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hat is the causative agent for fifth disease?
W
Human Parvovirus B19
How is fifth disease transmitted?
Through respiratory secretions, blood, and from mother to baby in utero
hat is the main age group which fifth disease affects?
W
15 and under
hat are the s/s of 5th disease?
W
"slapped cheek" appearance, then a lace-like maculopapular rash on the trunk.
onset of fever, sore throat, corya is about 1 week after exposure, and lasts 2-3 days,
followed by about 7 days symptom free. Then, the slapped cheek appearance with
circumoral pallor appears
hen you see the slapped cheek rash in 5th disease, is the patient contagious?
W
No. They are no longer contagious when the rashes appear. Children may attend school
hat are 5 differential diagnoses for 5th disease?
W
Rubella, Measles, scarlet fever, roseola, kawasaki disease, lyme disease,
mononucleosis, lupus
hat diagnostics are needed to determine 5th disease?
W
None are needed aside from a clinical exam.
You can do a b19 assay to confirm if you like, especially in pregnant females (must refer
to OBGYN if confirmed)
hy is 5th disease dangerous for pregnant women?
W
may cause fetal hydrops and demise
hat are complications with 5th disease?
W
Arthritis (especially in adult women)
Gloves and socks syndrome
,c hronic anemia
aplastic anemia crisis
hat follow-ups are needed with 5th disease?
W
none needed unless complications arise
If a parent asks how long the symptoms of 5th disease last, what should you tell them?
1-2 weeks is how long symptoms typically take to resolve. Most patients make complete
recovery, and complications are rare
hat steps need to be done if a patient presents with slapped cheek rash and is
W
pregnant?
Immediate referral to OBGYN
hat are the causative agents of influenza?
W
Influenza virus types A and B
hat time of year is most prevalent for an influenza infection?
W
late fall to early spring
hat are the signs & symptoms associated with influenza?
W
abrupt onset of fever, malaise, myalgia, HA, anorexia, rhinitis, sore throat and
non-productive cough.
Kids can have otitis media and GI issues (n/v/d)
hat distinguishes the common cold from influenza?
W
sore throat, nasal congestion and sneezing are less common in the flu versus the
common cold
hat distinguishes a URI from influenza?
W
Myalgia and malaise are not usually present with URI, but they are with the Flu
hat are the possible complications of the flu?
W
PNA, sinusitis, AOM, myositis, pericarditis, reye's syndrome, asthma/copd
exacerbations
an you give aspirin to a child with the flu?
C
No, because of the increased risk of Reye's syndrome. The flu already puts the children
at risk of Reye's syndrome as does Aspirin.
What diagnostics are used for the flu?
, apid antigen detection tests
R
Can do a CBC, UA, CXR, blood cx if you suspect a complication like PNA
ow can you prevent the flu?
H
Everyone 6m and older should be getting the influenza vaccine. The only
contraindication is an anaphylactic reaction to eggs. Be very cautious in giving the
vaccine to someone with a history of Guillain-Barre syndrome.
Do not give live vaccine to pregnant or immunocompromised patients
hen can you give medications for the flu?
W
if symptoms have been present for less than 48 hours
hat anti-viral medication should you NOT give to an asthma/COPD patient and why?
W
Zanamivir
This is given as a powdered inhaler and can cause exacerbations
hat antivirals can be given for flu patients?
W
tamiflu-- to patients 2weeks and older. given BID for 5 days
Baloxavir- for patients 12 years and older PO x 1 dose
Zanamivir- for 7 years and older. inhaled powder (not for asthma/copd)
What is the causative agent for Kawasaki disease?
It is unknown
ho is most at risk for developing Kawasaki disease?
W
Children under the age of 5. Asian descent is most affected
hat is the main concern with Kawasaki disease?
W
Development of cardiac problems such as aneurysm, mitral/aortic regurgitation and MI
What are the diagnostic criteria for Kawasaki disease?
(think "FEBRILE)
F-Fever
E- Exanthema...polymorphous generalized exanthema (rash associated with fever that
can have many forms)
Bulbar conjunctivitis without exudate
R-Red tongue/oral cavity (strawberry tongue...cracked lips)
I-Internal organ involvement
L-Lymphadenophay
Extremity changes (swollen/red hands or feet, desquamation of fingertips)
What is incomplete Kawasaki disease?
fever associated with only 2 of the 5 previously listed additional symptoms