ID

Question 1

dimorphic fungus found in the dry soil of areas with low rainfall in the southwest United States, northern Mexico, and areas in Central and South America.
Up to 60% children asym

Answer 1

Coccidioides

Question 2

crampy abdominal pain and bloody diarrhea after travel to Mexico (or resource limited)
can be asymptomatic or cause severe illness with bloody stools, severe abdominal pain, and fever

Answer 2

Entamoeba histolytica

Question 3

diagnosis of intestinal amebiasis

Answer 3

Presumptive identification of trophozoites or cysts in stool; definitive diagnosis is made by detection of anti-E histolytica antibodies with an enzyme immunoassay.

Question 4

Cryptosporidium infection in immunocompetent vs immunocompromised

Answer 4

immunocompetent: can be asymptomatic, but usually causes watery, nonbloody diarrhea lasting 1 to 2 weeks. Abdominal pain and cramping, n/v, fever, and weight loss caused by dehydration also can occur. clearance of oocysts from stool usually occurs within 2 weeks of illness resolution
immunocompromised: can be severe and life threatening. Rare complications include infection of the lungs, biliary tract, and disseminated disease. Oocyst shedding in those with immunodeficiency can last for months.

Question 5

Toxoplasma gondii in newborn

Answer 5

Only 10% to 30% of infants with congenital toxoplasmosis are symptomatic at birth.
The classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications is rare.
Symptomatic newborns with toxoplasmosis can present with various clinical manifestations, including temperature instability, rash (maculopapular or petechial), hepatosplenomegaly, jaundice, generalized lymphadenopathy, pneumonitis, microcephaly, meningoencephalitis, seizures, and chorioretinitis

Question 6

Congenital infection caused by cytomegalovirus (CMV)

Answer 6

symptomatic in 10% of newborns and can present with a petechial rash, hepatosplenomegaly, and central nervous system manifestations.
intracranial calcifications of CMV are characteristically periventricular rather than diffusely distributed.
Other manifestations of symptomatic congenital CMV infection can include microcephaly, chorioretinitis, intrauterine growth restriction, jaundice, and hearing loss.

Question 7

Manifestations of congenital rubella infection

Answer 7

ophthalmologic: cataracts, microphthalmos, retinopathy, glaucoma
neurologic: meningoencephalitis, microcephaly
cardiac: patent ductus arteriosis, peripheral pulmonary artery stenosis

Question 8

Toxoplasmosis

Answer 8

VISION LOSS
Chorioretinitis
70-90% asymptomatic at birth
Can have hearing loss, ID, learning disability
Rash, LAD, HSM, jaundice, thrombocytopenia

Question 9

most common side effect of CMV

Answer 9

Hearing loss

Question 10

Rubella can cause what problems

Answer 10

Can cause cardiac problems (PDA, PPS)

Question 11

Side effects of IVIG

Answer 11

Aseptic meningitis!
- severe HA, Michael rigidity, drowsy, fever, photophobia
More common in high dose (2g/kg)

Question 12

Most common pathogen for foodbourne gastro

Answer 12

Salmonella

Question 13

When do you give antibiotics for salmonella

Answer 13

Immunocompromised, infants <3mo, of <12mo with high fever or chronic GI illness

Question 14

Elevated LDH with bilateral interstitial infiltrates

Answer 14

Think PCP in HIV pt

Question 15

Treatment/prophylaxis for PCP (Pneumonia)

Answer 15

Bactrim

Question 16

Water park, diarrhea, and oocytes in stool

Answer 16

Cryptosporidium

Treat with nitazoxanide but most don’t need treatment

Question 17

Gram positive bug in UTI

Answer 17

Usually enterococcus

In sexually active females, could be staph saprophyticus

Question 18

chloroquine sensitive areas

Answer 18

Central and South America

Question 19

Lice resistant to permethrin, what do you use?

Answer 19

Malathion

Question 20

Neutropenia fever treatment

Answer 20

Meropenum or cefepime or ceftazidime

Question 21

Looks like strep but with negative strep testing

Answer 21

Arcanobacterium pharyngitis

Treat with erythromycin

Question 22

5 features that increase risk of HUS

Answer 22

Anti-motility agent, vomiting, age <5.5yo, white count >13K

And weakly antibiotic use

Question 23

Antibiotic class that interrupt cell wall synthesis

Answer 23

Beta lactams

Question 24

Antibiotic class that interrupt DNA gyrase

Answer 24

Fluoroquinolones

Question 25

Antibiotic class that interrupt folic acid

Answer 25

Sulfonamides

Question 26

Antibiotic class that interrupt 30s ribosome

Answer 26

Tetracycline and aminoglycoside

Question 27

Antibiotic class that interrupt 50s ribosome

Answer 27

Macrolides

Question 28

Cattle and prolonged fevers, with treatment

Answer 28

Brucellosis

Can have HSM and pancytopenia

Get blood culture

Treat wth doxy or Bactrim and Rifampin

Question 29

Hookworm symptoms

Answer 29

Anemia
Short stature
FTT
Iron deficiency

Question 30

Fever, bilateral cervical adenopathy

Grayish exudate on throat

Answer 30

Diphtheria

Give IV antitoxin to pt right away, then also erythromycin x 14days (or IV/IM PCN G x 14 days)

Give erythromycin orally for 14 days to close contacts

Question 31

Viral illness most associated with febrile seizures

Answer 31

HHV 6 - aka roseola

Question 32

Animals that if they bit someone you’d give them rabies prophylaxis

Answer 32

Bats
Raccoons
Skunks
Foxes
Coyotes

Give immunization and RIG

Question 33

Don’t worry about rabies if bit by one of these animals

Answer 33

Squirrels
Rats
Mice
Rabbits

Question 34

Common cause of septic joint in young children

Answer 34

Kingella
Resistant to vanc

Treat with CTX or ceftaz

Hard to grow, so culture may be negative

Question 35

4 uses for Rifampin

Answer 35

1) TB treatment
2) post exposure proph for H. Flu
3) post exposure proph for meningitis
4) Invasive MSSA/MRSA

Question 36

Second line therapy for PID

Answer 36

IV clinda, IV gent, followed by PO doxy x 14 days

Question 37

When could measles be transmitted

Answer 37

Within 3-5 days before the rash then 4 days after