Peds 11 Flashcards
(52 cards)
What are names of inhaled glucocorticoids used for asthma
Budesonide, Fluticasone, Beclomethasone
What are names of systemic glucocorticoids used for asthms
Oral prednisone/prednisolone or dexamethasone
IV methylprednisolone
Describe clinical presentation of HUS
♣ Findings (triad):
• Microangiopathic hemolytic anemia
• Renal insufficiency (thrombi involve vessels of the kidney)
• Thrombocytopenia
Often preceded by diarrhea (caused by E. Coli or Shigella)
Describe pathogenesis of thrombotic thrombocytopenic purpura (TTP)
♣ Platelets used up in pathologic formation of microthrombi in small vessels
♣ Due to decreased ADAMTS13, enzyme that normally cleaves vWF for degradation
• No vWF degradation = abnormal platelet adhesion = microthrombi
Describe clinical presentation of TTP
♣ Findings (Pentad):
• Thrombocytopenia = platelets being used up
• Microangiopathic hemolytic anemia = RBCs sheared by microthrombi
• Renal insufficiency (thrombi involve vessels of the kidney)
• Neurological symptoms (confusion, HA, seizures, coma) – thrombi involve vessels of CNS
• Fever
Describe pathogenesis of immune thrombocytopenic purpura (ITP)
♣ IgG autoantibodies to GP2b3a
♣ Antibodies produced by plasma cells of spleen and antibody-bound platelets consumed by macrophages of spleen
Clinical presentation of ITP
- Decreased platelet count
- Increased megakaryocytes on bone marrow biopsy
♣ Often triggered by preceding viral illness
o WBC and hemoglobin levels will be normal (unless excessive bleeding has occurred) because bone marrow infiltration does not occur
Tx of ITP
- Usually a self-limited disease
- Steroids and IVIG (autoimmune treatment)
- Platelet transfusion for life-threatening bleeding
- Splenectomy for serious complications without response to other therapies
What platelet count is considered thrombocytopenia
< 150,000 (nl = 150-400)
What is a normal WBC
4,500-11,000
Describe presentation of Henoch Schonlein purpura
o Most common vasculitis in children o Follows URI infections o Findings: ♣ Palpable purpura on butt and legs ♣ Arthralgias ♣ Abdominal pain ♣ Renal disease – IgA nephropathy (IgA immune complexes deposited in mesangium) aka Berger disease
Treatment of Henoch Scholnein purpura
♣ Disease is self-limited
♣ Steroids if severe
Necessary testing/tx of Kawasaki
♣ Echocardiography to identify coronary artery abnormalities, pericarditis, CHF, and valvular regurgitation
♣ Aspirin (to prevent thrombosis of coronary arteries)
♣ IVIG
Diagnostic criteria for Kawasaki
♣ Fever lasting > 5 days with at least 4 out of five of the following:
• Bilateral bulbar conjunctival injection
• Oral mucous membrane changes, including injected or fissured lips, injected pharynx, or strawberry tongue
• Peripheral extremity changes, including erythema or palms or soles, edema of hands or feet, and periungual desquamation
• Polymorphous rash
• Cervical lymphadenopathy
Describe presentation of Scarlet fever
o 3 main symptoms
♣ 1) redness and swelling of tongue (strawberry tongue)
♣ 2) pharyngitis
♣ 3) widespread rash that spares the face
• Rash has a “sandpaper” texture with accentuation in flexural creases known as Pastia lines
Diseases caused by H. Flu
- pneumonia
- epiglottitis
- otitis media
- meningitis
- sepsis
- septic arthritis
Two general names of diseases caused by Legionella
Pontiac fever and Legionnaire’s disease
Describe presentation of Pontiac disease
fever and malaise - usually self-limiting
Describe presentation of Legionnaire’s disease
Atypical pneumonia Unique characteristics: - hyponatremia - neuro sx (HA and confusion) - diarrhea - high fever
Tx of Legionairre disease
Macrolides, Fluoroquinolones
Describe clinical findings of Henoch Schonlein purpura
♣ Palpable purpura on butt and legs ♣ Arthralgias ♣ Abdominal pain • Intussusception is most common GI complication – intestinal edema and bleeding can act as a lead point Renal disease – IgA nephropathy
Tx of Henoch Schonlein
♣ Disease is self-limited
♣ Steroids if severe
Presentation and tx of Reye syndrome
o Clinical features
♣ Acute liver failure
♣ Enceophalopathy
o Treatment
♣ Supportive
Describe difference in CSF between bacterial and viral meningitis
o Bacterial meningitis
♣ WBC: > 1000
♣ Glucose: <40
♣ Protein: >250
o Viral meningitis
♣ WBC: 100-1000
♣ Glucose: 40-70
♣ Protein: >250
