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63 Cards in this Set
- Front
- Back
in kids under 6, most common cause of FUO?
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UTI or pyelonephritis, resp illness, localized infx (abscess, osteomyelitis), JA, & leukemia (rarely)
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in Ads, most common cause of FUO?
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TB, Inflammatory Bowel d/e, autoimmune d/os, lymphoma
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what is a fever?
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elevated body temp of 100.4F or 38C
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how does fever happen?
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resetting the hypothalamic heat regulatory center or when heat production exceeds heat loss
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febrile illness in infants usually what?
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congenital infx, infx acquired @ delivery (GBS), infx acquired in nursery (mostly premies), and infx acquired @ home (pneumococcal, meningococcal), or infx caused by anatomic or physiologic dysfunx
temps of kids under 2 usually consisten (ax temps can be 1F lower) |
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what age group is @ greatest risk for unsuspected bacteremia?
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birth-24 mos
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most common type of seizure in children?
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febrile seizires (can be brief, generalized, clonic, tonic-clonic, simple, or complex)
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simple febrile seizures
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last less than 15 min & do not recur w/in 24 hours
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complex febrile seizure
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last longer than 30 min, can recur on the same day, and can have focal attributes
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febrile seizures generally occur in kids how old?
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3-5 yrs
more common in boys |
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go to emergency center if seizure lasts longer than__?__
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10 min
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prophylaxis in febrile seizures?
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not usually indicated
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@ what ages do
-maxillary -ethmoid -sphenoid -frontal sinuses become a clinically sig site for infx? |
max & ethmoid- as early as infancy
sphenoid- 3-4 yrs frontal- 6-10 yrs |
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foreign bodies usually end up in which bronchus?
why? |
right- it is shorter and wider
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narrowest part of airway in infant?
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cricoid ring on the trachea
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barking cough- think...
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laryngotracheobronchitis (Croup)
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whooping cough in young infants- think...
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pertussis
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recurrent cough associated w/ what?
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asthma, allergies
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chronic (longer than 2-4 wks) cough associated with?
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CF
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time of day cough associated with asthma?
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night
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cough also malaise, sneezing, watery nasal d/c, mild sore throat, mild or low fever, not ill appearing
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URI
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don't use which meds in kids under 2yrs?
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anti-histamines, cough meds, expectorants, decongestants
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Tx of choice for strep?
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PCN
(cost, narrow spectrum, infrequ drug reactions) |
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goal of abx when TXing strep?
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1. prevent development of rheumatic fever (incubation=1-3 wks)
2. prevent spread to others & development of suppurative complications 3. shorten course/severity of illness |
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most common cause of viral pharyngitis & tonsilitis?
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adenovirus
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when can kids return to school after strep?
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when afebrile& have been taking abx for @ least 24 hrs
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what LNs swollen/tender w.strep?
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ant cervical
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Hx:
URI w.characteristic symptoms & a profuse & continuous, purulent, yellow-to-green nasal d/c for more than 3 days |
acute purulent rhinitis
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mucopurulent d/c worse in am--
common cold (acute viral rhinitis) or acute purulent rhinitis |
common cold
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difference btwn URI & sinusitis?
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persistance of URI sx for more than 10 days w.o improvement-- sinusitis
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acute sinusitis
subacute sinusitis chronic sinusitis |
acute- 10-30 days
subacute- 4-12 weeks chronic- sx lasting more than 12 wks |
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exudative tonsillitis most commonly seen w.?
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epstein-barr virus & group A strep
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lemierre d/e
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infx from oropharynx extends to cause septic thrombophlebitis of internal jugular vein & metastatic abscesses in the lungs
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fever in neonate is greater than?
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38C
100.4F |
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nature of fever usually if RSV w/ bronchiolitis?
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low grade, 2-3 days
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urine specimen is + if greater than __?__ w/ urine cath?
greater than __?__ if bag? |
urine cath- 0
bag- 10,000 |
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fevers more prevalent (and less concerning) if older than __?__
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3 months
(no tylenol- call provider!) |
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what constitutes fever if older and younger than 3 months?
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younger >38/100.4
older > 39/102.2 |
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alterations in normal temp in hypothal can be caused by...
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infx
vax tissue injury trauma malignancy drugs inflamm process immunologi-rhematologi d/os endocrine metabolic |
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no social smile, no real interaction until what age?
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2 months
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whats more likely to cause fever- viral or bac illness?
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viral
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when to IMMEDIATELY see a child with a fever?
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<3months old
fever >40 crying inconsolably or whimpering kid cries when moved/touched difficult to awaken stiff neck--> meningitis petechiae increased WOB drooling/unable to swallow seizures if kid looks really ill/parent really uncomfortable |
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kid should be seen in 24 hours if...
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btwn 3-6 months old
fever 40.6/105.08 > 39/102.2 burning/pain on urination fever >72 hrs |
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Dr. Paul McCarthy's Acute Illness Scale looks @ 6 observation items-
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1.quality of cry
2.reaction to parents stimulus 3.station variation (sleep<-->awake) 4.color 5.hydration 6.sociability response |
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ABCD toxicity
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Arousal/Alert/Activity
Breathing difficulty Color Decreased fluids |
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normal infants take how much per hour? per day?
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1oz/hr,
24oz/day bfeeding Q2-3 hrs |
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all febrile infants 0--28 days old should be admitted & TXd w/abx.!
which ones? |
ampicillin/cefotaxime or amp/gentamicin
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workup for 30-90 day old NON-toxic febrile appearing infant
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CBC w/differential, cath UA, UC, BC, stool eval if diarrhea, CXR if resp sympt, LP strongly considered
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without a LP don't give which drug??
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ceftriaxone
abx! |
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normals
WBC bands |
WBC5K-15K
bands <1,500 |
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normals
Urine Stool |
urine <5WBC/HPF
stool <5WBC/HPF |
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most common cause of fever in 3mo-3 yr old kid?
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*E coli
UTI bacteremia pneumonia |
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when to consider UA&UC for boys and girls if febrile?
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girls <2 yrs
boys (uncirc) <1 yr boys (circd) <6mos |
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think __?__ in febrile child with no obvious source of fever on exam
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UTI
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who is more likely to have UTI- male or female?
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female
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if greater than how many febrile seizures, send to neurology?
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7/yr?
(generally will have 5-7/yr) |
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Dosing of Tylenol if febrile
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10-15mg/kg Q4hrs
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Dosing of Motrin if febrile
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5-10mg/kg Q6-8Hrs (may be irritating to tummy)
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most common site of bac infx in young infant is?
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?? look up
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does pneumonia clear with coughing?
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no
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honey crusted lesions, can be secondary to URI
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impetigo
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FDA- no scientific evidence that OTC cough/cold meds are helpful for kids under what age?
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6
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children have how many colds/yr?
each lasts how long? |
3-8 (more if daycare)
each lasts 7-10days |