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74 Cards in this Set
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top pathogens for ages 0-1 mo |
1. GBS 2. E. Coli 3. List mono Tx: Ampicillin + gent/cef |
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top pathogens for ages 1-3 mo |
1. GBS 2. strep pneumo 3. List mono Tx: ampicillin + cef (and vanc if meningitis) |
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top pathogens for 3mo-2yrs |
1. strep pneumo 2. h. flu b 3. N.M. Tx: cef (and vanc if menigitis) |
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top pathogens for 3yrs+ |
1. strep pneumo 2. N.M. Tx: cef (and vanc if meningitis) |
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when to admit child with fever: |
-28 days old or less -29 days-3mo if they appear toxic, you suspect meningitis, they have PNA, pyelo, or bone infx not responsive to Abx, uncertain social situation |
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if kid with fever is 28 days or less |
IV Abx, bcx etc |
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if kid with fever 29+ |
parenteral Abx ok (ex: intramuscular Ceftriaxone) |
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child 3-36 months with fever |
1. looks toxic: admit with IV Abx and w/u for sepsis 2. nontoxic and fever <102.2, observe at home, no labs needed 3. nontoxic but temp >102.2.....LOTS |
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3-36months with fever >102.2 but nontoxic appearing |
-UCx for MALES <6 months and FEMALES <2yrs -BCx -CXR if distressed or tachypnic -STool Cx if needed -Empiric Abx!! |
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w/u for fever of unknown origin |
1. cbc with diff 2. ESR/CRP 3. transaminases (r/o hepatitis) 4. UA and UCx 5. BCx 6. Anti-streptolysin O titer (eval for prior strep infx, rheumatic fever) 7. ANA and RF 8. Stool Cx, ova , parasites 9. PPD 10. HIV |
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LP for BACTERIAL meningitis |
HIGH protein LOW glucose NEUTROPHILS |
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what imaging would you likely do in suspected meningitis |
CTbrain to eval for abscess |
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what to give kid with HIB meningitis to reduce risk of hearing loss |
corticosteroids (with Abx) |
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LP VIRAl meningitis |
NORMAL protein NORMAL glucose |
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LP FUNGAL meningitis |
Normal protein LOW GLUCOSE**** |
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LP in T.B. meningitis |
very high Protein! very low glucose! |
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most common cause of Aseptic Meningitis |
VIRAL meningitis |
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brain imaging for TB meningitis shows what? |
BASILAR enhancement! |
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common URI viruses |
rhinovirus parainfluenza coronavirus RSV |
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fever or sx of URI greater than 10 days should prompt you to look for overlying bacterial superinfx |
like a sinusitis or acute otitis media |
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most common cause of sinusitis |
strep pneumo |
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tx for sinusitis |
Augmentin (amoxicillin/clavulanate) |
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viral causes of Pharyngitis |
coxsackie, EBV, CMV |
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bacterial causes of Pharyngitis |
Strep Pyogenes***** |
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kid with pharyngitis, painful VESICLES/ULCERS on posterior pharnx and soft palate (HERPANGINA). blisters could also be present on palms/soles (hand foot mouth dz) |
coxsackie pharyngitis |
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pharyngitis with NO rhinorrhea/cough. has EXUDATES*** on tonsils, petechia on soft palat, STRAWBERRY tongue, large tener anterior cervical lymph nodes, SCARLATINIFORM rash |
Group A beta hemolytic pharyngitis (strep pyogenes) |
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URI with GRAY tonsillar membrane, ADHEREnt |
Diptheria |
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Dx of GABHS pharyngitis |
Cx (gold standard) or antigen testing (rapid strep test) |
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Tx for viral pharyngitis |
supportive |
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Tx for GABHS pharyngitis |
-PO* penicillin -VK -1 dose intramuscular benzathine penicillin (or erythromycin if pt is allergic) |
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Tx for EBV pharyngiti |
supportive/steroids if severe |
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Tx for diptheria pharyngitis |
-PO erythromycin or parenteral PNC -Antitoxin from CDC -respiratory isolation to prevent spread! |
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otitis media |
infx of middle ear |
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otitis media with EFFUSION |
fluid in middle ear but NO SX of infx |
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top pathogens causes otitis media |
1.strep pneumo 2. h flu 3. moraxella |
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pus/fluid draining from ear |
perforated tympanic membrane |
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Tx o.m. |
amoxicillin, unless resistant, then try high dose or augmentin or cephalosporin |
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most common pathogens in otitis EXTERNA |
1. pseudomonas 2. staph aureas 3. candida |
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pathogens for cervical LAD |
1. staph aureas 2. strep pyogenes c. TB 4. b. henselae (cat scratch) 5. reactive lymphadenitis (reponse to infx of teeth etc) 6. EBV, CMV, HIV 7. Kawasaki *unilateral 8. t. gondii 6. structural lesion |
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tx of cervical lymphadenitis (mobile, TENDER, warm with overlying skin redness) |
-empiric Abx tx for common organisms with first-gen cephalosporin or anti-staph penicillin |
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bilateral Parotitis |
Mumps, influenza, CMV, EBV, HIV |
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UNI enlargement of parotid gland |
staph, strep pyogenes, m. TB |
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complications of mumps |
meningoencephalitis, orchitis, epididymitis, pancreatitis |
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complication of accute suppurative (bacterial) parotitis |
abscess or osteo of the jaw |
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impetigo |
superficial skin infxn of the upper dermis: HONEY crusted lesions, especially nose/face. WITHOUT FEVER |
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common pathogens causing impetigo |
1. STAPH!!!! 2. GABHS (strep pyogenes) |
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tx impetigo |
-topical mupirocin -oral Abx (dicloxacillin, cephalexin, clinda) |
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complications of impetigo |
-bacteremia -post-strep glomerulonhephritis -SSSS |
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which of the complications of impetigo are NOT prevented with treatment? |
glomerulonephritis |
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Erysipelas |
dermal skin infxn involving LYMPHATICS |
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etiology of Erysipelas |
GABHS***** |
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complications of Erysipelas |
-post-strep glomerulonephritis -nec fasciitis -bacteremia |
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cellulitis |
skin infxn within the dermis: usually caused by a cut that gets infected |
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causes of cellulitis |
-GABHS -Staph |
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clinical dx of cellulitis |
erythema, warm, tender, INDISTINCT border |
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UNI bluish** discoloration of cheek in a young UNIMMUNIZED child |
buccal cellulitis: caused by HIB*** |
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tx for HIB |
cefuroxime/cefotaxime |
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what test to do with buccal cellulitis |
ALWAYS do an LP*** because high rate of bacteremia/meningitis |
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pain and systemic sx out of proportion to physical findings |
nec fasciitis; extends into muscle |
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fever, tender skin, BULLAE |
SSSSS |
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1. TRUNK 2. extremities -"sandpaper" -blanches -petechia within skin creases* (Pastia's lines) |
SCARLET fever: GABHS*-->erythrogenic toxin |
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transmission of scarlet fever |
droplet |
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rash can evelope during ANY GABHS infection |
impetigo, cellulitis, pharyngitis |
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consequence of Scarlet fever (GABHS*) |
-RHEUMATiC FEVER (your goal in tx is to prevent this!) |
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tx scarlet fever |
-oral penicillin VK or intramuscular benzathine penicillin -erythromycin/macrolide if PCN allergic |
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complications of GABHS infx |
-post strep glomerulonephritis (NOT PREVENTED by Abx) -rheumatic fever -post-strep arthritis (NOT PREVENTED by Abx) -pediatric autoimmune neuropsych disorder: acute onset OCD**** |
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patient had pharyngitis, now has HTN, coca-cola urine |
post-strep glomerulonephritis from GABHS infx |
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fever, shock, desquamating skin rash, MODS |
toxic shock syndrome |
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cause of TSS |
1. staph aureus |
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indication for empirical intramuscular ceftriaxone injection in baby with fever |
if WBC is 15000+ |
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why is monospot not a sensitive test in kids less than 4yo? |
because they don't form heterophile antibodies well yet |
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most common cause of mortality in measles |
bacterial pneumonia |
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koplik spots |
leave by the time rash is present |
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even if PPD +, don't medicate child till has sx of TB |
kids <12 actually are unlikely to be contagious cause of minimal cough and pulm involvement |
