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Host and Defense 2020 > 3/17/17 DOBY Pediatric infections TEST #3 > Flashcards

3/17/17 DOBY Pediatric infections TEST #3 Flashcards

1
Q

If a child has sepsis what might the core temperature be?

A
  • > 38.5

- < 36

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2
Q

If a child has sepsis what type of heart rate might they have?

A

-Tachycardia

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3
Q

If a child has sepsis what will happen to the respiratory rate?

A

-It will be elevated

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4
Q

T/F A high and low WBC can be a sign of sepsis

A

True

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5
Q

What is one of the key differences between SIRS in children versus adults?

A

-In adults you look for blood pressure, but not in children (they can still have a normal blood pressure)

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6
Q 
Which of the following make neonates (babies less than a month) more susceptible to infections?
A) Less IgG production
B) Declining maternal IgG
C) Less cytokine production
D) Decreased function of neutrophils
E) all of the above
A

-E) all of the above

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7
Q

The T and B cells present in utero have to coexist with who’s immune system?

A

-The mothers

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8
Q

In babies the anti-inflammatory cytokine production (T cells) is increased in diminished?

A

-Diminished

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9
Q

In babies immunoglobulin synthesis (B cells) is more or less?

A

-Less

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10
Q

T/F In babies neutrophils differ from adult functional capacity.

A

True

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11
Q

What is an SBI?

A

-Serious bacterial infection

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12
Q

What is a fever in a neonatal?

A

38.0 (100.4) in rectal

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13
Q

Globally SBI is responsible for how many neonatal deaths?

A

-1/3 to 1/4 of deaths

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14
Q

What are seven SBIs found in neonatals?

A
  • Meningitis
  • bactermia
  • UTIs
  • Pneumonia
  • Osteomyelitis/septic arthiritis
  • SSTI
  • bacterial gastroenteritis
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15
Q

What SBI accounts for most the infections in infants < 90 days old?

A

-UTIs

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16
Q

When is meningitis most common in infants?

A

-Within the first 30 days

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17
Q

What are the most common causes of neonatal SBI?
A) GBS, Salmonells sp., and E. coli
B) GBS, Staphylococcus aureus, and E. coli
C) GBS, listeria, and E. coli
D) Staphylococcus aureus, E. coli, and Listeria
E) GBS, Listeria, and Streptococcus pneumoniae

A

C) GBS (group B strep), Listeria, and E. coli

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18
Q

What are viral causes of neonatal sepsis?

A
  • HSV 1 and 2
  • VZV
  • Enteroviruses
  • Influenza
  • Adenoviruses
  • RSV
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19
Q

Group B strep is what type of gram stain?

A

-Gram + cocci

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20
Q

What hemolysis is Group B strep?

A

-Beta hyemolytic

21
Q

What are the bacterial pathogens of neonatal SBIs?

A
  • Group B strep ( S. agalactiae)
  • E. coli and other Gram - enteric bugs
  • Listeria monocytogenes
22
Q

T/F Group B strep is a common colonizer of GI and GU tracts

A

True

23
Q

What is the colonization rate of pregnant women?

A

-15-40%

24
Q

Group B strep early onset disease occurs within what time frame?

A

< 7 days

25
Q

Group B strep late-onset disease occurs within what time frame?

A

-7-89 days

26
Q

Group B strep late late onset disease occurs within what time frame?

A

-90 + days

27
Q

Early onset disease for group B strep is commonly associated with what?

A

-Maternal OB complications

28
Q

Which onset of group B strep has the highest mortality?

A

Early onset

29
Q

What are some symptoms of early onset group B strep?

A
  • Respiratory distress
  • Poor feeding
  • Lethargy
  • apnea/bradycardia
30
Q

What is the #1 cause of early neonatal morbidity and mortality in the US?

A

-Group B strep

31
Q

What is the drug of choice for Group B Strep treatment?

A

-Penicillin G (1 dose four hours before birth of baby)

32
Q

Intrapartum Antimicrobial Prophylaxis (IAP) reduces what type of onset of group B strep in infants?

A

-Early onset

33
Q

Today we do a universal screening of pregnant women at what week in gestation?

A

-35-37 weeks

34
Q

When should you use clindamycin to treat group B strep?

A

-Only if you know the isolate is susceptible

35
Q

What is the gram stain of Listeria monocytogenes?

A

-Gram + rod

36
Q

Listeria monocytogenes is ______ anaerobic and is _______?

A
  • Facultatively

- Nonsporulating

37
Q

What type of hemolysis is Listeria monocytogenes?

A

-Incomplete beta-hemolysis

38
Q

What temperature does Listeria monocytogenes grow well at?

A

-refrigerator temps

39
Q

What food is Listeria monocytogenes associated with?

A
  • Milk
  • Soft cheeses
  • Ready to eat pork
  • Deli meat
  • hot dogs
  • cantelopes
40
Q

If you have in utero infection of Listeria while pregnant what might happen?

A
  • Still birth

- abortion

41
Q

What is the drug of choice to treat Listeria infections?

A

-Ampicillin (plus gentamicin for synergy in certain cases)

42
Q

T/F E. coli is non lactose fermenting

A

False

-It is lactose fermenting

43
Q

What is the drug of choice for E. coli that textbooks say?

A

-Ampicillin (but they really use extended spectrum cephalosporin)

44
Q

T/F Think galactosemia with E. coli sepsis

A

True

45
Q

What is the best choice for empiric antimicrobial therapy for a febrile neonate?
A) Ampicillin and gentamicin
B) Ampicillin, cefotaxime, gentamicin
C) Vancomycin, cefotaxime, and gentamicin
D) Ceftriaxone and gentamicin
E) Vancomycin and Ampicillin

A

B) Ampicillin, cefotaxime, and gentamicin

46
Q

What empiric treatment of febrile infants do you use for Gram + infection of Group B strep and listeria and is the only active agent for listeria?

A

-Ampicillin

47
Q

What empiric treatment of febrile infants do you use as synergy for listeria and group B strep?

A

-Gentamicin

48
Q

What empiric treatment of febrile infants do you use if > 1 month old and dealing with E. coli or gram - coverage and is especially important if suspecting meningitis?

A

-Cefotaxime

Host and Defense 2020 (61 decks)

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