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My board review cards > ID & Immunology > Flashcards

ID & Immunology Flashcards

1
Q

EOS Pathogens

A

(<72 hr)
vertical transmission or hematagenous .

Preterm: GN 66%, GP 29%
E coli (G-), GBS (G+), Hemophilus, Klebsiella (G-), Enterococcus (G+), Virdans Strep.

Term: GP 79%, GN 19%
GBS, E Coli, Enterococcus, GAS, Strep Bovis.

listeria as EOS pathogen, also cause meningitis

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2
Q

LOS Pathogens

A

Mostly G+ organisms:
Coagulase negative staph.
Staph aureus
Enterococcus
GBS

G- enterics:
Klebsiella
E Coli
Enterobacter
Serratia
Pseudomonas

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3
Q

what bacteria are likely to cause meningitis
which one of them can cause brain abscess

A

Enteric G- (30-40%)
E. coli (dominant)
Klebsieall, Enterobacter
Citrobacter –> Brain abscess
Serratia

GBS (G+ cocci) –> type III
Listeria (G+ rod)

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4
Q

in preterm infant, who is more likely to have UTI, male or female

when UTI occurs

A

MALE (this reverse around 1 year of age)

Never in first 3 days of life. uncommon first week.

E. coli (80%), others include Klebsiella, enterobacter, proteus, citrobacter, salmonella, serratia.

ascending infection or hematogenous spread (1/3 will have bacteremia).

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5
Q

Ophthalmia neonatorum

causative agents

A

conjunctivitis in the first month of life

N gonorrhoeae, Chlamydia
Other:
S. aureus, non-typable H influenzae, pneumococcus, enteric GN, GBS

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6
Q

compare gonococcal vs. chlamydia conjunctivitis

type of bug
time of infection
rate from mom to baby

A

N gonorrhoeae:
* G - intracellular diplococci
* 30-40% + if maternal cervical infection
* 2-5 days of life
* use Thayer-martin media to grow.

erythromycin prophylaxis reduce gonococcal incidence from 10-0.5%.
if baby born to mom with active gonococcal infection, give erythromycin eye ppx AND 1x ceftriaxone.

Tx: 1x ceftriaxone or cefotaxime.

Chlamydia
* Obligate intracelular bacteria
* 20% of infants infected if mom’s infected
* 5-14 days: eye
* 2-8 weeks: pneumonia (cough/congestion w/o fever)

blood tinged discharge
erythromycin ppx not as effective.
Tx: erythromhycine oral for 2 weeks

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7
Q

osteomyelitis/septic arthritis spread and causative agents

A

x-ray SOFT tissue change in 48 hours.
Bony change 7-10 days after infection on X-ray

MRI change in 24-48 hours

hematogenous spread, metaphyses susceptible due to reduced rate of blood flow

staph aurues common cause

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8
Q

what GBS cause meningitis
also rate for GBS disease

A

Type III cause meningitis

early GBS 2-3/1000 -> 0.3-0.4/ 1000
late GBS stay at 0.3 / 1000
(late GBS 7 days to 3 month)

GBS is Strep agalactiae

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9
Q

Staph aureus (what kind of bacteria)

A

anaerobic G+ cocci

more late onset than early onset sepsis

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10
Q

CoNS

A

coagulase negative Staph. -> staph epidermidis (G+ cocci)
ELBW, VLBW. line infection.

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11
Q

what are examples of Gram negative enterics

A

E. coli (capsular polysaccharide, K1 strains, cause most of the meningitis and most sepsis)

Citrobacter species -> brain abscess

Klebeiella -> often ESBL, need meropenum
Enterobacter
Serratia
Pseudomonas species can cause noma neonatorium (gangernous process involving mucocutaneous jxn)

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12
Q

serratia is not transmitted transplanetally in most of the case.
T or F

A

TRUE

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13
Q

Syphilis:

bug, how is it transmitted

symptoms in the following systems:
respiratory, dermatologic, hematologic, renal, orthopedic, neuro, ophtho

A

Troponema pallidum –> spirochete.

Transmitted transplacentally (acquired thorough blood).
Older GA increase risk of infection.
30-40% infected fetus are stillborn.
present with non-immune hydrope and symmetric FGR (2/3 asymptomatic)

Respiratory
*Pneumonitis, rhinitis-”snuffles” (1 wk – 3 mos of age)

Dermatologic
*Cutaneous bullous eruption, pigmented macules, desquamating maculopapular rash (palms soles)

Hematologic
*Hyperbilirubinemia, hemolytic anemia, thrombocytopenia, leukopenia or leukocytosis

Renal
*Nephrotic syndrome

Orthopedic
*Osteochondritis (Wimberger sign = bilateral destruction of proximal medial metaphysis-tibia > humerus), periostitis, bone stippling

*Neurologic
*Erb palsy, leptomeningitis

Ophtho
*Chorioretinitis, uveitis

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14
Q

Wimberger sign

A

bilateral destruction of proximal medial metaphysis-tibia > humerus
in syphillis

periosteo = errosion.

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15
Q

Cutaneous bullous eruption,
pigmented macules,
desquamating maculopapular rash (palms soles)

A

syphillis

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16
Q

HSV:
type of virus

A

ds DNA

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17
Q

RSV:
type of virus

A

ssRNA (two strains)

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18
Q

in the absence of other symptoms, most likely infection causing severe fulminant hepatitis are

A

enterovirus > adenovirus > HSV > CMV

19
Q

Parvovirus (DNA Or RNA)

A

ss DNA

20
Q

DNA or RNA for:
HBV
what about HAV, HCV, HEV,
HDV

A

ds DNA
HAV, HEV, HCV are ssRNA,
HDV is defective RNA, need HBsAg for its surface coat

21
Q

VZV

A

ds DNA

22
Q

Chorioretinitis, microcephaly, IC calcifications, HSM, thrombocytopenia;
scarred skin (cicatricial lesions) and limbs with damaged nerves, muscle, and bone

what virus is this? when is the highest risk window for infant?

A

congenital VZV
greatest risk window is: maternal rash 5 days and 2 days after delivery.

23
Q

Tzanck prep

A

VZV, HSV

multinucleated giant cells

24
Q

when to give VZIG or IVIG for VZV

A

premature < 28 weeks.
mom has disease 5d prior up to 2d post birth.
> 28 wk mom with exposure

25
Q

treatment for VZV

A

acyclovir

26
Q

Rubella (type of gene)

A

ssRNA

Rubella is HUMAN HOST ONLY. Droplet and contact transmission.

27
Q

Risk of fetal rubella infection time pattern

A

BIMODAL (high first trimester and last 4 weeks)
(congenital anomalies rare if infection occurs after 20 weeks)

Kid or Adult Rubella infection has rashes.

28
Q

Congenital Rubella Syndrome:
symptoms by system

A

Ophthalmologic: cataracts, salt and pepper chorioretinitis, microphthalmos, and congenital glaucoma
Cardiac: PDA, peripheral pulmonary artery stenosis
Auditory: sensorineural hearing loss
Neurologic: microcephaly, learning impairment
Growth restriction, interstitial pneumonitis,
Radiolucent bone disease celery stalking
hepatosplenomegaly, thrombocytopenia
Dermal erythropoiesis (blueberry muffin lesions).

29
Q

Triad of Toxo

A

chorioretinitis, hydrocephalus, and IC calcification

30
Q

if mom has primary infection of toxo.
What’s the management for her?

A

treat with spiramycin during pregnancy to reduce risk of transmission to fetus

31
Q

infant with toxo need to be treated with what and for how long

A

pyrimethamine, sulfadiazine, folinic acid
for 1 year

32
Q

how is congenital TB acquired?

A

mostly commonly hematogenous from infected placenta, aspiration of amniotic fluid.

airborn disease

33
Q

congenital TB symptoms

A

Present 2-3rd week of life:
Respiratory distress, fever, HSM, poor feeding, lethargy, irritability, abdominal distention, LA, ear drainage, skin lesions, parenchymal infiltrates with hilar adenopathy, only 50% have a miliary pattern on CXR

Meningitis – 20% cases

34
Q

Miliary mottling in CXR

A

TB (congenital TB)

35
Q

Botulism
Triad of disease
on set
type of bug

A

1) acute symmetric descending flaccidity,
2) no fever,
3) autonomic dysfunction

onset 3 week to 6 month.

gram + bacilli

36
Q

Can you use antibotics for botulism

A

no
aminoglocoside can increase neuromuscular blockage.

toxin in serum or feces

37
Q

Tetanus and Botulism

A

Both tetanus and botulism may present with progressive diminished feeding, fussiness / crying and decreased movements

Both Clostridium tetani and C. botulinum are
spore-forming gram + rods, grow anaerobically

Neonatal tetanus usually presents early – most commonly after contamination of the umbilical cord

Stiffness, rigidity and spasms are characteristic of tetanus
vs.
Botulism presents with a symmetric, descending,
flaccid paralysis

38
Q

micro abscess
Granulomatosis infantiseptica

A

Listeriosis

39
Q

intracrnial lesion difference between Toxo vs. CMV

A

Toxo: corticol calcification. hyrodcephalus, younger cats
CMV: periventricular calcification

Both with mild hepatitis, thrombocytopenia

40
Q

diarrhea, failure to thrive, scaly eruption,
frequent illness

A

SCID

41
Q

eczema, thrombocytopenia, and recurrent infections

gender of patients

A

Wiskott-Aldrich syndrome

male

42
Q

x-linked aggamaglobuinemia

A

Bruton aggamaglobuinemia
no B-cells
Bruton Tyrosin Kinase defeciency

43
Q

leukocyte adhesion deficiency
vs
chronic granulomatous disease

A

LAD: no pus, delayed cord seperation (LAD-1 more common)
chronic granulomatous disesae (no oxidative burst function): a lot of pus

44
Q

Kostmann syndrome

A

Congenital neutropenia
Respond to GCSF
Mutation in neutrophil elastase gene

My board review cards (10 decks)

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