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T or F. Immune deficiencies are rare in children.
True, most who have infections are immunologically competent.
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What is the most common Primary immune deficiency?
Selective IgA deficiency
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What are some examples of relative immune deficiencies?
-DM, metabolic d/o, renal failure, malnutrition
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T or F. Most newborns have all of the components of their immune system.
True
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When do maternal IgG wane in babies?
reach nadir by 5 to 7 months
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What is the average number of URIs in a normal child?
3-8 through age 5
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What is the average number of GI infections for a normal child?
3 episodes per yr, first 3 years
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List 3 presentations seen in a child with immune system defects.
- 1. Severe, deep tissue or life-threatening events
- 2. Recurrent or protracted infections
- 3. Infections with unusual organism
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What are 4 reassuring features of children with recurrent illnesses?
- 1. Prior diagnosis are vague w/ unclear documentation
- 2. Lack of deep tissue infection
- 3. Presence of normal growth/development
- 4. General wellness
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What oral symptoms are associated with immune?
thrust, mucosal lesions
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What are 3 skin symptoms associated with underlying immune deficiency?
- 1. Eczema
- 2. Telangiectasia
- 3. Albinism
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Features of specific conditions w/ recurrent infections:
1. FTT
2. Skin d/o
3. Neuro sx
4. Motor weakness
- 1. FTT--> HIV, T-cell disorders
- 2. Skind d/o--> Wiskott-Aldrich syndrome (eczema)
- 3. Neuro sx--> ataxia-telangiectasia
- 4. motor weakness--> recurrent aspiration pneumonia
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What percentage of babies <3mo with fever can have a serious bacterial infection?
15%
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KNOW: What should you ALWAYS ask when a child presents with a fever and URI?
RASH!
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If a kid presents with diffuse petechiae and toxic appearance, what's your DD?
- 1. N Meningitides
- 2. Strep pneumoniae
- 3. H. Flu
- 4. Rocky MTN Spotted Fever
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A neonate with petechiae presents, what is your DD? (2)
- 1. Disseminated CMV
- 2. Enterovirus
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A kid presents with generalized erythroderma and peeling, what is your DD?
Toxic shock syndrome
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What are the S/S of meningococcemia? (3)
- 1. Acute ill
- 2. Febrile
- 3. Rash
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A baby presents with painful erythema, hemorrhagic bullae, crepitance, and dusky blotches, what's your DD?
Necrotizing fascititis
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What is the most common cause of severe, acute, disease in children?
Bacterial infection
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T or F. Infants <2mo and those who are immunocompromised have ⇑ probability of bacterial infection and should be treated.
True
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What are 3 sign of potential severe bacterial infection?
- 1. Fever in newborn < 2mo
- 2. Vascular instability (hypothermia, mottling, poor cap refill, unstable BP)
- 3. Skin rash (petechiae, eccymosis)
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T or F. Diptheria is noted to have acute onset sore throat and high fever.
FALSE: insidious onset sore threat, malaise anorexia, NOTABLE absence of high fever
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What are some s/s Diphtheria?
- -insidious sore throat, absence of high fever
- -Day 2-4, adherent gray, green, black membrane forms on mucosa w/ surrounding erythema
- -local adenopathy, bullneck
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What is the txt for Diptheria?
- Horse antitoxin from CDC for system
- -PCN/ERTH if locat infection
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How does Legionella present?
Acute pneumonia--> treat like it is, usually self-limiting
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What is txt for Lyme Dx?
Amox, cefuroxime, doxy for at least 21 days
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Which stage of Pertusis has non-specific URI?
Catarrhal stage 1
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What is the diagnosis of Pertusis?
- 1. WBC 15-100,000
- 2. CXR- normal or perihilar infiltrate
- 3. PCR- or isolation of organism
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T or F. Most nonspecific viruses are self-limiting and require no treatment
True
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