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pediatrics > bacinfxns > Flashcards

bacinfxns Flashcards

1
Q

incubation period of diphtheria (via resp droplets)

A

2-6 days

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2
Q

3 biotypes of diphtheria

A

mitis; gravis; intermedius

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3
Q

offending agent in pseudomembranous pharyngitis

A

Corynebacterium diptheriae

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4
Q

bullneck appearance and leather-like adherent membrane and extension beyond the faucial area

A

diptheria

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5
Q

difference bet diphtheria and strep throat

A

diphtheria: relative lack of fever and nonexudative throat

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6
Q

Dx of diphtheria

A

culture from nose and throat(negative results does not rule it out)

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7
Q

rationale for giving antimicrobials in diphtheria

A

to halt toxin production; treat localized infection and prevent transmission to contacts

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8
Q

Tx for diphtheria

A

Pen G IM/IV 100k-150k U/kg/day q6 fo 14 days; Erythromycin 40-50/mkd orally or IV for 14 days eradicates nasopharyngeal carriage

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9
Q

how to determine treatment of diphtheria

A

2 successive negative cultures taken 24 hrs apart after completion of therapy; antimicrobial prophylaxis given for 7-10days and diphtheria toxoid for asymptomatic carriers

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10
Q

most infectious stage of whooping cough

A

catarrhal stage

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11
Q

incubation period of whooping cough

A

7-10 days

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12
Q

characteristic of cough in pertussis

A

explosive outburst in series of 5-10 rapid coughs in one expiration and ending in a high pitched whoop(forceful inspiratory gasp) often associated with suffusion of face and popping out of eyes and vomiting

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13
Q

presumptive diagnosis of pertussis

A

symptoms + very high WBC count(leukemoid rxn) with absolute lymphocytosis

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14
Q

Dx of pertussis

A

(+) growth of culture in Bordet-Gengou agar from a swab taken from the posterior nasopharynx for 15-30s

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15
Q

complications of pertussis

A

Hemorrhage; Seizures; Otitis media;Atelectasis;apnea;activation of latent TB;Pneumonia

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16
Q

Tx of pertussis

A

Erythromycin 40-50mkd PO q6 x 14days; Erythromycin for 14 days given promptly to all household contacts and other close contacts

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17
Q

Diffuse adrenal hemorrhage; DIC; coma; death

A

Waterhouse-Friedrichsen syndrome

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18
Q

important features of meningococcemia

A

abrupt onset of fever chills headache vomiting; rapid worsening of symptoms within hours; initially morbiliform rash becoming petechiae then purpuric within hours

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19
Q

DOC for meningococcemia

A

Pen G 250k-450k U/kg/day IV in 4-6 divided doses at least 5-7days

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20
Q

who are considered exposed in meningococcemia

A

household; school or day care contacts during the 7 days before exposure

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21
Q

Prophylactic tx for those exposed to meningococcemia

A

Rifampicin 10mkd q12 x4doses; or Ceftriaxone 125mg single dose IM for less than 12yo; >18yo:Ciprofloxacin 500mg PO single dose

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22
Q

most common mode of transmission of enteric fever

A

ingestion of food or water contaminated with S. typhi from human feces

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23
Q

when is enteric fever infectious

A

throughout the duration of fecal excretion

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24
Q

incubation period of enteric fever

A

7-14days

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25
Q

what dse entity do you find rose spots

A

enteric fever

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26
Q

rare complications of enteric fever

A

toxic myocarditis; delirium; increased ICP; pyelonephritis; meningitis; endocarditis

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27
Q

when does the stool and urine cultures become positive in enteric fever

A

after the 1st week of illness

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28
Q

mainstay of diagnosis in enteric fever

A

blood culture

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29
Q

Tx for uncomplicated and fully sensitive enteric fever

A

Chlorampenicol 50-75mkd x14-21days OR Amoxicillin 75-100mkd for 14days

30
Q

Tx for severe typhoid fever

A

Fully sensitive: Ampicillin at 100mkd x14days; MDR: Fluoroquinolone 15mkd x10-14days; Quinolone resistant: Ceftriaxone 60-75 mkd x10-14days

31
Q

who are considered chronic carriers of S. typhi

A

those who secrete S. typhi for more than 3mos

32
Q

at what age is Shigellosis most common

A

2-3years old

33
Q

basic virulence trait of shigella

A

ability to invade intestinal epithelial cell (it crosses the colonic epithelium through the M cells overlying the Peyer patches)

34
Q

What species of Shigella produce Shiga toxin; a potent protein-synthesis inhibiting exotoxin that causes HUS

A

Shigella dysenteriae

35
Q

Presumptive diagnosis of shigellosis

A

fecal leukocyte and blood; leukocytosis

36
Q

definitive diagnosis of shigellosis

A

culture of stool and rectal swab (MacConkey agar; xylose-lysine deoxycholate; SS agar)

37
Q

Empirical tx of shigellosis

A

Cefixime 8mkd PO q12 x5days; OR Ceftriaxone 50mkd IV or IM OD x5days; OR Azithromycin 12mkd PO 1st day then followed by 6mkd for the next 4days; AND Zinc 20mg/day x14days improves immune response to Shigella

38
Q

group of E. coli that causes infantile explosive diarrhea with dehydration; few or no structural changes in the mucuso

A

ETEC

39
Q

group of E.coli that causes colonic lesions like dysentery

A

EIEC

40
Q

group of E.coli that causes nonbloody diarrhea with mucus

A

EPEC

41
Q

group of E.coli that causes significant dehydration

A

EAEC

42
Q

group of E.coli that produces shiga-toxin

A

EHEC

43
Q

Tx for culture confirmed ETEC

A

TMP-SMX

44
Q

slightly curved; gm(-) aerobic bacillus that has serotypes 01 and 0139

A

Vibrio cholerae

45
Q

predominant strain of cholera

A

O1 El Tor

46
Q

laboratory finding in cholera

A

hemoconcentration; hypokalemia; hyponatremia ; hypchloremia; metabolic acidosis

47
Q

confirmatory test for cholera

A

Cary-Blair transport medium plated onto TCBS (thousulfate-citrate-bile-sucrose media)

48
Q

rapid test for cholera

A

darkfiel microscopy (wetmount of liquid stool examined for DARTING organism)

49
Q

complications of cholera

A

dehydration that may lead to acute tubular necrosis; hypoglycemia; hypokalemia; pulmonary edema

50
Q

DOC for cholera

A

for 9yo:Tetracycline:50mkd PO qid x3days

51
Q

neurotoxin produced by C. tetani

A

tetanospasmin

52
Q

alternative to Ig Tet

A

Human IVIG

53
Q

tx for tetanus for best survival rates

A

NM blockers (Vecuronium and Pancuronium)

54
Q

clean painless papule (chancre) that appears 2-6wks after inoculation and heals spontaneously within 4-6hr

A

primary syphilis

55
Q

nonpruritic maculopapular rash on the palms and soles (may be pustular) manifests when if primary syphilis is not treated

A

2-10 wks (secondary syphilis)

56
Q

neurologic; cardiovascular GUMMAtous lesion (granulomas of the skin and MSS)

A

tertiary syphilis (latent)

57
Q

refusal to move the involved extremity in early congenital syphilis

A

pseudoparalysis of Parrot

58
Q

barrel-shaped upper central incisors in late congenital syphilis

A

Hutchinson teeth

59
Q

painless knee joint swelling with sterile synovial fluid in late congenital syphilis

A

Clutton joint

60
Q

linear scars on mouth anus and genitals in late congenital syphilis

A

rhagades

61
Q

Dx of congenital syphilis

A

darkfield microscopy; immunofluorescence; nontreponemal tests (VDRL RPR); Treponemal test(TPI FTA-ABS MHA-TP)

62
Q

Diagnostic test for syphilis to determine disease activity

A

nontreponemal tests (VDRL and RPR)

63
Q

Diagnostic test fro syphilis that measure antibody specific for T. pallidum

A

treponemal tests (TPI FTA-ABS MHA-TP)

64
Q

Tx for congenital syphilis

A

Aqeous Pen G 100k-150k Ukd IV for 10-14 days

65
Q

Tx for primary secondary and early latent syphilis

A

Benzathine Pen G 50k U/kg IM single dose

66
Q

acute systemic febrile rxn with exacerbation lesions occurs in 15-20% of all px with acquired or congenital syphilis who are treated with penicillin

A

Jarisch-Herxheimer rxm

67
Q

technique to visualize Leptospira

A

darkfield microscopy or silver staining impregnation staining

68
Q

manifestions of anicteric leptospirosis

A

conjunctival suffusion with photophobia and orbital pain; truncal maculopapular rash; fever; chills; headache; malaise; nausea; vomiting; severe muscle pain and tenderness on the LE

69
Q

other term for Icteric Leptospirosis

A

Weil’s syndrome

70
Q

Weil’s syndrome

A

hemorrhage and cardiovascular collapse; RUQ pain; hepatomegaly; increased liver enzymes; hyperbilirubinemia; azotemia-oliguria-anuria

71
Q

most useful screening test for Leptospirosis

A

microscopic slide-agglutination test using killed antigens

72
Q

Tx of Leptospirosis

A

Parenteral Pen G 6-8 M U/m2/day in 6 divided doses for 1wk; OR Tetracycline

pediatrics (16 decks)

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