
|
Drugs of choice for
Absence seizures? |
Ethosuximide
Valproic acid |
|
|
Alternative drugs for
Absence seizures? |
Lamotrigine
Zonisamide Levetiracetam |
|
|
Drugs of choice for
Lennox-gastaut seizures? |
Valproic Acid
topiramate lamotrigine |
|
|
Alternative drugs for
Lennox-gastaut seizures? |
Felbamate
zonisamide |
|
|
Drugs of choice for
infantile spasms? |
Adrenocorticotropic hormone
ACTH |
|
|
Alternative drugs for
infantile spasms? |
Vigabatrin, lamotrigine, tiagabine, topiramate, valproic acid, zonisamide
|
|
|
Methylphenidate immediate release (Ritalin)
|
BID-TID
50-50 ratio of active d-threo isomer and inactive 1-threo |
|
|
Dexmethylphenidate (Focalin)
|
BID-TID
only active d-threo isomer 1/2 the dose of Ritalin *no benefit over Ritalin |
|
|
Methylphenidate Sustained release/ extended release
(Metadate ER or Ritalin SR) |
BID
or QDAY with immediate release dose in afternoon |
|
|
Methylphenidate (OROS) (Concerta)
|
ADHD if over 6 years old
ONCE DAILY DOSING with or without food |
|
|
Dexmethylphenidate ER
(Focalin XR) |
faster onset but doesnt last all day
|
|
|
Methylphenidate modified release
(Metadate CD) |
doesnt last all day
ok to open and sprinkle |
|
|
Methylphenidate ER
Ritalin LA |
Once daily
but not all day ok to open and sprinkle |
|
|
Methylphenidate transdermal system (Daytrana)
|
Apply to hip
all day strong |
|
|
ADR of stimulants
|
Decreased appetite
stomachache headache insomnia |
