Term
| What should you be concerned about if a baby is drinking goat's milk? |
|
Definition
| folate or B12 deficiency leading to megaloblastic anemia; brucellosis if milk is unpasteurized because goats are particularly susceptible |
|
|
Term
| What is a lactovegetarian? |
|
Definition
| diet devoid of animal products but includes milk |
|
|
Term
|
Definition
| diet devoid of animal products but includes eggs |
|
|
Term
| How is goat's milk different from cow's milk? |
|
Definition
| lower sodium levels but more potassium, chloride, linoleic acid, and arachidonic acid; it is also low in vitamin D, iron, folate, and vitamin B12 |
|
|
Term
| Breast milk contains complete nutrition except for... |
|
Definition
|
|
Term
| How does breast milk help protect infants from infection? |
|
Definition
| contains high concentrations of immunoglobulin A which reduces viruses and bacteria intestinal wall adherence and macrophages which inhibit E coli growth |
|
|
Term
| What are the disadvantages of breast milk? |
|
Definition
| potential HIV transmission, jaundice exacerbation due to increased unconjugated bilirubinemia levels, low vitamin K levels |
|
|
Term
| How do you stop breast milk jaundice? |
|
Definition
| will resolve with a 12 to 24 hour breast-feeding interruption |
|
|
Term
| WHat are some special formulas for special needs infants? |
|
Definition
| formulas low in phenylalanine for infants with PKU, amino acid mixtures for pts unable to digest protein; soybean based for those with cow's milk allergy |
|
|
Term
| Vegan diets are high in fiber which can have health benefits because... |
|
Definition
| faster GI transit time leading to reduced serum cholesterol levels, less diverticulitis, and a lower appendicitis incidence |
|
|
Term
| What special nutrition supplements do vegan mothers and infants need? |
|
Definition
| breast feeding vegan mothers are given vitamin B12 to prevent methylmalonic acidemia; toddlers are given vitamin B12 and trace minerals |
|
|
Term
| Why are toddlers on a vegan diet given trace minerals? |
|
Definition
| increased GI transit time may deplete trace minerals |
|
|
Term
| What are the symptoms of methylmalonic acidemia? |
|
Definition
| failure tothrive, seizure, encephalopathy, stroke orotherneurologic manifestations |
|
|
Term
| What is the biochemical pathway interrupted in methylmalonic acidemia? |
|
Definition
| defect in the conversion of methylmalonyl-CoA to succinyl-CoA |
|
|
Term
| What are symptoms of vitamin A deficiency? |
|
Definition
| night blindness, xerophthalmia, keratomalacia, conjunctivitis, poor growth, impaired resistance to infection, abnormal tooth enamel development |
|
|
Term
| What are the symptoms of vitamin A excess? |
|
Definition
| increased ICP, anorexia, carotenemia, hyperostosis (pain and swelling of long bones), alopecia, hepatomegaly, poor growth |
|
|
Term
| What are the symptoms of vitamin D deficiency? |
|
Definition
| rickets (with elevated serum phosphatase levels appearing before bone deformities), osteomalacia, infantile tetany |
|
|
Term
| What are the symptoms of vitamin D excess? |
|
Definition
| hypercalcemia, azotemia, poor growth, nausea and vomiting, diarrhea, calcinosis of a variety of tissues including kidney, heart, bronchi, and stomach |
|
|
Term
| What are the symptoms of vitamin E deficiency? |
|
Definition
| hemolytic anemia in premature infants |
|
|
Term
| What are the symptoms of ascorbic acid deficiency? |
|
Definition
| scurvy and poor wound healing |
|
|
Term
| What are the effects of vitamin C excess? |
|
Definition
| may predispose to kidney stones |
|
|
Term
| What are the symptoms of thiamine deficiency? |
|
Definition
| beriberi (neuritis, edema, cardiac failure), hoarseness, anorexia, restlessness, aphonia |
|
|
Term
| What are the symptoms of riboflavin deficiency? |
|
Definition
| photophobia, cheilosis, glossitis, corneal vascularization, poor growth |
|
|
Term
| What are the symptoms of niacin deficiency? |
|
Definition
| pellagra (dementia, dermatitis, diarrhea) |
|
|
Term
| What are the symptoms of niacin excess? |
|
Definition
|
|
Term
| What does a pyridoxine deficiency cause? |
|
Definition
| in infants= irritability, convulsions, anemia; olderpatients (on isoniazid)= dermatitis, glossitis, cheilosis, peripheral neuritis |
|
|
Term
| What does pyrodoxine excess cause? |
|
Definition
|
|
Term
| What does a folate deficiency cause? |
|
Definition
| megaloblastic anemia, glossitis, pharyngeal ulcers, impaired cellular immunity |
|
|
Term
| What are the symptoms of cobalamin deficiency? |
|
Definition
| pernicious anemia neurologic deterioration, methylmalonic acid |
|
|
Term
| WHat isa pantothenic deficiency? |
|
Definition
| rarely depression, hypotension, muscle weakness, abdominal pain |
|
|
Term
| What are the symptoms of biotin deficiency? |
|
Definition
| dermatitis, seborrhea, anorexia, musclepain, pallor, alopecia |
|
|
Term
| What are the symptoms of vitamin K excess? |
|
Definition
| water soluble forms can cause hyperbilirubinemia |
|
|
Term
| What enzyme deficiency causes galactosemia? |
|
Definition
| uridyl transferase deficiency |
|
|
Term
| What are the symptoms of galactosemia? |
|
Definition
| jaundice, hepatosplenomegaly, vomiting, hypoglycemia, seizures, lethargy, irritability, poor feeding and failure to thrive, aminoaciduria, liver failure, mental retardation, and an increased risk of E coli sepsis |
|
|
Term
| How do you manage pts with galactosemia? |
|
Definition
|
|
Term
| How do you manage pts with MSUD? |
|
Definition
| low-isoleucine, low-leucine, low-valine |
|
|
Term
| What is the incidence of biliary atresia? |
|
Definition
|
|
Term
| What is the medical term for knock knees? |
|
Definition
|
|
Term
| What is teh medical term for bowed legs? |
|
Definition
|
|
Term
| Decreased vitamin D intake has what effects on lab values and clinical features? |
|
Definition
| low serum 25(OH)D, occasionally reduced serum calcium levels, markedly elevated alk phos, poor bone mineralization and increased riks of fractures |
|
|
Term
| Why do children with liver failure often have poor bone mineralization? |
|
Definition
| decreased bile production leads to decreased absorption of fat soluble vitamins like vitamin D; also ascites assoc with liver failure causes loop diuretics to be used which can cause urinary calcium loss |
|
|
Term
| What causes nutritional rickets? |
|
Definition
| inadequate dietary vitamin D or a lack of sunlight exposure |
|
|
Term
| What causes nutritional rickets? |
|
Definition
| inadequate dietary vitamin D or a lack of sunlight exposure |
|
|
Term
| Although nutritional rickets is rare in this country which infants are at risk? |
|
Definition
| dark skin infatns who do not recieve vitamin D supplementation or breast fed infants not exposed to sunlight |
|
|
Term
| What are common causes of rickets in children? |
|
Definition
| usually due to liver or renal failure and a variety of biochemical abnormalities in calcium or phophorus metabolism |
|
|
Term
| What is the MOST COMMON form of nonnutritional rickets and the pathophys of that disease? |
|
Definition
| familial, primary hypophosphatemia in which pohsphate reabsorption is defective and conversion of 25(OH)D to 1,25(OH)2D in teh proximal tubules of the kidneys is abnormal |
|
|
Term
| What lab values are suggestive of familial primary hypophosphatemia? |
|
Definition
| low serum 1,25(OH)2D, low-normal calcium, moderately low serum pohsphate, and elevatedserum alk phos levels, hyperphosphaturia and no evidence of hyperparathyroidism results |
|
|
Term
| What finding on physical exam is suggestive of familial primary hypophosphatemia? |
|
Definition
| smooth lower extremity bowing (as opposed to the angular bowing of calcium deficient rickets), a waddling gait, genuvarum, genu valgum, coxa vara, and short stature |
|
|
Term
| What physical exam findings are more specific to calcium deficient rickets and generally not seen in familial primary hypophosphatemia? |
|
Definition
| angular bowing, myopathy, rachitic rosary, pectus deformities, tetany |
|
|
Term
| What is the inheritance pattern of familial hypophosphatemia rickets? |
|
Definition
|
|
Term
| What is the difference in tooth defects sesn in calcium deficient rickets versus familial hypophosphatemia? |
|
Definition
| familial hypopohsphatemia causes intraglobular dentin deformities wherease calcium deficient rickets causes enamel defects |
|
|
Term
| What arehte radiologic findings of rickets? |
|
Definition
| coarse appearing trabecular bone and widening, fraying an dcupping of the metaphysis of the proximal and distal tibia, distal femur radius, and ulna |
|
|
Term
| How does sunlight create vitamin D? |
|
Definition
| the body turns cholesterol into 7-dehydrocholesterol and then sunlight turns that into previtamin D3 which is converted into vitamin D3 |
|
|
Term
| What step does the liver perform to activate vitamin D? |
|
Definition
| 25-dehydroxylase turns vitamin D3 into 25-hydroxyvitamin D3 |
|
|
Term
| What step does the kidney perform to activate vitamin D? |
|
Definition
| 25-OHD3-1-hydroxylase turns 25-hydroxyvitamin D3 into 1,25 dihydroxyvitamin D3 which is then convertedinto 24,25-dihydroxyvitamin D3 by 25-OHD3-24-hydroxylase |
|
|
Term
| What are the lab values for ca, phos, alk phos, and urine AA, found in hepatic disease? |
|
Definition
| normal or decresaed Ca, decreased phos, increased alk phos, increased urine AAs |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with a lack of vitamin D? |
|
Definition
| normal to low ca, low phos, increased alk phos and increased urine AA |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with malabsorption of vitamin D? |
|
Definition
| normal to decreased calcium, decreased pohs, increased alk phos, increased urine aa |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts on anticonvulsant drugs? |
|
Definition
| normal or decreased serum calcium, decreased pohs, increased alk phos, increased urine aa |
|
|
Term
| Which anticonvulsant drugs are associated with abnormal metabolism of calcium and phos? |
|
Definition
| phenobarbitol and phenytoin; pts have reduced 25(OH)D levels, possibly as a result of increased cytochrome P450 activity; treatment is with vitamin D and adequate dietary calcium |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with renal osteodystrophy? |
|
Definition
| normal to decreased ca, increased phos, increased alk pohs, variable urine aa |
|
|
Term
| What is the pathophys of renal osteodystrophy? |
|
Definition
| hypophosphaturia results in hypocalcemia that then stimulates parathyroid secretion and enhanced bone turnover; additionally diminished conversion of 25(OH)D to 1,25(OH)2D occurs as renal damage progresses |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with vitamin D-dependent type 1? |
|
Definition
| decreased calcium, normal or decreased phos, increased alk phos, increased urine AA |
|
|
Term
| What is the pathophys of vitamin D-dependent type 1? |
|
Definition
| autosomal recessive; believed to be reduced activity of 25(OH)D1 alpha hydroxylase; responds to massive doses of vitamin D2 or low doses of 1,25(OH)2D |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with genetic primary hypophosphatemia? |
|
Definition
| normal calcium, decreased phosphate, increasedalk phos, normal urine AA |
|
|
Term
| What are the types of Fanconi syndrome? |
|
Definition
| includes cystinosis, tyrosinosis, Lowe syndrome, and acquired forms; cystinosis and tyrosinosis are autosomal recessive; low syndrome is x linked recessive |
|
|
Term
| What is the MOA of bone loss in renal tubular acidosis, type II (proximal)? |
|
Definition
| leaching of bone calcium bicarbonate in an attempt to buffer retained hydrogen ions seen in this condition; bicarbonaturia, hyperkaluria, hypercalciuria and hypophosphatemia are common |
|
|
Term
| What is the pathophys of oncogenic hypophosphatemia? |
|
Definition
| caused by tumor secretion of a phosphate regulating gene product (PEX), which results in phosphaturia and impaired conversion of 25(OH)D to 1,25(OH)2D |
|
|
Term
| How do you treat oncogenic hypophosphatemia? |
|
Definition
| resolution often occurs after tumor removal |
|
|
Term
| WHere are the tumors that cause oncogenic hypophosphatemia usually located? |
|
Definition
| small bones of thehands and feet, abdominal sheath, nasal antrum and pharynx |
|
|
Term
| What conditions can lead to pohsphate deficiency or malaborption? |
|
Definition
| parental hyperalimentation or low-phosphate intake |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with phosphate deficiency or malabsorption? |
|
Definition
| normal calcium, decreased serum phosphate, increased alk phos, normal urine amino acids |
|
|
Term
| What is the MOA of vitamin D-dependent type II? |
|
Definition
| autosomal recessive, very high serum levels of 1,25(OH)2D may result from 1,25(OH)2D receptor binding disorder |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with vitamin D dependent type II? |
|
Definition
| decreased serum calcium, decreased or normal serum phos, increased alk pohs, and increased urine aa |
|
|
Term
| A spiral fracture of the humerous in a child means that... |
|
Definition
| you should be suspicious of child abuse; while further lab testing is appropriate you should manage this pt by providing a secure environment for the child |
|
|
Term
| What should you supplement CF pts for their GI tract? |
|
Definition
| pancreatic enzyme replacemnt; vitamines ADEK and iron; sometimes zinc |
|
|
Term
| How si Schmid metaphysealdysplasia inherited? |
|
Definition
|
|
Term
| How does schmid metaphyseal dysplasia present? |
|
Definition
| short stature, leg bowing and waddling gait |
|
|
Term
| Radiographs of pts with schmid meaphyseal dysplasia show... |
|
Definition
| irregular long bone mineralization |
|
|
Term
| What are hte lab values for ca, phos, alk phos, and urine aa in pts with Schmid metaphyseal dysplasia? |
|
Definition
| normal calcium, phos and alk phos; normal urinary aa |
|
|
Term
| What are the symptoms of DKA? |
|
Definition
| polyuria, nausea, vomiting, abdominal complaints, hypothermia, hypotension, kussmaul respirations, and acetone on the breath |
|
|
Term
| In a patient in DKA, how high is their glucose level usually? |
|
Definition
|
|
Term
| Besides elevated glucose levels, what other lab abnormalities are seen in DKA? |
|
Definition
| metabolic acidosis with anion gap, hyperketonemia, hyponatremia, normal or slightly elevated potassium, elevated BUN and CR reflecting dehydration, leukocytosis (esp if bacterial infection is exacerbating diabetes) |
|
|
Term
| How do you replace fluids in a pt with DKA? |
|
Definition
| bolus to stabilize the heart rate and blood pressure (20cc/kg), then slower IV rate (saline solution +/- glucose) to replace fluid losses and to ensureadequate urine flow is initiated. K is added to IV fluids after urine output is established to counteract the pts total body K depletion |
|
|
Term
| How much insulin do you give to a pt in DKA? How much glucose? |
|
Definition
| 0.1 u/kg bolus initially, then 0.1 U/kg/hr with the IV rateadjusted based on the results of hourly glucose measurements; glucose is added to IV fluids when serum glucose level drops to approximately 250 to 300 mg/dL and additional insulin rate adjustments are made on serum glucose levels |
|
|
Term
| How long does it take to correct DKA? |
|
Definition
| low plasma pH and elevated serum ketone levels will correct significantly in the first 8 to 10 hrs (the serum bicarb level may remain low for approximately 24 hrs or more) |
|
|
Term
| When can a pt being treated for DKA start oral feeds with insulin bolus? |
|
Definition
| improvement is characterized by a decrease in IV insulin rates and resolution of the ketonuria; then, the pt can take oral feedings and insulin is converted from IV to subQ |
|
|
Term
| When treating a pt for DKA what complications should you foresee? |
|
Definition
| hypokalemia (add K to IV fluids after UOP is established), cerebral edema (look out for symptoms), underlying bacterial infection (eval for infection and give antibiotics if appropriate) |
|
|
Term
| Why do you avoid giving bicarb in DKA? |
|
Definition
| avoid except in extreme circumstances because it may precipitate hypokalemia, shift the oxygen disociation curve to the left causing worsened oxygen delivery, overcorrect the acidosis, results in worsening cerebral acidosis while the plasma pH is being corrected (transfer into the cerebrum of Co2 formed when the bicarb is infused in an acid serum) |
|
|
Term
| What are the symptoms of cerebral edema you should be on the lookout for in pts with DKA? |
|
Definition
| headache, personality changes, vomiting, decreased reflexes |
|
|
Term
| What is the treatment of cerebral edema assoc with DKA? |
|
Definition
| reduction in IV fluids, administration of IV mannitol, and hyperventilation |
|
|
Term
|
Definition
|
|
Term
| What HbA1C levels indicate poor control? |
|
Definition
| greater than 12%= poor control |
|
|
Term
| What is the Somogyi phenomenon? |
|
Definition
| a patient has nocturnal hypoglycemic episodes manifested as night terrors, headaches or early morning sweating and then present a few hours later with yperglycemia, ketonuria, and glucosuria; counter regulatory hormones in response to the hypo cause the hyper |
|
|
Term
| What percent of diabetics experience a honeymoon period? |
|
Definition
|
|
Term
| What is the "honey-moon" period of diabetes? |
|
Definition
| in newly diagnosed diabetics, progressive decrease in daily insulin requirements in teh months after their diagnosis maybe to the point of not needing insulin at all; this lasts for a few months and then a requirement for insulin returns |
|
|
Term
| T/F Infants/children with mild URIs, gastroenteritis, and low grade fever should wait until their next visit when they are healthier to get their vaccinations. |
|
Definition
| false; those things are not a CI to vaccination |
|
|
Term
| Egg hypersensitivity is a CI to which vaccines? |
|
Definition
| influenza and yellow fever; MMR contains only minute amounts of egg products and is not a CI |
|
|
Term
| Liv evirus vaccines are not given to which pts? |
|
Definition
| pregnant and severely immunocompromised patients |
|
|
Term
| Can you give MMR and varicella to pts with HIV? |
|
Definition
| yes, if they are asymptomatic it is fine |
|
|
Term
| What is the hep B vaccine scheudle? |
|
Definition
| 1= birth; 2= 1-2 months of age; 3= 6 to 18 months of age |
|
|
Term
| What is the rotavirus vaccine schedule? |
|
Definition
|
|
Term
| What is the DTAP vaccine schedule? |
|
Definition
| 2mo, 4 mo, 6 mo, 15 to 18 mo, 4-6 yoa |
|
|
Term
| What is the Hib vaccine schedule? |
|
Definition
| 2 mo, 4 mo, 6 mo, 12 to 15 mo |
|
|
Term
| What is the PCV vaccine schedule? |
|
Definition
| 2 mo, 4 mo, 6 mo, 12-15 months |
|
|
Term
| What is the IPV schedule? |
|
Definition
| 2 mo, 4 mo, 6 to 18 mo; 4-6 yoa |
|
|
Term
| What is the influenza vaccine schedule? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the MMR vaccine schedule? |
|
Definition
|
|
Term
| What is the varicella vaccine schedule? |
|
Definition
|
|
Term
| What is the hep A vaccine schedule? |
|
Definition
| 2 doses given bt 12 and 23 months |
|
|
Term
| What are the adverse reactions to HIb and incidence? |
|
Definition
|
|
Term
| What are the contraindications to the Hib vaccine? |
|
Definition
| anaphylactic reaction to vaccine |
|
|
Term
| What ar ethe adverse events and incidence assocwith DTAP? |
|
Definition
| allergic rxn (2/100,000), seizures (1/1,750), hypotonic-hyporesponsiveness (1/1,750), Fever >105 (0.3% of recipients), persistent, severe, inconsolable crying (1/100) |
|
|
Term
| What are the contraindications to DTaP? |
|
Definition
| anaphylactic rxn to vaccine or vaccine constituents, moderate or severe illness +/- fever, encephalopathy within 7 days of administration of previous DTAP dose, |
|
|
Term
| What are hte precautions to taking dtap? |
|
Definition
| fever >105 within 48 hrs, hypotonic hyporesponsiveness within 48 hrs, seizures within 3 days, persistent crying >3hrs within 48 hrs, guillain-barre within 6 weeks |
|
|
Term
| What are contraindications to hep b vaccine? |
|
Definition
| anaphylactic reaction to vaccine or vaccine constituent; anaphylactic reaction to baker's yeast |
|
|
Term
| What are precautions to hep B vaccination? |
|
Definition
| moderate or severe illness +/- fever |
|
|
Term
| What are some serious complications of the MMR vaccine? |
|
Definition
| transient thrombocytopenia, encephalitis, allergic reaction, subacute sclerosing panencephalitis |
|
|
Term
| What are the contraindications to MMR vaccination? |
|
Definition
| anaphylactic reaction to neomycin or gelatin, pregnancy, known altered immunodeficiency (hematologic), solid tumors, severe HIV infection, congenital immunodeficiency, and long term immunosuppressive therapy |
|
|
Term
| What are the precautions for MMR vaccination? |
|
Definition
| recent Ig administration (within 3-11 mo depending on product); thrombocytopenia or history of thrombocytopenic purpura |
|
|
Term
| What are the contraindications to IPV? |
|
Definition
| anaphylacticreactions to streptomycin, polymyxin B and neomycin |
|
|
Term
| What are the precautions to IPV? |
|
Definition
|
|
Term
| What are the precautions for MMR vaccination? |
|
Definition
| recent IG administration or thrombocytopenia or history of ITP |
|
|
Term
| What are the adverse effects of varicella vaccination? |
|
Definition
| transmission to other people, zoster like illness |
|
|
Term
| What are the contraindications to varicella vaccination? |
|
Definition
| anaphylactic reactions to neomycin and gelatin, infection with HIV, known altered immunodeficiency |
|
|
Term
| What are the precautions to varicella vaccination? |
|
Definition
| recent Ig administration (within 5 mo) and family history of immunodeficiency |
|
|
Term
| What arethe contraindications to pneumococcal vaccination? |
|
Definition
| known anaphylactic reaction |
|
|
Term
| What are the contraindications to Hep a vaccination? |
|
Definition
| known anaphylactgic reaction |
|
|
Term
| What is the age limit for Hib? |
|
Definition
| not recommended for children age 5 and over |
|
|
Term
| When should infants be able to sleep throughout the night? |
|
Definition
|
|
Term
| When should pts be able to roll over? |
|
Definition
|
|
Term
| When do you potty train children? |
|
Definition
| starts when the child shows interest, usually no earlier than 2 yoa |
|
|
Term
| When are screening hematocrits done for children? |
|
Definition
|
|
Term
| When do you check childrens cholesterol? |
|
Definition
| only if they have a familial risk factor |
|
|
Term
| T/F You can give live virus vaccines to children living with a pregnant woman. |
|
Definition
|
|
Term
| what is the significance of hearing rales on lung exam? |
|
Definition
| wet or crackly inspiratory breath sounds due to alveolar fluid or debris; usually heard in pneumoniaor CHF |
|
|
Term
| What is a staccato cough? |
|
Definition
| coughing spells with quiet intervals, often heard in croup and chlamydial pneumonia |
|
|
Term
| To determine whether a pleural effusion is transudate or exudate you need to perform fluid analysis for.. |
|
Definition
|
|
Term
| What are some causes of pleural effusions? |
|
Definition
| cardiovascular (CHF), infectious (mycobacterial pneumonia), malignant (lymphoma) |
|
|
Term
| Empyema is usually seen in conjunction with... |
|
Definition
| bacterial pneumonia or pulmonary abscess |
|
|
Term
| What is the difference in onset between bacterial and viral pneumonia? |
|
Definition
| bacterial progresses rapidly over a few days while viral may develop more gradually |
|
|
Term
| What vital sign is a relatively sensitive indicator of pneumonia. |
|
Definition
|
|
Term
| CXR finding of pnumococcal ro staphylococcal pneumonia? |
|
Definition
| single or multilobar consolidation |
|
|
Term
| What is the CXR finding associated withviral pneumonia with bronchospasm? |
|
Definition
| air trapping with flattened diaphragm |
|
|
Term
| What isthe CXR finding associated with mycobacterial pneumonia? |
|
Definition
| perihilar lymphadenopathy |
|
|
Term
| What percent of pediatric pneumonias are bacterial? |
|
Definition
|
|
Term
|
Definition
| enteric cytopathic human orphan virus |
|
|
Term
| What are the primary bacterial etiologies of pneumonia in the first few days of life? |
|
Definition
| enterobacteriaceae and GBS; also, staph aureus, strep pneumo, and listeria monocytogenes |
|
|
Term
| How do you treat a newborn for pneumonia empirically? |
|
Definition
| braod spectrum antimicrobials (amp with either gent or cefotaxime) |
|
|
Term
| What are the symptoms and lab values associated with neonatal chlamydia trachomatis pneumonia? |
|
Definition
| staccato cough, tachypnea, +/- conjunctivitis, known maternal chlamydia history, eosinophilia, bilateral infiltrates with hyperinflation |
|
|
Term
| How do you treat chlamydia pneumonia? |
|
Definition
|
|
Term
| What are the viral causes of neonatal pneumonia? |
|
Definition
| HSV, enterovirus, influenza and RSV |
|
|
Term
| What are the common causes of pneumonia from infancy to 5 yoa? |
|
Definition
| most commonly viral= adenovirus, rhinovirus, RSV, influenza, parainfluenza; bacterial= sterp pneumo, nontypeable h flu |
|
|
Term
| How can you diagnose a viral pneumonia? |
|
Definition
| clinically or with CXR findings; PCR amplifications of secretion from a nasal swab can confirm |
|
|
Term
| What percent of pts between 1 and 5 yoa have mixed viral and bacterial pneumonia? |
|
Definition
|
|
Term
| What causes lower respiratory tract infection in patients over 5 yoa? |
|
Definition
| mycoplasma pneumonia (however most of the viral and bacterial etiologies from earlier age ranges are possible except for GBS and listeria) |
|
|
Term
| How d oyou treat bacterial pneumonia in pts over 5? |
|
Definition
| macrolides (azithromycin) or cephalosporin (ceftriaxone or cefuroxime) |
|
|
Term
| Pneumonia in intubated pts in the ICU with central lines= |
|
Definition
| pseudomonas aeruginosa or fungal species |
|
|
Term
| Pneumonia in pts with chronic lung disease? |
|
Definition
| pseudomonas and aspergillus |
|
|
Term
| Pt with rash and pneumonia= |
|
Definition
|
|
Term
| Pt with pneumonia and retinitis= |
|
Definition
|
|
Term
| Pneumonia + exposure to stagnant water= |
|
Definition
|
|
Term
| Pneumonia + refractory asthma= |
|
Definition
|
|
Term
| Pneumonia + fungus ball on xray= |
|
Definition
|
|
Term
| Pneumonia + travel to south western US= |
|
Definition
|
|
Term
| Pneumonia + exposrue to infected sheep or cattle= |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Pneumonia + working on a farm east of the rocky mountains= |
|
Definition
|
|
Term
| What is standard antiTB therapy while awaiting culture and sensitivities? |
|
Definition
| isoniazid, rifampin, pyrazinamide |
|
|
Term
| What drug can be added for drug resistant TB? |
|
Definition
|
|
Term
| If a pt is taking ethambutol you should periodically test their... |
|
Definition
|
|
Term
| How do you determine how long to treat TB? |
|
Definition
| depends on extent of CXR abnormalities, resistance patterns, and results of followup sputum samples; initial phase of approx 2 months on 3 or 4 medications followed by acontinuation phase of 4 to 7 months on isoniazid and rifampin |
|
|
Term
| How do infants get chalmydia pneumonia? |
|
Definition
|
|
Term
| What percent of babies born to mothers with chlamydia get conjunctivitis or pneumonia? |
|
Definition
| 25% get conjunctivitis and halfof that get the pneumonia |
|
|
Term
| How long after birth do infants present with chlamydial pneumonia? |
|
Definition
| most present in teh 2nd month but can be as early as the second week |
|
|
Term
| How do you diagnose chlamydial eye infection of the newborn? |
|
Definition
| inner eyelid swabs sent for PCR |
|
|
Term
| How do you treat chamydial conjuctivitis or pneumonia in infants? |
|
Definition
| oral erythromycin or sulfisoxazole if the infant is older than 2 months X 2 weeks |
|
|
Term
| What is the incubation period for mycoplasma? |
|
Definition
|
|
Term
| How long before mycolasma symptoms occur? |
|
Definition
| during the 2nd to 3rd week of infection |
|
|
Term
| CBC of a pt with mycoplasma infection may show.. |
|
Definition
| reticulocytosis because antibodies hemolyze RBCs |
|
|
Term
| What is the most common cause of pneumonia in neonates, toddlers and adolescents? |
|
Definition
| neonates= GBS, toddlers= RSV, adolescents= mycoplasma |
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