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Question &
Answer ID
Mohammad H.
Soltanzadeh , MD,ID
Professor of Pediatrics, Shaheed Beheshti
University
Of Medical Sciences , Tehran ,
IRAN
Question 1
What
medications are used for the treatment of influenza in children ?
Answer
Older
agents include
Amantadine
& Rimantadine
Both of which block
the entry of influenza into host cells and inhibit a viral assembly
protein called M2
Because the M2
protein of influenza B strains is unaffected by these agents
The drugs
are effective only against influenza A strains
Answer
Newer
agents
Inhibit viral
neuraminidase
Oseltamivir ( Tamiflu )
Useful for the
prophylaxis or treatment of both influenza A & B infection
Zanamivir
( Relenza ) for
influenza A&B
Question 2?
In which
patients should TMP – SMX be avoided or used with caution
?
Answer
Pregnancy
Fragile X syndrome
Known sensitivity
to any sulfonamide
Age of < 2 months
History of skin
Rash while receiving TMP-SMX
G6PD deficiency
Question 3?
Which Antibiotic is
associated with the Red Man Syndrome?
Answer
The red mn
syndrome is a frequent occurrence with the rapid infusion
of Vancomycin
Characterized by
flushing of the Neck, Face and Thorax
The Histamine
release underlying this reaction
Answer
It is not mediated
by IgE
Does not true
Hypersensitivity
The
reaction can be avoided by slowing the rate of drug infusion
H1 receptore
antagonist e.g. :
Diphenhydramine
before Vancomycin
Effective for
preventing this reaction
Question 4?
Name of 3 stages of
Pertussis
Whooping cough
Answer
Catarrhal 1-2 wks
low grade fever , URI symptoms
Paroxysmal 2-4 wks sever cough
Convalescent 1-2 wks resolution of symptom
Question 5?
What is the most common
cause of Death in children with whooping cough ?
Answer
90% of
deaths are attributed to:
Pneumonia
Which develops as a
secondary bacterial infection
These cases can be
missed during the paroxysmal phase
A new spiking
fever prompt a careful for pneumonia
Question 6?
Is the Erythromycin of
value in pertussis infection?
Answer
If used the first 14 days of illness or
Before the paroxysmal stage
Erythromycin
can decrease the severity of symptoms during the paroxysmal stage
Answer
If the diagnosis is later should be administered to eliminate
the N.F. carriage of Bor. Pertussis
50 mg /k/d 14 days
Answer
Recent
suggest :
Azithromycin 10/mg/k/d in one dose
Clarithromycin 10-20 mg/k/d divided in 2 dose for 5-7 d
Question 7?
Do antibiotic
prevent the development of pneumonia after a URI ?
Answer
Over 90% of URI
are used by Viruses
Children < 5 yrs
can experience 6-8 URI episodes per yr
Antibiotic does
not shorten their course or prevent the development of Pneumonia
Pediatrics ID j
12;115-120,1993
Question 8?
Sternal edema is
classically the sign of what infection?
Answer
MUMPS
Question 9?
How does Hatchcocks
sign help distinguish swelling as a result : Mumps from caused by
Adenitis ?
Answer
Upward pressure applied to the angle of the mandible produces
tenderness with mumps ( Hatchcocks sign )
This maneuver produces no tenderness with Adenitis
Question 10 ?
What is the best
approach to diagnosing HSV Encephalitis in children ?
Answer
In the past :
Definitive
diagnosis relied on Brain Biopsy
In recent
yrs :
Have demonstrated
that analysis of CSF using the PCR > 98%of cases
May be more
sensitive than Brain Biopsy
Clin. ID
20;414-420,1995
Question 11?
Can Acyclovir be
used to prevent or treat oral HSV infections ?
Answer
In immunocompetent host :
Oral
Acyclovir benefit in primary HSV gingivostomatitis
Limited efficacy for the treatment of recurrent herpes
labialis
Answer
Topical Acyc. Has
not shown benefit in this setting .
Prophylaxis with
oral Acyc. Can reduce the numbers of recurrence in Adults with
Herpes Labialis
But it
has not been studied in children.
Question 12 ?
Does Teething cause
fever ?
Answer
Long a Doctrine of Grandmothers The suggested association between
teething and temperature
Elevation may have some bases in fact.
Answer
In one study of 46 healthy infants with rectal T. recorder
before the eruption the 1st tooth
Nearly half had a new temperature elevation of > 37.5 on
the day of eruption
Answer
Other
study:
Have shown some
slight temperature increase
In any event
elevated fever should not be ascribed simply to teething
Listen to the
Grandmothers , but verify
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