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Pediatrics - clinical > ID > Flashcards

ID Flashcards

1
Q

where are atypical mycobacterial infections most frequently located in children?

A

Superior anterior cervical or submandibular nodes

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2
Q

what age group is commonly affected by atypical mycobacteria

A

1-5 year olds becasue there is an increased tendency of these children to put objects contaminated by soil or stagnant water into their mouths.

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3
Q

Who is affected by Mycobacterium avium complex (MAC)

A

HIV pateints with CD4 <50

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4
Q

what is the presentation of MAC

A

fever, diarrhea, weight loss, anemia

present in soil and water (not person to person)

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5
Q

how is MAC diagnosed?

A

AFB (Acid- Fast Bacilli) Smear and culture

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6
Q

how is MAC treated?

A

clarithromycin + ethambutol for at least 12 months (+/- rifampin)

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7
Q

what is the prophylaxis for HIV pts at risk of MAC

A

azithromycin or clarithromycin if their CD4 count is < 50

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8
Q

What is the presentation and treatment of Mycobacterium kansasii

A

causes tuberculosis like disease
tx with Rifampin + ethambutol

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9
Q

where is mycobacterium marinum found?

A

fresh and salt water

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10
Q

how is mycobacterium marinum diagnosed?

A

culture

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11
Q

how is mycobacterium marinum treated

A

tetracylclines, fluoroquinolones, macrolides, sulfonamides for 4-6 weeks

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12
Q

what viral illness is characterized by Fever + lymphadenopathy + pharyngitis (+ atypical lymphocytes)

A

Epstein Barr mononucleosis

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13
Q

what is the incubation period for EBV?
How is it transmitted?

A

30-50 days
transmitted via oropharyngeal secretions and saliva “kissing disease”

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14
Q

how is EBV mononucleosis diagnosed?

A

positive heterophile antibody screen (Monospot)
atypical lymphocytes with enlarged nuclei
maculopapular rash
LUQ pain

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15
Q

how is EBV treated

A

supportive
-acetaminophen or ibuprofen PRN
corticosteroids in severe cases

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16
Q

what is the return to sport recommendations for a patient with EBV mononucleosis

A

-athletes should avoid vigorous sports for at least first 3-4 weeks of illness

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17
Q

what is another name for erythema infectiosum

A

fifths disease

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18
Q

what virus causes erythema infectiosum

A

parvovirus B19

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19
Q

what is the presentation of erythema infectiousum

A

slapped cheek rash on the face and 2-4 day lacy reticular rash on extremities

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20
Q

what are sickle cell patients at a high risk of developing with erythema infectiosum

A

aplastic crisis

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21
Q

how is erythema infecttiosum diagnosed

A

based primarily on clinical observation, history and physical
(PARVO b19-specific IgM antibodies and PCR)

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22
Q

what is the treatment of erythema infectiosum

A

symtpomatic
resolved in 2-3 weeks

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23
Q

what is a common childrens infection caused by coxsackievirus type A virus producing sores in mouth, hands, feet and buttocks

A

hand-foot-and-mouth disease

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24
Q

what are symptoms associated with hand-foot-and-mouth disease

A

fever, sore throat, feeling unwell, irritability, and loss of appetite

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25
Q

what is the treatment of hand-foot-and-mouth disease

A

supportive, anti-inflammatories
- virus clears up on its own within 10 days

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26
Q

what are the two herpes simples virus and what do they affect

A

HSV1 - oral lesions (cold sore)
HSV2 - genital lesions

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27
Q

what are the different Herpes Human Viruses (HHV)

A

HHV3 - varicella zoster virus (VZV)
HHV4 - EBV
HHV5 - CMV (cytomegalovirus)
HHV6 - Roseolovirus
HHV7 - not yet classified
HHV 8 - Kaposi’s sarcoma - associated herpesvirus (KSHV)

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28
Q

what virus causes influenza

A

orthomyxovirus
Three strains: A, B and C

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29
Q

what is the treament for influenza

A

symptomatic (for most) or antivirals (ideally <48hours)

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30
Q
A
31
Q

what virus causes Measles and how is it transmitted?

A

Paramyxovirus
transmitted by respiratory droplets

32
Q

how are the stages of measles characterized

A

prodrome (1-3 days) - cough, coryza, conjunctivitis and fever
Enanthem (48hours prior to exanthem) - Koplik spots
Exanthem (2-4 days after fever) - rash from face spreading cephalocaudally.

33
Q

how is measles dx

A

clinical dx of measles requires hx of fever of atleast 3 days wtih at least one of the three C’s (cough, coryza, conjunctivation)
Koplik spots
IgM antibodies or isolation of measles virus RNA from respiratory sample

34
Q

how is measles treated?

A

supportive and MMR vaccine

35
Q

when is MMR vaccine given

A

12-15 months and then again at 4-6 years old

36
Q

what supplement helps to limit morbidity and mortality in pts with measles

A

vitamin A

37
Q

is there an isolation period for measles

A

isolated for 1 week after onset of rash

38
Q

what virus causes Mumps

A

paramyxovirus family

39
Q

what is hallmark sign for mumps

A

parotitis (painful parotid gland swelling)
can see orchitis or aspectic meningitis

40
Q

what is the treatment for Mumps?

A

supportive
scrotal support if painful
MMR vaccine

41
Q

what is another name for whooping cough

A

pertussis

42
Q

what type of bacteria causes pertussis

A

gram-negative bacteria
bordetella pertussis

43
Q

How is pertussis diagnosed

A

nasophayngeal swab and culture

44
Q

what is the treatment of pertussis

A

Macrolide (erythromycin/azithromycin)
supportive care with steroids / beta2agonists

45
Q

when is the DTap given

A

5 doses: 2, 4, 6,15-18 months and 4-6 years

46
Q

who else should recieve a Tdap vaccination and when

A

pregnant/expecting mothers during each pregnancy , usually 27-36 weeks

47
Q

what is the most common reason for itching in anal area making sleep difficult

A

pinworms

48
Q

how are pinworms diagnosed?

A

“scotch tape test” in the early morning
(eggs visable under microscopy)

49
Q

what is the treatment of pinworms

A

albendazole or mebendazole

50
Q

what is the only childhood viral exanthem that starts on the trunk and spreads to the face/legs

A

Roseola

51
Q

what are other names for Roseola

A

exanthema subitum
roseola infantum
rose rash of infants
sixths disease
baby measles

52
Q

what virus causes roseola

A

HHV 6 and 7

53
Q

what age range is often affected by roseola

A

6 months - 2 years of age

54
Q

what is the presentation of roseola

A

sudden high fever (102-104)
just as child appears to be recovering, red rash appears on trunk

55
Q

how is roseola diagnosed

A

clinically

56
Q

what is the treatment of roseola

A

supportive - typically benign - self-limited disease

57
Q

what is know as the “3-day rash”

A

Rubella

58
Q

what is the presentation of Rubella

A

“3 day rash” pink light-red spotted maculopapular rash first appears on face and spreads caudally to trunk and extremities

59
Q

does Rubella affect pregnancy?

A

teratogenic in 1st trimester - TORCH infection and can cause serios complications

60
Q

how is Rubella diagnosed?

A

lab dx warranted when congenital rubella syndrome is suspected
serologic assay and primarily enzyme immunoassays
rubella virus-specific IgM antibodies

61
Q

what is the treatment of Rubella

A

supportive care and prevention with MMR

62
Q

what virus is classically identified as ‘dewdrops on a rose petal’

A

varicella (chickenpox)

63
Q

where does Varicella lay dorment

A

dorsal root ganglion

64
Q

what is the reactivation of Varicella

A

herpes zoster (shingle)
dermatomal pattern

65
Q

what is Hutchinson’s sign

A

lesion on the nose - an early indicator of opthalmic (eye) shingles

66
Q

what is Zoster ophthalmicus

A

shingles involving CN5, dendritic lesion on slit lamp exam if keratoconjunctivitis is present

67
Q

what is zoster oticus

A

Ramsay-Hunt syndrome
facial nerve (CN7) otalgia, lesions on ear, auditory canal and TM, facial palsy, auditory sympotms

68
Q

how is herpes zoster treated

A

acyclovir, valacyclovir and famciclovir - given within 72 hours to prevent post-herpetic neuralgia

69
Q

what is postherpetic neuralgia

A

pain > 3months, paresthesias or decreased sensation.

70
Q

what is the treatment of postherpetic neuralgia

A

gabapentin or TCA, topical lidocaine gel and capsaicin

71
Q

when is Varicella Vaccine given

A

first dose at age 12-15 months and second dose at 4-6 yo

72
Q

if a patient 13+yo who has never had chickenpox or recieved vaccine - what is their vaccine schedule

A

two doses at least 28 days apart

73
Q

when is REcombinant zoster vaccine recommended

A

to prevent shingles in adults 50+
2 dose series: 2-6 months apart

Pediatrics - clinical (13 decks)

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