Strep Pharyngitis
What age group is most commonly affected by streptococcal pharyngitis?
Children aged 5–15 years
What is the classic symptom that presents with croup?
Barking cough
What virus is the most common cause of bronchiolitis?
Respiratory syncytial virus (RSV)
What is the most common bacterial cause of pneumonia in children?
Streptococcus pneumoniae
What is the nickname often used to describe pertussis?
"The 100-day cough"
Name 3 criteria from the Centor scoring system.
Fever, tonsillar exudates, tender anterior cervical lymphadenopathy, absence of cough
What virus is the most common cause of croup?
Parainfluenza virus
Name one risk factor for severe bronchiolitis in infants.
Prematurity, congenital heart disease, chronic lung disease, immunodeficiency
What is a key clinical finding on auscultation of a child with bacterial pneumonia?
Crackles or decreased breath sounds
What is the characteristic sound heard in pertussis?
Inspiratory "whoop"
What is the gold standard test for confirming strep throat?
Throat culture
What X-ray finding is associated with croup?
Steeple sign
What is the mainstay of treatment for bronchiolitis?
Supportive care (hydration, nasal suctioning, oxygen if needed)
What antibiotic is first-line treatment for outpatient bacterial pneumonia?
Amoxicillin (80 mg/kg/day)
What is the first-line treatment for pertussis?
Azithromycin 500mg daily on first day then 250mg daily x4 days.
What is the first-line antibiotic treatment for strep throat in children?
Penicillin V or Amoxicillin
What is the first-line treatment for mild to moderate croup?
Dexamethasone (0.6 mg/kg PO/IM) - improvement seen within 2-3 hours after single oral dose. Can give a second dose but no evidence that there is additional benefit over a single dose.
Why are corticosteroids generally not recommended for bronchiolitis?
Studies show no significant benefit in reducing severity or duration
What clinical sign is most predictive of pneumonia in children?
Tachypnea (increased respiratory rate)
What vaccine is used to prevent pertussis and how many vaccines from birth until age 18 are required for full immunization status?
DTaP (diphtheria, tetanus, acellular pertussis), 6 total does IM. Given at age 2 months, 4 months, 6 months, 18 months, 4-6 years, and grade 8.
Name 2 serious complications of untreated streptococcal pharyngitis.
Rheumatic fever or post-streptococcal glomerulonephritis
In severe cases, what nebulized medication is given to rapidly improve stridor?
Nebulized epinephrine - Epinephrine 0.5ml of 2.25% solution diluted in 3ml of NS or sterile water via nebulizer
What medication can be used as prophylaxis in high-risk infants to prevent severe RSV infection?
Palivizumab 15mg/kg IM once monthly during RSV season (fall-spring).
Name an atypical bacterial cause of pneumonia that requires a macrolide antibiotic.
Mycoplasma pneumoniae
What post-exposure prophylaxis is recommended for close contacts of a pertussis case?
Azithromycin (or another macrolide antibiotic)
-Infants <1 month: 10 mg/kg/day PO x 5 days
-Infants ≥1 month & children: Day 1: 10 mg/kg (max 500 mg), Days 2-5: 5 mg/kg/day (max 250 mg)
-Adults: 500 mg PO on day 1, then 250 mg PO daily x 4 days