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Paeds BPT Written Exam > ID > Flashcards

ID Flashcards

1
Q

Most useful test for diagnosing congenital HIV?

A

HIV DNA PCR
- perform at birth, 2months, 4 months and 12months
- reassuring if negative at 4months

HIV antibodies not useful until >18mo due to transplacental passage of ab’s

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2
Q

What medication is used to treat infants at low risk of HIV Mother-Child transmission?

A

4 week course of PO or IV zidovudine prophylaxis

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3
Q

Features of congenital syphilis?

A

IUGR
Anaemia and thrombocytopenia
Hepatosplenomegaly
Fever and rash
“snuffles”
Chorioretinitis and cataracts
Periostitis and osteochondritis

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4
Q

Common causes of osteomyelitis

A

S aureus most common
S pneumoniae
Kingella

Neonates: S aureus, GBS and gram negs

IVDU: pseudomonas

CGD: catalase positive microbes such as serratia, s aureus and candida

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5
Q

Which bacteria cause gastroenteritis by ingestion of preformed toxins?

A

Staph aureus
Bacillus cereus

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6
Q

Side effects of ciprofloxacin

A

photosensitivity
tendon rupture
seizures
prolonged QTc

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7
Q

Mechanism of methicillin resistance in MRSA

A

Many staph aureus carry the mecA gene that encodes for penicillin binding protein 2a, which has a low affinity for beta lactams so beta lactams are unable to bind and inhibit cell wall synthesis

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8
Q

Antibiotics with MRSA cover

A

Vancomycin
Clindamycin
Bactrim
Linezolid

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9
Q

Features of congenital CMV?

A

Microcephaly
Sensorineural hearing loss
Developmental delay
Thrombocytopenia
Hepatosplenomgealy, hepatitis
IUGR
Calcifications which CircuMVent the ventricles
Chorioretinitis in 10-20% (ie less than toxo)

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10
Q

Organism most likely responsible for infection post dog or cat BITE?

A

Pasteurella multocida

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11
Q

Organism most likely responsible for infection post cat SCRATCH?

A

Bartonella henselae

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12
Q

Neonatal conjunctivitis: gonococcal vs chlamydia

A
  • Gonococcal more likely to present early (2-7 days after delivery), chlamydia more likely to present later (onset 7-14days after delivery)
  • Chlamydia associated with neonatal pneumonia in first 4months
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13
Q

Management of neonatal chlamydia infection (conjunctivitis or pneumonia)

A

Azithromycin 20mg/kg PO for 3 days (per ASID guidelines)

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14
Q

Which organisms have inducible resistance to cephalosporins on treatment? ie inducible beta-lactamase activity that is chromosomally mediated

A

ESCAPPM organisms
* Enterobacter species
* Serratia marcescens
* Citrobacter fruendii (not koseri)
* Aeromonas species
* Proteus species
* Providencia species
* Morganella morganii

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15
Q

What % of children with invasive pneumococcal disease have an underlying immune deficiency syndrome?

A

1.3% overall.

Meningitis:
3.5% of children >5yrs
10.6% of children <15yrs

Pneumonia: 8%

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16
Q

Management of gonococcal ophthalmia

A

Ceftriaxone
and further investigate with BC and/or LP

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17
Q

Treatment of latent TB

A

3mo of Rifamp + isoniazid OR
3mo of rifapentin + isoniazid OR
4mo rifampicin only OR
6mo of isoniazid only
(RCH)

18
Q

Treatment of TB disease

A

2mo of Rifampicin, Isoniazid, Pyrazinimide, Ethambutol +
4 months of rifampicin and isoniazid (if non-severe can do 2mo)

19
Q

Who gets window prophylaxis in TB?

A

Children <5yrs should get latent TB treatment if TST/IGRA negative whilst awaiting repeat TST/IGRA in 3months

20
Q

Side effects of ethambutol

A

E= eyes
Optic neuritis
Red-green colour blindness

21
Q

Side effects of rifampicin

A

R= red urine
Thrombocytopenia
LFT derangement

22
Q

Side effects of isoNiazid

A

Peripheral Neuropathy
transaminitis
acne

Give pyradoxine (vit B6)

23
Q

Definitions for positive TST in TB?

A
  • 5+mm if high risk (immunocompromised, symptomatic + known close contact)
  • 10+mm if mod risk (age <4, high prevalence area)
  • 15+mm if low risk (age >4 w/o risk factors)
24
Q

CSF findings in TB meningitis

A

High protein (>5)
Low glucose (<0.3 CSF: serum ratio)
Neutrophils <100
Lymphocytes 50-1000 but maybe normal

25
Q

Transmission of leptospirosis

A

Rat urine

26
Q

Which infection commonly causes a relative bradycardia/ pulse-temperature dissociation?

A

Typhoid fever

27
Q

Most common organism causing cellulitis?

A

Group A strep (followed by staph aureus)

28
Q

Why is mycobacteria pneumoniae resistant to beta lactams?

A

It is an atypical bacteria that lacks a cell wall and therefore has intrinsic resistance to beta lactam antibiotics

29
Q

When to start treatment for HIV?

A

ASAP when diagnosis made, regardless of age

Usually 2x NRTIs + 3rd drug of different class

30
Q

Risk factors for MTCT of HIV?

A
  • Highest risk at delivery (60-75%)
  • High maternal viral load, low CD4 count, placental infection or STI
  • Prematurity, low birthweight
  • PROM, NVD or instrumental
  • Breastfeeding
31
Q

What maternal viral load is considered ‘low risk’ in HIV?

A

Maternal viral load <50copies/ml

32
Q

Rifampicin resistance gene in TB?

A

rpoB gene

33
Q

Which TB medication has poor CNS penetration (and is often not used in TB meningitis)?

A

Ethambutol

34
Q

How does zika virus present?

A

“Influenza like syndrome” with rash
Can cause guillain barre syndrome

Congenital zika virus presents with severe microcephaly, hypertonia, contractures, macular scarring

35
Q

What is cutaneous larva migrans?

A

Skin disease from animal hookworm (cat or dog faeces)

  • pruritic serpiginous tracts in skin
36
Q

Management of hookworm (ancylostoma) infection?

A

Albendazole

37
Q

What is cystic echinococcosis?

A

AKA Hydatid disease

tapeworm found in dogs (definitive host) and sheep, cattle, goats, and pigs (intermediate hosts).

Causes slowly enlarging cysts in lung and liver

38
Q

Management of echinococcocis (hydatid disease)

A

Cysts <5cm may be managed with anti-parasitic treatment (albendazole) alone

Larger, or complicated cysts need albendazole + surgical removal eg percutaneous aspiration, injection of chemicals, respiration (PAIR)

39
Q

Anopheles mosquito transmits which infection?

A

Malaria

40
Q

Classic triad of congenital toxoplasmosis?

A
  1. Chorioretinitis
  2. Calcifications - scattered throughout the brain
  3. Hydrocephalus (CSF)

also can get anaemia, thrombocytopenia, jaundice, hepatosplengomegaly, pneumonitis, rash

41
Q
A

Paeds BPT Written Exam (18 decks)

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