ID Flashcards
1
Q
Non blanching rash
A
neisseria meningitidis
2
Q
pustules
A
staph aureus
3
Q
ecthyma gangrenosum
A
pseudomonas - large pustules on an indurated inflamed base
4
Q
rose spots
A
salmonella typhosa
5
Q
afebrile baby with staccato cough and tachypnea
A
chlamydia trachomatis
6
Q
intracytoplasmic inclusion bodies
A
chlamydia trachomatis
7
Q
definitive diagnosis of chlamydia trachomatis
A
PCR
8
Q
treatment of chlamydia conjunctivitis
A
oral erythromycin or sulfonamides
9
Q
increased incidence of ___ with oral erythromycin in babies under 6 wks
A
hypertrophic pyloric stenosis
10
Q
uncomplicated chlamydia genital infection treatment
A
doxycycline x7 days OR 1 gram of azithro
11
Q
adolescent with low grade fever and infiltrates
A
chlamydia pneumoniae
12
Q
chlamydia pneumoniae treatment
A
azithromycin x 5 days OR erythromycin x 14 days
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
14
Q
RMSF clues if no rash
A
hyponatremia with depression of cell lines on CBC
15
Q
RMSF treatment
A
doxycycline until clinical improvementt and at least 3 days after fever resolves
16
Q
ehrlichiosis lab findings
A
leukopenia and elevated LFTs
17
Q
gram negative pleomorphic organisms
A
H. flu type b
18
Q
h. flu type b treatment
A
ceftriaxone, cefotaxime, meopenem or chloramphenicol
19
Q
conjunctivitis-otitis combination
A
non-typeable h. flu, tx w/ augmentin
20
Q
encapsulated organisms
A
strep pneumonia, h. flu and Neisseria meningitidis
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
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
23
Q
phases of pertussis
A
one week of asymptomatic carrier, then 1. catarrhal 2. paroxysmal 3. recovery
24
Q
lab findings with pertussis
A
leukocytosis with increased lymphocytes
25
diagnosis of pertussis
PCR
26
treatment of pertussis
erythromycin, clarithromycin, azithromycin or Bactrim (shortens the catarrhal stage but does not shorten cough just communicability)
27
post exposure prophylaxis with pertussis
all exposures need treated regardless of immunization status
28
salmonella carriers
chickens and humans (contracted from poultry, eggs, unwashed veggies, turtles, snakes, hedgehogs)
29
watery loose stool w/ vomiting, abdominal cramps and fever 1 to 2 days after a picnic in the summer
salmonella
30
salmonella treatment
supportive care UNLESS <3 months, severe colitis or immunocompromised, then ceftriaxone or cefotaxime
31
salmonella typhi presentation
malaise, fever, poor appetite, hepatosplenomegaly, red/rose spots (maybe constipation early)
32
lab finding with shigella
bandemia
33
bloody diarrhea and seizure
shigella
34
exposure to cattle, sheep or goats
brucellosis
35
brucellosis treatment
doxycycline or bactrim
36
pseudomembrane colitis
c. difficile
37
c. diff treatment
metronidazole
38
pastia lines
sandpaper rash of strep
39
treat strep to prevent ____
rheumatic fever
40
erysipelas
strep cellulitis (red streaks w/ lymphangitis)
41
hospital acquired MRSA treatment
vancomycin
42
community acquired MRSA treatment
vancomycin, bactrim, clindamycin
43
first sign of infantile botulism
constipation
44
botulism paralysis
descending symmetrical paralysis
45
diagnosis of infantile botulism
c. botulinum toxin in feces, wound exudate or tissue
46
botulism reporting
nationally notifiable disease
47
MOA w/ botulism
toxin blocks the release of acetylcholine into the synapse
48
infantile botulism treatment
supportive care, antitoxin (antibiotics, specifically aminoglycosides, can potentiate paralytic effects)
49
botulism vs myasthenia gravis
tensilon test is positive in myasthenia graves
50
wound botulism treatment
antitoxin and tiger penicillin or metronidazole
51
primary stage of syphilis
painless indurated ulcers (chancres) - 3 weeks post exposure
52
secondary stage of syphilis
rash, mucocutaneous lesions and LAD - 1 to 2 months after chancres
53
tertiary stage of syphilis
gumma, cardio, neurosyphilis - 15 to 30 yrs after chancre
54
screening test for syphilis
RPR and VDRL (can also be positive w/ EBV, varicella and hepatitis) aka non-treponemal tests
55
testing for syphilis after screening positive
FTA-ABS (stay positive even after treatment and may test positive w/ other spirochete diseases such as lyme disease
56
test that distinguishes syphilis from Lyme disease
VDRL (does not react w/ Lyme)
57
definitive diagnosis of syphilis
spirochetes on microscopic darkfield exam OR direct fluorescent antibody test of exudate
58
syphilis treatment
parenteral penicillin G (crosses the placenta so also treats baby in pregnancy)
59
when to treat newborn of Mom w/ syphilis
if Mom was treated within one month of delivery or if baby's titers are higher than Mom's
60
if Mom w/ syphilis was treated w/ penicillin 2 month before delivery, does baby need treatment?
no (>1 month from deliver w/ penicillin only, erythromycin does not cross placenta)
61
signs of congenital syphilis
snuffles, bulls lesions, osteochondritis, pseudoparalysis of joints, poor feeding
62
when do symptoms of untreated congenital syphilis arise?
after 2 years
63
hutchinson's triad
interstitial keratitis, 8th CN deafness, notched central incisors (w/ syphilis)
64
irregular staining G+ pleomorphic bacillus
corynebacterium diphtheria
65
corynebacterium diphtheria spread
respiratory and contact
66
corynebacterium diphtheria effect via respiratory tract
membranous nasopharyngitis (bloody nasal discharge and low grade fever)
67
corynebacterium diphtheria effect via cutaneous
extensive neck swelling (bull neck)
68
corynebacterium diphtheria treatment
equine antitoxin
69
enterococci
G+ cocci in chains, ubiquitous in normal GI flora, low virulence
70
enterococci treatment
ampicillin or vancomycin
71
kingella kingae
fastidious G- coccobacilli (aka moraxella)
72
kingella king treatment
penicillin
73
listeria monocytogenes
facultative anaerobic G+ bacillus
74
listeria transmission
foodborne, most often among pregnancy, infants, elderly and immunocompromised
75
symptoms of listeria in pregnant
asymptomatic or flu-like
76
listeria treatment
ampicillin and gentamicin
77
most common strains of meningococcemia in adolescents
serogroups C, Y OR W-135 (all in vaccine)
78
most common strain of meningococcemia in infants
serogroup B (not in vaccine)
79
meningococcemia treatment
penicillin G, ampicillin OR cephalosporin
80
meningococcemia spread
droplet (close contact)
81
prophylaxis w. meningococcemia
rifampin for all contacts >8 hours within 7 days prior to onset of illness
82
rifampin side effect
orange secretions
83
most common cause of bacterial gastroenteritis in developed world
campylobacter
84
campylobacter spread
ingestion of contaminated food OR direct contact w/ fecal material from infected animal or person (uncooked poultry, untreated water, unpasteurized milk)
85
treatment of campylobacter
hydration. azithromycin and erythromycin shorten duration
86
yersinia resovoir
swine
87
bubonic plague
yersinia pestis (usually handling dead animals)
88
5 year old eating chitterlings
yersinia enterocolitica
89
appendicitis mimickers
yersinia and campylobacter
90
groups that get bacteremia w/ yersinia
excessive iron storage (sickle cell, beta thalassemia), immunocompromised
91
bartonella treatment
supportive care if healthy. azithromycin or bactrim if immunocompromised or having hepatosplenomegaly or painful LAD (needle aspiration only, I&D causes fistula)
92
pasturella treatment if allergic to amox
doxycycline, azithromycin or bactrim
93
latent TB treatment
9 months of isoniazid (rifampin for 6 to 9 months if not tolerated)
94
active TB treatment
2 months of RIP (rifampin, isoniazide and pyrazinamide) then 4 months of INH and rifampin. OR 9 months of INH and rifampin
95
TB meningitis treatment
steroids plus 2 months of RIP AND streptomycin, then 10 months of RI
96
PCP prophylaxis
bactrim 3 days/wk
97
PCP CXR
ground glass appearance or general perihilar infiltrates
98
treatment of immunocompromised patient w/ neutropenia and fever
zosyn plus aminoglycoside or ceftazidime (G- coverage)
99
chronic watery diarrhea in immunocompromised
cryptosporidium
100
diarrhea w/ swimming pools or municipal water
crytptosporidium
101
diarrhea w/ petting zoos
cryptosporidium or E. coli
102
diarrhea w/ apple juice or undercooked ground beef
E. coli
103
diarrhea and chitterlings or pork
yersinia
104
diarrhea w/ recent antibiotics
c. diff
105
diarrhea w/ uncooked poultry, untreated water or dairy farms
campylobacter
106
diarrhea w/ unpasteurized milk
campylobacter or E. coli
107
aminoglycosides effectiveness dependent on
high peak levels
108
aminoglycosides side effect
ototoxicity (w/ high trough levels)
109
peak levels
30 minutes after dose
110
trough levels
30 minutes prior to dose
111
penicillin MOA
bing to PBPs to inhibit cell wall formation
112
MRSA resistance
interfere w/ PBPs
113
first generation cephalosporins
cefodroxil, cephalexin, cephradine, cefazolin
114
2nd gen cephalosporins
ceflacor, cefprozil, cefuroxime, cefotetan, cefoxitin,
115
3rd gen cephalosporins
cefdinir, cefixime, cefpodoxime, cefotaxime, ceftazidime, ceftriaxone
116
4th gen cephalosporins
cefepime
117
1st gen cephalosporin coverage
G+ cocci
118
1st gen cephalosporin does not penetrate
CSF
119
2nd gen cephalosporin coverage
some G+, best for beta lactamase producing G- (ex: enterobacter, h. flu and moraxella)
120
3rd gen cephalosporin coverage
beta lactamase producing G- w/ excellent CSF penetration
121
4th gen cephalosporin coverage
good G+ and G- including pseudomonas
122
clindamycin MOA
bacteriostatic so usually used in combo
123
rifampin contraindication
pregnancy
124
cause of red man syndrome
histamine release
125
definitive diagnosis of entamoeba histolytica
enzyme immunoassay in stool
126
amebic dysentery
1 to 2 wks of crapy abdominal pain, diarrhea, fever and tenesmus (entamoeba histolytica)
127
invasive entamoeba histolytica
liver and brain abscesses or lung disease in addition to diarrhea/tenesmus
128
treatment of entamoeba histolytica
metronidazole or tinidazole if symptomatic, iodoquinol or paromomycin if asymptomatic
129
fever with malaria
every 2 to 3 days
130
malaria treatment
quinidine
131
toxoplasmosis effect in pregnancy
lower chance but more severe consequences early in pregnancy, higher chance but less severe problems later in pregnancy
132
congenital toxoplasmosis symptoms
microcephaly, chorioretinitis, diffuse cerebral calcifications, jaundice, hepatosplenomegaly
133
symptomatic congenital toxoplasmosis treatment
pyrimethamine, sulfadiazine and folinic acid
134
human herpesvirus 5
CMV
135
CMV calcifications
periventricular (circumvent ventricles)
136
toxoplasmosis calcifications
diffuse
137
diagnostic study of congenital CMV
urine culture or urine/saliva PCR in the first 3 weeks of life
138
CMV symptoms
chorioretinitis, periventricular calcifications, sensorineural hearing loss, blueberry muffin (thrombocytopenia w/ petechiae and purpura)
139
human herpesvirus 4
EBV
140
EBNA
appears weeks to months after onset of infection and persists for life
141
positive EA and VCA, negative EBNA
acute EBV infection
142
positive VCA and EBNA, low EA
convalescent/past EBV infection
143
positive VCA and EBNA, high EA
reactivation of EBV
144
rash after treatment with ampicillin could be due to
EBV
145
human herpesvirus 6
roseola
146
roseola presentation
3 to 5 days of high fever, rash begins when fever ends
147
congenital rubella manifestation
cataracts and PDA
148
rubeola symptoms
measles - cough, coryza, conjunctivitis, koplik spots
149
measles transmission
rubeola - airborne droplets, incubation 8-12 days
150
when is measles most contagious
4 days before and 4 days after rash starts
151
post exposure management for measles
MMR to prevent if within 3 days of exposure, immune globulin if within 6 days
152
measles treatment
supportive care and 2 days fo vitamin A
153
return to school w/ mumps
9 days after onset of parotitis
154
unimmunized children return to school w/ classmate w/ mumps
get vaccinated OR stay home for 26 days after person developed parotitis
155
salivary gland stone
intermittent swelling
156
mumps vs parotid infection
mumps = low grade fever and non toxic appearing
| parotid infection = high fever and toxic appearing
157
erythema infectiosum aka
parvovirus B19 or fifth disease
158
hydrops fetalis
parvovirus B19 (erythema infectiosum) in pregnancy
159
aplastic crisis in sickle cell
parvovirus B19 (erythema infectiosum)
160
symptoms of erythema infectiosum
slap cheek rash, Lacey rash of extremities, polyarthropathy
161
temporal lobe seizure
HSV
162
most invasive herpes infections are
type 2
163
lab findings in HIV
low CD4 count
164
modes of transmission of HIV to neonates
vertical or breastfeeding
165
preventing vertical transmission of HIV
zidovudine for mom and baby, and no breast feeding
166
when does seroconversion occur w/ HIV
w/in 6 months (test at exposure, 6 wks, 12 wks and 6 months)
167
gold standard for HIV testing in neonate
PCR (IgG crosses placenta so serologic testing is not reliable)
168
vaccines contraindicated w/ CD4 count <15%
measles and varicella
169
varicella spread
airborne and contact for at least 5 days after rash onset and until all lesions crust over
170
precautions in neonates who receive varicella immune globulin
airborne and contact until 21 or 28 days
171
immunocompromised child exposed to varicella needs ___
VZIG
172
newborn exposure prevention
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
palivizumab
Synagis (decreases risk of RSV in chronic lung disease, preterm and congenital heart kids)
174
laryngotracheobronchitis
croup - from parainfluenza
175
rabies prophylaxis
immunization and HRIG
176
abdominal pain/obstruction after traveling to tropical region
ascaris lumbricoides
177
ascaris lumbrocoides treatment
albendazole OR ivermectin x1
178
hypochromic microcytic anemia with growth and developmental delay
necator americanus
179
initial skin penetration symptoms w/ necator Americans
stinging/burning followed by itching and papulovesicular rash for 1 to 2 weeks
180
cysticercosis
ingesting eggs of pork tapeworm (T. solium)
181
toxocariasis
GI and respiratory symptoms with eosinophilia after exposure to dogs/cats or eating dirt
182
visceral larva migrans
fever, hepatosplenomegaly and wheezing from toxocariasis
183
visceral larva migraines treatment
albendazole or thiabendazole
184
enterobius vermicularis
pinworms
185
enterobius vermicularis treatment
pyrantel pamoate or albendazole (pinworms)
186
treatment of neonates w/ invasive candidiasis
IV amphotericin
187
exposure to bird droppings
cryptococcosis (headache) or histoplasmosis (hepatosplenomegaly)
188
treatment of severe cryptococcosis
IV amphotericin with oral fluconazole
189
flu like symptoms in Arizona, Texas or california
coccidioidomycosis
190
treatment of coccidioidomycosis
amphotericin B, fluconazole or ketoconazole
191
asthmatic who is worsening despite treatment with eosinophilia and infiltrates on CXR
aspergillosis
192
diagnosis of aspergillosis
positive serum galactomannan (antigen on aspergillum cell wall)
193
treatment of invasive aspergillosis
voriconazole (amphotericin if neonate)
194
flu like symptoms in Ohio, Missouri or Mississippi with hepatospleomegaly
histoplasmosis
195
airborne precautions
aspergillosis, TB, measles, varicella, disseminated zoster
196
kid with cyanotic heart disease has new onset headache and seizure. MRI w/ brain abscess. what organism?
stash aureus
197
most common cause of IV catheter related bacteremia
staph epidermidis
198
empiric antibiotic choice for meningitis in child >3 months
ceftriaxone and vancomycin
199
16 month old w/ thick purulent nasal discharge, LG fever, poor PO and abdominal pain
streptococcosis - grp A beta hemolytic strep
200
child w. cochlear implant is at increased risk of CNS infection from what organism
strep pneumo
201
short incubation bacillus cereus
emetic type from preformed heat stabile toxin
202
longer incubation bacillus cereus
diarrheal type from heat labile enterotoxin
203
gonococcal ophthalmia time of presentation
2 to 7 days after delivery
204
amphotericin B causes renal losses of ____
potassium and magnesium
205
treatment of GBS
ampicillin plus gentamicin (synergistic bc gent lowers bacterial load), then IV penicillin G
206
2 yr old at daycare with fever, vomiting, bloody diarrhea, new seizure, rectal prolapse and bandemia on CBC
shigella
207
diarrhea with rectal prolapse
shigella
208
diarrhea with bandemia
shigella
209
HUS triad
renal failure, thrombocytopenia w/ purpura and hemolytic anemia
210
cause of HUS
E. coli O157:H7
211
14 yr old w/ diarrhea and has an iguana
salmonella
212
what do you need to evaluate in a neonate with meningitis that grows citrobacter
brain abscess
213
rash with hyponatremia and thrombocytopenia
RMSF
214
17 yr old with cough, lG fever, wheeze and negative cold agglutinins
chlamydia pneumonia
215
2 month old w/ staccato cough
chlamydia trachomatis
216
hyper pigmented scaly lesions that worsen in the sun
tinea versicolor (malassezia furfur)
217
scrapings of malassezia furfur
spaghetti and meatball (tines versicolor)
218
treatment of malassezia furfur
topical selenium sulfide or topical azole (tines versicolor)
219
watery diarrhea and sulfur smelling burps
giardia
220
4 yr old w/ fever, vesicles on buccal mucosa and tongue, maculopapular rash on hands and feet
coxsackievirus - HFM
221
fever, headache and sore throat for 1 to 5 days then rash that begins on the face and spreads distally
rubella (German measles)
222
main side effect of zidovudine
bone marrow suppression
223
presentation of early onset GBS
septicemia and pneumonia
224
presentation of late onset GBS
bacteremia and meningitis
225
granulomatosis infantisepticum
rash of listeria monocytogenes (erythematous with papules)
226
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
anthrax
227
17 yr old with pneumonia, diarrhea and headache/confusion
legionella pneumophila
228
triad of legionella pneumophila
respiratory, GI and CNS
229
kid in CT with fever, headache, leukopenia, thrombocytopenia, anemia and elevated LFTs
anaplasmosis
230
what to look for in kid with buccal cellulitis from H. flu
bacteremia
231
how many mm is positive for TST in 3 yr old w/o risk factors
>/= 10 mm (<4 yrs = moderate risk w/ homeless, IV drugs, prisoners, healthcare workers, diabetes, CKD, immunosuppressed)
232
drainage from skin around tooth infection with yellow sulfur granules
actinomyces
233
15 yr old lives on farm and eats chitterlings has appendicitis-like syndrome
yersinia
234
child from Arkansas or Missouri/oklahoma with swollen lymph node and fever
tularemia from francisella tularensis
235
treatment of tularemia
gentamicin or streptomycin for 10 days
236
pneumonia with splenomegaly and arounds chickens or pigeons
chlamydia psittaci
237
pneumonia with splenomegaly and live in ohio
histoplasmosis
238
14 yr old w/ fever, conjunctival injection, myalgia, jaundice, elevated Creatinine and bilirubin that swims in fresh water lagoons
leptospirosis
239
community wide outbreak of diarrhea due to acid fast organism
cryptosporidium
240
skin ulceration in someone who works with fish tanks
mycobacterium marinum
241
vesicles on tonsils, uvula and pharynx but not front of mouth
herpangina (herpes is front)
242
fever and descending paralysis
polio
243
endocarditis criteria
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
6 month old with beta thalassemia has fever
yersinia enterocolitica
