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Flashcards in Peds Infectious Diseases Deck (154):
1

Avoid tetracycline and minocycline in kids <____ years old

8

2

Fluoroquinolone ophthalmic solutions not ind. in children <___ years old

1

3

Which layers of the meninges are involved with meningitis?

pia and arachnoid

4

At what age is the greatest chance of getting bacterial meningitis?

1st month of life

5

What are the most common causes of bacterial meningitis in the neonate?

Group B strep and E. Coli

6

Petechiae and purpura are most common with bacterial meningitis d/t what?

N. meningitidis

7

What will the CSF show if a pt has bacterial meningitis?

Elev. CSF protein, decreased CSF glucose

8

Typical empiric abx tx for neonates with meningitis typically includes?

ampicillin, gentamycin, +/- cefotaxime

9

What abx are used to treat bac. meningitis if it is for an infant or child?

3rd gen ceph and vanco

10

If a neonate survives meningitis, what should be evaluated after recovery?

hearing

11

What is the most common cause of viral meningitis?

enterovirus

12

What is the clinical presentation of enterovirus infections?

conjunctivitis, pharyngitis, rash, herpangina, hand-foot and mouth disease

13

What diagnostic study do you want to get if you suspect HSV encephalitis in a kid?

MRI

14

What type of conjunctivitis is more common in kids?

Bacterial

15

Bacterial conjunctivitis in kids is usually caused by what 3 bacteria?

H flu, M. catt, strep pneumo

16

First line therapy for bacterial conjunctivitis?

erythromycin ophthalmic ointment or polymyxin/trimethoprim drops

17

If conjunctive has a "bumpy" appearance, what should you think of?

viral conjunctivitis

18

What sinuses are present at birth?

maxillary and ethmoid

19

By what age do sphenoid sinuses normally develop?

5

20

These sinuses develop by 7-8 years of age

frontal

21

Children <6 have an avg of ?? colds per year with typical symptom duration of 14 days

6-8

22

Is a fever more or less common with school-aged children that have the common cold?

LESS

23

What should you tell parents to avoid when their child has a cold when their child is <12?

OTC cough and cold meds

24

What are the most common pathogens for acute bacterial rhinosinusitis?

m. catt, h flu, s. pneumo

25

When a child has a cold, when should you worry about acute bacterial rhinosinusitis?

If symptoms are present for > or equal to 10 days WITHOUT improvement

26

When is imaging necessary for acute bacterial rhinosinusitis?

If complications are suspected

27

What meds are NOT recommended for acute bacterial rhinosinusitis?

antihistamines

28

Complications of acute bacterial rhinosinusitis?

intracranial extension, periorbital and orbital cellulitis, septic cavernous sinus thrombosis, meningitis or brain abscess, osteomyelitis, epidural or subdural abscess

29

When is it considered chronic rhinosinusitis?

complex inflammatory condition of the paranasal sinuses lasting >12 weeks despite medical therapy

30

What are the most common pathogens of otitis externa?

P. aeruginosa, S. epidermidis, and S. aureus

31

This condition commonly presents with ear pain, pruritis, discharge and hearing loss

Otitis externa

32

With this ear condition, the TM should have NORMAL mobility but have evidence of erythema/edema?

Otitis externa

33

What age group has the peak occurence of otitis media?

btw 6-18 mos

34

When should you worry about eardrum rupture?

If sudden drainage occurs from the ear

35

Bulging TM think?

OM

36

Are decongestants/antihistamines rec. for AOM?

NO

37

When are abx useful with acute otitis media?

if the child is 2 with bilateral disease or otorrhea

38

First line therapy if abx are used for AOM?

amoxicillin

39

What is 2nd line therapy for AOM?

augmentin

40

When is AOM considered recurrent?

> or equal to 3 distinct and well documented episodes of AOM within 6 mos or > or equal to 4 episodes or AOM within 12 mos

41

What are treatment options for recurrent AOM?

Abx prophylaxis or refer for tympanostomy tubes

42

Presence of a middle ear effusion in the absence of acute signs/symptoms of infection is?

Serous Otitis Media

43

Serous Otitis Media is accompanied by ?

conductive hearing loss

44

Treatment options for serous otitis media?

referall for surgery or watchful waiting

45

EBV infection begins with?

malaise, HA, low grade fever

46

What will a PE look like with someone with EBV/Mono?

exudative tonsillopharyngitis, posterior cervical LAD, +/-spleno and hepatomegaly, and occ. rash

47

What is the most common cause of sore throat?

Viral tonsillopharyngitis

48

CBC will reveal what if someone has mono?

lymphocytosis

49

bacterial tonsillopharyngitis is typically d/t ?

Group A strep

50

What are signs/symptoms of group A strep infection?

scarlatiniform rash, palatal petechiae, pharyngeal exudate, vomiting, and tender cervical lymph nodes

51

Common age for bacterial strep?

5-12

52

Bacterial tonsillopharyngitis involves ANT or POST cervical LAD?

Anterior

53

What should you do if you think your patient has bac. strep throat but their rapid strep test is neg?

Should get confirmatory throat culture

54

What is the treatment for bacterial tonsillopharyngitis?

PCN V or amoxicillin; erythromycin if PCN allergy

55

When is strep throat no longer considered contagious?

until 24 hours after abx are started

56

What are Pastia's lines?

bright red color in creases of the underarm of someone who has scarlet fever

57

What is the treatment for scarlett fever?

PCN V or amoxicillin (same as for strep)

58

This condition typically occurs 14-28 days after strep throat or scarlett fever?

Rheumatic Fever

59

Rheumatic fever most commonly affects kids of what ages?

5-15

60

Pancarditis that results in chest pain and dyspnea is usually?

Rheumatic fever

61

Erythema marginatum and sydenham chorea can be assoc. with what condition?

Rheumatic Fever

62

What condition will you have an elevated or rising antistreptolysin O Ab titer?

Rheumatic Fever

63

What may a CBC show with Rheumatic Fever?

mild normochromic, normocytic anemia

64

Treatment of Rheumatic Fever?

Abx (acute and long term prophylaxis), antiinflammatories, and possibly antiepileptics if sydenham chorea is severe

65

What are the most common VALVULAR complications of Rheumatic Fever?

mitral and aortic stenosis

66

This disease is characterized by a thick pharyngeal membrane and marked cervical adenopathy

diptheria

67

What are the "3 D's" assoc. with? (drooling, dysphagia, and distress)?

Epiglottitis

68

How is someone's voice described if they have epiglottitis?

"hot potato" voice

69

What is the "classic presentation" of someone with epiglottitis?

respiratory distress, anxiety and the characteristic "tripod" or "sniffing" position

70

Thumbprint sign = ?

Epiglottitis

71

Treatment of epiglottitis?

Admit to hospital (ICU), maintain airway, broad spectrum abx, +/- CS, supportive care

72

Pharyngeal abscesses generally affect kids < what age?

<5

73

Symptoms of this disease can include dysphagia, stiff neck, torticollis, changes in voice quality, respiratory distress, neck swelling, trismus, chest pain and often have a fever

Pharyngeal abscess

74

Imaging for a potential pharyngeal abscess can include?

lateral neck Xray or CT

75

Tx of pharyngeal abscesses include?

Hospitalize, maintain airway, may req. surgical drainage, abx, supportive care

76

What are the "more serious" complications of the Mumps?

meningitis, encephalitis, and orchitis

77

What is the treatment for mumps?

Symptomatic

78

Acute bronchiolitis is usually caused by?

RSV

79

This condition usually affects kids <2 and usually occurs in the winter months?

Acute bronchiolitis

80

What is the typical course of acute bronchiolitis?

typically begins with 1-3 day hx or URI symptoms followed by fever, cough and mild resp. distress

81

Auscultory findings with acute bronchiolitis?

exp. wheezing, prolonged exp phase, coarse and fine crackles

82

What treatments are NOT rec. for acute bronchiolitis?

GC, Abx, antivirals, hypertonic saline, heliox

83

What meds can you trial with acute bronchiolitis?

Inhaled bronchodilators

84

How is a diagnosis of RSV confirmed?

analysis of respiratory secretions

85

Treatment of RSV? Infants? Older kids?

Supportive, older kids you can trial CS but not in infants

86

This resp. illness is char. by inspiratory stridor, cough, and hoarseness

Laryngotracheitis (Croup)

87

What is the hallmark sign of Croup?

Barking cough

88

Is croup more common in boys or girls?

boys

89

What virus most commonly causes Croup?

parainfluenza type 1

90

How long do Croup symptoms usually last?

3-7 days

91

The "steeple sign" on Xray indicates what?

subglottic narrowing (Croup)

92

What treatment can you possibly consider in Croup?

Single dose of CS

93

If patient has Croup with significant stridor, what therapy may you consider?

nebulized epi

94

Which pulm disease is assoc. with 3 different stages?

Pertussis

95

What is the "catarrhal" stage of pertussis?

nonspecific prodrome lasting 1-2 weeks

96

What is the "paroxysmal" stage of pertussis?

persistent coughing attacks lasting 2-6 weeks

97

What is the "convalescent" stage of pertussis?

cough decreases over several weeks to mos.

98

How do you treat pertussis?

abx if early in course (macrolides = 1st line), supportive care, bronchodilator therapy

99

When can kids with pertussis return to school?

5 days after Abx therapy

100

Obtain PA/AP view for CXR if child in question of PNA is <4?

AP

101

If child you think has PNA is >4, what view CXR should you obtain?

PA

102

When should you always hospitalize if a child has PNA?

If they are <3-6 months old with suspected bac. PNA

103

What is first line therapy for O/P tx of PNA?

amoxicillin

104

What is generally first line tx of PNA if the patient is in the hospital?

3rd gen. ceph

105

VIRAL PNA is more likely to occur when child has exposure to ?

sick contacts

106

Most common symptoms/signs of this are fever, cough, tachypnea, malaise, emesis, hypoxemia, decreased breath sounds, and crackles

bac. PNA

107

Bac. PNA in neonates is usually d/t?

Group B strep

108

Infants and children <5, which type of PNA is more common?

VIRAL

109

Children >5, what is the most common type of PNA?

Bacterial, S. pneumo, M. pneumo, and chlamydophilia pneumo

110

HSV 1 is commonly referred to as?

herpes labialis

111

How does HSV 1 usually present in kids?

gingivostomatitis

112

What other condition can occur with HSV 1 in kids?

keratitis

113

What can in utero transmission of HSV cause?

hydrops fetalis and fetal in utero demise

114

This disease affects everywhere on the body EXCEPT the mucous membranes?

Roseola Infantum

115

This disease has a course of 3-5 days of high fever followed by a rash

Roseola infantum

116

What is roseola infantum usually caused by?

herpes virus 6

117

What age is typically affected by roseola infantum?

young kids, btw 7-13 months of age

118

What type of rash does someone get with roseola infantum?

blanching macular or maculopapular rash

119

How long does the rash of roseola infantum persist usually?

1-2 days

120

Treatment of roseola infantum?

supportive, typically is self-limiting, can control fever with tylenol

121

Acute febrile illness of unk etiology = ?

Kawasaki Disease

122

This disease usually affects kids >5 and affects more boys than girls

Kawasaki Disease

123

W/ Kawasaki disease, what do symptoms occur from?

they occur as a result of widespread inflamm of medium and small sized blood vessels

124

If you have a kid with a fever that persists 7-10 days and is resistent to antipyretics, what should you think of ?

Kawasaki disease

125

Besides fever, what other symptoms are common with Kawasaki disease?

mucocutaneous inflamm--bilat. conjunctivitis, erythema of the lips and oral mucosa, rash

126

Conjunctivitis and strawberry tongue....think?

kawasaki disease

127

What is the treatment of kawasaki disease?

IVIG and ASA

128

What test should a kid with Kawasaki disease have at diagnosis and 6-8 weeks after onset?

ECHO

129

Erythema infectiosum is caused by?

parvovirus B19

130

What is erythema infectiousum?

a viral illness that leads to rash on cheeks, arms and legs

131

Erythema infectiosum occurs most often in what season?

Spring

132

With this disease, the kid's rash fades from the center outwards, giving a lacy appearance and typically resolves within 1-2 weeks

Erythema Infectiosum

133

Tx of erythema infectiosum?

Self limited, no tx

134

What are other names for erythema infectiosum?

Fifth disease, Slapped Cheek

135

How long is someone infected with Measles usually before they have symptoms?

8-12 days

136

What does the "prodrome" for measles look like?

fever, malaise, anorexia followed by conjunctivitis, coryza, and cough

137

What is the sign that is pathognomic for measles?

Koplik's spots

138

What is rash like assoc. with measles?

maculopapular, blanching rash beg. on the face and spreading cephalocaudaly

139

How long does a measles rash typically last? What happens after?

3-4 days, followed by fine desquamination

140

Tx of Measles?

Supportive

141

With this disease, you worry about congenital infections?

Rubella

142

_______= "3 day" or "German" measles

Rubella

143

All pregnant women are tested for immunity to this bc of risk of congenital infections?

Rubella

144

What is the most frequent defect assoc. with congenital rubella infection?

hearing loss, foll. by mental retardation, C/V defects and ocular defects

145

When is antiviral treatment indicated for chickenpox?

If the child is >12

146

Hand, foot and mouth disease is caused by ?

enteroviruses (coxsackie A16)

147

What age of kids usually get Hand, foot, and mouth disease?

<5

148

Rash for this disease are usually on the palms of the hands and soles of the feet?

Hand, foot, and mouth disease

149

Is there a vaccine to prevent Hand, foot and mouth disease?

No

150

What is the most sig. cause of ped. viral gastroenteritis worldwide?

Rotavirus

151

Disease occurence of rotavirus increases in what season(s)?

winter and spring

152

Is there a vaccine available for rotavirus?

Yes

153

What are RotaTeq and Rotarix vaccines for?

Rotavirus

154

What is more common in causing viral gastroenteritis now that there is a vaccine for rotavirus?

Norovirus