Pediatrics
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| 3 C’s of measles (rubeola) | cough, coryza, conjunctivitis
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| Koplik’s spots | oral lesions (enanthem) appear before rash
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| Second dz tx | scarlet fever; Pen VK
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| Third dz | rubella; postauricular & occipital adenopathy
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| Measles vs rubella: resolution | measles self limiting in 7-10 days; rubella in 4 days; Rx = sx for both
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| Rubella dx: | paired sera
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| Rubella complication | arthralgia
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| Fifth dz s/s | mild flu-like; rash at 10-17 days (first: slapped cheeks; reappears for 2-4 wks; second: lacy on arms/legs)
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| Fifth dz complications | arthralgia (symmetric poly in older); fetal / 1st trimester death
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| Caused by parvo B19, spring/summer; adol/YA; LA, fever, arthralgia, self-limiting in 1-2 wks | Papular purpuric glove & sock syndrome
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| Roseola (6th dz) | Exanthem subitum; HHV6 & HHV&; 6 mos-3 yo; abrupt fever to 104 (3-7 days); Defervescence precedes rash
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| VZV: incubation in ___ & crusts in ___; contagious for ____ | 10-20 days; 3-5 days; 1 week
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| HFMD S/S | vesicles; poss genl scarlet rash; low fever, anorexia
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| HFMD comps | myocarditis, substernal chest pain, dyspnea
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| papular acrodermatitis of childhood AKA: | Gianotti-Crosti Syndrome
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| Gianotti-Crosti Syndrome age onset/etiology | 6-14 mos (mean 2 yo); EBV (poss HHV4 or hep B)
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| Gianotti-Crosti S/S | symmetric red-purpuric papules and papulovesicles on face, buttocks, extremities; low fever, LA; self-limiting 3-4 wks
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| Mumps parotitis is bilateral in ___% of cases | 70%
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| Mumps presentations | 2-3 wks incubation; stenson duct red w/yellow d/c; dx w/paired sera, clinical dx
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| Mumps comps | orchitis, pancreatitis, oophoritis, aseptic meningitis
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| Pearly dome shaped papules with central umbilication: | molluscum contagiosum (poxvirus)
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| Bacterial meningitis epidemiology | Highest from birth - 2 yo. Peaks during neonatal and 3-8 months. M > F. Winter-spring. Most at risk are kids <1 y.o.
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| Bacterial meningitis organisms in newborns | GBS, E. Coli, Listeria, H flu, SP, N meningitides
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| Viral meningitis usually due to: | coxsackie / enterovirus (mumps is uncommon)
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| Pinworm can cause: | vaginitis and/or UTIs in prepubescent girls
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| Kawasaki clinical features (CRASH) | Persistent fever (to 105F) up to 5 days. Conjunctivitis. Truncal rash. Cervical LAD. Oropharyngeal erythema & strawberry tongue. Erythema & desquamation of hands & feet.
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| Kawasaki labs | High WBC, ESR, CRP, platelets (late), proteinuria & pyuria.
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| Kawasaki mgmt | Beta-globulin and high-dose aspirin
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| Fever (>38C), <28 days old | Admit, blood cx, ucc, LP; poss cxr; IV amp/gent; NO ROCEPHIN due to kernicterus risk
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| Fever (>38C), 28 days - 3 mos | blood cx, ucc, LP, poss cxr; Rocephin 50 mg/kg; d/c home if cxs neg; f/u in 24 hr
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| Fever (>39C), 3 mos - 3 yo | ucc (M <6 mo, F <2 yo); poss cxr if sxs; poss stool cx; close f/u
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| < 2mo fever | Septic workup: blood Cx, LP
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| < 5yo fever, seizures = | Febrile seizure
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| Volume of distribution (Vd) and clearance in adult compared to neonate (eg, for gentamicin) | Vd of an adult is decreased compared to neonate. Clearance is comparatively increased.
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| Bacterial meningitis organisms in kids 3 months - 6 yo | SP, H flu, N meningitides, Listeria, aerobic GNR
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| Bacterial meningitis organisms in kids >7 yo | SP, N meningitides, Listeria, aerobic GNR
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| Bacterial meningitis mgmt | IV dexamethasone 0.15 mg/kg. <3 mos: CTX or ampicillin. >3 mos: CTX, cefotaxime, or amp + gent. Tx seizures prn
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