ID

Question 1

Differences between varicella and small pox (6)

Answer 1

1) Prodrome
2) Involves palms / soles
3) Centrifugal (vs centripetal) spread
4) Toxic on presentation
5) Lesions in same stage
6) Lesions involve dermis

Question 2

Is HBV / HCV contraindicated for breastfeeding?

Answer 2

No

Question 3

Predispositions for croup (10)

Answer 3

Viral infxn
reactive airways (allergic / spasmodic croup)
laryngeal / esophageal foreign body
 laryngeal web, vascular rings
 subglottic stenosis (from intubation)
laryngeal papilloma
airway hemangioma
vocal cord paralysis
cysts

Question 4

2nd line PID tx for pts allergic to cephalosporins / beta lactams? 3rd line?

Answer 4

1) Clinda / gent

2) Levo / flagyl

Question 5

Prophylactic antibiotic of choice to prevent pertussis in unvaccinated children <1yr of age?

Answer 5

Azithro x5d

Question 6

Complication of erythromycin therapy in infants <1month of age?

Answer 6

Infantile hypertrophic pyloric stenosis

Question 7

7 organisms of neonatal sepsis?

Answer 7

1) GBS
2) E coli
3) S. aureus
4) S. viridans
5) H.influ
6) Enterococcus
7) L monocytogenese

Question 8

What abx to add if suspecting neonatal meningitis and why?

Answer 8

3rd gen cephalosporin b/c of better CNS penetration than amino glycoside

Question 9

Potential dangers of ceftriaxone in neonates (2)

Answer 9

1) Death from precipitation when given with IV calcium

2) Inc risk of kernicterus due to competitive binding w/albumin

Question 10

Maternal fever + GI sx + meconium stained amniotic fluid + faint erythematous rash = ?

Answer 10

Listeria infxn. Rash called ‘granulomatosis infantisepticum’

Question 11

Criteria for recurrent UTI? Tx?

Answer 11

1) 3 UTIs in the past year with +UCx

2) 1 dose of post-coital abx (Macrobid / TMP-SMX / keflex)

Question 12

Treatment of unimmunized child or immunocompromised host to measles?

Answer 12

IM immune globulin

Question 13

First line agent for tinea capitis in children >2yrs?

Answer 13

Oral griseofulvin daily x8 weeks

• For longer courses need to monitor LFTs
• Take w/high fat foods to inc absorption
• Can Xreact w/pen allergy

Question 14

Vertical tx rate for HCV and associated risk factors? (4)

Answer 14

5-10%

1) HCV VL
2) HIV coinfxn
3) Prolonged / difficult delivery
4) Internal fetal monitoring

Question 15

CDC definition of measles? Most specific test?

Answer 15

1) Generalized rash lasting for 3 days a/w fever to >38.3, cough, coryza, conjunctivitis and epidemiologic link to a confirmed case
2) Measles IgM

Question 16

Tx for pubic and head lice? a) 1st line (1), b) 2nd line (2), 3) Not recommended? (1)

Answer 16

1) Topical permethrin
2) Topical malathion / oral ivermectin
3) Topical lindane (potential neurotoxicity)

TMP-SMX might be useful but not studied

Question 17

1) Test for maternal -> child transmission of HCV?

2) At what age?

Answer 17

1) HCV RNA PCR
2) 2 months of age
Rationale: RNA not reliably detected at birth and maternal Abs persist to 18 months of age

Question 18

Biggest risk factor for fetal demise in mother with active VZV?

Answer 18

Active infection in the 5 days prior and 2 days after delivery

Question 19

2 organisms for meningitis that require chemoprophylaxis of household contacts?

Answer 19

N.meningitidis / Hib (for contacts who have not completed primary course / immunocompromised; agent: rifampin)

Question 20

5 major Jones criteria for ARF

Answer 20

1) Chorea, 2) Erythema marginatum, 3) Carditis, 4) SQ nodules, 5) Polyarthritis

Question 21

Minor Jones criteria (4)

Answer 21

2 clinical:
1) Fever, 2) Arthralgias
2 lab:
3) Inc acute phase reactants, 4) Prolonged PR

Question 22

What is Fitz-Hugh-Curtis?

Answer 22

Inflammation of liver capsule from ascending PID seeding peritoneum from Fallopian tubes. Due to Neisseria / Chlamydia (often only sign is heavy menses)