peds exam 4

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  1. Chicken Pack (Varicella)
    • Agent: Varicella Zoster
    • Airborn / direct contact
    • Incubation:14-21 days
    • Comunicable: 1 day before to 6 days after lessions appeared
    • Symptoms: Fever, malice, headache, abdominal pain, clear filled fluid vesicles all over the body.
    • Treatment: Supportive, isolation, symptom management.
    • Complications: Secondary skin infections from scratching; secondary bacterial infection such as pneumonia, sepsis, scarring, transient thrombocytopenia
  2. Coxsackievirus
    • aka hand foot and mouth disease and herpangina 
    • Agent: coxsackievirus A16; enterovirus 71
    • transmission: fecal-oral and respiratory rout 
    • Symptoms: fever and sore throat; 
    • Herpangina: papulovesicular lesions on pharynx only kids don't want to eat 
    • Hand, foot and mouth disease: papulovesicular lesions on inside of cheek, gums, tongue as well as hands and feet 
    • Treatment: supportive, isolation, topical lotions and cool drinks,
  3. Diphtheria
    • Agent: corynebacterium diphtheriae 
    • Transmission: contact with nasal or eye discharge
    • Symptoms: fever, anorexia, rhinorrhea, cough, stridor, tonsils and pharynx covered in thick bluish white patches on throat 
    • Treatment: antibiotics, IV antitoxin, isolation and monitor for respiratory distress
  4. Erythema infectiosum
    • Aka fifth's disease
    • Agent: human parvovirus B19 
    • Transmission: through respiratory secretions and blood 
    • Incubation: 4-21 days 
    • symptoms: flu-like illness, fiery red rash, " slapped face appearance," maculopapular rash on trunk and limbs
    • treatment: supportive, isolation, fever control, antipruritics, soothing baths
  5. Haemophilus influenza type B
    • Agent: coccobacilli H. influenzae bacteria 
    • transmission: direct contact or droplet inhalation 
    • Symptoms: viral upper respiratory tract infection that invades blood stream, may cause meningitis, epiglottitis, pneumonia or sepsis
    • Treatment: antibiotics, isolation, prophylaxis for close contacts and antipyretics
  6. influenza
    • Agent: Orthomyxoviridae, types  and B 
    • Transmission: aerosolized particles, direct contact with secretions 
    • Symptoms: fever, chills, malaise, Headache, N&V
    • Treatment: antivirals for children at risk for complications, isolation, prevent dehydration, comfort
  7. Measles (Rubeola)
    • Agent: Morbillivirus, a member of the paramyxovirus group
    • Transmission: airborne, droplet, and contact
    • incubation: 10-21 days
    • comunicable: 4 days before and 5 days after rash appears 
    • Symptoms: high fever, conjunctivitis, cough, anorexia, malaise, Koplik spots on oral mucosa 2 days before rash, red blotchy maculopapular rash on face, trunk and limbs, becomes confluent 
    • Treatment: supportive, antibiotics for secondary infections, isolaion, antipyretics, antitussives, monitor resp status 
    • complications: OM,  pneumonia, bronchiolitis, laryngotracheitis; encephalitis
  8. Mononucleosis
    • Agent: Epstein-Barr virus
    • Incubation: 4-6 weeks
    • Transmission: direct contact with secretions
    • Symptoms: Malaise, headache, fever, fatigue, lymphadenopathy,weakness and lethargy may persist for months
    • Treatment: supportive, antipyretics, bed rest
    • complications: risk for ruptured spleen, avoid contact sports
  9. Mumps (Parotits)
    • Agent: Rubulavirus 
    • Transmission: contact with respiratory secretions
    • Incubation: 14-21 days 
    • Communicable: immediately before and after swelling appears 
    • Symptoms: malaise, fever, pain with chewing, parotid gland swelling 
    • Treatment: supportive, isolation, comfort measures, disease is self limiting
    • Complications: Epididymo-orchitis in older males; may cause sterility, hearing loss, encephalitis, meningitis, myocarditis, arthritis and hepatitis
  10. Pertussis (whooping cough)
    • Agent: Bordetella pertussis 
    • Transmission: respiratory droplets, direct contact with secretions
    • Incubation: 6-20 days
    • Symptoms: Runny nose, fever, mild cough that gets worse at night, may or may not whooping sound
    • Treatment: antibiotics, steroids, isolation, monitor resp status and hydration 
    • Complications: OM, pneumonia, seizures, hemorrhage, hernia, prolapsed rectum, weight loss, dehydration
  11. Pneumococcal infection
    • Agent: streptococcus pneumonia
    • Transmission: respiratory secretions and droplets
    • Symptoms: related to area of infection (Otitis media, sinusitis, bacteremia, pneumonia, meningitis.
    • Treatment: Antibiotics, isolation, antipyeitics, encourage fluids.
  12. Polio myelitis
    • Agent: polio virus
    • Transmission: Fecal oral route, and possible respiratory.
    • symptoms: CNS symptoms, respiratory weakness and paralysis.
    • Treatment: Supportive, monitor respiratory status, provide comfort.
  13. Roseola
    • AKA Exanthen Subitum; sixth disease
    • Transmission: possible respiratory secretions and saliba
    • Symptoms: High fever from 3 to 8 days, pale pink, maculopapular rash on trunk, face, and limbs
    • Treatment: Supportive, antipyretics, the disease is usually self limiting
  14. Rubella:
    • AKA German measles
    • Transmission: Droplet or direct contact
    • Incubation: 14 to 21 days
    • Communicable: 7 days before till 5 days after the rash
    • Symptoms: Low grade fever, headache, malice, anorexia, pink non confluent maculopapular rash
    • Treatment: Supportive, isolation for pregnant women
    • Complications: Teratogenic effect on exposed fetus.
  15. Streptococcus A
    • Agent: Group A B-Hemolytic Streptococci
    • Transmission: Contact with respiratory secretions, direct contact 
    • Symptoms: Pharyngeal (soar throat, common fever) skin manifestations (impetigo)
    • Treatment: Antibiotics, fever management, warm fluids
  16. Scarlet fever
    • Agent: Group A B-hemolytic streptococci
    • Transmission: Direct contact or droplet
    • Incubation: 2 to 5 days
    • Communicable: During incubation face, may become carrier
    • Symptoms: First 1 to 2 days (white strawberry tongue red pin size rash becomes generalized; absent in face but more intense in folds of joints), by 4 to 5 days (develops red strawberry tongue), by end of the first week (Desquamation of skin occurs, sand paper like on torso, sloughing of soles and palms)
    • Treatment: Penicillin or erythromycin, supportive, standard and droplet precaution until 24 hours of antibiotics
    • Complications: Peritoyonsillar abscess, Sinusitis, om, glomerulonephritis, acute fever, rheumatic, and poliarthritis,
  17. Tetanus
    • Agent: Clostridium Tetani or Tetatus Vacillus
    • Transmition: Via wounds
    • Symptoms: Neck or jaw stiffness, facial spasms, prolonged muscle contraction.
    • Treatment: Tetanus immune globulin, monitor respiratory status, hydration; may need mechanical ventilation
  18. Lyme disease
    • Agent: Borrelia Burgdorfuri (spirochete)
    • Transmission: VIA Tick bite
    • Symptoms: Malice, headache, mild fever, joint aches, red bull's eye, rash around tick bite.
    • Treatment: Antibiotics
    • Teaching: Proper removal of tick and prevention of tick bites, rest and complete all antibiotics
  19. Rabies (Hydrophobia)
    • Agent: Rhabdoviridae (two types, dogs and wild life)
    • Transmission: By infected saliva
    • Symptoms: Headache, fever, malice, difficulty swallowing, if untreated leads to coma and death
    • Treatment: Human rabies immune globulin for passive immunity; rabies vaccine, for active immunity
  20. West Nile virus
    • Agent: Arbovirus
    • Transmission: Infected wild birds-mosquito carries virus from bird to human.
    • Symptoms: Most people are A symptomatic; 20% have flue like symptoms; 1% have severe neurological symptoms
    • Treatment:Standard precautions, teach prevention of mosquito bites, and avoid having standing water near home.
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peds exam 4
peds exam 4
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