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35 Cards in this Set
- Front
- Back
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Some high risk factors for otitis media in children under 2
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Male, poor, smoking household, outside day care
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Some low risk factors for otitis media in children
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Breast feeding, female, home care
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What age range experiences the highest number of surgical interventions for otitis media?
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12-23 months
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5 step pathogenesis of otitis media
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1. URI
2. Congestion 3. Eustachian tube swells and obstructs 4. Middle ear mucus cannot drain 5. Pathogens from below have suddenly found a new home |
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Difference between Acute Otitis Media and Otitis Media with Effusion
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OME will not have any signs of inflammation or infection
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When does the eardum appear concave as opposed to convex, or bulging, in the disease process?
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When pus is draining. It will actually create a state of negative pressure that pulls the eardrum in. It is not pathological.
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How long can a case of otitis media take to resolve?
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3 months
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Main causes of Otitis media
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1. Hameo influenza - 47%
2. Strep pneumo - 38% (do not forget the vaccine) 3. M. catarrhalis - 8% |
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What's the problem with beta-lactam treatment of otitis media?
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Most strains are beginning to show serious beta-lactamase expression
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What's the problem, epidemiologically, with the strep pneumo vaccine?
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As strep pneumo incidence diminishes, hameo. influenzae incidence rises
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DOC for most otitis media?
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Amoxicillin. Otherwise Cephs and macrolides can be considered alternatives
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Complications of acute otitis media
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1. Meningitis
2. Mastoiditis 3. Abscess 4. Perforated eardrum |
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Most common cause of specific and non-specific bronchiolitis as well as pneumonia in children under 1
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RSV
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Common pediatric community causes of pneumoniae (in all differentials)
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Neonate: group B strep, enterics, CMV, viruses
Pretoddler: Chlamydia, RSV, parainfluenzae, Strep pneumo, etc Preschool: Strep Pneumo, Mycoplasma pneumo, virii Adolescents: Myco and Clam pneumo, strep pneumo, virii |
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Is it possible to distinguish between bacteria and viral pneumonia on clinical grounds?
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No.
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Do bacterial pneumonias typically have a faster onset than virii?
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Yes, in all things. Fungals are of course the slowest
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Lobar pneumonia on a radiograph
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Indicates a bacterial pneumonia
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Season of RSV
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Winter
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Review: Histo appearance of RSV
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Syncytium
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Bottom line on RSV reinfection
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It is generally not preventable--there will be heterologous and short-lived homologous immunity. Fortunately, subsequent infections tend to milder.
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What's a main hospital therapeutic consideration for treatment of RSV?
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Oxygen!! RSV children can become cyanotic
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Why are premies's more at risk for serious complications with RSV?
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The diameter of their bronchi is smaller than term neonates.
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Season of human metapneumovirus. Who does it mimic in clinical presentation?
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Winter. RSV.
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Treatment for children at very high risk of complicated RSV infection?
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Monoclonal antibody injections in the winter months.
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Why do people die from diarrhea?
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Acute, irreversible dehydration
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How many diarrheal deaths are attributed to the rotavirii?
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20-40%
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Season of rotavirus. Reservoir? Route of transmission?
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Winter. Small children. Fecal-oral
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What is the possible result of the rotavirus vaccine in Dayton, OH?
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The total lack of trend winter onset of the virus this past year.
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Which 3 of the 7 rota serotypes cause illness? Which of the three is the worst?
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A, B, and C. . . but A is the nastiest
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What does rota do to the intestinal lining?
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1. Kills the absorptive epi, resulting in malabsorption.
2. Secretes an enterotoxin 3. Stimulates enteric system. ALL OF THIS MEANS A LOT OF DIARRHEA |
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The two rota antigens that can induce immunity
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VP4, VP7
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Epi regarding group B strep infections
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It is more likely in infants, and more likely in infants of color.
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If a mother has GBS. . .
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Ther is a 50% chance her baby will be born with it, although there's a 98% chance the baby will be asymptomatic in the absence of other complications
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Prevention of perinatal GBS disease
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Intrapartum antibiotics
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Bottom-line on GBS
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culture late-term pregnancies for GBS.
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