Therapeutics - Peds

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  1. What is the only temporal thermometer that has been studied?
  2. When should you treat/refer a child under 1 month of age with a fever?
    IMMEDIATELY take to ER/Doctor
  3. When should you treat/refer a child 1 – 4 months for fever?
    Call physician right away
  4. When should you treat/refer a child over 4 months?
    • Treatment is based on symptoms
    • If not Eating, drinking, behaving normally
    • (Temp number is not needed by new guidelines)
  5. What is a normal dose of fever reducing agent for children?
    • 10mg/kg APAP Q4-6H
    • 10 mg/kg IBU Q6-8H
  6. When should you contact a physician about a fever, despite age?
    Greater risk of dehydration (cut back on milk, etc.)
  7. When should you contact a physician with Hyperthermia (Tachycardic, dry skin, hot)?
    Right away
  8. Leaning, Drooling, Doesn’t want to swallow, indicates what?
  9. What is slap cheek disease/Fifth disease?
    Mild viral illness that causes reddend cheeks/rash
  10. What are febrile seizures?
    • Temps above 102 (usually though can occur at any temp)
    • Looks like a seizure
  11. Do febrile seizures appear to cause epilepsy or long term effects?
    • No
    • Though a third may have another seizure
  12. Should you pretreat febrile seizures in a child with a fever?
    No, doesn’t really work
  13. What is hand foot and mouth disease?
    Viral disease
  14. What is the treatment for hand foot and mouth disease?
    Supportive/ pain treatment, especially for sores in the mouth
  15. What is Roseola?
    • Rash to a viral illness
    • Herpes family (HHV-6)
  16. What is the treatment for Roseola?
    • Supportive
    • Symptomatic relief
    • Hydration
    • Treatment usually not necessary
    • Though can treat fever
  17. What is German measles?
  18. Why is Rubella/German measles part of the vaccination schedule?
    Causes birth defects during pregnancy
  19. How does Roseola present?
    • Starts with high fever (104-105)
    • ~3 days fever is gone and rash appears
  20. What is the most common cause of diarrhea in pediatrics?
  21. What is the transmission pattern of Rotavirus?
    Fecal oral
  22. Is Rotavirus a big risk in the US?
    No, more worldwide
  23. What are the vaccines available for Rotavirus and how many injections are required for each?
    • RotaTeq -3 doses
    • Rotarix – 2 doses
  24. What is the effect of vaccinating for Rotavirus?
    > 90% reduction in hospitilizaion and ED visits for Gastroenteritis in peds
  25. What is the supportive treatment used for Rotavirus?
  26. What type of bacteria is Campylobacter?
    G- rods
  27. What is the leading cause of bacterial diarrhea in the US?
  28. Where is Campylobacter obtained from?
    • Undercooked poultry
    • Unpasteurized milk
    • Contaminated water
  29. What type of bacteria is Salmonella?
    G- rod
  30. Where is Solmonella usually obtained from?
    • Undercooked meat
    • Raw eggs
    • Contaminated water
  31. Why don’t we treat with antibiotics for bacterial causes of diarrhea?
    • Toxins are usually the cause
    • Bacteria has probably left the body when S/S appear
    • Usually run their course w/o medical intervention
  32. What Pediatrics might need Ciprofloxacin to clear diarrhea/bacteria?
    Newborns and immunosuppressed
  33. What E. coli is adssociated with undercooked hamburger?
  34. Where is O157:H7 E. coli naturally in the environment?
  35. Where is E. coli O157:H7 usually obtained?
    • Undercooked hamburger
    • Unpasteurized dairy
    • Contaminated water
  36. How does E. coli O157:H7 usually cause GI damage?
    Via toxins
  37. What bacteria is associated with Hemorrhagic diarrhea or hemolytic uremic syndrome?
    E. coli O157:H7
  38. What is the most common cause of kidney failure in children?
    E. coli O157:H7 induced Hemolytic-uremic syndrome
  39. Can any other E. coli strain cause Diarrhea other than O157:H7?
  40. What type of bacteria is Shigella?
    G- rod
  41. What benefits do antibiotics have for Shigella?
    May shorten duration
  42. How is Shigella transferred?
    Fecal oral
  43. What is the most important and main treatment for diarrhea in children?
    • Hydration
    • Usually don’t need antibiotics/will run its course
  44. Should you suggest anti-diarrheals (like immodium) for pediatric diarrhea?
    No, because you have stopped the flushing of the bacteria/toxins and so can cause prolongation of the disease
  45. What oral intake should you suggest for kids with diarrhea?
    • Electrolyte replacements
    • Solids as tolerate
  46. Is Gatorade useful for pediatric diarrhea?
    No, too much sugar
  47. Why should you give solids to kids with diarrhea?
    • May help absorb some water in the diarrhea
    • If they have problems, stop
  48. What are the main parasitic diseases of childhood?
    • Cryptosporidium
    • Giardia
  49. Where are parasitic diseases of childhood often obtained?
    • Fresh water swimming
    • Birds
    • Reptiles
    • Cows
  50. What is used to treat Giardia?
    • Tinidazole
    • Metronidazole – cheap 5-7D treatment
    • Furazolindone – comes in a suspension 7-10D treatment
    • Nitazoxanide – 1 dose - expensive
  51. What is the only FDa treatment for cryptosporidia?
    Nitazoxanide – 1 dose – expensive
  52. What is the causative agent of Pinworms?
    Enterobius vermicularis
  53. How is Enterobius vermicularis/pinworms transferred?
    Peron to person contact
  54. What is the treatment for Enterobius vermicularis/pinworms?
    • Mebendazole (Vermox) 100 mg x 1 dose, repeat in 1-3 weeks
    • Wash well, wash sheets, child’s hands, etc.
  55. Why do you frequently need multiple treatments and need to use combs when treating lice?
    The eggs are hard to kill and remove
  56. What are the DOCs for head lice?
    • OTC shampoos:
    • Permethrin (Nix)
    • Pyrethrins/piperonly butoxide (Rid)
  57. How effective are Rid and Nix?
    • Poorly effective but still DOC
    • Don’t kill nits well
  58. What is the advantage of Spinosad?
    • 85% lice free at 14 days vs. 45%
    • Nit combing not required
    • What is Spinosad used to treat?
    • Lice
  59. How do you use Spinosad?
    Apply to dry hair and rinse after 10 minutes
  60. How often should you repeat Nix or Rid treatments?
    Q7-10 days
  61. What is the MOA for Spinosad?
    Neuronal excitation and paralysis of lice
  62. What is the disadvantage of Spinosad for lice treatment?
  63. What is Ovide (Malathion) used for?
    Lice treatment
  64. What do you need to warn patients about Ovide (Malathion)?
    Do not use with heat tools, catch hair on fire
  65. What is Lindane (Kwell) used to treat?
  66. What states have banned Lindane (Kwell) and why?
    • Michigan restricts and California has banned
    • Can cause seizures and death
Card Set
Therapeutics - Peds
Therapeutics - Peds
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