CLIPP 11- Kawasaki Flashcards Preview

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Flashcards in CLIPP 11- Kawasaki Deck (11)
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1
Q

DDX fever and rash (11)

A
  • adenovirus (URI)
  • Kawasaki disease
  • meningococcemia (petechial rash, fever, shock/DIC)
  • Measles (fever, rash on neck/mouth, unimmunized)
  • RMSF (myalgias, tick exposure)
  • scarlet fever (GAS, sandpaper rash)
  • Stevens Johnson syndrome (erythema multiforme, stomatitis, hypersensitivity reaction)
  • Enterovirus (conjunctivitis, oral ulcers, diarrhea, aseptic meningitis)
  • Varicella (trunk to extremities, various stages of healing, unimmunized)
  • erythema infectiosum (parvovirus B19, slapped cheek, lacy, swelling, aplastic anemia)
  • Roseola (HHV6, trunk to arms and neck, follows 3-4 days high fever, <2)
2
Q

causes of unilateral cervical adenopathy (5)

A
  • reactive cervical adenitis (oral process)
  • Kawasaki disease
  • bacterial cervical adenitis (URI hx, high fever, overlying cellulitis)
  • cat scratch disease (Bartonella)
  • mycobacterial infection (nontuberculous 2-4yo, well appearing)
3
Q

Kawasaki disease diagnostic criteria (7)

A
  • fever at least 5 days
  • changes in oral mucosa (strawberry tongue)
  • extremity changes (redness/swelling)
  • unilateral cervical lymphadenopathy
  • rash
  • conjunctivitis (bilateral, nonpurulent)
  • no other apparent cause for presentation
4
Q

normal 4 year old heart rate

A

65-135bpm

5
Q

Strawberry tongue meaning on 3 causes

A
  • erythematous tongue with prominent papillae

- strep pharyngitis, Kawasaki disease, TSS

6
Q

Kawasaki disease definition and time course

A
  • acute inflammatory panvasculitis of unknown etiology in children
  • acute phase: fever, clinical findings, serologic evidence of systemic inflammation (0-10days)
  • subacute phase: most s/sx resolve, hands/feet peel, serologic inflammation (10days-3wks)
  • convalescent phase:all clinical findings resolved, serologic inflammation (3-8weeks)
7
Q

Kawasaki disease complications (5)

A
  • aseptic meningitis/CNS symptoms (90%)
  • coronary artery aneurysm (20-25%)
  • liver dysfuntion (40%)
  • arthritis (30%)
  • hydrops of the gallbladder (10%)
8
Q

Timing of CA aneurysm development

A

subacute phase (10days-4wks)

9
Q

Kawasaki disease treatment (4)

A
  • high dose aspirin (80-100mg/kg/day) for inflammation
  • IVIG (2g/kg) to reduce risk of CA aneurysm
  • low dose aspirin (3-5mg/kg/day) for anti-platelet effects
  • NO IBUPROFEN
10
Q

Kawasaki disease follow up care (3)

A
  • cardiology
  • aspirin
  • influenza vaccine (reye syndrome)
11
Q

Lab evaluation of Kawasaki disease (7)

A
WBC: elevated
Hgb/Hct: normochromic, normocytic anemia
Platelets: thrombocytosis
AST/ALT: evelvated
Albumin: low
ESR/CRP: elevated
UA: sterile pyuria (urethritis)