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13 Cards in this Set
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Tetanus |
cause: Clostridium tetani spores in soil and produce neurotoxin - causes uncontrolled spasm and exaggerated reflexes. s/s: pain/tingling at wound site, spasticity of muscles nearby, jaw/neck stiffness, dysphagia, trismus, asphyxia if not treated. tx: IM tetanus IG + a full course of tetanus toxoid once pt recoveres. Mechanical ventilation if needed. PCN given to all pts Immunization: 3-4 doses initially, followed by booster every 10 years. Additional booster if at risk and has been 5 yrs. |
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Diphtheria |
cause: Corynebacterium diphtheriae transmitted via respiratory secretions. Organism likes mucous membranes and respiratory tract. Produces exotoxin causing myocarditis and neuropathy. s/s: Nasal d/c, upper airway/bronchial obstruction, pharyngeal infection = MC form: tenacious gray membrane covers tonsils and pharynx, mild sore throat. dx: clinical and culture tx: pts should be isolated. A horse serum antitoxin must be given (get from CDC), removal of membrane via laryngoscopy, PCN or erythromycin. Treat contacts. |
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Rabies |
cause: rhabdovirus transmitted via infected saliva from open wound/animal bite. Common with bats. s/s: hx of bite, pain/paresthesias at site, muscle spasms, bizarre behavior, convulsion, paralysis, thick tenacious saliva, hydrophobia (painful spasms with drinking water). tx: mechanical ventilation and O2 1st. Rabies vaccin eIG given with monoclonoal antibodies, ribavirin, interferon-alpha, and ketamine. Usually fatal within 7 days. After bite, local cleansing/debridement. DO NOT suture. Immunization: Post exposure immunization includes rabies IG IM in the wound and at distant site + HDCV. Five injections given over course of several days. Titers should be checked every 2 yrs |
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Pinworms |
cause: parasite Enterobius vermicularis. Females pass through anus to lay eggs on perianal skin at night. Infection passed through hands, food, drink, and fomites. Eggs are swallowed and passed thru cecum. s/s: many asymptomatic, perianal itching at night. dx: tape on perianal skin reveals eggs. Three tries over 3 consecutive night = almost diagnostic tx: tx all members of household with albendazole, MEBENDAZOLE, or pyrantel. Wash hands thoroughly and often and wash linens. |
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Lyme Disease |
cause: Borrelia burgdorferi transmitted by Ixodides tick. Must feed 24-36 hrs to transmit. MC vector borne dz in US. s/s: Stage 1: erythema migrans "bulls eye rash" with flu like s/s. Stage 2: Disseminated infection that involves, skin, CNS, musculoskeletal --> HA, stiff neck, bells palsy, cardiac manifestations. Stage 3: Months to yrs later --> arthritis, encephalopathy, ataxia, bladder dysfxn..... dx: ELISA to detect antibodies (can be neg. within first few wks), Western blot confirms dx. IgM wanes in 6-8 wks but IgG remains. tx: Doxycycline = DOC. |
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Fever of Unknown Origin |
See table 9-5 CMDT Pediatrics pg 250. Basically if child is < 3months with fever 100.4 deg F or higher see immediately! Fevers within first couples weeks of life are an emergency! |
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Infectious Mononucleosis |
cause: EBV which is a HHV 4 transmitted via saliva "kissing dz". s/s: fever, sore throat, shaggy purple exudative pharyngitis, tonsillitis, soft palate petechiae, fatigue, splenomegaly. Administration of amoxicillin can exacerbate a maculopapular rash. dx: Atypical lymphocytes appear larger and stain darker, frequently vacuolated. Can develop hemolytic anemia. Monospot test if + highly likely have it, if negative get antibodies? Can have false + syphilis test. tx: symptomatic. If have splenomegaly, avoid contact sports. Steroids if have hemolytic anemia. Recovery can take months. |
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Sepsis |
what: major cause of death. tx: early recognition and aggressive fluid therapy leads to earlier reversal of septic shock and better outcomes. If not working administer vasopressor - Dopamine. Add empiric broad spectrum ATB within 1 hr. |
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Exanthems |
** For varicella, Rubeola (Measles), Rubella (German Measles), Fifth disease (slapped cheek) and Roseola see table 17-12 pf 378 green book. |
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Hand Foot and Mouth Disease |
Cause: coxsackie virus s/s: Red papules or vesicles on tongue, oral mucosa, hands, feet, and buttocks. Fever, sore throat, malaise. tx: supportive |
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Kawasaki Disease |
AKA Mucocutaneous Lymph Node Syndrome s/s: Fever > 5 days + four of the following needed for dx: conjunctivitis, lip cracking/fissuring, strawberry tongue, inflammation of oral mucosa, cervical LN, redness/swelling of hands and feet with desquamation. Can have cardiac manifestations. dx: always do two-dimensional echo of heart and angiography. tx: IVIg with high dose ASA. |
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Mumps |
what: virus that is highly contagious s/s: Bilateral parotid gland enlargement. yellow secretions from stensen duct. Can cause nerve deafness, meningoencephalitis from meningitis, pancreatitis, orchitis, and oophoritis. Dx: Viral culture of PCR tests. ELISA or single positive IgM antibody tx: supportive. |
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Mesenteric Lymphadenitis |
cause: adenovirus s/s: Mimics abdominal pain like appendicitis. Often have pharyngitis with it. tx: NONE |
