peds quiz 2

Fever

≥100.4°F (38°C)

Purpose of Fever

Natural defense that slows pathogen replication and enhances immune response.

Innate Immunity

Present at birth and non-specific.

Adaptive Immunity

Develops over time with exposure and is specific to antigens.

Steps of Infectious Process

Incubation - exposure to symptom onset, Prodromal - early, nonspecific symptoms, Illness - full symptoms develop, Convalescence - recovery and return to health.

Rubella

Caused by Rubella virus; Rash starts on face → trunk, mild fever, lymphadenopathy; Managed with supportive care, isolation, and is vaccine preventable.

Rubeola (Measles)

Caused by Measles virus; Koplik spots, cough, coryza, conjunctivitis, high fever; Managed with supportive care, vitamin A, and isolation.

Fifth Disease

Caused by Parvovirus B19; "Slapped cheek" rash, lacy rash on trunk/limbs; Managed with supportive care and avoiding pregnant women.

Roseola Infantum

Caused by Human herpesvirus 6/7; High fever then pink rash as fever subsides; Managed with antipyretics and reassurance.

Enterovirus

Caused by Coxsackievirus; Hand-foot-mouth, fever, sore throat, rash; Managed with supportive care and hydration.

Varicella-Zoster

Caused by Varicella virus; Pruritic vesicles in different stages; Managed with antihistamines and acyclovir if high risk.

Herpes Zoster

Reactivation of VZV; Dermatomal painful rash; Managed with analgesics and antivirals.

Mumps

Caused by Paramyxovirus; Swollen parotid glands, fever; Managed with supportive care and MMR vaccine.

CMV

Caused by CMV virus; Often asymptomatic or mono-like; Managed with antivirals in immunocompromised.

Epstein-Barr

Caused by EBV; Fever, fatigue, splenomegaly, sore throat; Managed with rest, hydration, and avoiding contact sports.

Rabies

Caused by Rabies virus; Hydrophobia, seizures, paralysis; Managed with post-exposure prophylaxis (PEP) ASAP.

Scarlet Fever

Caused by Group A strep; Sandpaper rash, strawberry tongue, fever; Managed with penicillin and isolation.

Pertussis

Caused by Bordetella pertussis; Whooping cough, apnea in infants; Managed with macrolides and monitoring airway.

MRSA

Caused by S. aureus; Boils, abscesses, cellulitis; Managed with incision/drainage and antibiotics (e.g., clinda).

C. difficile

Caused by C. difficile.

difficile

Diarrhea post-antibiotics; Stop causative antibiotic, use metronidazole

Rocky Mountain Spotted Fever

Organism: Rickettsia rickettsii; Transmission: Tick bite; Symptoms: Fever, headache, petechial rash (extremities → trunk); Diagnosis/Treatment: Serology, doxycycline; Isolation/Control: No isolation, insect repellents

Lyme Disease

Organism: Borrelia burgdorferi; Transmission: Tick bite; Symptoms: Bulls-eye rash, joint pain, neuro signs; Diagnosis/Treatment: ELISA/Western blot, doxycycline; Isolation/Control: No isolation, tick checks

Respiratory Distress Early Signs

Tachypnea, tachycardia, restlessness, nasal flaring, retractions, grunting, mild hypoxia (↓ SpO₂)

Respiratory Distress Late Signs

Bradycardia, cyanosis, decreased LOC, severe hypoxia, apnea

Lung Sounds Upper Airway

Stridor (inspiration)

Lung Sounds Lower Airway Wheezing

Expiratory, bronchiolar narrowing

Lung Sounds Lower Airway Rales/Crackles

Fluid in alveoli (pneumonia, CHF)

Best non-invasive hypoxia assessment

Pulse oximetry

Allergic Rhinitis

Assessment: Sneezing, runny nose, itchy eyes; Management: Antihistamines, nasal steroids; Family Ed/Prevention: Allergen avoidance

Otitis Media

Assessment: Ear pain, fever, pulling at ear; Management: Pain relief, possibly antibiotics; Family Ed/Prevention: Upright feeding, smoking cessation

Sinusitis

Assessment: Facial pain, thick nasal discharge; Management: Antibiotics, saline nasal spray; Family Ed/Prevention: Hand hygiene, treat allergies

Pharyngitis

Assessment: Sore throat, fever, possible strep signs; Management: Strep test, antibiotics if positive; Family Ed/Prevention: Finish full course of antibiotics

Tonsillitis

Assessment: Enlarged tonsils, sore throat; Management: Antibiotics, fluids, tonsillectomy (if recurrent); Family Ed/Prevention: Infection control

Croup

Assessment: Barky cough, stridor; Management: Cool mist, racemic epi, steroids; Family Ed/Prevention: Monitor airway

Epiglottitis

Assessment: Drooling, tripod position, sudden onset; Management: Emergency intubation, IV antibiotics; Family Ed/Prevention: Hib vaccine

Pneumonia

Assessment: Fever, cough, rales; Management: Antibiotics (bacterial), O₂ if needed; Family Ed/Prevention: Vaccine, hand hygiene

Bronchitis

Assessment: Cough, wheezing; Management: Supportive, hydration; Family Ed/Prevention: No smoking around child

Bronchiolitis

Assessment: RSV common cause, wheezing, retractions; Management: Supportive, suction, O₂; Family Ed/Prevention: Synagis in high-risk infants

Tonsillectomy Post-op Care

Monitor for bleeding (frequent swallowing), encourage fluids (avoid red liquids), pain control (acetaminophen, ice collar), avoid coughing/blowing nose

Foreign Body Aspiration Risks

Nuts, seeds, coins, small toys; Signs: Sudden cough, wheeze, unilateral breath sounds; Prevention: Age-appropriate toys, supervision

Cystic Fibrosis Respiratory Signs

Chronic cough, thick mucus, frequent infections

Cystic Fibrosis GI Signs

Steatorrhea, FTT, meconium ileus

Cystic Fibrosis S/S

Salty skin, poor weight gain, barrel chest

Cystic Fibrosis Interventions

Chest physiotherapy, pancreatic enzymes, high-cal diet

Asthma Exacerbation Interventions

Short-acting beta agonists (albuterol), oxygen, corticosteroids, peak flow monitoring, calm, quiet environment

Mantoux Test

PPD test for TB exposure; Read at 48-72 hrs; induration = positive

Seborrheic dermatitis

Assessment: Yellow, greasy scales; Management: Baby shampoo, soft brushing; Family Education: Reassure, hygiene

Diaper dermatitis

Assessment: Red, irritated skin; Management: Barrier creams, air dry; Family Education: Frequent diaper changes

Contact dermatitis

Assessment: Red, itchy patches; Management: Avoid triggers, topical steroids; Family Education: Patch testing if severe

Atopic dermatitis (eczema)

Assessment: Dry, itchy skin; Management: Emollients, antihistamines, steroids; Family Education: Avoid allergens, cool baths

Cellulitis

Assessment: Warm, red, swollen area; Management: Antibiotics; Prevention/Education: Hygiene, wound care

Thrush

Assessment: White patches in mouth; Management: Nystatin; Prevention/Education: Sterilize pacifiers, clean bottles

Impetigo

Assessment: Honey-crusted lesions; Management: Topical or oral antibiotics; Prevention/Education: Handwashing, avoid sharing towels

Tinea corporis

Assessment: Ring-shaped lesion; Management: Antifungal cream; Prevention/Education: No sharing hats/clothes

Tinea capitis

Assessment: Scalp ringworm; Management: Oral antifungals; Prevention/Education: Shampoo, avoid sharing hair tools

Tinea pedis

Assessment: Athlete's foot; Management: Antifungal creams; Prevention/Education: Dry feet, clean socks

Diaper Candidiasis

Assessment: Beefy red rash, satellite lesions; Management: Antifungal cream; Prevention/Education: Diaper hygiene

HSV

Assessment: Vesicular lesions; Management: Acyclovir, supportive care; Prevention/Education: Avoid contact when lesions active

Lice

Cause: Pediculus humanus capitis; Transmission: Head-to-head contact; Manifestations: Itching, nits in hair; Treatment: Permethrin, combing; Isolation/Concerns: Wash bedding, no sharing items

Scabies

Cause: Sarcoptes scabiei mite; Transmission: Prolonged skin contact; Manifestations: Burrows, intense itching (esp. at night); Treatment: Permethrin cream for whole family; Isolation/Concerns: Wash everything in hot water, close contacts

Acne Vulgaris

Avoid picking; Use non-comedogenic products; Benzoyl peroxide, retinoids, antibiotics if needed

Burn Classifications Superficial

Type: Superficial; Depth: Epidermis only; Appearance: Red, dry, blanches

Burn Classifications Superficial Partial

Type: Superficial Partial; Depth: Epidermis + part dermis; Appearance: Blisters, moist, painful

Burn Classifications Deep Partial

Type: Deep Partial; Depth: Deep dermis; Appearance: Dry, mottled, may be less painful

Burn Classifications Full Thickness

Type: Full Thickness; Depth: Through dermis to subq; Appearance: Waxy, white, no sensation

Burn Assessments Primary

ABCs, remove clothes, cool burn briefly, vitals

Burn Assessments Secondary

Extent (TBSA), depth, lab values, pain

Burn Teaching Prevention

Smoke alarms, water heater ≤120°F, no hot drinks near child

Burn Teaching Home care

Wound care, infection prevention, hydration, pain control

Pediatric Burn Complications

Fluid loss (higher surface area), hypothermia, infection risk, pain management challenges, emotional trauma