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NURS 629 EXAM 3 QUESTIONS AND ANSWERS
1. Hand, Foot, and Mouth Disease (HFMD): Caused by the coxsacki virus
3-6 day incubation period Symptoms: -Low grade fevers -sore throat, poor appetite -malaise prior to rash -Petechial rash, blisters start. -Oral lesions, then hands and feet. -Sometimes can have on torso and extremities. -Look like canker sores with yellow ulcers and red halo. Treatment- tylenol, warm baths. Oragel depending on age. Magic moulthwash (benadryl and maalox) mixture. push hydration. Education: -very contagious- must have all of the lesions crusted prior to going back to school. -Illness can last up to one week.
2. Hand-foot-and-mouth disease: · pustular, ulcerating lesions o
on the hands and feet o oral ulcers
3. Herpes Simplex Virus: Spread by respiratory droplets, contact with active
lesion, and contact with body fluid. Symptoms -fever -malaise -fever -swollen glands -grouped vesicles with an erythematous base -gingiva that bleeds easily with small yellow ulcers.
Treatment -Symptomatic treatments- oral antivirals or topical antivirals to shorten length of illness. -will most likely last 2-3 weeks
Symptoms -high grade fever -headache
-chills -body aches -runny nose -dry hacking cough -N/V and diarrhea -Croup Complications -myocarditis -pneumonia -atelectasis -Otitis media secondary bacterial infection Diagnosis -Rapid flu Treatment -supportive therapy -Tamiflu in the first 48 hours of onset of symptoms -for those under ages of 2, patients with respiratory disease, or immunocompro- mised patients
7. Measals: Acute viral respiratory illness that is transported through contact
Symptoms -fevers, malaise, cough -conjunctivitis -kolpik spots (maculopapular rash 14 days after exposure) -measles rash spreads from head to trunk to lower extremities so top to bottom. Treatment -supportive -High dose vitamin A
8. Mumps: Paramyxoviridae family of virus
-neck and muscular pain -can get a macular rash on trunk Diagnosis -PCR or serological tests Treatment -Corticosteroids for the swelling, and NSAIDS for pain
9. Fifths disease: Erythema infectiosum
Human parvovirus B Incubation 4-14 days Symptoms -Prodromal, fever, headache, nausea, and diarrhea -sore throat -Slapped cheek rash -Followed by reticular lace like rash on trunk -Maybe associated with arthralgia -petechia on hands and feet Diagnosis -parovirus IGM IGG Treatment -symptomatic treatment
10. Fifth disease: · fiery red, maculopapular facial rash concentrated on the
cheeks
o Slapped cheek appearance
11. Lime disease stage 1: Borrelia burgdorferi- spread by deer ticks
Stage 1 -2 weeks after the bite they will get that classic erythema migraines.
-The ration starts with a nice annular macule or papule at the side of the bite within 24-48 hours and -within that first 1-2 weeks they will start noticing that classic bull's-eye lesion, so at first after the tech has expelled itself they will notice that maculopapular red lesion, and then you will notice the bull's-eye with a 1-2 weeks later
Clinical features -systemic illness -erythematous popular 1 week after inoculation -linerar patter that follow the cat scratch -lymph node involvement that can last 1-2 months
Diagnostic IFA Treatment -moist wraps -symptomatic treatments -needle aspiration -antibiotics if bacterial involvement or immunocomprimised
17. Miningococcal disease: N. Meningitidis (A,B,C,Y & W-135)
Clinical features -fever -headache -myalgia -cold hands and feet -flu like symptoms -septic shock -stiff painful neck -petechial rash Diagnosis Culture or gram stain, CSF, synovial fluid, sputum Treatment -Hospitalization with IV antibiotics. -prophylaxis treatment to anyone in contact with antibiotics and vaccinations
18. Scarlet fever: Bacterial illness secondary to strep throat
Symptoms -rash sunburn lace like that has sandpaper feeling to it. -red lines in the skin folds -strawberry tounge
Treatment Amoxicillin 50-80mg/kg once daily
19. Iron deficiency anemia: -small, pale RBC and depletion of iron stores
Low HGB MCV low Hypochromic Cause -low birth weight -rapid weight loss -poor dietary intake Clinical presentation
- dyspnea -headache -murmurs -pallor -tachypnea -poor concentration -heart palpitations
20. sickle cell anemia: HCT low 18-
reticulocyte count elevated blood smear shows sickel cells and target cells Recurrent episodes of vaso-occlusion pallor, jaundice splenomeglay
21. Hemophilia A and B: Inherited x linked recessive gene
Deficiency of factor 8 and factor 9 Males are only effected, but females are carriers Clinical findings -excessive bruising -prolonged bleeding
-hemarthrosis in elbows, knees and ankles -prolonged ptt diagnosis
-chronically tired -hx of repeat infections, bleeding, lymphadenopathy, bone and joint pain diagnosis
CBC with diff. referral to heme onc.
24. lymphoma: Group of malignant tumors of lymph nodes and lymph tissue
Associated with EBV and cytomegalovirus Clinical features -most common site of tumor is in intestinal tract (abdominal pain, distention, fullness, and constipation) -non tender lymph node enlargement -symptoms usually present late refer to oncology.
25. Cellulitis: -Bacterial infection of the skin involving the dermis and subq tissue
-Group A beta strep and staph aureus most common organisms -May be H.flu esp in patients <3 years old diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling Diagnosis Wound culture CBC, blood culture if systemically ill Management antibiotic treatment, systemic symptoms and ill may need hospitalization
26. MRSA infections: •Clinical Presentation
-Rapid onset -Abscess that is not draining, warm, erythematous, and painful
- Treatment -Bactrim: children
2 months old 8-12 mg/kg/day X 10 days
- Bactrim DS bid X 10 days -Clindamycin
- 10-25 mg/kg/day (tid dosing)
-Doxycycline
8 years 100 mg bid X 10 days
27. Impetigo etiology: -Contagious, superficial skin infection
-Caused by staphylococci or streptococci
- Staph is most common cause
- Entrance through small cut or abrasion
- Frequently resides in the nasopharynx (what do kids do?) -Spread by contact -Most common on nose, mouth, and limbs -Self-limiting, but if untreated may last weeks to months
28. imptigo: •Symptoms
-Rash that won't go away -Pruritic -Begins in small area and increases -Yellow, crusted, draining lesions
- Clinical Presentation -Begins as a small area and then increases in size -Small vesicle that erupts and becomes yellow, crusted, draining lesions -If crust removed, becomes bright red and inflamed Treatment -Mupirocin /Bactroban (tid X 7-14 days) -Bacitracin (tid X 7-14 days) -Cephalexin 40 mg/kg/day X 10 days -Erythromycin 30 50 mg/kg/day X 10 days -If tx failure switch to TMP/SMX
29. Candidiasis / Tinea: -Skin infection caused by fungal organism
-Candida albicans invades the epidermis when there is a break in the skin, excessive heat and moisture -Transmission through direct contact—person or animal
-Can have multiple fungal infections caused by spreading infection Classified related to location -Tinea capitis—scalp -Tinea corporis—body -Tinea pedis—foot -Tinea cruris—male inguinal region
