Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
98 Cards in this Set
- Front
- Back
Infant born to HIV mother; while awaiting HIV test results what treat with?
|
prophylactic TMP-SMX to prevent PCP
|
|
what to do if HIV child exposed to measles?
|
give measles IG regardless of immune hx
|
|
All children w/ HIV will eventually have what?
|
wt loss and FTT due to poor calroic intake and poor appetite, int absorption + increased energy use due to chronic inf
|
|
Give vit C to HIV child?
|
not necessary
|
|
Meningitis vaccine (MCV4) to whom?
|
All kids 11-12 in day care; or adolescent entering high school;
or adolescent entering college!! |
|
specific absolute CI/ to MMR, varicella?
|
Pregnancy or severe immunodeficiency
|
|
absolute c/i's to DTaP vaccine?
|
encephalopathy within 7 d of administration of previous dose
|
|
absolute C/I to all vaccines?
|
severe anaphylactic rxn to previous dose
|
|
What vaccines must be given at 2,4,6 mo ?
|
2: DTAP, HIb, IPV, PCV HBV 2
4: " 6: " HBV 3 12-15: HIb4 PCV 4 mmr 15-18: DTAP4 4-6yr: DTAP5 IPV4 mmr2 VZV = > 1yr |
|
chldren w/ asplenia, give what?
|
MPSV4(plolysaccharide meningococcal) vaccine;
both polysaccharide and conjugate pneumococcal vaccines; |
|
high fever, sore throat, vesicular lesions > ulcers in soft palate, tonsils, and pharynx; in summer or fall? if also has palmar/sole rash lesions?
|
Herpangina = if palms/soles affected = HF&M disease
|
|
enterobacteria causing seizure in 30% of infections?
|
Shigella
|
|
tx of shigella?
|
supportive; +/- ampicillin or tmp-SMX; if resistance, +/- cef 3rd gen
|
|
2 diseases w/ scarlatiniform rash, desquamation, erythemaof mucous membranes, injected pharynx, strawberry toungue, cervical lymphadenopathy?
|
scarlet fever, Kawasaki's
|
|
2 identifying tests for Strep type A
|
ASO titers; throat swab/culture
|
|
tx of acute Kawasaki's?
|
Aspirin + IV IgG
|
|
6mo-18 mo w/scaliness and hair loss?
|
tinea capitis due to Trichophyton tonsurans ( a dermatophyte)
|
|
most common dermatophyte causing tinea capitis?
|
T tonsurans. (infects inner hair shaft)
|
|
wood lamp illuminates?
|
Microsporum canis (illuminated b/c infects OUTER hair shaft)
|
|
skin w/ pink-tan patches that don't tan under sun
|
T. versicolor caused by M. furfur = spaghetti and meatballs appearance on KOH slide
|
|
Parvo B 19 in sickle cell might cause? in pregnant?
|
sc: aplastic crisis: severe anemia
prego: severe anemia-->hydrops fetalis |
|
mechanism of Anemia causing hydrops fetalis?
|
profound anemia--> high cardiac output plus ELEVATED CVP --> Hydrops fetalis
|
|
acute scrotal swelling plus pyuria in sex active kid?
|
epididymitis, due to chlamydia or NG
|
|
kawasaki's presents mainly at what age?
|
80% present at < 5 years old
|
|
15 mo old w/ otitis media that progresses after tx to fever, rash, irritability... what do first?
|
FIRST do LP to r/o bacteremia in young, febrile pt with CHANGE IN MENTAL STATUS!! (If neg, should try and change drugs)
|
|
Is pertussis prevented by transplacental antibody from mother?
|
NO!!!! Thus, must give E-mycin immediately to newby with pertussis-positive sick contact (ie sister/mother)
|
|
Does pertussis immunity last into later life?
|
yes if previously infected; if vaccinated, immunity may decrease over time
|
|
Other markers of acute EBV infection besides Monospot + test?
|
AB's to VCA (viral capsid antigen) ;
AB's to anti-D early antigen; AB's to EBNA (e-b nuclear antigen) (comes later) |
|
site of osteomyelitis?
|
usually occurs at metaphysis
|
|
pathogen m/c causing osteomyelitis?
|
S. aureus
|
|
may follow an episode of deep cellulitis...?
|
acute osteomyelitis
|
|
bone changes in OM may take how long to show up on xray? on bone scan?
|
xray: up to 12 days!! so must make dx based on clinical findings...
bone scan: 24-48 hours; but OM pts often have false- negative bone scans |
|
Tx of Osteomyelitis and for how long?
|
high-dose, IV or PICC-line AB's; antistaph broad spectrums ie oxacillin.
tx for at least 3 weeks |
|
tx of neonatal meningitis?
|
need to cover for G+ (GBS(g+cocci), Listeria (g+rods) and - (Ecoli, HiB)so use amp + gent, or cefotaxime
|
|
infants that don't die from resp depression, but survive infant botulism may have what long-term problems?
|
none!
|
|
sudden onset of fever and left-shifting leukocytosis in infant that continues to appear otherwise normal?
|
Pneumococcal bacteremia
|
|
most common cause of orbital cellulitis in children?
|
infection of paranasal sinuses
|
|
proptosis, pain, ophthalmoplegia, and vision changes with fever in kid?
|
think orbital cellulitis!!!
|
|
common LAD seen in Rubella?
|
retro auricular or posterior cervical or postoccipital LAD!
|
|
Rash of Rubella stays or clears by 72 hours?
|
CLEARS!
|
|
rubella vs. measles (rubeola) vs Roseola sx?
|
Rubella: post-cervical or occipital LAD + LOW fever + m/p rash for 3 days.
Measles: HIGH fever, CCC's (conjunctivitis, cough, coryza), rash lasts 5 days, +/-Koplik spots Roseola: High fever, then rash as fever leaves |
|
Erythema infectiousum rash presents as?
|
Slapped-cheek sign on cheeks, then to trunk and extremities, then fades CENTRALLY at first
|
|
Orchitis in mumps is mostly seen in what age males?
|
POST-pubertal
|
|
swollen area around ear + change in taste sensation may be presentation of what?
|
mumps!
|
|
pre-HEP A jaundice has short or long period of viremia?
|
short..<2weeks
|
|
Hep A more severe in adults or children?
|
adults
|
|
Hep A sx in children?
|
USUALLY asx, however may see fever, nausea, vomiting,jaundice, dark urine
|
|
rash of RMSF ?
|
flexor surfaces of wrists and ankles, moves centripetally; Palms and soles ARE involved; may become hemorrhagic
|
|
Erythema chronica migrans + flulike sx, arthralgia/arrthritis, meningitis?
|
Lyme disease (and carditis, obviously)
|
|
Mantoux test (PPD) becomes positive after how long after infection?
|
2-10 weeks
|
|
when may PPD in TB + pt actually be negative?
|
In advanced stages (can't mount an immune response) or dirctly after live virus immunizations (ie MMR), or steroid or isuppressive drugs. Otherwise it's positive for life
|
|
PPD test +'s?
|
>15mm in normal kid (no risk factors)
<15 in high risk group ie homeless, prisoner, foreign born, IV /drug abuser, or living w/ adults w/ these rf's) 5mm if kid is HIV +, suspicious xray, or clinical sx of TB, or exposed to adult with contagious TB) |
|
are children w/ + TB contagious?
|
NO!! they rarely develop cavitary TB and therefore are not contagious
|
|
contraindication to LP in baby?
|
-increased ICP if fontanelle is CLOSED (if open, ok to do LP even if bulging!)
-severe cardiorespiratory distress -severe TCP causing ie bleeding diaatheses |
|
Cause of whooping cough? barking cough + inspiratory stridor?
|
WC: pertussis
Barking cough + insp stridor: CROUP (caused by Parainfluenza, RSV, etc OR..... epiglottitis (rare due to HiB vaccine)=toxic appearing kid w/high fever = surgical emergency!! |
|
SX of croup + age
|
low fever, barking coughk, hoarse, inspiratory stridor.
Age = 6mo-6yrs |
|
bacterial agent often seen as cause of day care center breakouts of diarrhea
|
Cryptosporidium parvum
|
|
Other causes of watery, frothy diarrhea besides Giardia?
|
Crypto. parvum, amebas, whipworms (trichuriasis), viruses
|
|
Does toxoplasmosis ordinarily cause diarrrhea?
|
NO. causes fever, myalgia, lad, maculopapular rash, Hmegaly, pneymonia, encephalitis, chorioretinitis, or myocarditis
|
|
Lab manifestations of Wiskott Aldrich?
|
first of all, is a mixed Ideficiency = lymphopenia;
Ig's: low IgM, High IgA and E; TCP |
|
4 types of combined Ideficiencies?
|
WA
SCID Ataxia-telangectasia Chronic mucocutaneous candidiasis |
|
what characteristic result occurs after administration of Amp to EBV pt?
|
rash
|
|
type of GI problem causing epigastric px and relieved by eating, worsened by fasting
|
H pylori - duodenal ulcer (gastric ulcer worsens directly after eating)
|
|
Pathogen causing roseola
|
Human herpesvirus 6
|
|
cough, tachypnea, and conjunctivitis in 2 month old?
|
Chlamydia trachomatis
|
|
OTHER pathogen causing bronchiolitis besides RSV?
|
Parainfluenza has been implicated
|
|
diagnosis of brachial plexus injury?
|
use chest ULTRASOUND to check for unparallel diaphragm movements = phrenic nerve injury
|
|
brachial plexus injury often due to what?
|
uncontrolled gest. diabetes mothers having LGA babies with shoulder trauma on the way out
|
|
value of sweat test =CF?
|
>60meq/L
40-60 is intermediate |
|
lung abscesses usually caused by what pathogens?
|
staph aureus, fusobacterium, anaerobic strep, Klebsiella, prevotella
|
|
tx of lung abscesses?
|
AB's ALONE!!! first, then consider surgery (for drainage or resection)
|
|
should you induce vomiting in a pt coming in for resp distress due to gasoline inhalation or aspiration after gasoline ingestion?
|
NO...this may cause aspiration. just support and may need ventilation or intubation...
|
|
TB skin test for infants?
|
No...usually negative in infants of age < 4 months, even if active disease is going on
|
|
repeated episodes of fever, respiratory infection ie lobar pneumonia, and hemoptysis in 4 y/o. with clear radiographs after each resolution...positive fecal occult blood, low iron, anemia
|
Idiopathic pulmonary hemosiderosis: chronic bleeding into the lungs
|
|
Test for Idiopathic pulmonary hemosiderosis:
|
Bronchioalveolar lavage to check for hemosiderin -laden macrophage
|
|
subset of patients with pulmonary hemosiderosis have what else that may be causing it?
|
Heiner syndrome = sensitivity to cows' milk; stop cows milk and patient may improve
|
|
diagnosis of OSA? tx of OSA?
|
dx: Polysomnography;
tx: home CPAP, tonsillectomy, adenoidectomy |
|
recognized complications of staph pneumonia? (2)
|
Often fast progressing, seen in pts <1yo with staph pneumonia:
empyema tension pneumothorax/pyopneumothorax |
|
sudden hypotension and low O2sats in respiratory distressed pt,think?
|
TENSION PT!!!!!!!!!!!!!! (Or, if cardio involvement,t think TAMPONADE, but would have bilaterally similar lung findings and muffled heart sounds)
|
|
severe and life threatening complication of laryngiotracheobronchitis?
|
bacterial tracheitis = acute high fever, TOXIC appearance, respi distress, BIPHASIC stridor
|
|
Croup vs
bacterial tracheitis vs epiglottitis? (cause, tx) |
Croup: Viral; tx =calm down child; mist tent/ humidifier; no other tx. If severe stridor: inhaled epi + oral steroids. (acetaminophen for fever)
Bacterial tracheitis: acute high fever, TOXIC look, respi distress, BIPHASIC stridor; tx = INTUBATION!!! + IV AB's!!!! epiglottitis: HiB; DROOLING and dysphagia, tx with INTUBATION!!! + IV AB's!!!! (ie ceftriaxone) |
|
Bacterial tracheitis dx?
|
laryngoscopy: sub-glottal inflammation with lots of PURULENT mucus
|
|
thumbprint sign seen in which pathogen for epiglottitis?
|
ALL! = GAS, HiB, M catarrhalis, S. pneumonia
|
|
pathogens causing epiglottitis TODAY?
|
GAS, HiB, M catarrhalis, S. pneumonia
|
|
respi difficulty + Hsplenomegaly in kid who eats dirt with dog at home. DX?
|
Toxocara canis. Dx: doesn't stay in intestine, so can't see ova/parasites in stool. Do ELISA for Toxocara to dx
|
|
cold > 10 days with facial pain and fever? Tx?
|
sinusitis
Tx = oral antibiotics for 14 days |
|
visualizing which meatus discharge means which sinus infection?
|
medial meatus = ant ethmoid, maxillary, or frontal sinusitis
superior meatus = posterior ethmoid or sphenoidal sinusitis |
|
Theophylline in asthmatics mustn't be given with which medications?
|
P-450 inducers/inhibitors
|
|
Tx of mycoplasma pneumonia?
|
macrolide
|
|
Staph pneum is usually seen in what age group?
|
"infants < 6mo old"
|
|
After giving an allergen for test, kid gets flushed face and muffled voice... how tx?
|
"immediate endotracheal intubation"
for anaphylaxis....O2, Then give sub-q epinephrine; +/-diphen |
|
fast onset of respi distress, cough, and high fever in sickle cell child NSiM?
|
immediate hospitalization (no labs/er course nec; this is most likely pneumonia, pulm embolus, or sepsis!!!)
|
|
triad of Kartagener's syndrome?
|
= defect in arm ofdynein protein
1 situs inversus, 2 chronic sinusitis/otitis media, 3 airway disease (also infertility, bronchiectasis) |
|
In baby w/o pre-natal dr. visits:
Multiloculated mass in left hemithorax, with N/G tube showing stomach below diaphragm...? |
CCAM = congenital cystic adenomatoid malformation = embryological malformation usually picked up in 20th week ultrasound. tx = surgical removal of affected lung
|
|
abrupt fever, drooling, sore throat, and dysphagia, muffled breathing in pt with 3 day history of pharyngitis? causative agent? tx?
|
retropharyngeal abscess; S. aureus;
surgical incision and drainage under gen anasthesia |
|
Is topical tx for conjunctival chlamydia in newborn successful in clearing nasopharynx of pathogen?
|
NO..! kid may still get chlamydial pneumonia few weeks later. tx with oral macrolides
|
|
complication of oral macrolides in neonate, infant to tx chlamydial pneumonia?
|
idiopathic hypertrophic pyloric stenosis
|
|
cause of one-sided hyperinflated lung seen on expiratory xray but not inspiratory; in otherwise healthy kid with recurrent cough
|
foreign body aspiration!!!
do rigid bronchoscopy for dx and removal |