FNP2 Exam 2 blueprint GNRS 5670 Latest

FNP2 Exam 2 blueprint GNRS 5670 Latest Update - 140 Questions with 100% Verified Correct Answers Guaranteed A+ Verified by Professor

○ Enterovirus - poliomyelitis (fecal oral transmission) - CORRECT ANSWER:

○ Enteroviruses - non-polio - CORRECT ANSWER: ■ Ø10-15 serotypes account for most diseases ■ ØMost common cause of aseptic meningitis ■ ØHand-foot-mouth, herpangina, acute hemorrhagic conjunctivitis, other ■ ØPrimary invasion through GI tract ■ ØTransmitted via respiratory route ■ ØTransplacental transmission can occur ■ ØInfants have highest prevalence rate

○ Enteroviruses - non-polio: clinical findings - CORRECT ANSWER: ■ ØHistory - mild URI; nonspecific febrile illness >3 days; onset within 2 weeks after delivery ■ ØPhysical examination ● •Skin - macular, macular-papular, urticarial, vesicular, petechial ● •Herpangina - sudden onset of high fever; vesicular lesions on oropharynx, palate ● •Acute lymphonodular pharyngitis ● •Hand-foot-mouth disease - vesicles ● •Aseptic meningitis - fever, stiff neck, headache

○ Fever without focus - CORRECT ANSWER: ■ ØBirth-24 months at greatest risk ■ ØAcute febrile illness without obvious etiology 1 / 4

■ ØTable 24-11 - most common pathogens ■ ØHistory and physical examination

○ Hep A - CORRECT ANSWER: ■ Good hand hygiene, esp after diaper changes

■ Fecal/oral transmission ■ Ig or HAV vaccine within 2 weeks of exposure ■ Good personal hygiene/safe drinking water (well water) ■ Routine HAV vaccine ■ ØCauses primary infection in liver ■ ØPerson-to-person; fecal-oral transmission ■ Ø<10% of young children develop jaundice; only 30% are symptomatic - allows for rapid spread ■ ØClinical findings ● •Preicteric phase - acute febrile illness; malaise, nausea, anorexia, vomiting, digestive complaints; may have RUQ pain ● •Icteric phase - jaundice, dark urine, clay-colored stools; feel sick; poor weight gain in infants ■ ØFulminant disease rare; complete recovery in 1-2 months; occasional relapses up to

• months

■ ØDiagnostic studies - serologic testing ■ ØDifferential diagnosis ● •Infancy - physiologic jaundice, hemolytic disease, galactosemia, hypothyroidism, biliary disorders, hypervitaminosis A ● •Older infants, children, adolescents - hemolytic-uremic syndrome, Reye syndrome, others ■ ØManagement, complications, prevention ● •Supportive care ● •Good hand hygiene, especially with diaper changes ● •Immunoglobulin or HAV vaccine within 2 weeks of exposure 2 / 4

● •Good personal hygiene; safe drinking water ● •Routine HAV vaccine

○ Hep B: - CORRECT ANSWER: Perinatal transmission can occur

○ Herpes family of viruses - herpes simplex virus - CORRECT ANSWER: ■ Include HSV 1&2, Mononucleosis (EBV), Roseola infantum, varicella ■ ØWidely disseminated in humans ● •HSV-1 - orolabial lesions ● •HSV-2 - genital lesions ■ ØBoth types associated with oral/genital infections ■ ØBoth types devastating to newborns ■ ØType 1 most common in children as gingivostomatitis ■ ØType 2 usually result of sexual activity ■ HSV1 (can give you a genital outbreak but does not like to live there) ■ Should child with HSV1 fever blister be kept out of school?● No ● Daycare drooling toddlers left out of daycare ● Wrestlers should not compete until lesions cleared ● Ask all pregnant women about HSV ■ Which is not true of HSV2: NOT most common as gingivostomatitis in children. It is: ● Cause of genital lesions ● Usually result of sexual activity ● Devastating to newborns

○ Herpes family of viruses - herpes simplex virus (Cont.) - CORRECT ANSWER: ■ ØNeonatal HSV-2 from mother during delivery ● •Conjunctivae, nose/mouth, broken skin 3 / 4

● •Can occur with C-section, asymptomatic shedding ■ ØPostnatal transmission, inoculation from fathers, lateral transmission from other infants may occur ■ ØPeriod of communicability 2 days to 2 weeks ■ ØSome congenital infections occur >6 weeks ■ ØCan transmit from primary/recurrent infection ■ ØClinical findings - determined by port of entry, age, health, immune competence ■ ØNeonatal infection - always symptomatic ● •Disseminated - multiple organ failure; encephalitis - day 10-12 of life ● •CNS - focal/generalized seizures, lethargy, irritability, poor feeding, herpetic lesions - day 16-19 of life ● •Skin, eye, mouth - limited to these sites - day 10-12 of life ■ ØTraumatic herpetic infection ● •Localized to area of abrasion, teething, laceration; inoculated by parent who kisses site ● •Fever, constitutional symptoms, regional lymphadenopathy ■ ØAcute herpetic meningoencephalitis ■ ØRecurrent infection - virus is dormant; recurrent infections are common ■ ØDiagnostic studies ● •Intrapartum cultures mother/child; within 12-24 hours after delivery ■ ØDifferential diagnosis ● •Coxsackievirus if viral stomatitis (hand foot mouth) ● •Always suspect HSV with neonatal respiratory distress/sepsis ■ ØManagement ● •Parenteral acyclovir with life-threatening/neonatal infection ● •Oral acyclovir for 6 months after parenteral treatment ■ ØComplications ● •Most cases mild; may have secondary bacterial infection

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