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ID Flashcards

1
Q

common bacteremia bugs in neonates

A

GBS, E coli, S pneumo, Staph aureus

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2
Q

common bacteremia bugs in infants

A

GBS, E coli, S pneuo, Staph aureus, salmonella

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3
Q

Common bacteremia bugs in immunocompromised patients

A

gram neg bacilli (pseudomonas, E coli, klebsiella), staph

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4
Q

common meningitis bugs in neonates

A

GBS, listeria, E coli

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5
Q

Common meningitis bugs in young children

A

strep penumo, N mening, enterovirus, Lyme, Rickettsia rickettsii

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6
Q

staccato cough and tachypnea in newborn

A

chlamydia
intracytoplasmic inclusion bodies
dx: PCR
tx: oral erythro, even if just conjunctivities

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7
Q

risk with oral erythromycin

A

pyloric stenosis

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8
Q

silver nitrate works for?

A

GC

NOT CT

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9
Q

erythromycin ointment works for?

A

GC ppx only

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10
Q

dx of C pneumoniae

A

immunofluorescent antibodies

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11
Q

dx of RMSF

A

serologic testing via indirect immunofluorescent antibody antibody - on presentation and 2-4 weeks later
dx: 4x increase in titers

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12
Q

RMSF like presentation but with leukopenia and elevated LFTs

A

erlichiosis

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13
Q

gram negative pleomorphic organism (or GN cocci in pairs)

A

HiB

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14
Q

conjunctivitis otitis combination

A

caused by H influenze - needs augmentin for tx

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15
Q

which type of meningitis can have IV steroids

A

HiB

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16
Q

HiB PEP

A

in household with an incompletely immunized child or immunocompromised child, everyone gets rifampin
underimmunized children should get Hib vaccine

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17
Q

HiB PEP in childcare/preschool

A

if 2+ cases within 60 days and incompletely immunized children at center –> rifampin for attendees and providers
underimmunized children should get Hib vaccine

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18
Q

cough with leukocytosis to 20-40 and lymph predominance

A

pertussis

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19
Q

dx pertussis

A

PCR

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20
Q

tx pertussis

A

erythro, clarithro, azithro
tx in catarrhal stage –> improves cough
tx in paroxysmal stage –> decreases communicability period

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21
Q

pertussis PEP

A

everyone exposed needs PEP with ABx to prevent spread

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22
Q

diarrhea from chicken, eggs, unpasteurized milk, unwashed raw fruits and veggies, turtles, hedgehogs

A

salmonella

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23
Q

who to tx with uncomplicated salmonella

A

< 3mos, hemoglobinopathies, malignancies, severe colitis, immunocompromise

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24
Q

fever, diarrhea, HA, HSM, rash - red spots

A

Salmonella typhi

tx: CTX/cefotax

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25
Q

watery diarrhea and fever –> bloody diarrhea with no fever

A

shigella

can have seizures, bandemia

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26
Q

tx for shigella

A

only if severe dz, dysentery, immunosuppression

tx: CTX, azithro, cipro

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27
Q

ABx for pseudomonas

A

zosyn, gent, carbapenems, ceftaz, cipro/levo

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28
Q

unpasteurized milk, cheese, cattle/sheep/goats

A

brucellosis

tx: bactrim or tetracycline

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29
Q

when can kid with C diff go back to child care

A

when diarrhea is resolved

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30
Q

tx C diff

A

flagyl –> PO vanc 2nd line

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31
Q

pharyngitis that mimics GAS but without palatal petechiae

A

arcanobacterium haemolyticum (corynebacterium haemolyticum)
resp infx mimic diphtheria
tx azithro, erythro, clinda

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32
Q

abscess size that only need I&D

A

<5cm

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33
Q

descending weakness

A

botulism

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34
Q

MOA of botulism

A

food- ingestion of preformed botulism toxin
infantile - ingestion of spores and germination –> toxin prod

toxin blocks ACh release at NM junction

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35
Q

dx of botulism

A

detection of toxin in specimen, no PCR

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36
Q

aminoglycosides and botulism

A

can potentiate paralysis

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37
Q

wound botulism tx

A

antitoxin, then PCN or flagyl

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38
Q

dx of syphilis

A

non treponemal tests (RPR, VDRL) –> treponemal test (FTA-ABS)
definitive: darkfield microscopy or DFA of specimen

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39
Q

what viruses cause false pos on nontreponemal tests

A

EBV, VZV, hepatitis

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40
Q

what else should you test for in pt with syphilis

A

HIV

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41
Q

how long is FTA ABS pos in syphilis

A

forever

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42
Q

false pos treponemal tests in which dz?

A

lyme (but would have negative non treponemal test)

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43
Q

tx of syphilis

A

parenteral PCN G

if allergic need desens

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44
Q

tx of neonate with maternal syphilis

A

if mom got PCN >1 mo prior to delivery, then no
if mom got erythro, must treat baby
if baby’s titers > mom’s titers must treat baby

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45
Q

HSM, corneal scarring, CN VIII deafness, lymphadenopathy, pseudoparalysis, poor feeding

A

congenital syphilis

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46
Q

membranous nasopharyngitis with bloody nasal discharge

A

diphtheria

47
Q

neck swelling with cervical lymphadenitis

A

bull neck = diphtheria

48
Q

complications of resp diphtheria

A

airway obstruction 2/2 membrane
myocarditis
neuropathies (cranial and peripheral)

49
Q

tx diphtheria

A

equine antitoxin

50
Q

tx enterococcus

A

ampicillin, vancomycin

51
Q

most common Kingella infections

A

septic arthritis, osteo, bacteremia

52
Q

tx kingella

A

penicillin

53
Q

Meningococcal PEP

A

all close contacts with invasive disease, generally w/in 7 days
rifampin

54
Q

farm animals, pets, untreated water, improperly cooked poultry

A

campylobacter
bloody diarrhea
can mimic intussusception or appendicitis

55
Q

tx campy

A

azithro shortens duration and excretion

56
Q

raw meat, unpasteurized milk, chitterlings, pigs

A

yersinia

pseudoappendicitis

57
Q

tx yersinia

A

supportive unless bacteremia, immunosuppressed, hemoglobinopathies
tx: bactrim, cefotax, aminoglycosides, quinolones

58
Q

dx bartonella

A

serology with enzyme immunoassay or immunofluorescent antibody

59
Q

tx bartonella

A

supportive

if HSM, large/painful adenopathy, or immcomp –> azithro, erythro, bactrim, rifampin

60
Q

tx latent TB

A

INH monotherapy x 9 mos
2nd line: rifampin monotherapy x 6-9 mos

can also do INH+rifapentine DOT x 12 weeks

61
Q

forms of extrapulmonary TB

A

meningitis, adenitis, pleuritis, disseminated

62
Q

petting zoos, swimming pools, child care centers

A

cryptosporidium
non bloody
lasts long time

63
Q

toxicity of aminoglycosides

A

assoc with high trough (30 min before dose)

ototoxicity

64
Q

Latin America/Africa/Asia, contaminated food/water, crampy abd pain, liquid stools x 1-2 weeks

A

E histolytica

can cause invasive disease with liver/brain abscesses, lung disease

65
Q

dx E histolytica

A

definitive: enzyme immunoassay in stool
can also see cysts in stool, stool culture usually pos
can get abd US for liver cysts

66
Q

tx entamoeba histolytica

A

flagyl/tinidazole –> iodoquinol
(if asymptomatic, only iodoquinol)
screen household contacts

67
Q

toxo effects with timing of infection during preg

A

early: low risk of transmission, severe neonatal disease
late: high risk of transmission, less severe disease

68
Q

microcephaly, hydrocephaly, chorioretinitis, diffuse calcifications

A

toxo

69
Q

late manifestations of toxo

A

deafness, vision issues, seizures, ID, learning disabilities

70
Q

VCA test

A

IgG to EBV viral capsid antigen - positive early and for life

71
Q

EBNA test

A

antibodies to EBV nuclear antigen

positive weeks to month after onset of infection

72
Q

periventricular calcifications, HSM, hypotonia, weak suck

A

CMV

73
Q

most common nongenetic cause of SNHL

A

congenital CMV

74
Q

dx congenital CMV

A

urine culture/PCR

75
Q

3-5 days of fever followed by rash

A

roseola

can have febrile seizure

76
Q

cataracts, PDA

A

congenital rubella

77
Q

acquired rubella presentation

A

mild viral illness, maculopapular rash, lymphadenopathy

78
Q

confluent rash, conjunctivitis, fever, cough

A

measles

AIRBORNE

79
Q

incubation period of measles:

A

8-12 days

80
Q

measles PEP

A

pregnant, <12 mos, immunocompromised –> give IG if <6 days since exposure
incompletely immunized –> give vaccine

81
Q

how long after measles IG to give vaccine

A

minimum 5 months

82
Q

measles vaccine timing and PEP

A

if <=3 days since exposure, give vaccine as may prevent disease
if > 3d, should give IG then vaccine later

83
Q

mumps outbreak in school - who can go back

A

fully immunized - OK
due for booster/vaccine - get imm then OK
vaccine refusal - wait 26 days after last person had sx
has mumps - 9 days after onset of sx

84
Q

dx of HSV

A

CSF PCR

DFA of vesicle scrapings

85
Q

dx of neonatal HIV

A

HIV DNA and RNA PCR

86
Q

dx of HIV in non-neonates

A

enzyme immunoassays –> Western blot

87
Q

timing of HIV testing post exposure

A

0, 6 wks, 12 wks, 6 months

use antiretrovirals only if very strong likelihood of transmission

88
Q

precautions for varicella

A

airborne and contact until all lesions are crusted

or for neonates of mothers w/ VZV - until 21-28 days of age

89
Q

superinfection with VZV

A

staph aureus

90
Q

immunocompromised VZV PEP

A

VZIG

needs to be given within 96 hours of exposure

91
Q

when are people with VZV contagious

A

several days before rash until all lesions crusted

92
Q

VZV PEP for neonate

A

mother with VZV 5 days before until 2 days after

give VZIG

93
Q

dx of RSV

A

definitive: immunofluorescence

94
Q

who gets synagis

A

CLD, preterm, congenital heart disease

95
Q

dx flu

A

rapid antigen screen

96
Q

dx rotavirus

A

antigen testing of stool

97
Q

rabies PEP

A

HRIG inflitrate, 4 dose rabies vaccine

98
Q

traveler with abd pain and sx of GI obstruction

A

Ascaris lumbricoides
ingestion of eggs from contaminated soil
tx: albendazole or ivermectin

99
Q

eating undercooked pork, horse meat

A

trichinella

can get eye pain

100
Q

stinging/burning, pruritus, papulovesicular rash –> microcytic anemia, growth delay, cognitive defects, developmental delay

A

hookworm = necator americanus

101
Q

hepatomegaly and wheezing, eosinophilia

A

Toxocara canis

exposure to dogs/cats, eating dirt

102
Q

manifestations of toxocariasis

A

visceral larva migrans - hepatomegaly, fever, wheeze
ocular larva migrans - visual disturbances
covert - GI, pruritus, rash

103
Q

dx toxocara

A

ELISA

stool cultures to rule out other infx

104
Q

tx toxocara

A

albendazole, thiabendazole

105
Q

prianal or perivulvar itching

A

pinworms = enterobius

fecal oral, direct or via fomites

106
Q

tx enterobius

A

pyrantel pamoate, albendazole

107
Q

tx cryptococcus

A

amphotericin + fluconazole/flucytosine

108
Q

travel to CA, AZ, TX with flu like symptoms

A

coccidiomycosis

109
Q

tx coccidio

A

amphotericin, fluconazole, ketoconazole

110
Q

dx aspergillus

A

galactomannan

111
Q

tx aspergillus

A

voriconazole

ampho in neonates

112
Q

OH, MO, MI with flu like symptoms, HSM

A

histoplasmosis

bird droppings

113
Q

tx histo

A

healthy - supportive

disseminated or immcompro - amphotericin, fluconazole

114
Q

pulmonary disease, meningitis, pigeons

A

cryptococcus

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