NR 602 WEEK 3 CASE STUDY - WEEK 3:
IMMUNIZATION CASE STUDY CHAMBERLAIN
UNIVERSITY
What are s/s of bacterial pharyngitis? - answers- :Swollen uvula
White spots
Red/swollen tonsils
Red/swollen throat
Gray, furry tongue
What commonly causes viral pharyngitis? - answers- :Rhinovirus
Adenovirus
Parainfluenza
Epstein-barr virus
What commonly causes bacterial pharyngitis? - answers- :Group A strep
What increases the risk of getting pharyngitis? - answers- :Fam h/o rheumatic fever
Day care
What are s/s of strep throat? - answers- :Cervical adenopathy
Fever >102
,No cough/nasal congestion
Petechiae on soft palate
Beefy red tonsils
Sandpaper rash (nose, neck, torso)
Abd pain
HA
What are some diagnostic tests for pharyngitis? - answers- :Rapid strep
CBC (WBC shift to the left)
Monospot if mono suspected
What are some treatments for pharyngitis? - answers- :Gargle with salt water
Change toothbrush
PCN x1 IM or x10d PO
1st gen cephs x10d
Azithro (if PCN)
What is the incubation period for pharyngitis? - answers- :2-5d
When is a consult/referral needed for pharyngitis? - answers- :Evidence of acute renal failure
Reddish, tea colored urine (2-3w post-infection)
When is a pt no longer contagious with pharyngitis? - answers- :After 24h on abx
What is kawasaki dz? - answers- :Acute, febrile, immune-mediated, self-limited dz characterized
by vasculitis.
, Leading cause of acquired heart dz in kids.
85% <5yo
Most prevalent in Japan
What is diagnostic criteria for Kawasaki dz? - answers- :Requires 5d of fever plus >/= 4 of the
following:
-Bilat bulbar conjunctival injection
-Oral mucus membrane changes (injected/fissured lips, injected pharynx, strawberry tongue)
-Periph extrem. changes (erythema of palms/soles, edema of hands/feet, periungual)
-Polymorphous rash
-Cervical lymphad. (>/= 1 lymph node >1.5cm in diam)
What is stage 1 of Kawasaki dz? - answers- :Acute (1-2w):
-High fever 103-105 x5d unresponsive to abx
-Oral mucosa lesions may last 1-2w
-Perineal rash
-Non-tender cervical lymphad.
-Painful rash/edema on feet
What is stage 2 of Kawasaki dz? - answers- :Subacute (2-8w after onset, without treatment):
-Desquamation of palms, feet, periungual area
-Coronary artery aneurysm
IMMUNIZATION CASE STUDY CHAMBERLAIN
UNIVERSITY
What are s/s of bacterial pharyngitis? - answers- :Swollen uvula
White spots
Red/swollen tonsils
Red/swollen throat
Gray, furry tongue
What commonly causes viral pharyngitis? - answers- :Rhinovirus
Adenovirus
Parainfluenza
Epstein-barr virus
What commonly causes bacterial pharyngitis? - answers- :Group A strep
What increases the risk of getting pharyngitis? - answers- :Fam h/o rheumatic fever
Day care
What are s/s of strep throat? - answers- :Cervical adenopathy
Fever >102
,No cough/nasal congestion
Petechiae on soft palate
Beefy red tonsils
Sandpaper rash (nose, neck, torso)
Abd pain
HA
What are some diagnostic tests for pharyngitis? - answers- :Rapid strep
CBC (WBC shift to the left)
Monospot if mono suspected
What are some treatments for pharyngitis? - answers- :Gargle with salt water
Change toothbrush
PCN x1 IM or x10d PO
1st gen cephs x10d
Azithro (if PCN)
What is the incubation period for pharyngitis? - answers- :2-5d
When is a consult/referral needed for pharyngitis? - answers- :Evidence of acute renal failure
Reddish, tea colored urine (2-3w post-infection)
When is a pt no longer contagious with pharyngitis? - answers- :After 24h on abx
What is kawasaki dz? - answers- :Acute, febrile, immune-mediated, self-limited dz characterized
by vasculitis.
, Leading cause of acquired heart dz in kids.
85% <5yo
Most prevalent in Japan
What is diagnostic criteria for Kawasaki dz? - answers- :Requires 5d of fever plus >/= 4 of the
following:
-Bilat bulbar conjunctival injection
-Oral mucus membrane changes (injected/fissured lips, injected pharynx, strawberry tongue)
-Periph extrem. changes (erythema of palms/soles, edema of hands/feet, periungual)
-Polymorphous rash
-Cervical lymphad. (>/= 1 lymph node >1.5cm in diam)
What is stage 1 of Kawasaki dz? - answers- :Acute (1-2w):
-High fever 103-105 x5d unresponsive to abx
-Oral mucosa lesions may last 1-2w
-Perineal rash
-Non-tender cervical lymphad.
-Painful rash/edema on feet
What is stage 2 of Kawasaki dz? - answers- :Subacute (2-8w after onset, without treatment):
-Desquamation of palms, feet, periungual area
-Coronary artery aneurysm
