ID and Immunology Flashcards
Days of malaise w/ fever and cough, conjuctivitis with widespread maculopapular rash
Measels
Also has Koplik spots
Diffuse maculopapullar rash for 3 days w/ enlarged POSTERIOR CERVICAL and OCCIPITAL LN. May have sore throat w/ occasional conjuctivitis, arthralgias
Rubella in child
Mild sore throat + malaise and +/- fever. Quick progression to adherent membrane on oropharynx and hypopharnx and glottic area. Lymphadenopathy with ‘bull neck’
Diptheria
What can we provide child with HIV + mom with while awaiting his HIV status?
PCP prophy as well as TMSX at 6 weeks
What should the vaccine schedule be for infant w/ HIV
Get the primary and booster DPT, the MMR (unless severly compromised) Hep B vaccine, Hib vaccine and the inactivatd polio vaccine (IPV) in place of active oral polio vaccine
What is the cause of death in patients w/ Reye syndrome
Cerebral edema and hernation; towards end of disease kiddos have seizure, coma, hypervent, respiratory arrest and loss of DTR
DONT use ASA in kids with varicella or influenza
What are the manifestations of Shigellossis?
Tx?
watery stools, high fever and abdominal pain. Some have bloody stool and often present with fever (for 3 days). Dx w/ stool culture adn provide supportive care
Two illnesses that cause scarlatiniform rash, desquamating rash, erythema of mucous mmb with injected pharynx and strawberry tongue and cervical lymphadenopathy
Kawasaki dx or Scarlet fever (Group A beta-hemolytic strep)
What causes scarlet fever?
erythrogenic toxin-producing group A B-hemolytic strep; see rise in antistreptolysin titer
What causes Rheumatic heart dx
Strep. Pharyngitis; prevent w/ PCN
Kiddo with bald spot on head with black dots, dx and tx
Trichophytan tonsurans; tinea capitus and need to use long term griseofulvan or other PO antibx. will NOT see flouresence on Wood lamp but dx w/ KOH prep
-if bad you devo a kerion (boggy area) w/ occipital lympahdenopathy
10yo w/ 7 day course of fever, chills, severe msl pain, pharyngtitis, headache and scleral injection w photophobia and cervical adenopathy–> got a little better then devo fever, n/v, headache w/ nuchal rigiditiy. CSF 200 WBC, all monocytes adn elevated protein
Cause is leptospirosis; often mild or subclinical course. Exposure to dogs, cats, livestock. Anicteris lept and icteric start with septecemic phase that resolves then have ‘immune’ phase w/ meningitic symptoms.
PCN and tetracyline are appropriate therapy
What is the preferred antibx to start on neonate with meningitis?
Ampicillin (listeria) and cefotaxime (gram -)
can use gentamycin instead but has more risk for hearing complications later on
14 mo infant with sudden onset high grade fever 104; with WBC 22 and left shift. BAby is otherwise normal
pneumococcal bacterimia; may present similar to roseola but roseola doesn’t have a left shift. less common bc of pneumococcal vaccine
3 day hx malaise, fever to 106, cough, corzya and conjuctivitis with white pinpoint spots on buccal mucosa. Dx
Rubeola or german measels
Complications: pneumonia, laryngitis, myocarditis, encephalitis
low grade fever, headache mild URI and red cheeks
Parvo B19, erythema infectiousum or 5ths disease
How would rubella present in a 4 yo
mild URI, retoauritular and posterior cervical and postoccipital lymphadenopathy with diffuse erythematous maculopapular rash clears w/in 72 hrs
Patient has severe cough, photophobia, conjuctiviys and high fever that peaks at height of generalized rash.
Rubeola (measels)
3 yo girls with viral exanthem all over body and disappears with onset of high fever.
Roseola
Target like lesions on skin and mucous associated with infection or drugs
ERythema multiforme
What sequela can we see with mumps
orchitis in post pubertal males, parotitis, and also have meningitis, pancreatitis and renal involvement can occur; need live attenuated vaccine to prevent.
What tx is recommended for anyone in contact w/ animal that may have rabies?
wound cleansing (if present) rabies immune globulin adn 5 injections of rabies vaccine series
Kid was out hiking a few days ago now has headache, malaise w/ fever. Next day has maculopapular rash on extensor surface of wrist and ankles move in central direction
Dx and Tx?
Rocky moutain spotted fever; need doxycycline
How does tularemia present
abrupt fever, chills, malaise and variety of rashes. also hae pharyngitis, hepatospelno
Family goes to barbeque, one week later have abdominal pain, nausea/vomitting and malaise. Second week see muscle invasion, fever, eosinophilia
T. Spirali from improper pork cooking; cyst can stay encased for years
Complications of meningococcemia
meningitis, purulent pericarditis, endocarditis, pneumonai, otits media, arthritis.
-Potent endotoxin–> induce shock and disseminated invtravascular coagulation w/ hemorrhage and get Waterhorse Friderichsen
Recommended tx for close contacts of people infected with menigoccocal
Rifampin or sulfadiazine
Contraindication to LP
increased ICP in pt w/out open fontanelle severe cardiorespiratory distress, skin infection at puncture site or severe thrombocytopenia
How does Brutons present? What doe’s patients Ig’s, lymphocytes and T cell look like?
Has low Ig of all classes and low B cells with normal T cells; will have pneumonia, diarrhea, sinusitis but can protect self from fungal and viral infectoin
What does MacConkey culture help dx?
E.coli 0157 from stool sample
What do you use Thayer-Martin culture for?
helps to culture sites like cervix and rectum
9 mo child w/ abrupt onset of fever and respiratory distress following several days of URI sxs. May cuase pleural effusion, empyema adn can see elevated WBC w/ left shift
Pneumonia by Staph Aureus
CXR: nonspecific–> more dense and homogenous may involved entire lobe
Kiddo with sudden onset fever, cough and chest pain and recently tx for bacterial infection
Pneumococcal pneumonia
Tx: high dose penicillin, cefuroxime, augmentin
