Pediatrics
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| In what age group does a fever need to immediatley be seen? | 6-8weeks old
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| In the ER, what are four broad areas tha can be reversed quickly to prevent cellular damage? | Hypoxemia, Hypoglycemia, Poisoning, and Shock (Septic, Hypovolemic, Cardiac)
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| What is the most subtle sign of possible inadequate perfusion? | tachycardia
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| In shock pt, what fluids should be given? | NS bolus, 20ml/kg
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| In emergency, if IV line cannot be established, what is the next best option? How long do you try to get the peripheral IV in? | Interosseous line should be placed if peripheral IV cannot be placed within 90 seconds
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| Pt presents with fever and petechiae, what is at the top of your ddx? | Meningococcal sepsis
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| Fu for fever and petechiae? | Blood cx and Abx until meningococcal sepsis can be ruled out
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| Kawasaki disease presentation? | strawberry tongue, lips that are red, dry and cracked; mouth that is red, red/edematous hands and feet; polymorphic truncal rash
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| Toxic shock syndrome presentation? | rough rash looking like sunburn and fever
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| Rocky Mountain Spotted Fever presentation? | fever, petechie on palm and soles
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| Scarlet fever presentation? | fever then truncal rash (pink) 12-48 hrs later, redness spreads to arms/legs; feels like sandpaper
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| What is Pastia's sign? | linear petechiae evident in body folds
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| What does the tongue look like in Scarlet fever? | tongue initially white and rough (strawberry tongue); white sloughs off in 4-5 days and tonge becomes bright red
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| What is tx for meningococcus? | Penicillin G
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| What is tx for adults and kids in contact with meningococcus pt (household contacts); meningococcus prophylaxis | Adults: ciprofloxacin; Kids: Rifampin or ceftriaxone
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| WHo gets meningococcus vaccination? | Kids between ages 11-18; kids <10 get a different form if they are at risk
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| What are meningococcus disease complications? | hearing loss, neuro disability, finger/limb amputations, skin scarring
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| What are the signs of shock in kids? | RR inc, HR inc, contractility inc, systemic vascular resistance inc, venous tone inc
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| Indications for LP | confirm dx of meningitis, encephalitis, or subarach hemorr; evaluate demyelinating, degenerative, and collagen vascular diseases or tumor cells w/in subarach space
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