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Fetus And Newborn > ID > Flashcards

ID Flashcards

1
Q

What dx?
Newborn with afebrile Staccato cough?
W or wo eye discharge

A

Chlamydia trachomatis

Dx with intracytoplasmic inclusion bodies, (definitivie) PCR

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2
Q

How do you tx chlamydia conjunctivitis?

A

Oral erythromycin or sulfa

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3
Q

Dx?
Patient in May is purpuric macular rash progression to petechial that started on ankles, wrists, palms, soles with headache.
Also seen with hyponatremia, depression of 1-3 cells lines on CBC.

A

RMSF

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4
Q

Once thought of RMSF, most imp next step; test or tx?

A

Treat with doxy 7 days or until fever resolves for at least 3

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5
Q

What lab differences will u see between ehrilicia and RMSF

A

Ehrlicia: leukopenia and elevated LFTs
RMSF: thrombocytopenia and hyponatremia

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6
Q

Asplenic pt or from developing country w GN pleomorphic organism.
Bug and tx?

A

H influenzae

T.mx w rocephin, cefotax

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7
Q

What is prophy for hib with contact younger than 12mo wo primary immunization series

A

Rifampin

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8
Q

When do you use rifampin prophy for hib ?

A

If One household contact younger than four who is incompletely immunized,

immunocompromise child even if over four

If two or more cases within 60 days and unimmunized or in completely immunized then children/attendees/workers at childcare facility should get it

NO prophy if all members are immunocomponent and immunized OR if non typable h flu

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9
Q

Patient was at a picnic 1-2 days prior then Got watery loose stools with vomiting, abdominal cramps and fever.
What bug?

A

Salmonella
Dx stool cx

Tx only needed if infant younger than 3 or immunocompromised (tx w rocephin)

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10
Q

Initial presenting sign of typhoid and tx

A

Constipation

Rocephin or cefotax

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11
Q

Patient with watery diarrhea and fever several days after ingestion. Once the fever subsides then bloody diarrhea
Dx?

A

Shigella
(WBC or RBC in stool)
Only treat with Bactrim or amp (if susceptible) in severe disease or immunocompromised

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12
Q

Dx ?
Fever of unknown origin?
Patient with fever and malaise, exposure to cattle sheep or goats and unpasteurized milk or cheese

A

Brucellosis. Treat with Bactrim or tetracycline

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13
Q

What is treatment for CDIff

A

Metronidazole

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14
Q

What is the purpose in treating strep throat

A

Prevent rheumatic fever

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15
Q

What is the treatment for infantile botulism

A

Supportive care, unless presented with antitoxin

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16
Q

If mother was treated for syphilis during pregnancy, do you treat them

A

No if she was treated with penicillin more than a month before delivery,
yes if she was treated with in the last month of pregnancy,
yes if she was treated with erythromycin,
yes if babies titers are higher than mothers titers

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17
Q

What might you see in and traded infants with syphilis after two years of age

A

Hutchinson Triad:
interstitial keratitis,
eighth cranial nerve deafness Hutchinson teeth or Peg shaped notched central incisors

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18
Q

Infant with sniffles or copious nasal secretions, bolus lesions, osteochondritis and pseudo-paralysis of the joints

A

Congenital syphilis

May also see lymphadenopathy, Nico cutaneous lesions, pneumonia, Adema, low platelets, HSM, humility anemia, jaundice, maculopapular rash at birth or within 4 to 8 weeks of age

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19
Q

What is Drug of choice for king Ella

A

Penicillin

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20
Q

How to treat penicillin allergic patients with listeria

A

Desensitization

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21
Q

What is treatment of the N.meningitidis

A

Initial therapy with vanc and Rocephin

Then definitive tx a pen g, amp or rocephin

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22
Q

Who should get meningogocal prophylaxis and what is drug

A

HouseholdContacts especially younger than two
Preschool contacts at any time during seven days before onset of illness
Direct exposure to secretions are kissing toothbrushes or utensils at any time seven days prior to onset of illness
Anyone with mouth-to-mouth recess or Indo tracheal intubation seven days prior to illness
Passengers seated directly next to on flights lasting more than 8 hours
Slept in same house 7 days prior to onset

Rifampin

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23
Q

Patient with recent handling of dead animals now has painful swollen inguinal nodes.
Dx?

A

Bubonic plague

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24
Q

Patient with bloody diarrhea right lower quadrant pain and elevated white blood cells
History of drinking and pasteurize milk or eating Chitterlings

A

Yersinja

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25
Q

When is treatment indicated for cat scratch disease

A

Those with hepatosplenomegaly, large painful adenopathy or immunocompromised

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26
Q

What bug to consider if chronic diarrhea in and immunocompromise patients

A

Cryptosporidium

27
Q

What bug to consider if diarrhea in swimming pools in municipal water

A

Cryptosporidium

28
Q

What bug to consider if diarrhea and farm or petting zoos

A

Cryptosporidium And E. coli

29
Q

What bug to consider with diarrhea and apple juice or under cooked beef

A

E. coli

30
Q

What bug to consider with diarrhea and chitterlings or pork

A

Yersinia

31
Q

What bug to consider with diarrhea and improperly cut poultry, and treated water, or dairy farm

A

Campylobacter

32
Q

What bug to consider with diarrhea and unpasteurized milk

A

Campylobacter and E. coli

33
Q

What is bag with 1 to 2 weeks of belly pain, diarrhea, Tenesmus, with stools of water blood and mucus?

A

Entomeba histylotica

Complications liver and Brian abscess

Tx symptomatic pts w metronidazole followed by IOdinoquil or paromomycin

If asympatomatic. Then no metro

34
Q

What is bug? Acute onset of watery diarrhea fell smelling stalls flatulence abdominal distention and weight loss with anemia

A

Giardia diagnosed with Eia. Treat with metronidazole or nitazoxanidd

35
Q

What is severity of toxo pregnancy both early and late

A

If early, lower chance of infection the consequences are more severe. If later greater chance of infection but complications or less severe

36
Q

What are congenital findings of toxo

A

Microcephaly, hydrocephaly, chorioretinitis, cerebral calcifications, Jaundicd, HSM

37
Q

What is the difference between CMV and toxo

A

CMV calcifications are periventricular

Toxo are diffuse

38
Q

What are later complications of toxo

A

Tremors, zero hearing, blindness, zero intelligence

T0X0

39
Q

What are the five C’s with CMV

A

Chorioretinitis, cerebral calcifications, urine culture diagnosis, potential for Censouinral hearing loss

40
Q

What are additional findings with cmv (HUman herpsevirus 5)

A

HSM, jaundice, SGA, seizures, hypotonia, weeks that

Think CMV with transfusion related info, esp pna

41
Q

What confirms EBV or human herpesvirus four diagnosis

A

Heterophile in antibody

If neg then serum is esp if <4yo

42
Q

What is human herpesvirus six

A

Roseola

Often associated with febrile seizure

43
Q

What is associated with congenital rubella

A

Cataracts and PDA

44
Q

Name the back. Unknown immunized patient with low-grade fever generalized maculopapular rash and enlarged occipital and preauricular lymph nodes.

A

Rubella

45
Q

What is bug? Patient with confluence macular papular rash with conjunctivitis and koplik

A

Rubeola
Three C’s cough coryza and conjunctivitis

Most contagious 4 days before and 4 days after rash appears

46
Q

What is bug patient with cough coryza vomiting and diarrhea

A

Flu

47
Q

Post exposure prophy for measles

If exposure has been within six days, give immunoglobulin especially to infants under 12 pregnant women and immunocompromise.

Who should receive vaccine ?

A

Persons exposed that are not completely immunized including 6 to 12 month olds

48
Q

When should revaccination for Measels occur after immunoglobulin

A

Five minutes after immunoglobulin was given if child is at least 12 months

49
Q

Should mild or asymptomatic HIV patients be given the MMR vaccine

A

Yes

50
Q

What is the most common complication of mumps

A

Orchitis

51
Q

Disease associated with hydrops fetalis, aplastic crisis and sickle cell

A

Parville be 19, erythema infectious

52
Q

What is gold standard for infant HIV testing and when

A

HIV dx w DNA PCR is gold standard in neonatal period.

For 18mo+ can get EIA as initial test w positive verified with western blot

53
Q

What do you see on chest x-ray with pneumocystis jiroveci

A

Ground glass appearance

54
Q

HIV children receive all vaccines except what

A

Measles and vera Cella or contra indicated with kids who have CD4 count less than 15% of normal age

55
Q

When is the VZIG treatment of choice for a newborn exposed to chickenpox

A

If mother developed chickenpox between five days before delivering in two days postpartum

56
Q

When should you get rabies prophylaxis

A

If an animal is suspected to be rabbid after bite especially ferrets cats dogs wolves coyotes raccoons skunks possums and bat

57
Q

If presented with patient who woke up in a room with bat should you treat even if no bite

A

Yes treatment is indicated

58
Q

What infection if patient from faraway place has signs of obstruction or abdominal pain

A

Ascadis lumbriocoides

59
Q

What is infection? Preschooler who has been eating dirt with exposure to dogs and cats and associated HEpatmegaly/abdominal pain and wheezing. Eosinophilia noted

A

Toxocara canoe
Visceral larval migrants
Ocular w eye
Covert w GI and rash symptoms

Dx w Elisa
Tx w albendazole

60
Q

What is bug? AIDS patient with exposure to bird or pigeon droppings

A

Ripped a caucus. Treat with ampho and flucystine or fluconzole

61
Q

What is bug? Influenza like symptoms with recent travel to California Arizona and Texas

A

Coccidio
CATccido

Tx ampho fluconazole or ketacon

62
Q

What is bug?

Asthmatic with worsening symptoms, is infiltrated, infiltrate on chest x-ray

A

Aspergillosis. Diagnosed with positive serum galactomannan. Treat with Vori or ampho in infants

63
Q

What bug?

Flu like symptoms with recent travel to Ohio Missouri and Mississippi Valley. Also HSM

A

Histoplasmosis. Treat with ampho or azole

Fetus And Newborn (9 decks)

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