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53 Cards in this Set
- Front
- Back
_______ may be given to the pt who APPEARS WELL, but has no source for fever & has a WBC COUNT > 15,000
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Ceftriaxone
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If meningitis with S. pneumoniae is a possibility, then _____ should be added to the regimen
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Vancomycin
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What are the 3 bacteria that MCC Meningitis in patients < 3 months of age?
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GBS
L. monocytogenes E. coli |
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What are the 3 MCC of Meningitis in pts > 3 months old?
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N. meningitides
S. pneumoniae HiB |
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Patients with CSF shunt infections may have _______ infections
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S. epidermidis
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Pts with Sick Cell Disease & CSF leaks are prone to _______ infections
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Pneumococcal
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What is the Brudzinksi sign?
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involuntary flexion of the knees & supine hips after flexion of the neck while supine
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What is the Kernig Sign?
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flexion of the hip 90 degrees with subsequent pain on extension of the leg
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Data suggest that the administration of ________ given to kids > 6 wks w/ acute bacterial meningitis may reduce the incidence of hearing problems, decrease fever, & lower CSF protein & lactate levels
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IV Dexamethasone
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When does Aseptic Meningitis usually occur?
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Summer & Fall
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When is the only time when Aseptic Mengitis is treated?
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HSV = acyclovir
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What drug is given to family contacts of pts with HiB & N. meningitides Meningitis?
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Rifampin
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Pts with Sickle Cell disease are predisposed to these 2 pathogens that can cause Osteomyelitis
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S. auerus
Salmonella |
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________ infections may be associated with puncture wounds of the foot thru a sneaker causing Osteomyelitis
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P. aeruginosa
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A 12-month old infant presents to the physician with the CC of refusing to bear weight on his left lower extremity. The mother states that the child had an ear infection 1 wk ago. The patient was prescribed Abx, but the mother states she did not fill the prescription
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Osteomyelitis
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What is done to confirm the diagnosis Osteomyelitis?
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Periosteal Bone Cx
Radiographs turn + after 10-14 days, showing soft tissue swelling & periosteal elevation If radiographs are negative, but there is still a suspicion, then an MRI should be performed as the next step |
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What are the best ways to determine response to therapy of Osteomyelitis treatment?
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ESR & C-reactive protein
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How long is treatment for Osteomyelitis?
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4-6 wks
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A 5-yr old presents with fever, knee pain, & a limp. On physical examination the knee is red, warm, & swollen. Full ROM of the knee is not possible on physical exam
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Septic Arthritis
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In newborns, what bacteria are important agents of septic arthritis?
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S. aureus
GBS Gram-negative bacilli |
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What is the cause of Whooping Cough = forceful inspiratory gasp (whoop) after a paroxysmal cough
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B. pertussis
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What are the 3 stages of Pertussis?
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Catarrhal: lasts 1-2 wks & consists of rhinorhea, conjunctival injection, & cough
Paroxysmal: lasts 2-4 wks & consisting of coughing spasms, insiratory whoop, & facial petechiae Convalescent: lasts 1-2 wks w/ decreased frequency of symptoms |
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What does a CBC show in Pertussis Whooping Cough?
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Leukocytosis caused by absolute Lymphocytosis
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What is the treatment for Pertussis infection?
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Supportive Care
ERYTHROMYCIN shortens the period of communicability -family members should recieve for 14 days -does not affect duration of Paroxysmal stage |
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Lyme disease
1. bacteria 2. vector |
1. B. burgdorferi
2. Ixodes scapularis = deer tick |
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What is the presentation of Lyme Disease?
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Early localized disease = Erythema Migrans = red-raised border with central clearing
Early disseminated = Neurologic & Cardiac -Neurologic = "aseptic meningitis", Bell palsy, neuropathy -Cardiac = myocarditis, heart block Late = Arthritis |
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What is the treatment for Early disease Lyme Disease?
What is Rx for Disseminated dx? |
Doxycycline or Amoxicillin
-kids <8 yo should not receive Doxy Ceftriaxone or Penicillin G |
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What is the MC complication of Measles infection?
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Otitis Media
Pneumonia & Encephalitis are other major complications |
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A 15-month-old infant is brought to the physician b/c of a RASH. The mother states that the pt had a FEVER of 104 F for the last 3 DAYS without any source of infection. She explains that the ever has resolved, but now the child has pink, slightly raised lesions on the trunk, upper extremities, face, & neck
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Roseola = HSV-6
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Explain the rash in Roseola
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Before the rash physical findings are minimal but may include mild URI signs such as rhinorrhea & conjunctival redness. Occipital Lymphadenopathy may be found
Rash is rose colored & begins on the trunk & spreads to the neck, face, & proximal extremities |
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A 5 yo kid has low-grade fever, pinpoint rash, postoccipital & retroauricular lymphadenopathy, & rose spots on the soft palate
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Rubella
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How does the RMSF rash present?
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begins on the extremities & spreads to the entire body, including the palms & soles, & which turn into petechiae
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What is the treatment of choice for RMSF?
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Tetracycline or Doxycycline
-chloramphenicol for pts able to take tetracycline |
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What are the complications if RMSF is not treated?
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-Death
-Vasulitis = gangrene of digits, ear lobes, nose, scrotum, or entire limbs -Meningoencephalitis |
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a 5 year old child is brought to the emergency center b/c he has a temperature of 102 F & is developing a pruritic rash. Rash appears to be in various stages of papules, vesicles, & crusts. It began on his trunk & spread to his extremities
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Varicella = chicken pox
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What is the cause of Whooping Cough = forceful inspiratory gasp (whoop) after a paroxysmal cough
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B. pertussis
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What are the 3 stages of Pertussis?
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Catarrhal: lasts 1-2 wks & consists of rhinorhea, conjunctival injection, & cough
Paroxysmal: lasts 2-4 wks & consisting of coughing spasms, insiratory whoop, & facial petechiae Convalescent: lasts 1-2 wks w/ decreased frequency of symptoms |
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What does a CBC show in Pertussis Whooping Cough?
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Leukocytosis caused by absolute Lymphocytosis
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What is the treatment for Pertussis infection?
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Supportive Care
ERYTHROMYCIN shortens the period of communicability -family members should recieve for 14 days -does not affect duration of Paroxysmal stage |
|
Lyme disease
1. bacteria 2. vector |
1. B. burgdorferi
2. Ixodes scapularis = deer tick |
|
What is the presentation of Lyme Disease?
|
Early localized disease = Erythema Migrans = red-raised border with central clearing
Early disseminated = Neurologic & Cardiac -Neurologic = "aseptic meningitis", Bell palsy, neuropathy -Cardiac = myocarditis, heart block Late = Arthritis |
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What is the treatment for Early disease Lyme Disease?
What is Rx for Disseminated dx? |
Doxycycline or Amoxicillin
-kids <8 yo should not receive Doxy Ceftriaxone or Penicillin G |
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What is the MC complication of Measles infection?
|
Otitis Media
Pneumonia & Encephalitis are other major complications |
|
A 15-month-old infant is brought to the physician b/c of a RASH. The mother states that the pt had a FEVER of 104 F for the last 3 DAYS without any source of infection. She explains that the ever has resolved, but now the child has pink, slightly raised lesions on the trunk, upper extremities, face, & neck
|
Roseola = HSV-6
|
|
Explain the rash in Roseola
|
Before the rash physical findings are minimal but may include mild URI signs such as rhinorrhea & conjunctival redness. Occipital Lymphadenopathy may be found
Rash is rose colored & begins on the trunk & spreads to the neck, face, & proximal extremities |
|
A 5 yo kid has low-grade fever, pinpoint rash, postoccipital & retroauricular lymphadenopathy, & rose spots on the soft palate
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Rubella
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|
How does the RMSF rash present?
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begins on the extremities & spreads to the entire body, including the palms & soles, & which turn into petechiae
|
|
What is the treatment of choice for RMSF?
|
Tetracycline or Doxycycline
-chloramphenicol for pts able to take tetracycline |
|
What are the complications if RMSF is not treated?
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-Death
-Vasulitis = gangrene of digits, ear lobes, nose, scrotum, or entire limbs -Meningoencephalitis |
|
a 5 year old child is brought to the emergency center b/c he has a temperature of 102 F & is developing a pruritic rash. Rash appears to be in various stages of papules, vesicles, & crusts. It began on his trunk & spread to his extremities
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Varicella = chicken pox
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A mother brings her 4 yo child to the physician with hx of Anal itching. The pt attends day care, & you are told that the child's favorite activity is playing in the sandbox
Dx? Diagnostic tests? Rx? |
Enterobiasis = Pinworms
Cellophane tape test Albendazole, Mebendazole, Pyrantel pamoate |
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A patient is brought to the physicians office b/c the mother found a worm in the diaper
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Ascariasis
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A 5 yo presents w/ complaint of anorexia, ab pain, & diarrhea. The pt is noted to have a yellow-green pallor
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Hookworm = Ancylostoma duodenale, Necator Americanus
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