ID Flashcards
Mom has husband who lived in Brazil up to 12 months ago, babe comes out looking well with a normal head circumference, weight and length. Normal physical exam. What testing do you do on newborn ?
A. zikv PCR in blood and urine of babe and HUs
B. MRI
C. ZIKV serologies
D. Do nothing
D. Do nothing
Serologies on mom first ;)
Girl comes into office over the summer, has hypopigmented patches over face and chest, with poorly- defined borders, fine white scale. History of asthma
A. Tinea Versicolor
B. Pityriasis Alba
C. Vitiligo
B. Pityriasis Alba
Parvo B19 daycare restrictions (given picture of child with facial rash)
A. Now
B. As soon as the child is well enough to go
C. After the rash resolves
D. After the fever and the rash resolves
B. As soon as the child is well enough to go
A 5 year old boy has a fever and a sore throat. Initially prescribed amoxicillin., defervesced. A few days later returns with a brassy cough, high fever, toxic appearance. What is the next step in management ?
A. Nebulized epi
B. Dexamethasone
C. Call ENT
D. Lateral X-ray
C. Call ENT - toxic appearance
Bacterial tracheitis
15 y. O male with fever x 24h, one sided scrotal pain and swelling with dysuria and pyuria. u/A shows WBC - best management ?
A. Refer to urology
B. Treat him with abx
C. Treat him and sexual partners with abx
C. Treat him and sexual partners with abx
You are seeing a newborn born to a hepatitis B positive mother. What is the best management for the baby ?
A. Hep B Ig/ Hep vaccine now
B. Hepatitis B vaccine within 12h and immunoglobulin within 7 days
A. Hep B IG and vaccine now
Red book - best to give both <12h of birth if mom known to be positive.
Exam tip
Vaccine always before <12h
For HbIG depends on mom status and birth weight
If mom status unknown And BW > 2kg can wait up to seven days
2 year old fully immunized girl fell on playground and has a deep arm laceration. After laceration has been cleaned and sutured, what further management ?
A. Tetanus toxoid
B. Tetanus toxoid and immunoglobulin
C. Antibiotics
D. Nothing
D. Nothing
6 month old mother with hepatitis C ( antibody positive, HCV RNA positive). Babe is well with normal liver enzymes and negative anti- HCV antibody. What do you do ?
A. Reassurance, no further testing needed
B. Repeat HCV serology in 6 months
C. Liver biopsy
D. Measure HCV RNA
Controversial
A. Reassurance and no further testing needed - this would be the case from CPS statement if abs are negative at any age then no transmission occurred and no need to do RNA testing. However red book says that there can be false negatives with antibody testing thus do RNA testing !!!!!
Vs
Repeat HCV serology in 6 months - this is when antibody testing is usually done but mostly to allow maternal and to leave the system
A child at daycare bites another child and causes bleeding but it’s not a deep bite. Both are immunized but their hepatitis B status is unknown. The best next step ?
A. Do HBV serology in both
B. Give oral clavulin prophylaxis to the bitten child
C. Check both for HBV surface antigen and antibodies
D. Give hepatitis vaccine to both
D. Give hepatitis B vaccine to both
Boy with 2 day history of mouth sores and rash. Preceded by 1 week of fever and cough, given amox and acetominophen. What is the most likely cause ? (Picture give of rash with hands and lips looking like erythema multiforme)
A. HSV
B. Amoxicillin
C. Mycoplasma
D. Acetominophen
C. Mycoplasma - Mcc of erythema multiforme
Teenager with fever and sore throat. Treated with amoxicillin and initially improved but now fever is back and having difficulty opening mouth due to pain, also has moderate anterior cervical lymphadenopathy bilaterally. What is the diagnosis ?
A. Peritonsillar abscess
B. Retropharyngeal abscess
C. EBV
A. Peritonsillar abscess
Kid with orbital cellulitis, started on ceftriaxone. Improves and things are getting better. 48h later left eye is swollen and becomes lethargic. What is the next step ?
A. MRI
B. Start vancomycin
C. Start dexamethasone
D. Consult for drainage of orbital abscess
B. Start Vanco - as per Dr. Pernica
Controversial some people say MRI and others consult for drainage or orbital abscess.
Up to date = start Vanco next
Baby with pneumonia on CXR, CBC shows eosinophilia, management ?
A. Erythromycin
B. Ceftriaxone
C. Nothing
D. Ampicillin
A. Erythromycin - chlamydia pneumonia
Kid with fever, swelling of face from ear to angle of the jaw. What is the treatment ?
A. Supportive
B. Antibiotics
A. Supportive - mumps
AOM, 3 y.o 39.1 degrees, red bulging tympanic membrane. Severe pain. Management plan.
A. Amox 75-90mg/kg BID x 5 days
B. Amox 75-90mg/kg BID x 10 days
C. Rex for above you be filled in 24h if still symptomatic or febrile
D. Reassess in 24-48h
A. Amox 75-90mg/kg BID x 5 days
What I don’t get is no mention of MEE
