Fever

Question 1

The Shaw study found that what variables were more predictive of UTI in a febrile child (boys younger than 1 and girls younger than 2)?

Answer 1

• Caucasian race
• Females
• Uncircumcised boys
• History of UTI
• Malodorous urine
• “Toxic appearing” child
• Lack of a possible source for the fever
• Higher fever

Question 2

Interestingly, what features did not correlate with higher rate of UTI in Shaw’s study?

Answer 2

• Length of fever
• GI symptoms
• Poor feeding
• Exposure to ill contacts

Question 3

From the Shaw study’s results:

“Our study supports… our current clinical practice of obtaining _________________.”

Answer 3

urine cultures on febrile infants without a definite

source of fever on examination

Question 4

In a nutshell, what did Hsiao’s study show?

Answer 4

Hsiao’s study showed that infants age 8 weeks to 6 months with fevers had a 10% incidence of serious bacterial illness – defined as bacteriuria or bacteremia – and that almost 40% had positive viral direct fluorescent antibodies (DFAs).

Question 5

Urine cultures are considered positive if _____________.

Answer 5

there are greater than 10,000 CFUs per mL

Question 6

Which viruses are most common for positive DFAs in a febrile infant?

Answer 6

• RSV (19.1%)

* Influenza A (12.3%)

Question 7

In Hsiao’s study, what correlated with higher rate of SBI?

Answer 7

•Increased duration of fever

Question 8

What did not correlate with increased risk of SBI in Hsiao’s study?

Answer 8

•Height of fever

Question 9

One of the big takeaways is that young patients with URIs may __________________.

Answer 9

also have UTIs; as such, the authors advocate that providers keep UTI in mind as a possible additional diagnosis when bronchiolitis is diagnosed

Question 10

What are four common causes of tachycardia in children?

Answer 10

• Fever
• Fear/anxiety
• Dehydration
• Pain

Question 11

What’s the formula that gives 5th percentile for SBP in children?

Answer 11

(2 x age in years) + 70

Question 12

To what childhood illnesses does secondhand smoke predispose children?

Answer 12

• URIs
• Asthma
• OM

Question 13

In Hsiao’s study, what percent of positive blood cultures were true positive?

Answer 13

About 1.5% of febrile kids had a TP blood culture and about 5.6% of kids had a FP blood culture.

Question 14

What formula tells you what size tube to use?

Answer 14

• Uncuffed: age/4 + 3

* Cuffed: age/4 + 4

Question 15

____________ is the first-line agent for pediatric shock.

Answer 15

Dopamine