ID

Question 1

Most blood cultures have 80% of the bacteria growing by 24hours. Keep longer(7-48 days) for which bacteria?

Answer 1

Legionella
Micobacterium

Question 2

Gram POs bacteria stain purple, gram negative stain red.

Question 3

An example of rod bacteria is _____. An example of cocci is ______

Answer 3

E. Coli - rods
Strep pyogenes - cocci

Question 4

How do you know if a blood culture is NEGATIVE?

Answer 4

Preliminary report negative is no growth after 2 days
Final for most BCx is no growth after 5 days.

Question 5

Fungal cultures take ______ to grow.

Answer 5

14days - 4 weeks

Question 6

CBC in pediatrics is based on _____, _____ and _____

Answer 6

Gender
Age
Altitude

Question 7

Left shift happens in _____ and ______

Answer 7

Early and late bacterial and viral infections

Question 8

Left shift of neutrophils is

Answer 8

Immature neutrophils produced as body mounts a response to BACTERIAL infections.

Question 9

Role of neutrophils

Answer 9

1st line of defense - phagocytize bacteria and cell debris

Question 10

Lymphocytes are more common in bacterial or viral infections?

Answer 10

Viral - B cells make antibodies. T and NK cells attack cells with virus in them.

Question 11

Neutrophils could be decreased in:

Answer 11

Newborn sepsis, cancer treatment, some hereditary disorders, some medications

Question 12

Neutrophils are increased in

Answer 12

Stress/inflammation
Tissue damage
Bone marrow malignancies
Steroid therapy

Question 13

Lymphocytes are decreased in

Answer 13

Steroid therapy
Adrenocortical hyperfunction
Stress/shock

Question 14

Eosinophils are increased in

Answer 14

Parasitic infection
Asthma
Allergic reactions
Hay fever
Drug reactions

Question 15

Eosinophils decreased in

Answer 15

Steroid therapy
Adrenocortical hyper function
Stress/shock

Question 16

Monocytes AKA ______
Present in

Answer 16

Macrophage.
Viral infection
TB
Parasitic disease
Monocytic leukemia

Question 17

Basophils present in

Answer 17

Chronic inflammatory and hypersensitivity reactions.

Question 18

Children born prior to 28 weeks gestation don’t have any passive immunity from mom. Immunity transfer usually happens over _________

Answer 18

Week 28-32

Question 19

Baby’s T-cells begin to fully function at adult capacity at _____yo

Answer 19

1 year old

Question 20

Babies with SCID (severe comorbid immunodeficiency ) are screened _______ . They lack ______. They are treated with ______.

Answer 20

At birth.
T-Cells.
Bone marrow transplants.

Question 21

What is lymphocytosis? When is it seen

Answer 21

High lymphocytes count
Viral infection

Question 22

A child taking steroids can have a decrease on which WBCs on a CBC?

Answer 22

Everything! Lymphocytes, monocytes, eosinophils and basophills

Question 23

Most common cause of SEVERE, ACUTE disease in children?

Answer 23

Bacterial (Encephalitis, meningitis, osteomyelitis, CALI)

Question 24

S/s of congenital syphilis

Answer 24

50% are asymptomatic at birth, but symptoms appear before 2 years.
Snuphles/congestion
Mucocutaneous lesions
Maculopapular rash all over
Hepatosplenomegaly
Hemolytic anemia
Thrombocytopenia
Late Signs:
Hutchinson incisors
Interstitial keratitis, 8th nerve deafness.

Question 25

Cat scratch disease should always be in the differential for _______

Answer 25

Unexplained lymphadenopathy

Question 26

Use amoxicillin or doxycycline in kids 8 years and older if Lyme is suspected for 14-21 days. Kids younger than 8, prophylactic antibiotics are discouraged - do watchful waiting and then test later if needed.

Question 27

What things could make you concerned for RMSF?

Answer 27

Fever, HA, malaise with rash starting 2-5 days after symptoms,
Rash is maculopapular, involves palms and soles and is more severe in feet and ankles and less severe as it ascends the body.

Question 28

Unique PE findings of Diphtheria

Answer 28

Notable absence of high fever despite sickness
Green/gray membrane covering tonsils and soft palate
Bullsneck appearance with lymphadenopathy

Question 29

Highest risk for kids converting to active TB from LTBI is in ______

Answer 29

First 12 months of contracting the disease.

Question 30

What pathogen is responsible for infectious mononucleosis ?

Answer 30

EBV - Epstein Bar Virus.

Question 31

What treatment would you NOT give in Denghe fever?

Answer 31

NO NSAIDS.

Question 32

Warning signs for impaired immune system

Answer 32

4 or more ear infections in 1 year
2 or more serious sinus infections in 1 year
2 or more months on antibiotics with little effect
2 or more pneumonias within 1 year
FTT
Recurrent SSTI/abscess
Persistent thrush or fungal skin infection
Need for IV abx to clear infections
Family hx of immunodeficiency
2 or more deep seated infections including septicemia.

Question 33

Reassuring signs of functional immune system?

Answer 33

Normal growth and development
Lack of deep tissue infection
Vague explanation of past infections (no need for meds, er or hospitalization)
Normal activity between episodes

Question 34

Innate vs Adaptive Immunity

Answer 34

Innate - non-specific, rapid, phagocytes, macrophage, mast cells, complement and cytokines
Adaptive - specific, antigen specific, antibodies, B and T lymphocytes.

Question 35

Physiologic or structural abnormalities are the most common causes of recurrent infections.

Question 36

Infants passive immunity acquired from mom wanes at about _______ and they must then develop their own.

Answer 36

5-7mo.

Question 37

Evaluation of a child with suspected impaired immune system?

Answer 37

CBC w/ differential
Cultures
Immunologic testing - Serum complement, serum IgG, IgM, IgA and IgE, +/- CD4 subcounts
HIV 4th gen
Draw immunization titres to make sure they are adequately protected.