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Pediatric Boards > ID > Flashcards

ID Flashcards

1
Q

What bacteria is responsible for ecthyma gangrenosum (round, indurated black lesion with central ulceration)?

A

Pseudomonas

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2
Q

Who to prophylax for meningococcemia (4)?

A

1) Household contacts
2) Close contacts outside the home
3) Contact with oral secretions
4) Anyone who examined the throat

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3
Q

What prophylaxis for meningococcemia?

A

Rifampin for children; rifampin, ceftriaxone, cipro, azithro for >18yo

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4
Q

Risk factors for SBP?

A

Nephrotic syndrome and cirrhosis of liver

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5
Q

Bacteria responsible for SBP?

A

Enteric flora; in nephrotic syndrome–encapsulated organisms (loss of IgG in urine)

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6
Q

Treatment of SBP?

A

3rd gen cephalosporin and aminoglycoside

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7
Q

Bacteria responsible for secondary peritonitis?

A

GNR and anaerobes; consider staph epi in PD patients

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8
Q

Infections that latex agglutination can test for (BINS)?

A

B (Group B strep)
Influenza, haemophilus
Neisseria meningitidis
Strep pneumo

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9
Q

What is cryptosporidium?

A

Protozoan causing severe, watery, non-bloody diarrhea mostly in immunocompromised (but also immunocompetent) patients

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10
Q

How long does cryptosporidium diarrhea last?

A

Self-limiting in immunocompetent (~10 days); much longer in immunocompromised–can be indefinite and resistant to treatment

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11
Q

Treatment for cryptosporidium?

A

Nitazoxanide or paromomycin+azithro

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12
Q

What is cryptococcus?

A

Encapsulated yeast causing pulmonary disease and meningitis/meningoencephalitis–think AIDS!

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13
Q

Risk factors for cryptosporidium?

A

Contaminated pools

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14
Q

Risk factors for cryptococcus?

A

Exposure to bird-droppings (pigeons)

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15
Q

Treatment of cryptococcus?

A

Ampho B +/- flucytosine, then fluconazole

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16
Q

Classic CXR finding on active TB?

A

Hilar adenopathy

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17
Q

Treatment of active TB pulmonary disease?

A

2 months of RIP (rifampin, INH, pyrazinamide) then 4 months of rifampin and INH

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18
Q

Other sites of TB infection?

A

Meningitis
Adenitis
Pleuritis
Disseminated (Miliary disease)

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19
Q

Treatment of TB meningitis?

A

2 months of RIPS (rifampin, INH, pyrazinamide, and streptomycin) then 10 months of rifampin and INH; always use steroids

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20
Q

What is constitutes a positive PPD?

A

5mm–HIV+, abnormal CXR, close contacts, severely immunocompromised
15mm– >/= 4yo and no risk factors
10mm–everyone else

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21
Q

Presentation of chlamydia trachomatis pneumonia?

A

Afebrile, staccato cough, tachypnea, +/- eye discharge

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22
Q

Treatment of chlamydia trachomatis conjunctivitis?

A

PO erythromycin or sulfonamides; NOT topical treatment

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23
Q

Treatment of chlamydia trachomatis pneumonia?

A

Azithromycin x5 days, erythromycin x14 days

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24
Q

Treatment of chlamydia genital infections?

A

Azithromycin x1 or doxycycline x7 days

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25
Q

Presentation of chlamydia pneumoniae pneumonia?

A

> 5yo (usually adolescent), low grade fever, infiltrates, bronchospasm

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26
Q

Presentation of RMSF?

A

Fevers, myalgias, headache, petechial rash (starts peripheral–>central), May/June

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27
Q

Bug causing RMSF?

A

Rickettsia rickettsii

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28
Q

Treatment of RMSF?

A

Doxycycline (even if <8yo)

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29
Q

Other presenting lab abnormalities of RMSF?

A

Thrombocytopenia and hyponatremia

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30
Q

What other tick-born illness presents like RMSF?

A

Ehrlichiosis (more likely to have leukopenia and elevated LFTs)

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31
Q

What is Q fever?

A

Rickettsial illness (Coxiella) causing pneumonia, no rash, spread by inhalation of infected animal particles; not caused by tick bite

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32
Q

The 4 C’s of Coxiella?

A

Cattle
Cats
Cilled (killed–slaughterhouses)
Conception (exposure to infected animal products during birthing)

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33
Q

Treatment of Q fever and ehrlichiosis?

A

Doxycycline

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34
Q

Treatment of cat scratch disease?

A

Supportive mostly; don’t I&D; azithro and rifampin can reduce time to lymph node resolution or in immunocompromised patients

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35
Q

Bacteria and treatment of cellulitis from cat or dog bite?

A

Pasteurella multocida; Augmentin (Bactrim + clinda if PCN allergic)

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36
Q

Possible infections from HiB?

A

Meningitis, pneumonia, periorbital cellulitis, pyogenic arthritis, epiglottitis

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37
Q

Treatment of HiB?

A

Ceftriaxone (meropenem if PCN allergic)

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38
Q

What to use for ppx of HiB close contacts?

A

Rifampin

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39
Q

Who and how to treat Salmonella gastroenteritis?

A

Infants <3mo, immunocompromised; treat with ceftriaxone

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40
Q

Presentation of typhoid fever (Salmonella typhi)?

A

Fever, malaise, HSM, “rose spots” on trunk

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41
Q

Diagnosis of typhoid fever?

A

3 sets of blood cultures; bone marrow culture is best

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42
Q

Treatment of typhoid fever?

A

Ceftriaxone, ampicillin, Bactrim, fluoroquinolones based on sensitivity

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43
Q

Types of infections with Pseudomonas?

A

Pneumonia, sepsis, nail-puncture cellulitis/osteomyelitis, endocarditis (IV drug user), bacteremia in burn patient, ecthyma gangrenosum

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44
Q

Presentation of brucellosis?

A

Fever, malaise, mylagias, LAD, HSM

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45
Q

Transmission of brucellosis?

A

Unpasteurized milk and cheest, inhalation (cows, dairy farm), or handling carcasses

46
Q

Treatment of brucellosis?

A

Doxy + aminoglycoside or doxy + rifampin or Bactrim + rifampin (high rate of relapse–must use combo)

47
Q

What virus can be superinfected to cause strep TSS or necrotizing fasciitis?

A

Varicella

48
Q

Can strep cellulitis cause rheumatic fever?

A

No–only post-strep GN (strep throat can cause both)

49
Q

Why treat strep?

A

To prevent rheumatic fever (does not prevent post=-strep GN)

50
Q

Presentation of early onset GBS infection (up to 7 days of life)?

A

Sepsis, pneumonia, meningitis

51
Q

Presentation of late onset GBS infection (7 days - 3 months?

A

Bacteremia, meningitis, osteomyelitis

52
Q

What give pregnant moms GBS ppx?

A

Decreases early onset GBS, but not late onset

53
Q

Who to give GBs ppx to (4)?

A

1) GBS+ this pregnancy
2) GBS bacteriuria this pregnancy
3) Previous infant with invasive GBS disease
4) Unknown GBS and 18hrs, or intrapartum fever

54
Q

Diagnosis of botulism?

A

Organisms and/or toxin in blood or stood

55
Q

How does botulinum toxin work?

A

Blocks release of Ach into synapse

56
Q

Treatment of infantile botulism?

A

Supportive care or anti-toxin (NO antibiotics)

57
Q

Treatment of campylobacter?

A

Azithromycin

58
Q

Presentation of tularemia (Francisella tularensis)?

A

Fevers, HSM, LAD, irregular ulcer at site of innoculation

59
Q

Transmission of tularemia?

A

Rabbits, transmitted by tick or fly bites

60
Q

Treatment of tularemia?

A

Gentamicin, doxycycline, or streptomycin

61
Q

Presentation of bubonic plague (Yersinia pestis)?

A

Septicemia (with buboes–large, suppurative, painful LN); pneumonic form; meningeal form

62
Q

Transmission of bubonic plague?

A

Wild rodents is reservoir; transmitted by fleas or direct contact; pneumonic form transmitted to bystanders by coughing (bioterrorism)

63
Q

Geographical difference between tularemia and plague?

A

Tularemia–midwest (AK, MO, OK)

Plague–desert southwest

64
Q

Treatment of plague?

A

Streptomycin (2nd line–gent, doxy, fluoroquinolones)

65
Q

Presentation of anthrax?

A

Cutaneous–painless papules->paniless vesicle->painless ulcer->painless black eschar

66
Q

Treatment of anthrax?

A

Cipro or doxy (ppx with cipro)

67
Q

In what patient is rifampin contraindicated?

A

Pregnant patient (known teratogen)

68
Q

Treatment of shigella?

A

Ceftriaxone, cipro, or azithro (all patients should be treated)

69
Q

Diagnosis of neonatal CMV?

A

Urine CMV culture in first 3-4 weeks of life

70
Q

4C’s of CMV?

A

Chorioretinitis
Cerebral calcifications (periventricular)
Censorineural hearing loss
Culture, urine for dx
(Also thrombocytopenia, blueberry muffin lesions, HSM, jaundice, SGA, microcephaly, seizures, hypotonia)

71
Q

Infection with blood transfusion (especially pneumonia)?

A

CMV

72
Q

Coxsackie B can cause what “-itis”?

A

Myocarditis

73
Q

Presentation of mumps?

A

Fever, headache, malaise, myalgias, swelling of parotid gland and/or testicles

74
Q

Complications of MUMPS?

A 
Meningitis
Underwear (orchitis)
Muscle aches
Pancreatitis
Swelling of the parotid gland
75
Q

What causes intermittent parotid swelling?

A

Stone in the salivary gland

76
Q

Which is more common from mumps–orchitis, meningitis, pancreatitis?

A

Orchitis

77
Q

Presentation of congenital rubella infection?

A

Cataracts, glaucoma, hearing loss, PDA, thrombocytopenia, blueberry muffin lesions, HSM, hepatitis

78
Q

What are blueberry muffin lesions?

A

Extramedullary hemotopoiesis

79
Q

Presentation of measles?

A

Cough, coryza, conjunctivitis, fever, Koplik spots, rash at hairline

80
Q

Who should get measles immunoglobulin?

A

Infants <12 months, pregnant women, immunocompromisde individuals (give within 6 days of exposure)

81
Q

Does delivery via C-section rule out HSV transmission with active infection?

A

NO–can still be transmitted as ascending infection (although it does decrease the risk)

82
Q

Best test for HIV in children 18 months and younger?

A

HIV DNA by PCR

83
Q

When to test for HIV after exposure?

A

At exposure, 6 weeks, 12 weeks, and 6 months

84
Q

Presentation of childhood HIV?

A

Recurrent bacterial infections, recurrent or persistent thrush, HSM, FTT, DD, cognitive impairment

85
Q

When to screen infants for HIV (with PCR)?

A

Birth, 2 months, 4 months, and 6 months

86
Q

Buzzword for PCP on CXR?

A

Ground glass opacities or appearance

87
Q

What vaccines to give kids with HIV?

A

All except live viruses

88
Q

Complications of VZV infection?

A

Secondary bacterial infection (staph and strep), pneumonia, encephalitis, transient cerebellar ataxia

89
Q

What is VZV exposure for a neonate (to treat with VZIG)?

A

Mom develops VZV between 5 days before delivery through 2 days after delivery (treat with VZIG within 96 hours of exposure)

90
Q

When are children with VZV contagious?

A

1-2 day prior to rash until all lesions are crusted over

91
Q

Treatment for rabies exposure?

A

Rabies Ig and vaccine within 7 days of exposure

92
Q

Presentation of ascaris lumbricoides (parasite)?

A

Returning from endemic area, abdominal pain, bowel obstruction (travel through GI to blood to lungs then are swallowed)

93
Q

Treatment of ascaris lumbricoides?

A

Albendazole, mebendazole, or ivermectin

94
Q

Non-dysentery presentation of entamoeba histolytica?

A

Liver abscess, brain abscess, lung disease

95
Q

Treatment of entamoeba histolytica?

A

Iodoquinol, paromomycin, or diloxanide; metronidazole 1st if severe or extraintestinal disease

96
Q

Presentation of toxocara canis?

A

1) Visceral larbal migrans–GI symptoms (hepatomegaly and abdominal pain) and respiratory symptoms (wheezing)
2) Ocular larval migrans–visual disturbances
3) Covert toxocariasis–GI symptoms and pruritic rash
- Eosinophilia!

97
Q

Risk factors for toxocara canis?

A

Exposure to cat and dogs; preschooler eating dirt

98
Q

Diagnosis of visceral larval migrans?

A

ELISA and stool culture (to rule out other infections)

99
Q

Treatment of toxocara canis?

A

Mebendazole or thiabendazole

100
Q

Treatment of schistosomal/liver fluke/tapeworm?

A

Praziquantel

101
Q

Treatment of strongyloidiasis?

A

Ivermectin

102
Q

Treatment of enterobius vermicularis (pinworms–scotch tape test!)?

A

Menbendazole, pyrantel pamoate, or albendazole (treat whole family)

103
Q

Presentation of coccidioidomycosis?

A

Vague flu-like illness, travel to CA, AZ, or TX

104
Q

Treatment of coccidioidomycosis?

A

Amphotericin B or fluconazole

105
Q

Presentation of aspergillosis?

A

“Asthmatic” with worsening symptoms despite tx; increased eosinophilias and CXR infiltrates

106
Q

Who develops invasive aspergillosis?

A

Immunocompromised patients

107
Q

Treatment of aspergillosis?

A

Voriconazole or amphotericin B

108
Q

Presentation of histoplasmosis?

A

Flu-like illness; HSM; OH, MO, MS

109
Q

Transmission of histoplasmosis?

A

Bird droppings; cave exploration

110
Q

Treatment of histoplasmosis?

A

Supportive care for healthy kids; amphotericin B for immunocompromised patients

Pediatric Boards (12 decks)

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