ID Flashcards
(62 cards)
1
Q
4 main bugs
A
- bact
- virus
- fungi
- parasites
2
Q
3 main fungi
A
- yeast
- dimorphic
- molds
3
Q
2 main parasites
A
- protozoa
2. helminths
4
Q
4 main bact
A
- Gram +
- gram -
- mycoplasma
- mycobacteria
5
Q
3 main types of Gr + and their types
A
- rods
- bacillus
- clostridium
- cornybac - branching
- cocci
- staph
- strep
6
Q
4 main gr -
A
- cocci
- neiseeria
- moraxella - pleomorphic
- chlam
- ricketsia - spirochetes
- treponema
- berrelia - bacilli
- enterics - e coli, shigella etc.
- other - H flu
7
Q
ABx therapy in children
A
see table in 153
8
Q
def. fever without a source
A
acute febrile illness with no obv. cause after looking well
9
Q
def. fever of unknown origin
A
- daily
- 2 weeks
- no source
10
Q
4 DDx for fever
A
- infection
- inflammatory
- malignancy
- misc
11
Q
def. low risk based on rochester crit
A
- 1-3 month of age
- good past health
- >37wks
- home with mom
- no issues - Phx
- rectal
12
Q
when to do a workup for sepsis
A
sock, toxic looking child with no obv. cause, irritable, LOC
13
Q
6 parts of sepsis WO
A
- CBC and diff
- blood Cx
- urineanal and Cx
- LP
- CXR if resp Sx
- stool if diarrhea
14
Q
algorithm for non-toxic child
A
p 157
- if under 1mo - full workup
- if over 1 - rochester
15
Q
typical bugs for AOM
A
- S. pneumo
- M cata
- H flu
- viral
16
Q
risks for AOM
A
- young
- premature
- DS
- not breastfed
- daycare
- crowding
- smoke
- Hx
- immunodef.
17
Q
Hx of AOM
A
- ear tug
- N/V
- irritabel , fever
18
Q
Phx for AOM
A
- vitals
- HandN exam
19
Q
***3 requirements for AOM Dx
A
- rapid onset of ear pain
- signs of middle ear effusion
- immobile TM
- opacification
- air fluid levels - signs of middle ear inflammation
- bulging TM
20
Q
2 mgmts for AOM
A
- watchful waiting
- 48-72hrs
- if older than 6mos
- previously well
- not severe - ABx
- amox
- if fails clav
21
Q
complications of AOM
A
- perf and drainage
- earing loss
- mastoiditis
22
Q
def. sinusitis
A
inflammation of mucosal lining of sinuses
- 5-13% of URTIs
50% resolve spontaneously
23
Q
most common sinuses
A
- maxillary and ethmoid
24
Q
times of various types of sinusitis
A
acute - 10-30d
subacute - 30-90d
recurrent acute - 3x in 6 mos
chronic - >90d
25
work-up for sinusitis
NONE
| - xray would show opacification, air fluid levels
26
mgmt of sinusitis
amox - 75-80/kg/d x 10-14
27
complications of sinusitis
1. periorbital/orbital
- cellulitis
- abscess
- osteomyelitis
2. intracranial
- meningitis
- brain abscess
- empyema
3. pott's puffy tumor
- osteomyeltis and abscess of frontal bone
- Abx and ENT
28
diff between periorbital and orbital cellulitis
peri
- anterior to septum
- eyelid and periorbital structures
orbital
- spread deep to septum
- may involve optic nerve and muscles
29
common bugs in orbital
- staph
- strep
- H flu
30
sx that suggest orbital
- pain on eye movement
- diplopia
- visual loss
- proptosis
31
Phx signs that suggest orbital
- decreased EOM
- proptosis or displacement
- visual acuity
- disc swelling
32
invest. if suspect orbital
1. CBC
| 2. emergency CT
33
mgmt of orbital
- EMERG
- admit and ENT
- IV clox + IV ceftriaxone + IV clinda
- surgical mgmt
34
mgmt of periorbital
```
usually outpatient
if traumatic
- IV cefazolin/clox
non-traumatic
- IV ceftriaxone/cefotaxime
- mild can be PO
admit for
-
```
35
def pharygitis
inflamm of the pharynx - esp tonsils
36
common etiology of phar
1. viral most common
| 2. group A strep
37
feat of bact phary
- late winter
- 5-11yo
- sudden onset
- exudates
- tender and enlarged
38
feat. of viral phay
- all seasons
- all ages
- mild sore throat
- non-tender, no exudates
39
common viruses for pharyng
1. URT - rhino, flu, corona
2. adeno - with conjunctivitis
3. coxsackie - hand foot mouth
4. EBV - sig. exudates, HSM
40
fever associated with strep pharyng
- scarlet fever
- sandpaper rash
- begins on face and moves to flexural lines
41
2 tests for pharyng
1. rapid
- if neg. still need a culture
2. culture
42
mgmt of GAS phayrgitis
- need ABx, but hold until culture confirms, unless high index of suspicion and exposure
- need to prevent rheumatic fever
- does not prevent acute glomerulonephritis
- amox of pen V for 10 days
43
complications of pharyngitis
- suppurative - abscess or celluitis, otitits media
non-supputaive
- ARF
- AGN
44
most common cause of CAP
viruses
| - most can be treated outpatient
45
risk factors for CAP
- premature
- malnutrition
- SES
- smoke
- daycare
- crowding
- previous PNA
46
Phx findings for CAP
- fever
- cough
- tachypnea
- resp distress
- dulness on percussion
- tactile fremitus
- decreased breath sounds
-
47
invest. for CAP
- pulse ox
- CBC
- blood Cx
- CXR - 2 views - good to confirm
- chest US
- thoracentesis - for effusions
48
guidelines to Tx kids 3mos to 17 years with CAP
1. non severe - amox PO or ampicillin IV
- if atypical - clarythro
- if severe - ceftriaxone + axitho or clarythro
2. assess if has influenza
- if yes, give anti-viral and amox. clav
3. if has pleaural effusion
- consider tap
- use ceftriaxone and clinda
4. if seems like might have MRSA
- add vanco or linezolid
49
CAP needs hospital if:
1. toxic
2. age 70
5. resp distress
6. vomiting, decreased oral intake
7. failed oral therapy
8. large pleural eff
9. psychosocial
50
ICU for CAP if:
> 60% O2 needed
shock
increase RR and distress with signs of exhaustion
recurrent apnea or irreg. breathing
51
UTI prev. in kids with fever
5%
- more likely for males 4-6weeks
- more liekly females over 12
52
risk factors for UTI
- female
- toilet training
- dysfunct. voiding
- constipation
- tract abnormality
- labial adhesions
- intrumentation
- uncirc
53
presentation
- younger are very non-specific, fever and upset
| - older the usual
54
2 Phx finding of UTI
- fever
| - suprapubic tender
55
invest for UTI
- clean catch, cath, or suprapubic
- never use steile bag as culture
- unrinalysis - leuks, nitrites,
56
mgmt of UTI
ABx
- neonates- ampa + genta
- older - amox clav, cephalexin
- acute for 7 days
- pyelo for 10-14 days
57
imaging for UTI
should get and US of kidney and bladder to look for anatomic abnormalities
- VCUG if if US finds abnormalities
58
infant signs of meningitis
- fever
- poor feeding
- lethary
- crying a lot
- bulging fintanelle
- apnea
- petechaie
-
59
older child signs of meningitis
- fever
- HA
- vomiting
- neck pain/stiff
- photophobia
- kernig and bruds
- focal neuro
60
invest for meningitis
- LP definite
| - gramstain, culture, cell count, viruses, glucose and protein
61
bugs and Abx by age
```
0-28
- GBS, ecoli, listeria
- amp and cefotaxime
28-90
- overlap
- cefotaxime + vanco
90+
- strep pneumo, n meningitis, h flu
- ceftriaxone, + vanco
```
62
other care for meningitis
- suportive - CP and manage ICP
- dexmethasone - if older than 6 weeks
- - must be given prior to Abx
