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39 Cards in this Set
- Front
- Back
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Roseola: - Presentation? - Virus? |
- Young child (maybe 2) gets high fever (105) and 3 days later gets a pink, mac-pap rash on trunk, arms, and legs. - HHV6 |
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5th Disease: - AKA? - Presentation? - Virus? |
AKA: Erythema Infectiosum - Young child (maybe 2) gets low grade fever, lacy reticular rash on cheeks and upper body (spares the palms/soles). |
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Who is 5th disease BAD for? |
Pregnancy, sickle cell, thalassemia |
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Scarlett Fever: - Presentation? - Virus? - Treatment? |
- Fine, mac-pap desquamating rash begins on chest and spreads to neck, trunk, and extremities + strawberry tongue. Sore throat 1-2 weeks PRIOR. - Group A strep - Tx: PNC prevents rheumatic fever (won't help reduce changes in APSGN) |
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Measles: - Presentation? - Virus? - Tx? |
- Cough, runny nose, fever... then, macular rash begins behind ears and spreads down. Gray spots on the buccal mucosa. - Virus: paramyxovirus - Tx: vitamin A + supportive care |
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Rubella: - Presentation? - Virus? - Complication? |
Sore throat, joint pain, fever... then, pinpoint rash on the face and spreads down. Rose spots on the palate. Virus: Paramyxovirus Complications: Congenital rubella syndrome |
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Hand-Foot-and Mouth Disease: - Presentation? - Virus? |
Baby with poor feeding. Vesicles in the mouth on palms and soles + rash on buttocks. Coxsackie virus A16 |
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Mumps: - Presentation? - Virus? - Complications? |
Older child, like 16, with swollen parotid glands, fever, and HA Virus: Paramyxovirus Complications: if male, orchidis and sterility |
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Lyme Disease: - Presentation? - Virus? - Complications? - Treatment? |
Child who went camping and had a fever. Virus: Borrelia burgorferi Complications: - Arthritis - Heart block - Meningitis - Bells Tx: - Amoxicillin if < 8 - Doxy if > 8 |
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Rocky Mountain Spotted Fever: - Presentation? - Virus? - Complications? - Treatment? |
Child went camping. Had fever, myalgia, abdominal pain. Virus: Rickettsia rickettsii Complications: Vasculitis and gangrene Tx: Doxy no matter what age |
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Scabies: - Presentation? - Treatment? |
Kid, multiple excoriations on arms. Itchy at night. Tx: 5% permetrin for whole family ! |
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Impetigo: - Presentation? - Etiology? - Tx? |
Honey-colored crusted plaque on face MC bug is staph if bulls Tx: topical muciprocin if localized |
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Staph Scalded Skin Syndrome: - Presentation? - Etiology? - Tx? |
Inflamed conjunctiva and multiple blisters. Nikolsky's +/ From exfoliative toxin Tx: Tx w/ IV ox or nafcillin |
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Meningitis: - MC bugs? Tx? - If young and immune suppressed? Tx? - In ppl w/ brain surgery? Tx? |
MC bugs: - Streph pneumo - H. Influenza - N. meningitidis - Tx: Ceftriaxone and Vanco In young and immune suppressed: - Add lysteria - Tx: Ampicillin In ppl w/ brain surgery: - Add staph - Tx with Vanco |
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Meningitis and Lyme: - Tx? |
IV Ceftriazone |
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Meningitis: - Best first step? - Diagnostic test? |
Best first step: - Start empiric treatment (+ steroids if you think it is bacteria) Diagnostic test: - Then, check CT if signs of increased ICP. Then, do a LP |
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Roommate of the kid in the dorms who has bacterial meningitis and petechial rash: - Diagnostic criteria? - Tx? |
+ gram stain, > 1000 WBC is diagnostic. High protein and low glucose support bacteria. Tx: Rifampin!!! |
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2 y/o w/ fever to 102, tugging on his right ear. Patient’s tympanic membrane is red and bulging: - Diagnosis? - Most sensitive dx test? - Risk factors? - Treatment? - Complications? |
Diagnosis: OM Most sensitive dx test: - Limited mobility on insufflation or air-fluid level Risk factors: - Decreased SES - Native Americans - Formula fed - Tobacco smoke - Around kids Treatment: - Amox or azithromycin for 10 days - If no improvement in 2-3 days, switch to amox-clav Complications: - Effusion-place tubes if bilateral effusion > 4 mo or if bilateral hearing loss |
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12y/o in summer swim league has pain when adjusting his goggle straps behind his ear. Thick exudates coming from the ear and tender posterior auricular nodes. - Diagnosis? - Tx? - Complications? |
Diagnosis: OE Tx: Topical ciprofloxacin Complications: - Malignant external otitis. Can invade to temporal bone and leads to facial paralysis, vertigo. Need CT and IV abx. May need surgery. |
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7y/o w/ exudative pharyngitis w/ tender cervical lymph nodes and fever to 102. - Diagnosis? - Best first test? - If negative? - Tx? |
Diagnosis: sounds like GABHS Pharyngitis Best first test: rapid strep antigen If negative: - If clinical suspicion is high (no viral sxs), do culture Tx: - PCN or erythromycin. Why?*** |
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A child presents w/ “muffled voice”, stridor and refuses to turn her head to the left. - Diagnosis? - Tx? - Complications? |
Diagnosis: Retropharyngeal abscess Tx: - I&D for C&S. GAS + anaerobes. 3rd gen ceph + amp or clinda Complications: - Retropharyngeal space communicates w/ mediastinum |
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A child presents w/ “hot potato voice” and upon throat exam her uvula is deviated to the right 2/2 a bulge. - Diagnosis? - Tx? - Indications for tonsilectomy? |
Diagnosis: - Peritonsillar abscess Tx: Aspiration or I&D + abx, tonsillectomy if recurrent. Indications for tonsilectomy: - > 5 episodes of strep/year for 2 years or > 3 episodes/year for 3 years. |
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Epstein-Barr virus: - Presentation? |
Older kiddo with sore throat. Fever, fatigue, generalized adenopathy and splenomegaly (anterior and posterior cervical nodes). |
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What happens if you give Mono patient Ampicillin or Amoxicillin? |
Maculopapular rash (immune mediated vasculitic) |
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Mono: - Diagnosis? - Tx? - Precautions? |
Diagnosis: - Blood smear shows lymphocytosis w/ atypical lymphs + Heterophiles antibody (Monospot) test Tx: rest and symptomatic therapy Precautions: - Splenic hemorrhage or rupture (most in 2nd week) - No contact sports until splenomegaly resolves. |
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1 y/o w/ fever to 100.5 & “barking” cough and loud noises on inspiration. - Diagnosis? - Most common bug? - X-ray buzzword? - Tx? |
Diagnosis: Croup Most common bug: - Parainfluenza virus X-ray buzzword: - "Steeple sign" Tx: - Mist, epinephrine neb, steroids |
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2 y/o w/ fever to 104 & drooling w/ intercostal retractions and tripod position. - Diagnosis? - Most common bug? - X-ray buzzword? - Next best step? - Tx? |
Diagnosis: - Epiglottis Most common bug: - H. Flu B only in unimmunized - Strep pyo, strep pneumo, staph X ray buzzword: - "thumbprint sign" Next best test: - Go to OR and intubate Tx: - Anti-staph abx + 3rd generation cephalosporin |
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Kid comes in w/ cough productive of yellow-green sputum, runny nose and T = 100.8. Lung exam only reveals some coarse rhonchi. - Diagnosis? - Next best step? |
Diagnosis: - Acute bronchitis Next best step: - Supportive tx with anti-pyretic, tussles, histamines. |
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Kid comes in w/ similar sxs but decrease breath sounds and crackles in the LLL and WBC = 16K. - Diagnosis? - Next best step? |
Pneumonia CXR to confirm. Typical vs. atypical |
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Pneumonia MC causes: - Neonates < 28 days? - 1 mo- 3 mo? - 4 mo to 5 years? - > 5 years? |
Neonates < 28 days: - GBS - E. coli - Lysteria 1 mo-3 mo: - C. trachomatis - RSV - Paraflu - STrep pneumo 4 mo to 5 years: - VIRAL!! RSV, then s. pneuma > 5 years: - Mycoplasma - S. pneumo |
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What are specific findings for chlamydia pneumonia? |
Staccato cough, eosinophilia |
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9mo infant w/ runny nose, wheezy cough, T = 101.5, and RR = 60. Retractions are visible and pulse ox is 91%. - Diagnosis? - MC bug? - CXR findings? - Tx? - Who needs vaccine? |
Diagnosis: - Bronchiolitis MC bug: - RSV. Confirm w/ swab. CXR Findings: - Hyperinflation w/ patchy atelectasis Tx: - Hospitalize if respiratory distress - Albuterol nebs - NO steroids Who needs vaccine: - Palivizumba for premies - CHD - Lung dz - Immature dz |
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9mo infant with severe coughing spells with loud inspiratory whoops and vomiting afterwards. 2 weeks ago she had runny nose and dry cough. - Diagnosis: - Responsible bug? - Lab findings? - Tx? |
Diagnosis: - Whooping cough Responsible bug: - Bordetalla pertussis Lab findings: - CBC shows lymphocytosis Tx: - Erythromycin for 14 days - Also tx family members and kids in daycare. |
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UTI: - S/S in neonates? |
sxs are vague-fever, dehydration, fussy.–If fever is present its pyelo. Cystitis has NO fever |
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Gender UTI |
Before age 1, boys are ML to get UTI than girls. |
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Anatomic risk factor for UTI? |
Vesicoureteral reflux. Need abs prophylaxis. |
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UTI: - Diagnosis? - Tx? - Tx of pyelo? - F/U? |
Diagnosis: - Clean catch or cath sample, UA, and culture. (> 10 K CFU) - Need U/S if febrile UTI for anatomy, abscess, or hydronephrosis Tx of UTI: - PO trim-sulfa or nitrofurantoin Tx of pyelo: - 14 days of IV ceftriaxone or amp & gent Follow up: - Test of cure to confirm sterility |
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Who needs VCUG? |
All males, females < 5, any pyelo, females > 5 w/ 2nd UTI |
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Role of Tc-labeled DMSA scan? |
it is most sensitive and accurate study of scarring and renal size, but is not first line. |
