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60 Cards in this Set
- Front
- Back
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Single Large lesion followed by eruptions of smaller papulosquamous oval lesions?
Christmas Tress distribution |
Herald Patch Ptyriasis Rosea
Lesions are usually located on the trunks and upper extremities Prodromal sx not usually mentioned with the patients Age 10-35 usually Tx- antihistamines hydroxyzine loratidine possible low dose steroids topically |
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This is a member of the herpes virus 6 and usually occurs after a 3-5 hx of fever followed by a discrete 3-5 pink red macules and papules on the trunk
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Roseola!
Common ages is usually <2 years Rash has no vesicles or pustules Tx: Acetometiophen IB profen .Avoid ASA to prevent reye's disease |
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Inspiratory whooping
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Pertussis
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Causative agent of Pertussis
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Brodetella Pertussis from nasal secretions
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1st line tx of Pertussis
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Macrolides- Azithromycin
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What are the 3 stages of disease progression of pertussis?
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Stage 1 - catarrhal stage -last from 1-2 weeks. URI like sx such as cough, sneezing, rhinorrhea, low grade feverf
stage 2- severe cough inc in frequency lasting around 2 weeks. This stage lasts around 6 to 10 weeks Stage 3 - convalescent stages - cough usually dissappears atthis time but can occur with subsequent infxn many months afterwards |
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Who are the main vectors of transmitting pertussis
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adults and teenages who become immnocomprised for however long mostly transmit to their newborns and infants
It is extremely contagious mostly through direct contact with discharge |
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What is 2nd line after macolides
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TMP/SMX - bactrum
<1 month azithomycin >1 month azitromycin, clarithromycin, erythromycin |
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What are the pertussis vaccination guidelines?
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Kids younger than 7 get Dtap because it is not a booster
At ages 2,4,6 and 18 months and a booster dose between 4-6 years and then 11-12 years |
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What are some complications of pertussis?
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pneumonia, pneumothorax, seizure, apnea/bradycardia, rib fx
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What are the 3 stages of disease progression of pertussis?
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Stage 1 - catarrhal stage -last from 1-2 weeks. URI like sx such as cough, sneezing, rhinorrhea, low grade feverf
stage 2- severe cough inc in frequency lasting around 2 weeks. This stage lasts around 6 to 10 weeks Stage 3 - convalescent stages - cough usually dissappears atthis time but can occur with subsequent infxn many months afterwards |
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Who are the main vectors of transmitting pertussis
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adults and teenages who become immnocomprised for however long mostly transmit to their newborns and infants
It is extremely contagious mostly through direct contact with discharge |
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What is 2nd line after macolides
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TMP/SMX - bactrum
<1 month azithomycin >1 month azitromycin, clarithromycin, erythromycin |
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What are the pertussis vaccination guidelines?
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Kids younger than 7 get Dtap because it is not a booster
At ages 2,4,6 and 18 months and a booster dose between 4-6 years and then 11-12 years |
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What are some complications of pertussis?
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pneumonia, pneumothorax, seizure, apnea/bradycardia, rib fx
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Causative agent of hand foot and mouth dz?
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coxsackie A16 virus which is part of the enterovirus
Dz is very very contagious and spread from direct contact with nose and throat discharge |
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Typical age presenting with HFMD
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< 10 years with low onset fever, loss of appetite , cough abdominal pain ,diarrhea, malaise
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What are the characterisitic signs of HFMD?
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The oropharynx is inflamed, with scattered papules, macules, vesicles, or ulcers on an erythematous base present on the tongue, pharynx, buccal mucosa, gingiva, and occasionally the lips. If the child presents late, only yellowish ulcerations will be seen, as vesicles tend to rupture quickly. The ulcers are 4 to 8 mm in size and may be sharply marginated. Lesions do not usually involve the soft palate, and generalized ulceration in the mouth is unusual. Erythema and edema of the tongue may also occur.
There is usually an acral rash involving the palms and soles, with small oval or linear gray-white vesicopustules. The vesicles are flaccid and thin-walled, with an erythematous halo. They may occasionally be painful or pruritic. They tend to ulcerate and become crusted. Lesions heal within 1 week. A maculopapular rash may be seen on the buttocks in infants and small children, but it does not usually ulcerate. Younger children tend to have all the features, whereas older children may have only the oral lesions or the acral lesions. |
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What are the tx options of HFMD patients?
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Lidocaine topical (2% gel) for the pruritis
adequate fluid and intake IBprofen |
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What are some complications of Coxsackie viruses ?
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myocarditis, meninoencepahlitis, aseptic meningitis, paraltyic disease, systemic illness resembling rubeolaand spontaneous abortion in the pregnant mom.
Hydrops fetalis ( volume overload) in the newborn because the mom was exposed to it prepartum |
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What are the m/c agents for acute OM
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Strep Pneumo
Staph Aureus H.Flu |
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A 5 year old present with acute pharyngitis,What is the m/c organism for Pharyngitis
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Adenovirus
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What is the m/c form of childhood cancer?
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ALL
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Fine Pincer Grasp
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9 months
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Speaks short phrases , two words or more
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24 months
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How does a child with Nursemaid's elbow usually present?
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refusal to move the arm and they hold it slightly flexed at the elbow and pronated at the forearm
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A patient present with Post-occipital, periauricular and posterior chain adenopathy.. what are you thinking
THey also have Foreshhheimer's spots at the sfot palate |
Rubella
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What are the usual presenting sx of Rubella?
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Rash usually starts at 1-3 day
post- occipital and perisauricular lymphadenotpathy usually presents at 2 weeks |
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When in pregnancy is congenital rubella particularly bad?
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1st trimester
Transient Manifestations- organomegaly, interstital pneumonitis thrombocytopenis with purpura and petechiare -- " blueberry muffin syndrome" hemolytic anemia Permanent problems- hearing impairment, congenital heart defects( PDA) Eye defects ( cataracts, cloudly cornea) microcephaly CNS |
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Koplik's spots and the Three C's ( cough corzya and conjunctivitis) are pathognomonic for?
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Rubeolla
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What are Koplik Spots
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are the earliest diagnostic sign of the measles; they are pathognomonic. One or 2 days before the exanthem appears, small white spots appear opposite the molars, and sometimes elsewhere, on the buccal mucosa (Fig. 7–56A). Each is surrounded by a narrow red areola
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Where does the rash usually begin in measles ( rubeolla)
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usually begins at the forehead and spreads to the rest of the body
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What is the expected weight gain of a baby born 7lbs at one year
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they should double their weight by 6 monthd
and triple their weight at 1 year |
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What is the first sign of puberty in normal male?
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Enlargement of the testes
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hypsarrythmia on EEG is what kind of seizure?
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infantile spasms
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high=pitched muscial systolic ejection murmur heard best at the left lower sternal border with radiation to the axilla
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Still's murmur
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Changes in cap refill, postural blood presssure, changes in HR, loack of tears and dec skin turgor is what type of dehydration?
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6% to 10%
Severe dehydrations would be- marked dec skin turgor, parched or mottled mucous membrances, absence of tears, tachycardia, capillary refill >4 sec, hypotension, circ. collapse, anuria |
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What are some clinical findings in congenital hypothyroidism?
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hypotonia
coarse facial features hirsute forehead large fontanels widely open sutures umbilical hernia protruding/ large tongue hoarse cry distended abdomen and prolonged jaundice |
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What is the causative agent of 5th dz?
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Parovirus B19
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Vertical transmission can result in congenital infection if a woman becomes infected during her pregnancy.3 The risk of a fetal loss or hydrops fetalis is greatest (loss rate of 11%) when the infection occurs within the first 20 weeks of gestation.4
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5th's dz
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What are some of the clinical features of 5th's dz
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1- slapped cheek appearance
2- fever 3- lace like rash on hands wrists kneeds and ankles 4-Causes papular purpuric gloves-and-socks syndrome with pruritic erythema, edema, and petechiae of the hands and feet, fever, and oral erosions in adolescents. |
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What age range does kawasaki's usually affects
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3 months to 5 years old
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What is the criteria for kawasaki's ?
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At least 4 of the 5 for at least 4-5 days
1- b/l nonexudative conjunctivitis 2- red crusted lips 3- edema of extremities 4- maculopapular rash 5- unilateral cervical adenopathy |
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What are some complications of Kawasaki Dz?
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25% of untreated patients can develop arteritis and anuerysms of the coronary vessels and on occasion Myocardial infarction
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MUMPS
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paramyxoviral disease
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What are the physical findings of mumps?
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parotid swelling and overlying tenderness usually presents with 48 hours.
. Testicular swelling and tenderness (unilateral in 75% of cases) denote orchitis; the testes are the most common extrasalivary site of disease in adults. Orchitis develops 7–10 days after the onset of parotitis in about 25–40% of postpubertal men, but sterility is rare. Acute hormonal disturbances are prevalent |
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A baby who is YOUNGER than 3 months develops sepsis.
What are the causative possible agents and tx? |
GBS, E.Coli and Listeria
Tx is ampicillin and ceftriaxone or cefoxatime + vancomycin |
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In a patient greater than 3 months and septic meningitis is suspected, what are the causative agents in this case and what is the tx?
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S. pneumo
Neisseria H.flu Tx- ceftriaxone and vancomycin YOU DO NOT GIVEN AMPICILLIN |
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annular erhthematous lesion on right cheek. Scaly with central clearing and papulovesicular border. Non-tender to touch
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Ringworm Tina corporis
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Discoid or coin shaped plaque cause by dry skin and possible atopy. No active or clearing borders of the lesion
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Nummular eczema
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A 4 y.o present to the ER after falling on her elbow with a sustained small abrasion. The kid was picking at the abrasion and it started to pus and developed redness. She spiked a 103 fever and the redness inc rapidly throughout the day. What is the m/c agent to be causing this problem?
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Most likely Group A strep causing septic arthritis
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Tx of seborrheic Dermatitis
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anti-seborrheic shampoo like selenium sulfide, sulfuric acid , zince pyrithion and tar for scalp lesion
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What are some supporting factors that ca nconfirm dz of atopic dermatitis ?
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Hx of asthma , hay fever, inc IgE levels, eosinophilia and caucasian race
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What is the clinical picture of atopic dermatitis
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weepy erythematous patchs on the cheek with extension to the face neck wrists head and abdomen and extensor surface of the wrists. They are extremely pruritic
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What are milia?
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superficial cysts that contain laminated kertainized material .They appear on the face and gingivae
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Giant Cells demarcate what on a Tznack smear of an infant?
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Herpes
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What is transient neonatal pustular melanosis
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A Comon neonatal rash that is common in mostly black babies. Characterized by superficial vesicles that rupture leaving a collarette of scale and a hyperpigmented macule
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circular plaque with broken off hair at the hair follicule on the scalp. causing development of a large boggy mass called a kerion
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Tinea capitis
Tx- oral griseofulvin |
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How do the clinical features or peri-orbital and orbital cellulitis differ?
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Children with preseptal cellulitis often present with erythematous and edematous eyelids, pain, and mild fever. The vision, eye movements, and eye itself are normal. Decreased vision, restricted eye movements, and an afferent papillary defect suggest orbital cellulitis.
Orbital cellulitis presents with signs of periorbital disease as well as proptosis (a protruding eye), restricted eye movement, and pain with eye movement. Fever is usually high. CT scanning or MRI is required to establish the extent of the infection within the orbit and sinuses. |
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Acute non-inflammatory encephalopathy
Hepatic dysfunction with fatty degeneration Rcent viral illness with exposure to salicyclates |
Reye;s syndrome
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