In newborns, what is the most common etiology of conjunctivitis?
Chlamydia
bacterial conjunctivitis etiology
S. pnuemoniae, Haemophilis, Chlamydia
Kawasaki disease tx
intravenous immunoglobulin and aspirin
When do you suspect Kawasaki disease? (2 factors)
below age 1 and above age 6
unexplained fever for more than 5 days
Kawasaki disease hallmarks (4)
non-exudative conjunctivitis
erythema of the lips and mucosa
strawberry tongue
high fever
confirm a corneal abrasion by using?
fluorescein stain
tx for corneal abrasion?
topical antibiotics, followup in 24-48h
bacterial infection of the nasolacrimal duct is?
Dacrocystitis
Dacrocystitis etiology
S. aureus, S. pnuemoniae
Dacrocystitis tx
oral and topical abx
Acute Otitis Media txs (3)
Under 6 mo old: abx
6 mo-2 y/o w/ fever of 102.2: abx
2 y/o+ w/ fever and certain diagnosis of AOM: abx
Otitis media w/ effusion tx?
None- time.
Frontal sinuses develop when?
5 y/o
Sphenoid sinuses develop when?
9 y/o
Thrush risk factors
Use of broad-spectrum abx or inhaled steroids
Thrush tx
Nystatin or oral suspension
Bacterial pharyngitis tx?
oral penicillin
Red uvula, petechiae, cervical lymphadenopathy, tonsilar exudate indicate?
Strep throat
severe sore throat, high fever, unilateral tonsilar swelling is caused by what infection?
B-hemolytic strep
Tx for peritonsilar abscess
IV antibiotics, drained by specialist
etiology of viral croup (2)
Parainfluenza virus or RSV
Treatment of mild croup
Cool mist, symptomatic
Treatment of moderate croup (2)
Corticosteroids, nebulized racemic epinephrine
dysphagia, drooling, distress indicate?
Epiglottitis
What’s important to remember about examining epiglottitis?
Don’t use a tongue blade- can trigger respiratory spasms
abrupt onset of cough, choking, wheezing in kids 12 mo - 4 years could indicate?
foreign body aspiration
infection of the small airways
Bronchiolitis
Tx for bronchiolitis (3)
B-agonist (Albuterol), nebulized epinephrine, RSV immunoglobulin
Chronic cough w/ sputum
Bronchiectasis
dilation of bronchi
Bronchiectasis
thick, viscous secretions in the lungs, pancreas, liver, intestine, reproductive tract
Cystic fibrosis
persistent, productive cough; hyperinflation on CXR
Cystic Fibrosis
Cystic fibrosis tx (5)
antibiotics chest physiotherapy mucolytics steroids bronchodilators
Respiratory distress w/in minutes of birth, tachypnea, chest retractions, etc
Infant Respiratory Distress Syndrome
Infant Respiratory Distress Syndrome etiology
lungs aren’t matured, lack surfactant —> alveoli collapse
infant respiratory distress syndrome prophylaxis
glucocorticoids given to pregnant mom
Pneumonia etiology 1-12 mos.
RSV1
Pneumonia etiology 2-5 y/o
Parainfluenza, influenza viruses
Pneumonia etiology 5-18 y/o
bacterial
paroxysomal cough, whooping sounds, post-tussive emesis, prolonged URI, lymphocytosis
Pertussis
3 phases of Pertussis are?
Catarrhal, Paroxysmal, Convalescent
describe the catarrhal phase of pertussis
URI, fever, 1-2 weeks
the paroxysmal phase of pertussis is
classic symptoms, 2-6 weeks
pertussis treatments
Erythromycin, Azithromycin
Asthma diagnosis?
Spirometry and rule of 2
Rule of 2
re: asthma
using rescue bronchodilator more than 2x/week?
more than 2x/month at night?
refilling more than 2x/year?
what is measured by spirometry for asthma dx
forced expiratory volume in 1 sec (FEV1)
asthma tx
Albuterol
long-acting B-agonists like Salmetrol and Formoterol (never use these alone)
reduce risk of SIDS by?
sleeping baby on the back, monitoring for infant overheating, and reducing maternal smoking/exposure to smoke
