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CLIPP23 Meningitis

Pediatrics

QuestionAnswer
In what age group does a fever need to immediatley be seen? 6-8weeks old
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)
What is the most subtle sign of possible inadequate perfusion? tachycardia
In shock pt, what fluids should be given? NS bolus, 20ml/kg
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
Pt presents with fever and petechiae, what is at the top of your ddx? Meningococcal sepsis
Fu for fever and petechiae? Blood cx and Abx until meningococcal sepsis can be ruled out
Kawasaki disease presentation? strawberry tongue, lips that are red, dry and cracked; mouth that is red, red/edematous hands and feet; polymorphic truncal rash
Toxic shock syndrome presentation? rough rash looking like sunburn and fever
Rocky Mountain Spotted Fever presentation? fever, petechie on palm and soles
Scarlet fever presentation? fever then truncal rash (pink) 12-48 hrs later, redness spreads to arms/legs; feels like sandpaper
What is Pastia's sign? linear petechiae evident in body folds
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
What is tx for meningococcus? Penicillin G
What is tx for adults and kids in contact with meningococcus pt (household contacts); meningococcus prophylaxis Adults: ciprofloxacin; Kids: Rifampin or ceftriaxone
WHo gets meningococcus vaccination? Kids between ages 11-18; kids <10 get a different form if they are at risk
What are meningococcus disease complications? hearing loss, neuro disability, finger/limb amputations, skin scarring
What are the signs of shock in kids? RR inc, HR inc, contractility inc, systemic vascular resistance inc, venous tone inc
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
Created by: stephanie.thomas
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