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301 Cards in this Set
- Front
- Back
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What birthweight #s:
Extremely low bw |
<1,000 g
(contrast very low: 1k - 1,499) |
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What birthweight #s:
Very low bw |
1,000-1,499
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What birthweight #s:
Low bw |
1,500 - 2,499
(contrast very low: 1,000-1,499) |
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What birthweight #s:
NORMAL |
2,500 - 4,000
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Ballard score: estimates what? includes what criteria?
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Gestational age (s/p birth)
Criteria: neuromuscular & physical maturity |
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Dubowitz exam: what 3 categories?
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Estims gestational age (alternative to Ballard score; older tech)
1. Preterm (<37w) 2. Term 3. Post (>42) |
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Cephalohematoma: 2/2 what device?
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VACUUM
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If baby is LGA --> risk hypo or hypergly?
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HYPO
(same if baby is SGA --- inadeq glycogen stores) |
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If baby is SGA --> risk hypo or hyper gly?
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Hypo (2/2 low glycogen store)
Same if baby is LGA (2/2 overproduction of insulin) |
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SGA neonate: expect pale or ruddy?
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RUDDY --- due polycythemia --> increased viscosity
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Premature infant: do you need to establish breast-feeding before discharge?
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YES
(risk hypothermia, decreased glycogen stores) |
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Newborn:
Is 1st phys exam (at birth) a good indication of successful transition to extrauterine? |
YES
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Newborn:
1st breath --> where does fluid in lungs go? |
Squeezed out (cxns, air) --> absorbed by PULMONARY LYMPHOCYTES
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0-1h life: normal V/S:
-pulse -rr |
p 160-180
rr 60-80 |
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2h life: normal V/S:
-pulse -rr |
p 120-160
rr 40-60 |
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2h neonate: suspect resp distress if RR > ____
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rr > 60
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Neonate:
Use glucometer to confirm hypogly? |
NO - use to SCREEN
(NOT confirm) |
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Neonate glucometer read:
If neonate BG <40 ---> what is next step? |
Meas serum BG (to confirm neonatal hypogly)
START TX WHILE WAITING |
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Neonate glucometer:
Start tx if neonatal BG < ___ |
<40
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If neonate with RDS --> order what 3 tests?
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1. CBC w/diff
2. Blood cx 3. LP |
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Tx hypoglycemic neonate if:
-symptomatic and BG <___ -asympto and BG <___ |
sympto & <45
asympto & <35 |
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Hypoglycemic neonate: how tx?
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5% dextrose in WATER --> then feed breast/formula (prevent rebound hypogly) --> monitor until BG > 40 & stable
If no respond H2O --> IV dextrose |
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How define:
Microcephaly (what %s) |
HC <10% for GA
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Jaundice: accum bili in what skin layer?
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Epiderm
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Jaundice:
Occurs what % newborns? |
60%
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How does bilirubin travel in blood?
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Binds ALBUMIN
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Bilirubin:
Transported by albumin to what site? |
LIVER
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Bilirubin:
Conjugated in liver by WHAT ENZYME? |
UDPGT
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UDPGT: fxn?
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Conjugates bilirubin (transported from blood to liver) with glucoronide
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Bilirubin:
Conjugated to WHAT MOLECULE in liver? |
glucoronide (via UDPGT)
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Conjugated bilirubin is excreted into bile in WHAT FORM?
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Stercobilirubin
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Unconj (indirect) or Conj (direct):
Physiologic jaundice |
Unconj
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Unconj (indirect) or Conj (direct):
Breast milk jaundice |
UNconj
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Unconj (indirect) or Conj (direct):
Breast feed jaundice |
Unconj
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Unconj (indirect) or Conj (direct):
Direct Coombs jaundice |
Unconj
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 spherocytosis |
Unconj
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Unconj (indirect) or Conj (direct):
PK deficiency |
Unconj
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Unconj (indirect) or Conj (direct):
Jaundice due G6PD |
Unconj
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 cephalohematoma |
Unconj
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 bruising |
Unconj
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 swallowed blood |
UNconj
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Unconj (indirect) or Conj (direct):
Crigler-Naijjar |
Unconj
(decreased bili clearance) |
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Unconj (indirect) or Conj (direct):
Galactosemia |
Unconj
(decreased bili clearance) |
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Unconj (indirect) or Conj (direct):
Hypothyroid |
Unconj
(decreased bili clearance) |
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 neonatal asphyxia |
Conj
(due liver ischemia) |
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 sepsis |
Conj
(liver isch) |
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 congenital metabolic toxins |
Cong
(liver isch) |
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Unconj (indirect) or Conj (direct):
Jaundice 2/2 biliary atresia, intestinal malrotation |
COng
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Physiologic jaundice:
-occurs in bili <___ -peaks what day? resolves what day? |
Bili <15
Peaks d3-4 --> resolves d4-5 |
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Physiologic jaundice: what 2 mxns?
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Lack gut flora & increased activity beta-glucoronidase --> convert bili to unconj and reabsorb
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Leads to what dz:
Neonate lacks gut flora & has increased beta-glucoronidase --> converts bili to unconj form --> reabsorbs |
Physiologic jaundice (normal, benign)
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How disting:
Physiologic vs. breast milk/feed jaundice? |
Physio appears d0 --> peaks at d3 -- resolves d4
Breast: appears d4 |
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Breast-milk/feed jaundice: underlying mxn?
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INHIBITORY SUBSTANCE in milk --> increase enterohepatic circulation
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Do RBC membrane defects (sphero) & enzyme defects (PK, G6PD) cause un/conj jaundice?
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UNCONJ
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3 etios of hepatobiliary dysfxn that can cause conjugated jaundice
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Ischemia induced by: asphyxia, sepsis, congen metabolic toxins
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Biliary atresia in neonate:
Absent INTRA or EXTRA hepatic bile ducts? |
EITHER
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Biliary atresia in neonate:
Assoc with what 2 other conditions? |
Congenital HD
Intestinal malrotation |
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Biliary atresia in neonate:
If no tx --> what complication --> how long until die? |
Develop cirrhosis --> die 2yo
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Suspect what dz:
Neonate w/2 weeks of progressive jaundice |
Biliary atresia
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What dz:
Acholic stools, hepatomegaly, dark urine, increased alk phos |
Biliary atresia (conj/direct jaundice)
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Conj or Unconj jaundice:
See dark urine, acholic stools |
DIRECT/CONJ
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Biliary atresia in neonate: assoc w/elevation of which LFT?
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ALK PHOS
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Biliary atresia of neonate: possible to see increase in INDIRECT BILIRUBIN?
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NO -- ALWAYS SEE INCREASED DIRECT BILI
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Affect risk of severe hyperbili in newborn?:
-jaundice at d0-1 |
Earlier jaundice --> higher risk of severe hyperbili
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What GESTATIONAL AGE:
highest risk of severe hyperbilirubinemia |
35-38!!!
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Jaundice: increased risk:
Breast or formula |
Breast
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Jaundice: increased risk:
M or F? |
Male
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Jaundice: increased risk:
White or Asian? |
Asian (esp East Asian)
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Jaundice: increased risk:
young or old mom |
>25yo mom
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Require further w/u?
Neonatal jaundice + VOMIT |
Yes
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Require further w/u?
Neonatal jaundice + fever |
Yes
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Require further w/u?
Neonatal jaundice + ONSET AFTER D3 |
YES
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Require further w/u?
Neonatal jaundice + high-pitched cry |
YES
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Require further w/u?
Neonatal jaundice + bili <15 |
NO - suspect physio
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Jaundiced neonate:
Does normal CBC rule out hemolytic dz? |
NO ---- order retic to check for anemia
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Breast milk:
Contain growth factors? |
Yes
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#1 carbohydrate in breast milk
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Lactose
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See lactose intolerance in neonates?
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Uncommon 0-1yo
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Breast milk:
Fats comprise what % calories? Most fat at beginning or end of feed? |
50%
Most fat at end (encourage baby to drain boob) |
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Breast milk:
Contains what 2 proteins? |
Whey
Casein |
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Breast milk:
More or less protein than cowmilk? |
3x cow > breast
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Do not give regular milk until what age?
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>1yo
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Colostrum: produced which days? slowly or rapidly replaced by milk?
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d0-5
Slowly replaced by milk |
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Which has more: colostrum or breastmilk:
-minerals -protein -fats -carbs -IgA |
Minerals: col
Protein: COLOSTRUM Fat: milk Carb: milk IgA: milk |
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Breast-feeding: affect incidence of:
-SIDS? -Allergies? -DM? |
Breast --> decrease incidence all
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Should mother expect menses while breastfeeding?
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NO - no ovulate
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Breast-feed: increase or decrease risk breast cancer in mother? ovarian cancer? osteoporosis?
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Decrease all
(since suppresses estrogen) |
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Breastfeed:
Is it common for infant to fall asleep before finish feed? |
YES
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Breastfeed:
How many feeds per day? How frequently? How many minutes each breast? |
8-12 feeds/day
Every 2-3h 15mins/breast |
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Breast milk contains all vitamins EXCEPT _____
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Vitamin K
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Do breast-fed babies req suppl Vitamin D?
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Only if <15 min sun /week
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Fluoride: supplement at what age? Under what conditions?
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Suppl all infants >6mos if <0.3ppm
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Kernicterus: stain what structures?
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Basal ganglia & hippocampus
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Kernicterus: highest risk if 1st or subsequent episode of jaundice?
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Highest risk if FIRST episode of jaundice
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Bilirubin encephalopathy:
see HYPO or HYPERtonia? |
TRICK
Hypotonia early --> hypertonia late |
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What dz:
yellow baby with hypotonia, vomit --> hypertonia, szs, ataxia |
Bilirubin encephalopathy
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Bilirubin encephalopathy: early OR late?:
Hypotonia |
Early
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Bilirubin encephalopathy: early OR late?:
Hypertonia |
Late
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Bilirubin encephalopathy: early OR late?:
Opisthotonous |
Late
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Bilirubin encephalopathy: early OR late?:
Szs |
Late
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Bilirubin encephalopathy: early OR late?:
Deafness |
Late
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Bilirubin encephalopathy: increased risk in whites or Asians?
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Asians
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Bilirubin encephalopathy:
Assoc w/prematurity? |
Increased risk if premature
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Bilirubin encephalopathy:
Assoc w/altitude? |
Increase risk at high alt
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Bilirubin encephalopathy:
What other medical problem is a risk factor? |
Small bowel obstruction
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How tx:
Breast + jaundice + bili 16-25 |
Cont breast + observe
OR Suppl formula 24-48h + phototx |
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How tx:
Term + jaundice + hemolysis + bili 17.5-23 |
Exchange transfusion
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Can you administer phototx while breast-feeding?
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YES
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Neonate w/hyperbili: can you lower via admin H2O/dextrose?
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NO
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Neonate:
What day stop meconium --> yellow BM |
day 3
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Neonate: what day:
3-4 stools/day |
By d3-4
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By d3-4 life: how many stools per day? how many wet diapers?
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3-4 stools
3-4 wet diapers |
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By d6 life: how many stools per day? how many wet diapers?
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3-4 stools
6 diapers |
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Return to birth weight at what age?
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2w
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At d5 life:
-at what % of birthweight? -require w/u at what %? |
At d5: 7-10% below birthweight
If >10% or no regain bw by w2 --> further w/u |
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How obtain FONTANELLE SIZE?
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Avg length & width
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Anterior fontanelle:
-suspect what problem if barely open at birth? -what is avg diam? |
Over-riding sutures (benign; separates w/in few days)
Avg: 2.5 - 5.0 cm |
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Name for:
Edema/serum over presenting part of scalp |
Caput succedaneum
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Caput succedaneum: where located?
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PRESENTING part of scalp (=edema)
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Caput succedaneum:
Leads to hyperbili? |
NO -- overlies periosteum
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Anatomic difference b/w:
Caput succedaneum & cephalohematoma |
Caput: edema overlies periosteum --> NOT increase bili
Cephalo: SUBperiosteal hemorr (not extend suture line) --> can cause hyperbili |
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Cephalohematoma:
-where located in re: periosteum -cross suture lines? |
SUBperiosteal
NOT cross suture lines |
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Can you approximate the bilirubin level based on the extent of jaundice?
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YES
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Normal amount of breast tissue (mm) in term infant
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5-6mm
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Suspect what problem:
Neonate 0-72h & anorexia/vomit/sz |
Inborn error of metab
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What fraction of sick, full-term neonates without infection risks have an underlying metabolic dz?
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20% !!! (1/5) --- that's a lot
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Inborn error of metabolism: can appear insidiously?
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Yes
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Neonate screen: all states screen what 2 dzs? What method?
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PKU
Hypothyroid via tandem mass spec |
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Red reflux: see from how far away?
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1 foot
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Spleen: normally how far below L costal? Should you push to find tip?
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1-2 CENTIMETER below L costal
Never push to find tip |
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Ortolani & Barlow: 1st perform at what age?
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BIRTH
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Developmental Dysplasia of Hip:
More common L or R? |
3x L > R
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Developmental Dysplasia of Hip:
F or M? White or black? |
F
White |
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Developmental Dysplasia of Hip:
Assoc w/birth position? |
More common BREECH
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Developmental Dysplasia of Hip:
Genetic component? |
Higher risk if FHx DDH
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Neonate phys exam:
Perform hip exam at what ages? (to assess DDH) |
0-3mos
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What test:
Thumb on lesser trochanter --> flex hip --> downward pressure |
Barlow Test
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Barlow test:
-where is thumb? -flex or extend hip? what degree? -ab/duct? |
Thumb on LESSER trochanter --> flex to 90 --> ADDuct & down
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What test:
Abduct hip & push femoral head anteriorly |
Ortolani
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Ortolani maneuver:
-ab/duct hip? -push fem head ant or post? |
ABDUCT (contrast Barlow - adduct)
Push fem head ANTERIORLY over greater troch |
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Barlow or Ortolani:
Feel CLUNK |
Ortolani
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T/F Every IUGR infant is SGA
T/F Every SGA infant was IUGR |
T: every IUGR --> SGA
F: SGA may be 2/2 ethnicity, maternal ht, etc (not necessarily IUGR) |
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IUGR: poor wt gain in which TM is a risk factor?
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TM3
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IUGR: due to fetal abns?
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Possible; can see with chromo abns, metabolic dz, congen infxn
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What is safe amt of EtOH in preg?
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NO SAFE AMT
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Smoking --> what facial abns?
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none
just low bw |
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How does cocaine/stimulant affect birth weight? (mxn)
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Vasocon --> placental insuff --> low bw
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What drug:
s/e fetal hydantoin syndrome |
Phenytoin
(see in 30% exposed infants) |
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Phenytoin: safe in preg? safe in breastfeed?
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S/E Fetal Hydantoin Synd (30% exposed fetuses)
SAFE IN BREAST FEED |
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Suspect what etiology:
Neonate with: hypoplastic nails & distal phalanges, cardiac defects, cranio deforms, IUGR, M.R. |
Phenytoin --> fetal hydantoin syndrome
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Higher risk in young or old moms:
-GHTN -Preeclampsia |
ADOLESCENT moms
--> low birth wt neonates |
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What is most ominous finding of respiratory distress?
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PARADOXICAL BREATHING
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Paradoxical breathing: see what? indicates what condition?
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Inspire --> chest draws inward
See in resp distress |
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Name for sound:
Forced expiration against a closed glottis |
Grunting
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Grunting: due to what action?
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Forced EXPIRATION against closed glottis
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Grunting: see in what 3 lung dzs?
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1. Atelectasis
2. PNA 3. Pulm edema |
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Head-bobbing in resp distress: synchronized with INSP or EXP?
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INSP
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Name for resp sound:
musical, CONSTANT PITCH, loudest at neck |
STRIDOR
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Stridor:
-constant or variable pitch? -where ausc loudest? -lower or upper aw? |
Constant pitch (musical)
Loudest at neck Upper aw |
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Stridor: see with insp, exp or both?
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INSP ONLY
(according to CLIPP) |
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Difference between:
Wheeze vs. rhonchi |
Basically same mxn
Wheeze: high pitch Rhonci: low |
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Wheeze/rhonchi:
-due to RESONANCE? -see w/insp, exp or both? -where loudest? |
NOT due resonance; due to VIBRATION of narrowed aws
EXP (or exp+insp; never insp alone) loudest at chest |
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What resp sound:
Only here during EXP or EXP+INSP (never insp alone) |
Wheeze/rhonchi
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Wheeze/rhonchi: does longer & higher pitch indicate more severe dz?
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YES
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Crackles: dis/continuous?
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DISCON
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Crackles: sound differences b/w coarse & fine
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Coarse: low pitch, loud, few
Fine: high pitch, quiet, many |
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Lower or upper aw obstrution:
Wheeze |
Lower
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Lower or upper aw obstrution:
Prolonged expiratory phase |
Lower
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Lower or upper aw obstrution:
VIRAL URI |
LOWER!!!!
(see wet cough, no wheeze) |
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Viral URI: common to see wheeze?
|
NO
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Asthma: is wheeze severity correlated with asthma severity?
|
NO
If severe asthma with no air exchange --> no wheeze (BEWARE) |
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Severe asthma --> what CV change?
|
Pulsus paradox
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What dz: CXR shows:
Bilat hyperinflation, flat diaphs, atelectasis |
Asthma
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Lower or upper aw obstrution:
Acute bronchiolitis |
LOWER
Edema/mucuus --> obstruct bronchioles |
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Lower or upper aw obstrution:
Pertussis |
LOWER
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Acute bronchiolitis:
What % due RSV? |
50%
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Acute bronchiolitis:
In addition to RSV - what other viruses? |
para/influ
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Acute bronchiolitis:
See what temps? (#) |
38.5 - 39
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Acute bronchiolitis:
See wheezing? |
YES
(contrast VIRAL URI) |
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Acute bronchiolitis:
How appear CXR? |
Bilat hyperinflat (sim asthma) w/scattered atelect
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Asthma: due inflamm/edema of mucosa or parenchyma?
|
Mucosa
(contrast PNA - parenchyma) |
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Pneumonia: what BACTERIAL pathogen:
-5-6yo (#1) -school age (#1-2) |
5-6yo: Strep pneumo
School: MYCOPLASMA #1, Strep pneumo #2 |
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Viral pneumonia: what 4 viruses common?
|
RSV, para/influ, adeno
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Indicates what dz:
Crackles |
PNA (bact or viral)
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Chlamydia trachomatis PNA: presents how long after birth?
|
3-4w
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Whooping cough: what pathogen?
|
Bordatella pertussis
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Bordatella pertussis: vaccine is how effective? (%)
|
70-90%
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What pathogen/dz:
3 stages (catarrhal, paroxysmal, convalescent) |
Bordatella pertussis
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Bordatella pertussis: 3 stages & duration of each
|
1. Catarrhal: 1-2w (URI sxs)
2. Paroxysmal: 4-6w (staccato) 3. Convalescent: mos cough |
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What dz:
Staccato cough |
Bordatella pertussis (whooping)
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Bordatella pertussis: cough may persist how long?
|
Paroxysmal cough 4-6w --> regular cough for mos
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Lower or upper aw obstruct:
Foreign body |
Upper
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Lower or upper aw obstruct:
Epiglottitis |
Upper
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What dz:
Assymetic wheeze in 5yo w/out hx aw dz |
foreign body
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Foreign body asp: most common location
|
R mainstem bronchus
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Epiglottitis: what age group?
|
2-5yo
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Lower or upper aw obstruct:
Croup |
TRICK - both (subglottic)
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Croup: caused by 6 pathogens
|
Para/influ
Adeno RSV MYCOPLASMA MEASLES!!!! |
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Indicates what dz (general name):
Insp stridor + barking cough |
Croup
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Cerebral palsy:
incidence |
2:1,000
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Cerebral palsy:
Progressive? |
No
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Cerebral palsy:
Defining feature |
Decreaesed motor control
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Cerebral palsy: is spasticity dependent on velocity?
|
YES - greater resistance w/rapid movement
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Cerebral palsy: is resistance greater with SLOW or RAPID movement?
|
RAPID
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Cerebral palsy: in/decreased tendon jerks
|
INCREASED
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What dz:
See spastic diplegia |
C.P.
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Name for:
Increased tone, esp in lower extrems |
Spastic diplegia
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Spastic diplegia: assoc w/prematurity?
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Yes
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Leads to what TYPE of cerebral palsy:
-birth asphyxia -kernicterus |
Both lead ot DYSKINETIC cerebral palsy
(NOT other types) |
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Cerebral palsy: see pts with GLOBAL developmental delay?
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No - just motor
GDD = cogn disabl/MR |
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MR/cognitive disability: possible to see FHx?
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Yes - if 2/2 inborn error metab
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Abn development 2/2 neglect:
See improvement if stop abuse? |
YES
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Do premature babies have increased risk of abuse?
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Yes
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Myopathy: p/w gross or fine motor abns?
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BOTH
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What class of dz:
abn tone, fasciculations, weakness |
Myopathy
(NOT CP - see spasticity, increased tendon jerks) |
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Cerebral palsy: how dx?
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MRI & assessment by developmental specialist (use Bayley scales of infant development)
(determines etio of abn neuro exam) |
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Infant UTI: how obtain urine sample?
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CATH
(NOT bag specimen) |
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Fever: #
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100.5 (38)
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Name for:
Viable bacteria in circulation |
Bacteremia
(no necess systemic dz) |
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Name for:
Systemic dz 2/2 microorgs in circ |
Septicemia
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Difference b/w:
Fever w/out source AND fever unknown origin |
W/out source: no focus despite H&P
Unknown origin: 2weeks fever with 1w failed w/u |
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Fever of unknown origin: present for how long?
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2w
(with 1w of failed w/u) |
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Occult bacteremia: definition (what tests)
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Pos blood cx despite normal:
1. CXR 2. UA 3. LP |
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Occult bacteremia: see in what age range?
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0-3yo
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Qualify as SERIOUS bacterial illness (SBI)?:
Enteritis |
Yes
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Qualify as SERIOUS bacterial illness (SBI)?:
PNA |
Yes
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Qualify as SERIOUS bacterial illness (SBI)?:
Cellulitis |
Yes
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Qualify as SERIOUS bacterial illness (SBI)?:
Osteomyelitis |
Yes
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Qualify as SERIOUS bacterial illness (SBI)?:
Otitis Media |
No
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Meningismus: due to stretching of nerves in what SPACE?
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Subarachnoid
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Nuchal rigidity: in/vol?
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INVOL
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Name for:
Extreme nuchal rigidity --> hyperextend entire spine |
Opisthotonus
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What is it?:
Opisthotonus |
Extreme nuchal rigidity --> hyperextend entire spine
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Name for:
flex hip & extend knee --> pt resists knee extens |
Kernig
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Name for:
flex neck --> pt flexes knee & hip |
Brudzinski
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Difference b/w:
Kernig Brudzinski |
Kernig: flex hip --> resist knee EXTENSION
Brud: flex neck --> automatic flex knee & hip |
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If you plan to tx infant w/IV abx for presumed bacterial infxn --> do you require a LP?
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YES - RULE
If want to use IV abx --> get LP first |
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LP contraindication: platelets <___ (#)
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<50k
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Must perform LP if fever <__ (what age)?
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1yo
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Does normal CSF definitively r/o meningitis?
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YES
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Febrile infant:
Suspect UTI in what ages? |
2mo - 2yo
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Gastroenteritis: see low or high fever with:
-viral -bact |
HIGH FEVER with both
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Upper resp infxn: see low or high fever?
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Can see high fever
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Work-up of BACTERIAL infxn: low or high predictive value:
>15,000 WBC w/left shit |
LOW predictive value
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Viral infection: do most have ab/normal WBC?
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Most have NORMAL
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UA: nitrites have high or low:
-spec -sens |
HIGH SPEC (few FPs)
LOW SENS (many FNs) |
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UA: is a positive LE enough to dx UTI?
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No - only indicates that WBCs are in urine
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Voiding cysturethrogram (VCUG): order in which infants?
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ALL infants w/FIRST uti
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VUR: is most mild/mod/severe? req tx?
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Most mild --> spont resolve
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UTI in <1yo:
what % have vesicourethral reflux? |
50%
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VUR: affect risk of UTI? req ppx abx?
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Increase risk of UTI --> GIVE PPX ABX (until VUR resolves or surg)
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VUR: what is alt way to monitor (if not want VCUG)?
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Periodic radionuclide cystograms
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1st UTI --> order what imaging tests?
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1. VCUG
2. Abdominal U/S (renal structure, dilation) |
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UTI in infant:
-required in ALL cases? -duration? -route? -repeat urine cx? |
ALL pts w/1st UTI (even if asympto)
7-14d po --> IV if severe dehydr Repeat urine cx if no response after 2d |
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Pyelo: 2 most common pathogens
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E coli > enterococcus
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Pyelo:
-2 best abx & route for INPATIENT -outpatient |
Gent + Amp INTRAVENOUS
--> TMP-SMZ bid (total 7-14d) |
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Pyelo: what is disadvantage of:
-Ceftriaxone -Ciprofloxacin |
Ceftriax: no cover enterococci (#2), pseudomonas
Cipro: damages articular cartilage (esp knees) |
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Nitrofurantoin: use in what type of UTI?
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Lower UTI (cystitis)
NOT pyelo |
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Sulfisoxazole: used to tx pyelo?
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No - resistance
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Always consider what dz:
HIGH fever x 5d.... |
Kawasaki
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Kawasaki: usually <___yo
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<4yo
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Always consider what dz:
HIGH fever x 5d.... |
Kawasaki
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Kawasaki: usually <___yo
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<4yo
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Kawasaki: requires how many findings?
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4 (in addition to fever)
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Kawasaki: requires how many findings?
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4 (in addition to fever)
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3 dzs with palmar rash
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Kawasaki
Syphilis RMSF |
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Kawasaki: where see rash (2)?
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Groin
PALMS |
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3 dzs with palmar rash
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Kawasaki
Syphilis RMSF |
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Kawasaki: where see rash (2)?
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Groin
PALMS |
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Kawasaki: what 2 eye findings?
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1. Conjuncitivitis w/out discharge
2. ANTERIOR uveitis (slit lamp) |
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Kawasaki: what 2 eye findings?
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1. Conjuncitivitis w/out discharge
2. ANTERIOR uveitis (slit lamp) |
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Anterior uveitis 2/2 Kawasaki:
-how detect (what test)? -minority or majority of pts? |
Slit-lamp
80% pts in 1st week |
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Strawberry tongue: what 3 dz?
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1. Kawasaki
2. Strep pharyngitis 3. Infectious mono |
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Anterior uveitis 2/2 Kawasaki:
-how detect (what test)? -minority or majority of pts? |
Slit-lamp
80% pts in 1st week |
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Strawberry tongue: what 3 dz?
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1. Kawasaki
2. Strep pharyngitis 3. Infectious mono |
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Kawasaki: see LAD?
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YES
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What dz:
HIGH FEVER x5d, groin rash, conjuncitivitis, strawberry tongue, puffy/peeling hands & feet |
Kawasaki
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Kawasaki: see LAD?
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YES
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What dz:
HIGH FEVER x5d, groin rash, conjuncitivitis, strawberry tongue, puffy/peeling hands & feet |
Kawasaki
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Kawasaki: low or high fever?
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HIGH x 5d
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4 causes of UNILATERAL cervical adenitis (non-cancerous)
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1. Kawasaki
2. Cat Scratch 3. Pharyngeal infection --> reactive node 4. Mycobacteria |
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Kawasaki: see uni/bilat LAD?
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UNILAT
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SJS:
-see conjuncitivitis? -what type of rash (name)? |
Conjunctivitis
Erythema multiform |
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#1 fatal tick dz
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RMSF
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RMSF: how transmit?
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Tick
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RMSF: what type of rash? where located?
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Petichial rash on palms
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What dz:
Petechial rash, HEADACHE, fever, myalgia |
RMSF
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Kawasaki: see change in CBC?
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1. INCREASE WBC, esp PMNs
2. Normocytic, normochromic anemia 3. Increase platelets (week 2) |
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Kawasaki: would you still suspect if negative ESR?
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no
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Kawasaki: see changes in LFTs?
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INCREASE (nonspecific)
decrease albumin |
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Suspect what dz:
Increased WBC (esp PMNs), normo normo anemia, increased platelets, increased LFTs, STERILE PYURIA |
Kawasaki
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Kawasaki: what UA change? how collect UA?
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STERILE PYURIA (2/2 sterile urethritis)
Collect via CLEAN CATCH (would not detect pyuria by cath) |
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Kawasaki: order what imaging test?
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Baseline ECHO --> repeat ECHO 4 weeks
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Kawasaki: how tx? (2)
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HIGH-dose ASA (other antipyretics not effective)
HIGH-dose intravenous Ig (only tx ot decrease coronary art sequel) |
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Kawasaki: see CNS complications in what % pts?
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90%: lethargy, aseptic meningitis
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Kawasaki: see coronary art aneurysm in what % untx pts?
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25%
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Kawasaki: what GI complication? (2)
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Liver dysfxn (40%)
Gallbladder hydrops (10%) |
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Kawasaki: after discharge --> when RTC for repeat ECHO?
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Echo at weeks 0 & 4
(usually RTC 2 weeks after discharge for repeat) |
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What pathogen:
Vesicular rash on hands & feet; ulcers in mouth |
COXSACKIE (enterovirus) --> hand-foot-mouth dz
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What pathogen:
Hand-foot-mouth dz |
Coxsackie (enterovirus)
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What pathogen:
Prodrome fever >101 --> cough, runny nose, conjunctivitis --> maculopap rash behind ears --> reaches feet |
MEASLES
3Cs |
