very high-yield Ped question - jeyhof
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very high-yield Ped question - jeyhof
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11-14-2010, 04:09 PM
5 yo child presents with fever 104F (40C), eritematous rash, strawbery tongue and a single cervical lymph node which is 2cm tender. Response to which of the following drugs is the most prognostic for this child?
a. acetaminophen b. penicillin c. cyclosporin d. oxacillin e. vancomycin
11-14-2010, 05:07 PM
all choices can be eliminated except for penicillin and cyclosporin, so what do you think?
11-14-2010, 05:54 PM
any more opinions? anybody thinks about Kawasaki?
11-14-2010, 06:05 PM
Kawasaki; Prophylax with Aspirin and pred. Guess in the absence of pred cyclosporin can go
11-14-2010, 06:15 PM
Cyclosporin is the last resort drug for Kawasaki's that is not responsive to aspirin and IVIG.
Response to cyclosporin is the most prognostic in fatality from Kawasaki's. I only have doubts about whether it is Kawasaki's or Scarlet. Single enlarged lymph node + bulbar conjunctivitis sounds more like Kawasaki's, however most of sources say there is absolutely nothing pathognomonic to distinguish the two.
11-14-2010, 06:17 PM
sorry, forgot to mention conjunctivitis in the stem
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