Common Presentations Flashcards
Fever, UTI, OM, URI, LRI, Asthma, Croup, Abdominal Pain, NVD, Head Injuries, Bronchiolitis (34 cards)
In which populations should we take fever more seriously?
Immunocompromised, age <2mos, ill appearance
Give a ddx of SBIs we need to rule out in the febrile child
UTI, meningitis, bacteremia, septic joints, appendicitis, pneumonia
What are the most common bacterial organisms in kids <28 days?
E coli, S. pnuemo, listeria, GBS, MRSA
Workup that should be performed in all febrile neonates < 28 days?
LP, blood&urine cultures, CBC, +/- CXR, stool Cx, HSV testing
Start empiric amp+gent and consider acyclovir
What workup should be performed in a febrile 1-3mo?
CBC, UA, Blood&urine cultures. Look at either Rochester/Philly/PECARN guidelines and stratify the child–if not low risk get the LP
Is hypotension a late or early finding in pediatric sepsis?
Late finding! Children have increased sympathetic tone and can maintain BPs despite sepsis or hypovolemia
What life threatening diagnosis should always be considered with URI sxs?
Meningitis!
What age group should never get ibuprofen?
Children <6mos
What is the most common SBI in children <36mos?
Urinary Tract Infections
What are risk factors for urinary tract infections?
Females <12mos, uncircumcised males, nonblack race, >24 hours of fever, fever >39C, no obvious infection source
Which marker on a UA is sensitive for UTI and which marker is specific for a UTI?
leukocyte esterase=sensitive
nitrates=specific
What non-infectious ddx items should be considered in the ill appearing infant <60 days old
congenital heart disease, metabolic disease (e.g. galactosemia), congenital adrenal hyperplasia with adrenal crisis, seizure and non-accidental trauma
If a patient has >/= 2 of which criteria should you consider performing a strep swab
absence of cough, tonsillar exudate/edema, fever, anterior chain cervical adenopathy, age between 15yrs and 3mos
What criteria indicate a patient who may benefit from tamiflu and thus warrant flu testing?
= 24 mos, pt with chronic conditions, patient sick enough to require admission
What diagnoses should be considered in children who present with URI sxs?
influenza, OM, strep pharyngitis, sinusitis
What criteria should alert you to consider bacterial sinusitis?
URI sxs not improving for >10 days, worsening sxs after initial URI sxs resolve, severe sxs (purulent nasal discharge, fever >39C) for >3 days
What clinical criteria are used to diagnose pertussis infection?
a cough illness >/= 2wks w/out a more likely diagnosis and atleast 1 of the following: paroxysms of coughing, inspiratory whoop, post-tussive emesis, apnea in infants <1yo
What lab should be obtained in all children to be hospitalized for pneumonia?
blood culture
What antibiotics should be used for pneumonia?
<5yo=amoxicillin or ampicillin
>5yo=macrolide
If pertussis=azithromycin
What should be assessed during an asthma exacerbation?
ability to speak full sentences, retractions, O2 sat, respiratory rate, auscultory findings
What therapies should be given in a severe asthma exacerbation?
NS bolus, duonebs, continuous albuterol, IV magnesium, steroid.
Consider IM epi, heliox, NIPPV, and intubation
Give a ddx for croup
retropharyngeal abscess, peritonsillar absces, tracheitis, foreign body, epiglottitis
Tx for croup
dex, racemic epinephrine
Which patients are most at risk for bronchiolitis complications?
Age<3mos, preemies, pts w/ comorbidities
