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Flashcards in peds80 Deck (49):
1

management of dog bite wounds

sutured; also give antibiotics like amoxicillin-clavulanic acid; tetanus prophylaxis if needed

2

victims of cat bites have a high risk of infection of what orgnism?

P. multicoda

3

cat scratch disease

regional lymphadenitis

4

metcarpophalyngeal joint

remember three phalanges and then the metacarpal

5

infections in human bites

infecton rate is high! Mixed bacterial infection is often present; other systemic infections like hep B, HIV, and syphillis may be transmitted

6

black widow spider- what does it look like

red or orange hour glass marking on its ventral surface

7

clinical features of a black widow spider bite

few local sx except for burning or a sharp pinprick; pathognomonic sx are severe htn and muscle cramps

8

management of black widow spider bite

local wound care (tetanus if needed); benzos or narcotics to relieve muscle cramps; lactrodectus antivenin is given for signs and sx suggestng severe envenomation

9

brown recluse spider- what does it look like?

brown violin shaped marking on the dorsum of the thorax

10

brown recluse spider bite clinical features

cytotoxic compound that destroys the tissues; bite initially little pain then 1-8 hrs later, a painful itchy papule that increases in size and discolors during the course of 3-4 days develops

11

systemic symptoms in brown recluse spider bite

may develop 24-48 hours after the bite

12

management of recluse spider bite

wound care and tetanus prophylaxis if needed; there is no antivenom

13

pit viper snake bite

venom is a mixture o proteolytic enzymes; local puncture marks and progressive swelling and ecchymosis

14

systemic effects of pit viper snakes

paresthesias of the scalp, periorbital fasciculations, weakness, diaphoresis, dizziness, nausea, and a metallic taste in the mouth; coagulopathy, thrombocytpenia, hypotension, and shock also

15

management of pit viper snake bite

immediate transport to closest Er; use crotalidae polyvalen antivenin within 4-6 hours; kids need more

16

complications of the pit snake antivenin

common; serum sickness and anaphylaxis

17

coral snake venom

neurotoxic venum; mild local swelling and severe systemic sx (paresthesias, vomiting, weakness, diplopia, fasciculations, confusion, resp distress)

18

management of coral snake bite

antivenon, local wound care, and supportive care

19

Ziehl-Neelson stain

for acid-fast bacili

20

silver stain

for funghi

21

Wright stain

stool white blood cells

22

intradermal tests

for TB and coccidioides immitis

23

antibody testing

for vruses (EBV, CMV, VZV, and HIV), toxoplasma gondii, bartonella henselae, and mycoplasma pneumonia

24

fever is defined as what?

rectal temp of 100.4 (38 deg) or higher

25

what are high risk groups that should be evaluated for serious infection?

infants less than 28 days because of immaturity of immune sys; older infants with fecers over 39 deg who appear ill; infants and kids who are immunodef, have SS disease, or chronic liver, renal, pulm, or cardiac dz

26

toxic appearance

child appearing extremely ill with diminished interactivity or poor peripheral perfusion

27

normal band count

a band is a young neutrophil; less than 3% is normal

28

normal urinalysis

less than 10 WBCs per HPF

29

normal stool analysis WBC count

less than 5 WBCs per hpf on stool Wright stain

30

when do you hospitalize a kid with a fever?

all infants less than 28 days; infants between 29 days and 3 months with any of the following: toxic appearance, suspected meningitis, pneumonia, pyeloneph, or bone or soft tissue infections unrespons to oral antibiotics; patients in social circumstances in which there is uncertain follow up

31

antibiotic management for infants less than 28 days

IV in the hospital until cultures of blood, urine, CSF, and stool, if diarrhea is present, are neg

32

antibiotic management of infants 29days to 3 mos

empiric outpatient parenteral antibiotic therapy on a daily basis while cultures are pending; unless they are high risk, and those need to be hospitalized

33

most common bacterial pathogens in 0-1 month olds

Group B strep, E. coli, listeria

34

most common bacteria in 1-3 month olds

group B strep, strep pneumonia, listeria

35

most common bacteria in 3 months-3 years

strep pneumonia, Haemophilus influenza type B, neisseria meningitidis

36

most common bacteria in 3 years to adults

strep pneumoniae, neisseria meningitidis

37

empiric IV antibiotics for 0-1 month old

Ampciillin + gentamycin or cefotaxime; IV acyclovir if kid has apnea, seizures, or cutaneous vesicles for HSV

38

empiric IV antibiotics for 1-3 month olds

ampciillin + cefotoxamine (+ vanc if bacterial meningitis suspected, given that strep pneumo can be resistant to cef)

39

empiric IV antibiotics for 3 months to 3 yeasr

cefotoxamine (+vanc if bacterial mening suspected)

40

empiric IV antibiotics for 3 years to adults

cefotoxamine (+vanc if bacterial meningitis suspected)

41

definition of fever of unknown origin

greater than 8 days in length; prior history, physical exam,a dna prelim lab eval all fail to lead to diagnosis

42

when is the highest incidence of bacterial meningitis?

first month of life

43

what could potentially meningitis do to a fontanelle?

bulging fontanelle

44

signs suggestive of meningeal irritation

alteration in level of consciousness; nuchal rigidity (pos Kernig's sign and Brudzinski's sign); seizures; photophobia; emesis; headache

45

kernig's sign

severe stiffness of the hamstrings causes inability to straighten the leg when the hip is flexed

46

brudzinski sign

severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed

47

LP of meningitis has a predom of what type of cell?

neutrophils

48

blood culture in bacterial meningitis?

yes, do it; because usually positive

49

do you need to do a brain CT scan with contrast for suspected meningitis?

yes, because you might have a brain abscess