Pediatric Infectious Diseases and Complications

Practice questions covering Varicella, Acute Rheumatic Fever (ARF), Penicillin allergies, and Lyme disease based on clinical lecture notes.

What type of vaccine is the Varicella vaccine, and what precautions must be taken?

It is a live vaccine, so caution is required around individuals who are immunocompromised or pregnant.

What is the underlying cause of Acute Rheumatic Fever?

It is an immune-mediated complication that develops from untreated Group A strep (Bacterial).

What are the components of the $F-E-V-E-R-S$ mnemonic used for Acute Rheumatic Fever?

$F$: Fever, $E$: Erythema Marginatum, $V$: Valvular Damage, $S$: Subcutaneous Nodules, $R$: Red Hot Joints, and $S$: Sydenham Chorea.

What temperature threshold is associated with the fever in Acute Rheumatic Fever?

The temperature will be above $100.4^{\circ}\text{F}$ because of the infection.

How is the rash 'Erythema Marginatum' described?

It is a rash with irregular borders.

In Acute Rheumatic Fever, which heart valve is typically weakened by bacteria sitting on the leaflets?

The mitral valve, which has 2 cusps, is the best example; it eventually weakens and leads to regurgitation.

What is the surgical treatment for heart failure resulting from valvular regurgitation in Acute Rheumatic Fever?

Valve Replacement.

What is the clinical presentation and management of Sydenham Chorea?

It involves uncontrollable movements of the arms and legs; nursing concerns include preventing injury, and patients should not play sports right away. Symptoms can take weeks to months to subside.

What is the primary intervention for a parasitic/bacterial infection like Rheumatic Fever?

Broad-spectrum antibiotics, specifically Penicillin if the patient is not allergic.

What is the difference between the first and second exposure to Penicillin in a reactive patient?

The first exposure results in an allergic reaction (rash, hives/wheals, itching), while the second exposure can lead to anaphylactic shock, airway trouble, and the need for intubation.

What supportive measures are included in the interventions for Rheumatic Fever?

Bed rest (to avoid injury), fluids, controlling fever, proper nutrition, and $O_2$ as needed.

What is the cause and clinical presentation of Lyme Disease?

It is caused by a tick and presents with fever, a bull's eye rash, and potential cardiotoxicity.

What precautions should be followed for Active Strep vs. Inactive Strep?

Active Strep requires droplet precautions (surgical mask, private room, PPE for bodily fluids PRN, hand hygiene), while Inactive Strep requires standard precautions (hand hygiene, appropriate PPE).

What is the long-term antibiotic protocol for Acute Rheumatic Fever?

If not allergic to Penicillin (PCN), the patient receives an IM injection every month until the condition resolves.

What three diagnostic tools are used for cardio checkups to monitor valve destruction in Rheumatic Fever?

Echo, EKG, and Auscultation.