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cps > ID volume 2 > Flashcards

ID volume 2 Flashcards

1
Q

how do kids present with chronic HCV infection

A

hepatomegaly

+/- intermittent or chronic high LFT

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2
Q

what organisms transmitted via droplets are very fragile and will not survive in the environment or on hands

A

H. influenza b
N. meningitidis
bordetella pertussi

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3
Q

what bug need airborne precautions

A

measles
TB
varicella
small pox

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4
Q

what is the risk of transmission of HBV from needle stick injury?

A

2-40%

can survive up to 1 week

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5
Q

if needle stick injury and high risk of HBV, what is the treatment

A

anti-HBV Ig + hep B vaccine

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6
Q

what is the risk of transmission of HCV from needle stick injury?

A

3-10%

no post exposure Rx

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7
Q

what is the risk of transmission of HIV from needle stick injury?

A

0.2-0.5%

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8
Q

what are increased RF for transmission of HIV from needle stick injury

A 
viral load
size of needle
depth of penetration
whether bld was injected
fresh blood
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9
Q

post HIV exposure prophylaxis will reduce the risk of HVI by….?

A

80%

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10
Q

how do you manage a needle stick injury

A
  1. clean with soap and water
  2. check the extent of the wound
  3. check vaccination status - Tetanus..
  4. document ++++
  5. Take bld for baseline HIV, HBV, HCV
  6. do not test needle
  7. if known user - assess risk and if possible test them
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11
Q

what is Hep B prophylaxis regiment for a pt not fully vaccinated?

A

if NOT vaccinated:

  1. test for anti-HBs Ab and HBsAg
  2. HBIG ideally within 48 h
  3. give vaccine within 7 d

if both #1 neg - complete vaccine series
if positive - do FU HBsAg

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12
Q

what is Hep B prophylaxis regiment for a pt fully vaccinated?

A
  1. test ant-HBs, if results not availbel within 48H - give vaccine
  2. if Anti-HBs + = do nothing because were immunized
  3. if anti-HBs Neg = test for HBsAg ( if neg do Ig+vacc)
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13
Q

when should a child receive HIV prophylaxis

A

if high risk
if source considered likely to have HIV
if visible blood in serynge/needle
if blood may have been injected

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14
Q

when should HIV prophylaxis be started?

A

within 1-4 hr post injury, max within 72 hours

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15
Q

what are the HIV prophylaxis regiments

A

HIGH risk = ZDV +Lamivudine + lopinavir/ritonavir
LOW risk = ZDV + LMV
for 28 days

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16
Q

what is the FU plan post HIV prophylaxis start

A

2-3 D via phone
IF on HIV prophylaxis = BW at 2, 4, 6 weeks for CBC, AST, ALT, BUN/Creat
at 4 weeks for 2 nd HBV if needs
at 6 weeks for anti-HIV Ab
at 3 month for anti-HIV and anti-HCV Ab
at 6 for anti-HIV/HCV/Bs ag Ab AND give 3rd Hep B if needed

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17
Q

who should get the flu vaccine?

A
  1. > 6 mo to 5 years
  2. chronic med issues
  3. pregnant
  4. family mb
  5. healthcare workers
  6. aboriginal children
  7. all in care
18
Q

who cannot receive the live attenuated flu vacc

A 
if immunocompromised
if severe asthma
if pregnant
if on ASA
if < 2 yrs
19
Q

what are the 2 types of flu vacc

A

trivalent inactivated vaccine 0.5ml

LAIV .2 ml per nostril

20
Q

when should we try to initiate Tamiflu?

A

< 12 hrs

can still get later if admitted, if illness is progressive

21
Q

how can we give antiviral drugs for influenza?

A

oseltamivir via PO/NG

Zanamivir IV or inhaled

22
Q

who should get zanamivir vs oseltamivir?

A

if not responding to oseltamivir
if illness despite oseltamivir prophylaxis
if severely unwell - can do IV

23
Q

who should get influenza antiviral if they have mild disease?

A

if mild + RF - treat after 1 year

if mild and NO RF - (<48h) consider treateing the 1-5 yr olds

24
Q

who should receive prophylaxis against IE

A
  1. Hx of IE
  2. CHD - unrepaired including palliative shunts/conduits
  3. CHD - with prosthetic material for 6 mo post
  4. CHD - repaired but residual defect
  5. Heart transplant if develop valvulopathy
25
Q

what dental procedures warrant IE prophylaxis?

A

manipulation of gingival tissue

periapical region of teeth or perforation of oral mucosa

26
Q

when should IE be taken and what Abx choice

A

1 to 0.5 hr pre and up to 2 hrs post
Amoxicillin
(clinda/azith/clarithro if allergic)

27
Q

other than dental procedures, what other simple procedures require IE prophylaxis

A

any incision or bx of resp mucosa- T&A
bronchoscopy IF incision on mucosa
Maybe if have enteroccocus in urine and need cystoscopy
procedures on infected skin or muscle

28
Q

what are the 5 important steps to bring up with vaccine hesitant parents

A
  1. what are their concerns - what is their understanding of disease risk? what is their understanding of vaccine benefits and risks?
  2. Explain clearly the benefits and risks
  3. discuss the rigorous vaccine safety system
  4. address issues of pain
  5. Do not dismiss children from your practice
29
Q

what is the preferred treatment for pulmonary aspergillosis?

A

Voriconazole

30
Q

what are SE of amphotericin?

A

nephrotixicity

infusion related - fever, chills and rigors

31
Q

what are SE of fluconazole?

A

P450 inducer

hepatotoxicity

32
Q

what is fluconazole NOT used for?

A

Aspergillus and other moulds

33
Q

what is fluconazole used for?

A

candida
cryptococcus
prophylaxis for HSCT

34
Q

what are SE of Itraconazole?

A

GI upset, vimiting, diarrhea
inc LFTs
inhibit P 450

35
Q

what is Itraconazole used for

A
  1. prophylaxis HSCT- oral/esoph Candida and Aspergillus
  2. prophylaxis for lung transplant if colonized with Aspergillus
  3. Blastomycosis
  4. Chronic pulmonary histo
36
Q

what are SE of Voriconazole?

A 
skin rash
visual abnormalities
photosensitivity reaction
elevated hepatic transaminase
p450 interaction
37
Q

when do we use caspofungin?

A

invasive candidiasis
invasive aspergillosis
SE: LFTs, fever HA, GI

38
Q

When do we use Flucytosine?

A

in combination with Ampho B
for Candida of cryptococcal infection
ESPECIALLY CNS

39
Q

When do we use Ampho B?

A

invasive fungal

febrile Neutropenia

40
Q

what are complications of MUMPS

A

orchitis
meningitis
pancreatitis
thyroiditis

cps (10 decks)

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