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BOARDS > ID > Flashcards

ID Flashcards

1
Q

Non blanching rash

A

neisseria meningitidis

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2
Q

pustules

A

staph aureus

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3
Q

ecthyma gangrenosum

A

pseudomonas - large pustules on an indurated inflamed base

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4
Q

rose spots

A

salmonella typhosa

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5
Q

afebrile baby with staccato cough and tachypnea

A

chlamydia trachomatis

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6
Q

intracytoplasmic inclusion bodies

A

chlamydia trachomatis

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7
Q

definitive diagnosis of chlamydia trachomatis

A

PCR

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8
Q

treatment of chlamydia conjunctivitis

A

oral erythromycin or sulfonamides

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9
Q

increased incidence of ___ with oral erythromycin in babies under 6 wks

A

hypertrophic pyloric stenosis

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10
Q

uncomplicated chlamydia genital infection treatment

A

doxycycline x7 days OR 1 gram of azithro

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11
Q

adolescent with low grade fever and infiltrates

A

chlamydia pneumoniae

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12
Q

chlamydia pneumoniae treatment

A

azithromycin x 5 days OR erythromycin x 14 days

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13
Q

rash of RMSF

A

purpuric macular rash that becomes petechial. starts on wrists, ankles, palms and soles. spreads centrally after 2 to 4 days of fever

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14
Q

RMSF clues if no rash

A

hyponatremia with depression of cell lines on CBC

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15
Q

RMSF treatment

A

doxycycline until clinical improvementt and at least 3 days after fever resolves

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16
Q

ehrlichiosis lab findings

A

leukopenia and elevated LFTs

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17
Q

gram negative pleomorphic organisms

A

H. flu type b

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18
Q

h. flu type b treatment

A

ceftriaxone, cefotaxime, meopenem or chloramphenicol

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19
Q

conjunctivitis-otitis combination

A

non-typeable h. flu, tx w/ augmentin

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20
Q

encapsulated organisms

A

strep pneumonia, h. flu and Neisseria meningitidis

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21
Q

H. flu type b prophylaxis in household

A

rifampin for all household members if a contact is <12 months and not yet vaccinated OR a contact is immunocompromised

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22
Q

H. flu type b prophylaxis at daycare

A

rifampin for all attendees and caregivers if 2 or more cases within 60 days and some kids are unimmunized OR immunocompromised

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23
Q

phases of pertussis

A

one week of asymptomatic carrier, then 1. catarrhal 2. paroxysmal 3. recovery

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24
Q

lab findings with pertussis

A

leukocytosis with increased lymphocytes

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25
Q

diagnosis of pertussis

A

PCR

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26
Q

treatment of pertussis

A

erythromycin, clarithromycin, azithromycin or Bactrim (shortens the catarrhal stage but does not shorten cough just communicability)

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27
Q

post exposure prophylaxis with pertussis

A

all exposures need treated regardless of immunization status

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28
Q

salmonella carriers

A

chickens and humans (contracted from poultry, eggs, unwashed veggies, turtles, snakes, hedgehogs)

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29
Q

watery loose stool w/ vomiting, abdominal cramps and fever 1 to 2 days after a picnic in the summer

A

salmonella

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30
Q

salmonella treatment

A

supportive care UNLESS <3 months, severe colitis or immunocompromised, then ceftriaxone or cefotaxime

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31
Q

salmonella typhi presentation

A

malaise, fever, poor appetite, hepatosplenomegaly, red/rose spots (maybe constipation early)

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32
Q

lab finding with shigella

A

bandemia

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33
Q

bloody diarrhea and seizure

A

shigella

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34
Q

exposure to cattle, sheep or goats

A

brucellosis

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35
Q

brucellosis treatment

A

doxycycline or bactrim

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36
Q

pseudomembrane colitis

A

c. difficile

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37
Q

c. diff treatment

A

metronidazole

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38
Q

pastia lines

A

sandpaper rash of strep

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39
Q

treat strep to prevent ____

A

rheumatic fever

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40
Q

erysipelas

A

strep cellulitis (red streaks w/ lymphangitis)

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41
Q

hospital acquired MRSA treatment

A

vancomycin

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42
Q

community acquired MRSA treatment

A

vancomycin, bactrim, clindamycin

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43
Q

first sign of infantile botulism

A

constipation

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44
Q

botulism paralysis

A

descending symmetrical paralysis

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45
Q

diagnosis of infantile botulism

A

c. botulinum toxin in feces, wound exudate or tissue

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46
Q

botulism reporting

A

nationally notifiable disease

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47
Q

MOA w/ botulism

A

toxin blocks the release of acetylcholine into the synapse

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48
Q

infantile botulism treatment

A

supportive care, antitoxin (antibiotics, specifically aminoglycosides, can potentiate paralytic effects)

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49
Q

botulism vs myasthenia gravis

A

tensilon test is positive in myasthenia graves

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50
Q

wound botulism treatment

A

antitoxin and tiger penicillin or metronidazole

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51
Q

primary stage of syphilis

A

painless indurated ulcers (chancres) - 3 weeks post exposure

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52
Q

secondary stage of syphilis

A

rash, mucocutaneous lesions and LAD - 1 to 2 months after chancres

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53
Q

tertiary stage of syphilis

A

gumma, cardio, neurosyphilis - 15 to 30 yrs after chancre

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54
Q

screening test for syphilis

A

RPR and VDRL (can also be positive w/ EBV, varicella and hepatitis) aka non-treponemal tests

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55
Q

testing for syphilis after screening positive

A

FTA-ABS (stay positive even after treatment and may test positive w/ other spirochete diseases such as lyme disease

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56
Q

test that distinguishes syphilis from Lyme disease

A

VDRL (does not react w/ Lyme)

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57
Q

definitive diagnosis of syphilis

A

spirochetes on microscopic darkfield exam OR direct fluorescent antibody test of exudate

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58
Q

syphilis treatment

A

parenteral penicillin G (crosses the placenta so also treats baby in pregnancy)

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59
Q

when to treat newborn of Mom w/ syphilis

A

if Mom was treated within one month of delivery or if baby’s titers are higher than Mom’s

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60
Q

if Mom w/ syphilis was treated w/ penicillin 2 month before delivery, does baby need treatment?

A

no (>1 month from deliver w/ penicillin only, erythromycin does not cross placenta)

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61
Q

signs of congenital syphilis

A

snuffles, bulls lesions, osteochondritis, pseudoparalysis of joints, poor feeding

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62
Q

when do symptoms of untreated congenital syphilis arise?

A

after 2 years

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63
Q

hutchinson’s triad

A

interstitial keratitis, 8th CN deafness, notched central incisors (w/ syphilis)

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64
Q

irregular staining G+ pleomorphic bacillus

A

corynebacterium diphtheria

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65
Q

corynebacterium diphtheria spread

A

respiratory and contact

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66
Q

corynebacterium diphtheria effect via respiratory tract

A

membranous nasopharyngitis (bloody nasal discharge and low grade fever)

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67
Q

corynebacterium diphtheria effect via cutaneous

A

extensive neck swelling (bull neck)

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68
Q

corynebacterium diphtheria treatment

A

equine antitoxin

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69
Q

enterococci

A

G+ cocci in chains, ubiquitous in normal GI flora, low virulence

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70
Q

enterococci treatment

A

ampicillin or vancomycin

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71
Q

kingella kingae

A

fastidious G- coccobacilli (aka moraxella)

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72
Q

kingella king treatment

A

penicillin

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73
Q

listeria monocytogenes

A

facultative anaerobic G+ bacillus

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74
Q

listeria transmission

A

foodborne, most often among pregnancy, infants, elderly and immunocompromised

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75
Q

symptoms of listeria in pregnant

A

asymptomatic or flu-like

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76
Q

listeria treatment

A

ampicillin and gentamicin

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77
Q

most common strains of meningococcemia in adolescents

A

serogroups C, Y OR W-135 (all in vaccine)

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78
Q

most common strain of meningococcemia in infants

A

serogroup B (not in vaccine)

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79
Q

meningococcemia treatment

A

penicillin G, ampicillin OR cephalosporin

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80
Q

meningococcemia spread

A

droplet (close contact)

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81
Q

prophylaxis w. meningococcemia

A

rifampin for all contacts >8 hours within 7 days prior to onset of illness

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82
Q

rifampin side effect

A

orange secretions

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83
Q

most common cause of bacterial gastroenteritis in developed world

A

campylobacter

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84
Q

campylobacter spread

A

ingestion of contaminated food OR direct contact w/ fecal material from infected animal or person (uncooked poultry, untreated water, unpasteurized milk)

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85
Q

treatment of campylobacter

A

hydration. azithromycin and erythromycin shorten duration

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86
Q

yersinia resovoir

A

swine

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87
Q

bubonic plague

A

yersinia pestis (usually handling dead animals)

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88
Q

5 year old eating chitterlings

A

yersinia enterocolitica

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89
Q

appendicitis mimickers

A

yersinia and campylobacter

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90
Q

groups that get bacteremia w/ yersinia

A

excessive iron storage (sickle cell, beta thalassemia), immunocompromised

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91
Q

bartonella treatment

A

supportive care if healthy. azithromycin or bactrim if immunocompromised or having hepatosplenomegaly or painful LAD (needle aspiration only, I&D causes fistula)

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92
Q

pasturella treatment if allergic to amox

A

doxycycline, azithromycin or bactrim

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93
Q

latent TB treatment

A

9 months of isoniazid (rifampin for 6 to 9 months if not tolerated)

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94
Q

active TB treatment

A

2 months of RIP (rifampin, isoniazide and pyrazinamide) then 4 months of INH and rifampin. OR 9 months of INH and rifampin

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95
Q

TB meningitis treatment

A

steroids plus 2 months of RIP AND streptomycin, then 10 months of RI

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96
Q

PCP prophylaxis

A

bactrim 3 days/wk

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97
Q

PCP CXR

A

ground glass appearance or general perihilar infiltrates

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98
Q

treatment of immunocompromised patient w/ neutropenia and fever

A

zosyn plus aminoglycoside or ceftazidime (G- coverage)

99
Q

chronic watery diarrhea in immunocompromised

A

cryptosporidium

100
Q

diarrhea w/ swimming pools or municipal water

A

crytptosporidium

101
Q

diarrhea w/ petting zoos

A

cryptosporidium or E. coli

102
Q

diarrhea w/ apple juice or undercooked ground beef

A

E. coli

103
Q

diarrhea and chitterlings or pork

A

yersinia

104
Q

diarrhea w/ recent antibiotics

A

c. diff

105
Q

diarrhea w/ uncooked poultry, untreated water or dairy farms

A

campylobacter

106
Q

diarrhea w/ unpasteurized milk

A

campylobacter or E. coli

107
Q

aminoglycosides effectiveness dependent on

A

high peak levels

108
Q

aminoglycosides side effect

A

ototoxicity (w/ high trough levels)

109
Q

peak levels

A

30 minutes after dose

110
Q

trough levels

A

30 minutes prior to dose

111
Q

penicillin MOA

A

bing to PBPs to inhibit cell wall formation

112
Q

MRSA resistance

A

interfere w/ PBPs

113
Q

first generation cephalosporins

A

cefodroxil, cephalexin, cephradine, cefazolin

114
Q

2nd gen cephalosporins

A

ceflacor, cefprozil, cefuroxime, cefotetan, cefoxitin,

115
Q

3rd gen cephalosporins

A

cefdinir, cefixime, cefpodoxime, cefotaxime, ceftazidime, ceftriaxone

116
Q

4th gen cephalosporins

A

cefepime

117
Q

1st gen cephalosporin coverage

A

G+ cocci

118
Q

1st gen cephalosporin does not penetrate

A

CSF

119
Q

2nd gen cephalosporin coverage

A

some G+, best for beta lactamase producing G- (ex: enterobacter, h. flu and moraxella)

120
Q

3rd gen cephalosporin coverage

A

beta lactamase producing G- w/ excellent CSF penetration

121
Q

4th gen cephalosporin coverage

A

good G+ and G- including pseudomonas

122
Q

clindamycin MOA

A

bacteriostatic so usually used in combo

123
Q

rifampin contraindication

A

pregnancy

124
Q

cause of red man syndrome

A

histamine release

125
Q

definitive diagnosis of entamoeba histolytica

A

enzyme immunoassay in stool

126
Q

amebic dysentery

A

1 to 2 wks of crapy abdominal pain, diarrhea, fever and tenesmus (entamoeba histolytica)

127
Q

invasive entamoeba histolytica

A

liver and brain abscesses or lung disease in addition to diarrhea/tenesmus

128
Q

treatment of entamoeba histolytica

A

metronidazole or tinidazole if symptomatic, iodoquinol or paromomycin if asymptomatic

129
Q

fever with malaria

A

every 2 to 3 days

130
Q

malaria treatment

A

quinidine

131
Q

toxoplasmosis effect in pregnancy

A

lower chance but more severe consequences early in pregnancy, higher chance but less severe problems later in pregnancy

132
Q

congenital toxoplasmosis symptoms

A

microcephaly, chorioretinitis, diffuse cerebral calcifications, jaundice, hepatosplenomegaly

133
Q

symptomatic congenital toxoplasmosis treatment

A

pyrimethamine, sulfadiazine and folinic acid

134
Q

human herpesvirus 5

A

CMV

135
Q

CMV calcifications

A

periventricular (circumvent ventricles)

136
Q

toxoplasmosis calcifications

A

diffuse

137
Q

diagnostic study of congenital CMV

A

urine culture or urine/saliva PCR in the first 3 weeks of life

138
Q

CMV symptoms

A

chorioretinitis, periventricular calcifications, sensorineural hearing loss, blueberry muffin (thrombocytopenia w/ petechiae and purpura)

139
Q

human herpesvirus 4

A

EBV

140
Q

EBNA

A

appears weeks to months after onset of infection and persists for life

141
Q

positive EA and VCA, negative EBNA

A

acute EBV infection

142
Q

positive VCA and EBNA, low EA

A

convalescent/past EBV infection

143
Q

positive VCA and EBNA, high EA

A

reactivation of EBV

144
Q

rash after treatment with ampicillin could be due to

A

EBV

145
Q

human herpesvirus 6

A

roseola

146
Q

roseola presentation

A

3 to 5 days of high fever, rash begins when fever ends

147
Q

congenital rubella manifestation

A

cataracts and PDA

148
Q

rubeola symptoms

A

measles - cough, coryza, conjunctivitis, koplik spots

149
Q

measles transmission

A

rubeola - airborne droplets, incubation 8-12 days

150
Q

when is measles most contagious

A

4 days before and 4 days after rash starts

151
Q

post exposure management for measles

A

MMR to prevent if within 3 days of exposure, immune globulin if within 6 days

152
Q

measles treatment

A

supportive care and 2 days fo vitamin A

153
Q

return to school w/ mumps

A

9 days after onset of parotitis

154
Q

unimmunized children return to school w/ classmate w/ mumps

A

get vaccinated OR stay home for 26 days after person developed parotitis

155
Q

salivary gland stone

A

intermittent swelling

156
Q

mumps vs parotid infection

A

mumps = low grade fever and non toxic appearing

parotid infection = high fever and toxic appearing

157
Q

erythema infectiosum aka

A

parvovirus B19 or fifth disease

158
Q

hydrops fetalis

A

parvovirus B19 (erythema infectiosum) in pregnancy

159
Q

aplastic crisis in sickle cell

A

parvovirus B19 (erythema infectiosum)

160
Q

symptoms of erythema infectiosum

A

slap cheek rash, Lacey rash of extremities, polyarthropathy

161
Q

temporal lobe seizure

A

HSV

162
Q

most invasive herpes infections are

A

type 2

163
Q

lab findings in HIV

A

low CD4 count

164
Q

modes of transmission of HIV to neonates

A

vertical or breastfeeding

165
Q

preventing vertical transmission of HIV

A

zidovudine for mom and baby, and no breast feeding

166
Q

when does seroconversion occur w/ HIV

A

w/in 6 months (test at exposure, 6 wks, 12 wks and 6 months)

167
Q

gold standard for HIV testing in neonate

A

PCR (IgG crosses placenta so serologic testing is not reliable)

168
Q

vaccines contraindicated w/ CD4 count <15%

A

measles and varicella

169
Q

varicella spread

A

airborne and contact for at least 5 days after rash onset and until all lesions crust over

170
Q

precautions in neonates who receive varicella immune globulin

A

airborne and contact until 21 or 28 days

171
Q

immunocompromised child exposed to varicella needs ___

A

VZIG

172
Q

newborn exposure prevention

A

VZIG if mom has chickenpox 5 days before to 2 days after delivery (must be given within 96 hours as it is prevention not treatment)

173
Q

palivizumab

A

Synagis (decreases risk of RSV in chronic lung disease, preterm and congenital heart kids)

174
Q

laryngotracheobronchitis

A

croup - from parainfluenza

175
Q

rabies prophylaxis

A

immunization and HRIG

176
Q

abdominal pain/obstruction after traveling to tropical region

A

ascaris lumbricoides

177
Q

ascaris lumbrocoides treatment

A

albendazole OR ivermectin x1

178
Q

hypochromic microcytic anemia with growth and developmental delay

A

necator americanus

179
Q

initial skin penetration symptoms w/ necator Americans

A

stinging/burning followed by itching and papulovesicular rash for 1 to 2 weeks

180
Q

cysticercosis

A

ingesting eggs of pork tapeworm (T. solium)

181
Q

toxocariasis

A

GI and respiratory symptoms with eosinophilia after exposure to dogs/cats or eating dirt

182
Q

visceral larva migrans

A

fever, hepatosplenomegaly and wheezing from toxocariasis

183
Q

visceral larva migraines treatment

A

albendazole or thiabendazole

184
Q

enterobius vermicularis

A

pinworms

185
Q

enterobius vermicularis treatment

A

pyrantel pamoate or albendazole (pinworms)

186
Q

treatment of neonates w/ invasive candidiasis

A

IV amphotericin

187
Q

exposure to bird droppings

A

cryptococcosis (headache) or histoplasmosis (hepatosplenomegaly)

188
Q

treatment of severe cryptococcosis

A

IV amphotericin with oral fluconazole

189
Q

flu like symptoms in Arizona, Texas or california

A

coccidioidomycosis

190
Q

treatment of coccidioidomycosis

A

amphotericin B, fluconazole or ketoconazole

191
Q

asthmatic who is worsening despite treatment with eosinophilia and infiltrates on CXR

A

aspergillosis

192
Q

diagnosis of aspergillosis

A

positive serum galactomannan (antigen on aspergillum cell wall)

193
Q

treatment of invasive aspergillosis

A

voriconazole (amphotericin if neonate)

194
Q

flu like symptoms in Ohio, Missouri or Mississippi with hepatospleomegaly

A

histoplasmosis

195
Q

airborne precautions

A

aspergillosis, TB, measles, varicella, disseminated zoster

196
Q

kid with cyanotic heart disease has new onset headache and seizure. MRI w/ brain abscess. what organism?

A

stash aureus

197
Q

most common cause of IV catheter related bacteremia

A

staph epidermidis

198
Q

empiric antibiotic choice for meningitis in child >3 months

A

ceftriaxone and vancomycin

199
Q

16 month old w/ thick purulent nasal discharge, LG fever, poor PO and abdominal pain

A

streptococcosis - grp A beta hemolytic strep

200
Q

child w. cochlear implant is at increased risk of CNS infection from what organism

A

strep pneumo

201
Q

short incubation bacillus cereus

A

emetic type from preformed heat stabile toxin

202
Q

longer incubation bacillus cereus

A

diarrheal type from heat labile enterotoxin

203
Q

gonococcal ophthalmia time of presentation

A

2 to 7 days after delivery

204
Q

amphotericin B causes renal losses of ____

A

potassium and magnesium

205
Q

treatment of GBS

A

ampicillin plus gentamicin (synergistic bc gent lowers bacterial load), then IV penicillin G

206
Q

2 yr old at daycare with fever, vomiting, bloody diarrhea, new seizure, rectal prolapse and bandemia on CBC

A

shigella

207
Q

diarrhea with rectal prolapse

A

shigella

208
Q

diarrhea with bandemia

A

shigella

209
Q

HUS triad

A

renal failure, thrombocytopenia w/ purpura and hemolytic anemia

210
Q

cause of HUS

A

E. coli O157:H7

211
Q

14 yr old w/ diarrhea and has an iguana

A

salmonella

212
Q

what do you need to evaluate in a neonate with meningitis that grows citrobacter

A

brain abscess

213
Q

rash with hyponatremia and thrombocytopenia

A

RMSF

214
Q

17 yr old with cough, lG fever, wheeze and negative cold agglutinins

A

chlamydia pneumonia

215
Q

2 month old w/ staccato cough

A

chlamydia trachomatis

216
Q

hyper pigmented scaly lesions that worsen in the sun

A

tinea versicolor (malassezia furfur)

217
Q

scrapings of malassezia furfur

A

spaghetti and meatball (tines versicolor)

218
Q

treatment of malassezia furfur

A

topical selenium sulfide or topical azole (tines versicolor)

219
Q

watery diarrhea and sulfur smelling burps

A

giardia

220
Q

4 yr old w/ fever, vesicles on buccal mucosa and tongue, maculopapular rash on hands and feet

A

coxsackievirus - HFM

221
Q

fever, headache and sore throat for 1 to 5 days then rash that begins on the face and spreads distally

A

rubella (German measles)

222
Q

main side effect of zidovudine

A

bone marrow suppression

223
Q

presentation of early onset GBS

A

septicemia and pneumonia

224
Q

presentation of late onset GBS

A

bacteremia and meningitis

225
Q

granulomatosis infantisepticum

A

rash of listeria monocytogenes (erythematous with papules)

226
Q

15 yr old works on a sheep farm and has painless papule with vesiculates and forms painless ulcer, then painless black eschar with non pitting painless induration and swelling

A

anthrax

227
Q

17 yr old with pneumonia, diarrhea and headache/confusion

A

legionella pneumophila

228
Q

triad of legionella pneumophila

A

respiratory, GI and CNS

229
Q

kid in CT with fever, headache, leukopenia, thrombocytopenia, anemia and elevated LFTs

A

anaplasmosis

230
Q

what to look for in kid with buccal cellulitis from H. flu

A

bacteremia

231
Q

how many mm is positive for TST in 3 yr old w/o risk factors

A

> /= 10 mm (<4 yrs = moderate risk w/ homeless, IV drugs, prisoners, healthcare workers, diabetes, CKD, immunosuppressed)

232
Q

drainage from skin around tooth infection with yellow sulfur granules

A

actinomyces

233
Q

15 yr old lives on farm and eats chitterlings has appendicitis-like syndrome

A

yersinia

234
Q

child from Arkansas or Missouri/oklahoma with swollen lymph node and fever

A

tularemia from francisella tularensis

235
Q

treatment of tularemia

A

gentamicin or streptomycin for 10 days

236
Q

pneumonia with splenomegaly and arounds chickens or pigeons

A

chlamydia psittaci

237
Q

pneumonia with splenomegaly and live in ohio

A

histoplasmosis

238
Q

14 yr old w/ fever, conjunctival injection, myalgia, jaundice, elevated Creatinine and bilirubin that swims in fresh water lagoons

A

leptospirosis

239
Q

community wide outbreak of diarrhea due to acid fast organism

A

cryptosporidium

240
Q

skin ulceration in someone who works with fish tanks

A

mycobacterium marinum

241
Q

vesicles on tonsils, uvula and pharynx but not front of mouth

A

herpangina (herpes is front)

242
Q

fever and descending paralysis

A

polio

243
Q

endocarditis criteria

A

Duke criteria
major criteria = positive blood culture w/ strep viridans, evidence of endocardial involvement
minor criteria = IV drug use or heart condition, fever, +RF,

244
Q

6 month old with beta thalassemia has fever

A

yersinia enterocolitica

BOARDS (24 decks)

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