N635 Mngmnt Of Common Pedi

Front 1

in kids under 6, most common cause of FUO?

Back 1

UTI or pyelonephritis, resp illness, localized infx (abscess, osteomyelitis), JA, & leukemia (rarely)

Front 2

in Ads, most common cause of FUO?

Back 2

TB, Inflammatory Bowel d/e, autoimmune d/os, lymphoma

Front 3

what is a fever?

Back 3

elevated body temp of 100.4F or 38C

Front 4

how does fever happen?

Back 4

resetting the hypothalamic heat regulatory center or when heat production exceeds heat loss

Front 5

febrile illness in infants usually what?

Back 5

congenital infx, infx acquired @ delivery (GBS), infx acquired in nursery (mostly premies), and infx acquired @ home (pneumococcal, meningococcal), or infx caused by anatomic or physiologic dysfunx

temps of kids under 2 usually consisten (ax temps can be 1F lower)

Front 6

what age group is @ greatest risk for unsuspected bacteremia?

Back 6

birth-24 mos

Front 7

most common type of seizure in children?

Back 7

febrile seizires (can be brief, generalized, clonic, tonic-clonic, simple, or complex)

Front 8

simple febrile seizures

Back 8

last less than 15 min & do not recur w/in 24 hours

Front 9

complex febrile seizure

Back 9

last longer than 30 min, can recur on the same day, and can have focal attributes

Front 10

febrile seizures generally occur in kids how old?

Back 10

3-5 yrs
more common in boys

Front 11

go to emergency center if seizure lasts longer than__?__

Back 11

10 min

Front 12

prophylaxis in febrile seizures?

Back 12

not usually indicated

Front 13

@ what ages do
-maxillary
-ethmoid
-sphenoid
-frontal
sinuses become a clinically sig site for infx?

Back 13

max & ethmoid- as early as infancy
sphenoid- 3-4 yrs
frontal- 6-10 yrs

Front 14

foreign bodies usually end up in which bronchus?
why?

Back 14

right- it is shorter and wider

Front 15

narrowest part of airway in infant?

Back 15

cricoid ring on the trachea

Front 16

barking cough- think...

Back 16

laryngotracheobronchitis (Croup)

Front 17

whooping cough in young infants- think...

Back 17

pertussis

Front 18

recurrent cough associated w/ what?

Back 18

asthma, allergies

Front 19

chronic (longer than 2-4 wks) cough associated with?

Back 19

CF

Front 20

time of day cough associated with asthma?

Back 20

night

Front 21

cough also malaise, sneezing, watery nasal d/c, mild sore throat, mild or low fever, not ill appearing

Back 21

URI

Front 22

don't use which meds in kids under 2yrs?

Back 22

anti-histamines, cough meds, expectorants, decongestants

Front 23

Tx of choice for strep?

Back 23

PCN
(cost, narrow spectrum, infrequ drug reactions)

Front 24

goal of abx when TXing strep?

Back 24

1. prevent development of rheumatic fever (incubation=1-3 wks)

2. prevent spread to others & development of suppurative complications

3. shorten course/severity of illness

Front 25

most common cause of viral pharyngitis & tonsilitis?

Back 25

adenovirus

Front 26

when can kids return to school after strep?

Back 26

when afebrile& have been taking abx for @ least 24 hrs

Front 27

what LNs swollen/tender w.strep?

Back 27

ant cervical

Front 28

Hx:
URI w.characteristic symptoms & a profuse & continuous, purulent, yellow-to-green nasal d/c for more than 3 days

Back 28

acute purulent rhinitis

Front 29

mucopurulent d/c worse in am--

common cold (acute viral rhinitis) or
acute purulent rhinitis

Back 29

common cold

Front 30

difference btwn URI & sinusitis?

Back 30

persistance of URI sx for more than 10 days w.o improvement-- sinusitis

Front 31

acute sinusitis
subacute sinusitis
chronic sinusitis

Back 31

acute- 10-30 days
subacute- 4-12 weeks
chronic- sx lasting more than 12 wks

Front 32

exudative tonsillitis most commonly seen w.?

Back 32

epstein-barr virus & group A strep

Front 33

lemierre d/e

Back 33

infx from oropharynx extends to cause septic thrombophlebitis of internal jugular vein & metastatic abscesses in the lungs

Front 34

fever in neonate is greater than?

Back 34

38C

100.4F

Front 35

nature of fever usually if RSV w/ bronchiolitis?

Back 35

low grade, 2-3 days

Front 36

urine specimen is + if greater than __?__ w/ urine cath?

greater than __?__ if bag?

Back 36

urine cath- 0

bag- 10,000

Front 37

fevers more prevalent (and less concerning) if older than __?__

Back 37

3 months

(no tylenol- call provider!)

Front 38

what constitutes fever if older and younger than 3 months?

Back 38

younger >38/100.4

older > 39/102.2

Front 39

alterations in normal temp in hypothal can be caused by...

Back 39

infx
vax
tissue injury
trauma
malignancy
drugs
inflamm process
immunologi-rhematologi d/os
endocrine
metabolic

Front 40

no social smile, no real interaction until what age?

Back 40

2 months

Front 41

whats more likely to cause fever- viral or bac illness?

Back 41

viral

Front 42

when to IMMEDIATELY see a child with a fever?

Back 42

<3months old
fever >40
crying inconsolably or whimpering
kid cries when moved/touched
difficult to awaken
stiff neck--> meningitis
petechiae
increased WOB
drooling/unable to swallow
seizures
if kid looks really ill/parent really uncomfortable

Front 43

kid should be seen in 24 hours if...

Back 43

btwn 3-6 months old
fever 40.6/105.08 > 39/102.2
burning/pain on urination
fever >72 hrs

Front 44

Dr. Paul McCarthy's Acute Illness Scale looks @ 6 observation items-

Back 44

1.quality of cry
2.reaction to parents stimulus
3.station variation (sleep<-->awake)
4.color
5.hydration
6.sociability response

Front 45

ABCD toxicity

Back 45

Arousal/Alert/Activity
Breathing difficulty
Color
Decreased fluids

Front 46

normal infants take how much per hour? per day?

Back 46

1oz/hr,
24oz/day

bfeeding Q2-3 hrs

Front 47

all febrile infants 0--28 days old should be admitted & TXd w/abx.!

which ones?

Back 47

ampicillin/cefotaxime or amp/gentamicin

Front 48

workup for 30-90 day old NON-toxic febrile appearing infant

Back 48

CBC w/differential, cath UA, UC, BC, stool eval if diarrhea, CXR if resp sympt, LP strongly considered

Front 49

without a LP don't give which drug??

Back 49

ceftriaxone
abx!

Front 50

normals
WBC
bands

Back 50

WBC5K-15K

bands <1,500

Front 51

normals
Urine
Stool

Back 51

urine <5WBC/HPF

stool <5WBC/HPF

Front 52

most common cause of fever in 3mo-3 yr old kid?

Back 52

*E coli

UTI
bacteremia
pneumonia

Front 53

when to consider UA&UC for boys and girls if febrile?

Back 53

girls <2 yrs

boys (uncirc) <1 yr
boys (circd) <6mos

Front 54

think __?__ in febrile child with no obvious source of fever on exam

Back 54

UTI

Front 55

who is more likely to have UTI- male or female?

Back 55

female

Front 56

if greater than how many febrile seizures, send to neurology?

Back 56

7/yr?

(generally will have 5-7/yr)

Front 57

Dosing of Tylenol if febrile

Back 57

10-15mg/kg Q4hrs

Front 58

Dosing of Motrin if febrile

Back 58

5-10mg/kg Q6-8Hrs (may be irritating to tummy)

Front 59

most common site of bac infx in young infant is?

Back 59

?? look up

Front 60

does pneumonia clear with coughing?

Back 60

no

Front 61

honey crusted lesions, can be secondary to URI

Back 61

impetigo

Front 62

FDA- no scientific evidence that OTC cough/cold meds are helpful for kids under what age?

Back 62

6

Front 63

children have how many colds/yr?

each lasts how long?

Back 63

3-8 (more if daycare)

each lasts 7-10days