Infectious, Nelson + Misc Flashcards
(295 cards)
1
Q
condition seen in using erythromycin as treatment of pertussis in infants less than 1 month
A
infantile hypertrophic pyloric stenosis
2
Q
bacteria associated with miller fisher syndrome
A
campylobacter jejuni
3
Q
characteristic skin lesion of pseudomonas
A
echthyma gangrenosusm
4
Q
acute angulation of the chin and larynx cause by weakness of the hyoid muscle due to Polio
A
rope sign
5
Q
called the first disease
A
measles (rubeola)
6
Q
called second disease
A
scarlet fever
7
Q
it is called the third disease
A
rubella
8
Q
fourth disease is called
A
filatov-dukes disease (atypical scarlet)
9
Q
6th disease is called
A
roseola infantum / exanthem subitum
10
Q
incubation period of hepatitis A
A
15-50 days
11
Q
bacteria with appendicitis like symptom diarrhea
A
yersinia enterocolitica
12
Q
triad of EBV
A
fatigue, generalized lymphadenopathy, pharyngitis
13
Q
the atypical lymphocytes characteristic of mononucleosis
A
cd8 t lymphocytes
14
Q
x linked lypmhoproliferative syndrome of Duncans syndrome is associated with what disease
A
EBV infection
15
Q
this type of lymphadenopathy is suggestive of infectious mononucleosis
A
epitrochlear lymphadenopathy
16
Q
this happens to patients with ebv treated with ampicillin
A
ampicillin rash
17
Q
rash on the cheek with multiple papules seen in ebv is seen in what syndrome
A
gianotti-crosti syndrome
18
Q
diagnosis of ebv is done through __
A
specific antibody or heliotrope Ab
19
Q
what is the most feared complication of EBV
A
splenic rupture or subcapsular hemorrhage
20
Q
exanthem subitum or 6th disease is caused by
A
HHV-6
21
Q
fever for 3 days then fever lyses and a pink morbilliform rash appears in the trunks the face and extremities; the rash lasts for 1-3 days and on PE; there are ulcers in the palatoglossal junction; what is the diagnosis and what do you call the ulcers
A
roseola (infantum subitum); nagayama spots
22
Q
virus that causes kaposi sarcoma
A
HHV8
23
Q
children aged___ can not receive influenza vaccine
A
Less than 6 months
24
Q
how many doses in influenza vaccine
A
2 doses 1 month apart for 6-36 month
25
what is the first sign of infection in infants with rsv
rhinorrhea
26
Infectious diarrhea without bloody stool and wbc is caused by
rotavirus
27
what coagulation factor is depressed in dengue
factor 12 hageman factor
28
what are the criteria for dengue hemorrhagic fever
fever for 2-7 days, biphasic; major or minor hemorrhagic manifestations (thrombocytopenia less than or equal to 100); increase capillary permeability ( inc HCT by = 20%); pleural eff/hyoalb/ ascitis
29
what is the pathologic hallmark of rabies
negri bodies
30
clinical for of rabies where there is throat pain, malaise, paresthesia and pruritus in the bite site then cns manifestation and phobic spasms
furious or encephalitic
31
form of rabies that is characterized by fever and ascending motor weakness affecting both limbs and cranial nerves
paralytic or dumb rabies
32
cardinal signs of rabies
hydrophobia and aerophobia
33
rabies vaccine alters the course of the disease. T or F
false. neithere vaccine or IG can alter the course of the disease once sx appeared
34
vaccine in rabies and Ig are contraindicated once Sx develop. T or F
TRUE
35
pre exposure immunization for rabies
3 IM injections at day 0, 7, 21 or 28; if the patient had pre exposure prophy before you give 2 dose of vaccine no Ig on days 0 and 3
36
patients with this disease is resistant to malaria
sickle cell
37
erythrocyte without duffy antigen is resistant to what malaria sp.
p. vivax
38
___ are resistant to p falciparum
Hg F (fetal Hgb); ovalocytes
39
paroxysmal fever occur with rupture of schizonts that occurs every__ hr in p. vivax and ovale
42 hrs
40
paroxysmal fever occur with rupture of schizonts that occurs every__ hr in p. mlariae
72 hrs
41
nephrotic syndrome is associated with what malaria sp.
p. malariae
42
contraindication to coartem medication in malaria
children with prolonged QT
43
katayama fever is caused by
acute schistomiasis
44
cicatrial penetration of of schistosomiasis in the skin
swimmers itch or schisto dermatitis
45
shisto that causes hematuria
hematobium
46
shisto that can migrate to the brain
japonicum
47
shisto that causes transverse myelitis
hematobium; mansoni
48
laboratory test for shisto
microscopy of miday 10ml urine; katokatz of stool
49
tx of shisto
praziquantel 40mg for hematobium, mansoni, intercalatum; prazi 60 mg for japonicum and mengkongi; oxaminiquine for mansoni
50
taenia that causes neurocysticercosis
taenia solium
51
tx for taenia
albendazole
52
tx for ascariasis
albendazole
53
tx for trichuris
mebendazole
54
whipworm causes
trichuriasis
55
what is the diagnosis of pin worm or enterobius
cellophane tape in the morning
56
produces deep blue punctate rash
toxoplasmosis
57
dx of malaria
giemsa stain; thin smear allows for positive identification of malaria sp
58
poor prognostic indicator of severe malaria
respiratory distress
59
patients with measles are infective from
3 days before rash until 4-6 after onset of rah
60
pathognomonic for rubeola ( measles)
warthin-finkeldey giant cell
61
virus shedding begins in what phase of measles
prodromal phase
62
viral replication subside on the onset of __
rash
63
pathognomonic SIGN of measles
koplik spot
64
this appears 1-4 days prior to appearance of rash in measles
koplik spot
65
lab findings in measles
decrease in total wbc count with lympho decreased more than neutrophils; normal esr and crp
66
measles igm is detectable in blood when
1-2 days after the onset of rash ( 72 hrs)
67
morbidity and mortality is greatest in measles in what age group
less than 5 and more than 20
68
most common cause of death in measles
pneumonia ( giant cell pneumonia)
69
most common bacterial pathogen in pneumonia of measles
PIA; pneumoniae, influenzae, aureus
70
most common complication of measles
otitis media
71
csf findings in measles encephalitis
lymphocytosis and elevated protein
72
what protein is missing in measles virus in sspe patients
M protein
73
manifestation of sspe begins at what age
7-13 yrs after primary infection
74
in stage 1 of sspe -- there is temper tantrums; in the second phase what is the hallmark
massive myoclonus
75
diagnostic criteria of sspe
1 of the ff: measles antibody in csf, eeg with suppression burst, brain tissue biopsy of sspe
76
vit A treatment in measles
* 6m-2 yrs with complication (50,00iu for 6m-1yr and 100,000iu in more than 1yr OD)
77
you should avoid immunization of measles in what condition
severe hypersensitivity to neomycin and gelatin
78
vaccine is effective in modification of measles if pre exposure prophylaxis is given when
within 72 hr of exposure
79
measles Ig may be given up to __ days after exposure to prevent or modify infection (0.25 in immunocompetent and 0.5 immunocompromised)
6 days
80
virus shedding for rubella starts when
10 days after infection
81
highest infectivity for rubella is seen when
5 days before rash and 6 days after rash
82
in congenital rubella infection, what trimester results in severe defects
1st 8 wks of pregnancy
83
rash begins in the hairline then trunk extremities then palms
measles (rubeola)
84
rash begins in face that spreads centrifugally (trunk to extremities)
rubella [THINK Centri-petal = center seeking, centri-fugal = center fleeing]
85
rose colored lesion seen in rubella
forschheimer spots
86
the sspe counter equivalent in rubella
PRP progressive rubella panencephalitis
87
single most common finding in infants with CRS (congenital rubella syndrome)
deafness
88
most serious eye finding in CRS (congenital rubella syndrome) and what is the most common ocular abnormality
* cataract; * salt and pepper retinopathy
89
most common heart defect in CRS
PDA
90
most devastating result of polio
paralysis
91
paralysis in polio appears when
3-8 days after initial symptom
92
occurs in the 2nd phase of polio with severe muscle pain asymmetric flaccid paralysis with paresis commonly involving 1 leg
spinal paralytic polio
93
polio after IM injection
provocation paralysis
94
rope sign, dysfunction of cranial nerves, palatal and pharyngeal weakness , ascending paralysis. what disease
bulbar polio
95
diagnosis of polio
2 stool exam 24-48 hrs apart
96
vaccine associated paralytic polio
polio after receiving oral polio 7-14 days before
97
hand and foot mouth disease is caused by
cocksakie A16
98
enterovirus that causes myocaridtis and pericarditis
cocksackie B
99
most common cause of meningitis in mumps immunized population
enterovirus
100
enterovirus that does not grow in culture
cocksackie A
101
cause of 5th disease or erythema infectiousum
parvovirus b19
102
this virus affects the erythroid cell line and has no effect on myeloid thus causes aplastic crisis
parvovirus B19
103
virus associated with hydrops fetalis
parvovirus b19
104
slapped cheek
5th disease - parvovirus b19
105
what is the most common manifestation of parvovirus b19 in immunocompromised
chronic anemia
106
syndrome of parvovirus b19 that is characterized as purpuric rash in hands and feet
papular purpuric sock and gloves syndrome
107
what is not used as a treatment of parvovirusb19 induced arthropathy
IVIG
108
where does latent hsv and VZV lays dormat
in the sensory ganglion neuron
109
leading cause of fatal encephalitis in children
hsv encephalitis
110
hallmark of hsv infection
skin vesicles and ulcers
111
6 mos - 5yrs, painful vesicles in the mouth , drooling, sudden onset. what is the diagnosis
herpetic gingivostomatitis
112
herpes from rugby playing
scrumpox
113
herpes from wrestling
herpes gladiatorum
114
hsv of the paronchia seen in patients who suck their thumb
whitlow
115
csf analysis of this disease shows moderate mononuclear, erythrocytes, protein increase and normal to low glucose
hsv encephalitis
116
hsv, recurrent aspetic meningitis called
mollaret meningitis
117
most common aseptic meningitis
HSV (other: coxsackie b)
118
fever is uncommon in this type of encephalitis
hsv enceph
119
the best test for hsv infection
viral detection by pcr or virus isolation
120
tx for hsv
acyclovir
121
tx of herpes labialis
oral valacyclovir
122
in hepes gladiatorum what meds can prevent recurrence
oral valacyclovir
123
hsv associated erythema multiforme is treated with antivirals T or F
false, it has no effect
124
chicken pox is infective during
1-2 days before vesicles and 3-7 days after when they are crusted
125
illness of varicella being __ days after exposure
14-16 days
126
incubation period of varicella
10-21 days
127
simultaneous presence of lesion in various stage is characteristic of what infection
varicella
128
distribution of rash in varicella is __
centripetal [THINK Centri-petal = center seeking, centri-fugal = center fleeing]
129
varicella that occurs in person vaccinated more than 42 days before rash
breakthrough disease caused by wild type of varicella
130
if the mother has varicella __ days prior to delivery she may pass the virus to the child but it is attenuated since there is Ab of the mother passed also.
more than 5 days
131
maternal varicela IgG can pass through the placenta at what aog
by 30 wks
132
neonate with cicatrical skin scarring with limb hypoplasia and neurologic manifestation
congenital varicella syndrome
133
leukopenia is low in the first __ of varicella infection
72 hrs
134
varicella vaccine is given when
total of 2 dose on 12-15 months and 4-6 year old; pag catch up na less than 12 -- 2 dose 3 months apart and pag more than 12, 2 dose na 1 month apart
135
post exposure prophy for varicella can be given if exposure is
3- 5 days after exposure
136
new borns whose mother has varicella 5 days before delivery or 2 days after delivery should be given
1 vial of Varicella Ig
137
amphotericin is inactive in this sp of candida
c. lusitanea
138
fluconazole is inactive againts this strain of candida
c. krusei and some gabrata
139
what is the most common clinical syndromes associated with m. pneumoniae infection
tracheobronchitis and bronchopneumonia
140
lobar infiltrates with necrotizing pneumonia with normal wbc but elevated esr
m. pneumoniae infection
141
tx for m pneumoniae infection
claryth or azith
142
bacteria that is the most common infectious agent in SJS
m. pneumoniae
143
treatment for NGU (ureaoplasma and m. hominis)
1 dose azith and doxy for 7 dyas
144
the absence of ___ differentiates c trachomatis pneumonia from rsv
fever and wheezing
145
blood result of c trachomatis infection shows increased
peripheral eosinophilia
146
the most common cause of pyogenic skin and soft tissue infection
s. aureus
147
TSS caused by staph aureus is associated with
mensturation and focal staph infection
148
food poisoning caused by s. aureus is caused by ingestion of ___
preformed toxin
149
tx of life threatening s aureus infection
vanco plus genta or vanco plus rif
150
tx for non life threatening aureus infection
nafcillin or oxacillin; clindamycin
151
tx for mrsa
vanco + genta or ; vanco + rif
152
drug test that confirms effectivity of clinda for aureus infection
D-test
153
diagnosis of tss is based on __
clinical manifestation
154
major criteria of TSS caused by aureus in which all are required
REMEMBER: HAR-Tss -- hypotension, acute fever, rash
155
scarliniform rash with desquamation of the hands and soles associated with shock, strawberry tongue
TSS aureus
156
most common cause of nosocomial bacteremia associated with vascular catheter
CONS particularly s. epidermidis
157
most common cause of shunt meningitis
CONS
158
most common cause of uti in sexually active females
saphrophyticus
159
DOC of CONS
vanco
160
the second most common cause of meningitis in children
strep pnemoniae
161
round pneumonia with 2 day hx of cough and spiking fever. there is also leukocytosis. what is the dlt
strep pneumonia, culture, cefotaxime ceftri clinca vanco
162
if erythromycin is resistant to streo pneumo and clinda is sensitive what should you do
do a D-test of clinda, if it is positive you can not use it anymore since resistance with clinda can be induced by the organism
163
the most common cause of osteomy and suppurative arthritis in children
s. aureus
164
penicillin prophylaxis is often administered for at least ___ after splenectomy
2 yrs after or upto 5 yrs of age
165
pneumococcal vaccination is given
* 3 doses 1 month apart for 2-6 mos then booster at 12 to 15 months * 2 doses 2 months apart for 7-11 mos with booster on 12-15 mos * if more than 1 year old 2 doses no booster
166
what strep pyogenic exotoxin is responsible for the rash of scarlet fever
toxin A,B,C
167
patient has upper respiratory tract infection and on after 24- 48 hrs punctate rash on the neck spreading to the trunk which blanches on pressure. the skin is rough and has goose pimple feel. no rash on the face after 3 days the rash desquamates cephalocuadally. there is strawberry tongue appearance
scarlet fever caused byGAS
168
swollen red tender superficial bleb on the skin that has slightly elevated border involving the deeper layer of the skin
erysepelas caused by GAS
169
the most common cause of prepubertal vaginits
GAS
170
criteria of strep tss
clinical criteria: hypotension plus 2 of CHARGS - coagulopathy- hepatic involvement - ards - generalized rash - renal impairment - soft tissue necrosis; definitive case: culture form sterile site
171
the most common cause of acute paryngitis
virus
172
most common cause of bacterial phayrngitis
GAS
173
DOC of GAS
penicillin
174
bacteria associated with PANDAS ( neurospsychiatric disease ) TiC,tourettes, chorea
GAS
175
if treatment is started within _ days of onset for GAS infection, rheumatic fever is prevented
9 days
176
major jones criteria
SPECC - subcutaneous nodules - polyarthritis - erythema marginatum - chorea - carditis
177
minor jones criteria
CAPE FP - crp elevated - arthralgia - phase reactants - esr - fever - prolonged pr interval
178
positive result in jones criteria
2 major or 1 major 2 minor
179
may occur as the only manifestation of acute rheumatic fever
chorea
180
the only manifestation of acute rheumatic fever months after having acute rheumatic fever
carditis
181
the joints affected in ARhF
larger joints (WEAK) - wrist - elbows - ankles - knees
182
True or False
TRUE
183
most serious manifestation of ArhF
carditis ( particularly Endocarditis) and chronic rheumatic heart disease
184
major consequence of rheumatic carditis
valvular stenosis
185
erythematous,serpinginous macular lesion with pale centers that are non puritic seen in trunk and extremities only. it is seen in ArhF
erythema marginatum
186
tx for ArhF
10 days of pen G or 1 dose of IM Benz PenG then start long term prophylaxis
187
in patients with carditis in ARhF what meds should you start aside from pen G
aspirin, prednisone
188
DOC for syndenhams chorea
Phenobarbital, if not effective you give haloperidol or chlorpromazine
189
antibiotic prophlaxis for ARhF should continue for how long
for 5 yrs or until 21 yrs old whichever is longer
190
what is the prophy antibiotic regimen for ARhF
600,00IU in
191
duration of treatment for RF with carditis
10 yrs or until 21 yrs which ever is longest
192
duration of treatment for RF with residual heart disease or valvular disease and carditits
10 yrs or until 40 yrs which ever is longer ( sometimes lifelong treatment is needed)
193
late onset GBS infection presents in __ days
more than 7 days
194
more common serotypes in late onset GBS
serotype III
195
the most common manifestation of early onset GBS is
sepsis
196
the most common manifestation of late onset GBS is
bacterimia and meningitis
197
late onset GBS infection is more severe than early onse. True or False
TRUE
198
syndromes common in childhood GBS disease beyond early infancy
bacteremia and endocarditis
199
doc of GBS
Penicillin
200
duration of treatment for GBS ventriculitis and oseteomyelitis
4 weeks
201
duration of treatment for bacteremia without focus in GBS
10 days
202
duration of treatment for GBS meningitis
2-3 weeks
203
periventricular leukomalacia and dev delay are complications of what disease causing meningitis
GBS
204
corynobacterium that is urease positive
C. ulcerans
205
most common site of diptheria
pharynx and tonsils; the second is nose and larynx
206
the universal early sx of diptheria
sore throat
207
bull neck appearance
diptheria
208
tissue affected by diptheretic toxin
heart and CNS
209
tx of diptheria
diphtheria antitoxin; erythromycin for carriage
210
when an asymptomatic carrier is identified prophylaxis for diptheria is given for how many days
10-14 days then give dt if no booster as been given within 1 yr
211
the only contraindication for tetanus and diptheria toxoid
hx of neurologic or severe hypersensitivity reaction to previous dose
212
Diptheroid toxin should be not be given frequently than every __
10 yrs
213
umbrella type formation in medium is characteristic of what bacteria
listeria
214
the only mode of transmission of listeria
maternal fetal transmission only
215
most common manifestation of late onset listeriosis ( >/= 5 days)
neonatal meningitis
216
manifestation of early onset listeria
neonatal sepsis
217
history of oral trauma/ dental procedure; painless slow growing mass with fistula; what is it called and is the etiologic agent
lumpy jaw; actinomycosis
218
the hallmark of actinomycosis
spread that fails to respect tissue or facial planes
219
the pathogenic strain of n. meningitidis
A,B,C, W-135 and Y
220
what age is the highest incidence of meninggococal disease
less than 1 yr old
221
what are the clinical hallmark of severe meningococcal sepsis
activating coagulation, bleeding, stimulating cytokine
222
the severity of meninggococcal disease is related to the level of exotoxin in the bloodstream; true or false
false, endotoxin related
223
diffuse adrenal hemorrhage without vasculitis seen in fulminant meningococcemia is called what syndrome
waterhouse-friderchisen syndrome
224
a meningococcemia that progresses from without sx to shock in several hours and purpura
fulminant meninggococcemia
225
diagnostics of meningo and treatment
culture of blood csf or synovial fluid; penicillin ampi ceftri
226
most common neurologic sequelae of meningo meningitis
deafness
227
prophylaxis for Neisseria carriage
rifam 15- 10mgkg for 2 days a cipro one dose
228
meninggo vaccine recommendation
one dose at 11-19 yrs old booster after 5 yrs; if high risk group 2 dose 2 months apart
229
most common sexually transmitted infection in sexually abused children
n gonorrhea
230
cause PID in post pubertal females
gonorrhea
231
dissemination of gonorrhea from fallopian tube through the peritoneum to the liver capsule causing perihepatitis is seen what syndrome
fitz hugh curtis syndrome
232
initial sx of disseminated gonorrhea
acute onset poly arthralgia with fever
233
tx of gonorrhea
ceftriaxone (even in pregnant and for neonates )IM single dose or cefixime single dose
234
doc of H influenza
amoxicillin
235
what are the most common cabteria of otitis media? otitis externa?
* PIM - s. pneumoniae, h. influ, moraxella * pseudomonas
236
prophylaxis for h influ exposure
rifampicin for 4 days
237
painful genital ulceration (chancroid) is caused by
h. ducreyi
238
buboes are formed by
h ducreyi
239
tx for chancroid
azith OD or Ceftri IM OD
240
severe coughing episodes with extreme gasps for air followed by vomiting
pertussis
241
neither natural disease nor vaccination provides complete or lifelong immunity against this bacteria. protection wanes 3- 5 yrs after vaccination
pertussis; DTaP protective until adolescence
242
Contraindications to DTaP
-immediate anaphylactic reaction, encephalopathy, CNS complication w/in 7 d --> give DT instead of DTaP (adverse reactioins attributed to *pertussis* component of vaccine)
243
__- marks the start of paroxysmal stage of pertussis
coughing
244
infants __ age does not manifest the classic stage of pertussis -- sudden onset of reddening of face, choking, gagging and gasping (ALTE)
less than 3 months
245
leukocytosis is seen in what stage of pertussis
cattarhal stage
246
not a manifestation of pertussis
eosinophilia
247
tx of pertussis
macrolide (azith is preferred) x 14 days -- catarrhal stage; hospitalize infant
248
machine gun-like cough
pertussis
249
Stages of whooping cough
1) catarrhal stage: congestion & rhinorrhea; 2 wks 2) paroxysmal stage: coughing + gasping for air + vomiting + burst of eye blood vessels; 3o days 3) convalescent stage: decreased cough freq; 2 wks
250
-CXR: "butterfly pattern"(clouded mid lung fields)
pertussis
251
Whooping cough, Retinal hemorrhage, child stroke
pertussis
252
#1 child preventable dz
pertussis
253
the most common clinical presentation of salmonellosis
acute enteritis
254
tx of salmonella AGE
ceftri, cefotox, ampi ceficime
255
incubation of typhoi
1-2 wks
256
rash in typhoid
rose spot in trunk on 7th day of illness
257
most common extra intestinal manifestation of bacillary dysentery (shigella)
neurologic
258
most common complication of shigellosis
dehydration
259
tx of shigellosis irrespective of age
ciprofloxacin
260
e coli that causes bloody diarrhea
invasive and shiga toxin
261
antibiotic should not be given to this type of e coli because it may increase the risk of HUS
STEC
262
most severe form of cholera
cholera gravis
263
DOC for severe cholera
doxycycline or tetracycline; alternative is erythromycine
264
syndrome associated with campylobacter
GBS
265
yersinia enterocolitica is associated with what vasculitis
kawasaki
266
ecthyma gangrenosum ( gangrenous skin lesion with eschar ) is caused by
pseudomonas
267
prominent symptom of infant botulism
loss of head control
268
antibiotic therapy is not part of the treatment of this disease
infant botulinism -- toxin is intracellular
269
clinical hallmark of botulism
fatiguability with repetitive muscle activity
270
__source of botulism, not a safe food for children less than 1 yr
honey
271
localized tetanus involving bulbar musculature is called
cephalic tetanus
272
poor prognosis in tetanus is onset of trismus in less than 7 days and onset of tetanic spasm in __-
less than 3 days
273
flesh eating bacteria
gas
274
measles Ig is given until how many days post exposure
vaccine is given 72 hrs; Ig is given until 6 days
275
what complement is decreased in dengue
c3
276
rash of dengue
morbilliform rash that spares the palms and soles
277
criteria for dengue hemorrhagic fever
fever, major/minor bleeding, thrombocytopenia (= 100), increase permeability (hct >20%), effusion (ascitis/pleural eft), hypoalbuminemia
278
dengue shock criteria
criteria of hemorrhagic + hypotension, narrow pulse, poor perfusion, tachycardia
279
h/o vaccination delinquency; hot potato voice(muffled); fever; drooling in tripod position; refuses to lie flat
Epiglotitis
280
T/F Epiglotitis is a life-threatening emergency
T
281
T/F In Epiglotitis, do not inspect airway
T, bronchospasm may completely obstruct the airway
282
what agent causes epiglottitis
unimmunized-haemophilus influenza type B; immunized-streptococcus spp
283
*acute onset high fever*,*Respiratory distress*: drooling, dysphagia, inspiratory retractions, neck hyperextension, sniffing dog position, leaning forward
Epiglotitis
284
Xray is the initial diagnostic test for epiglotitis
F
285
how to treat epiglottitis
-intubation in OR(initial!) -tracheostomy(2ndary) -ceftriaxone for 7-10 days -rifampin to all close contacts!
286
Definitive diagnosis of epiglottitis
fiberoptic visualization of cherry red epiglottis
287
floppy epiglottis, disproportionately small soft larynx; noisy breathing, worse with lying on back (gravity); larygoscopy: collapse of laryngeal structures during inspiration; no treatment needed, resolves by 18 months
traceomalacia/laryngomalacia
288
MCC of stridor in children
traceomalacia/laryngomalacia
289
what does the steeple sign specify in resp tract imaging
croup (LTB), represents SUBGLOTTIC narrowing
290
what causes croup
parainfluenza virus 1 & 2 (mcc); RSV(2nd mcc)
291
barking cough!; coryza; INSPIRATORY stridor; worse dyspnea upon lying down + possible hypoxia (not in epiglottitis!, develops later)
croup (LTB)
292
how to dx croup (LTB)
1) clinical(initial) 2) XR: steeple sign!; not initial next step!
293
Treatment of Croup based on severity
1) mild: cool mist tx, fluids 2) moderate: supp O2, IM corticosteriods, nebulized racemic epinephrine 3) severe: nebulized racemic epinephrine-racemic (not intubation (for epiglottitis)!)
294
inflammation of the larynx w/in the sub-glottic space
croup (LTB)
295
Seal-like cough
Croup
