ID volume 2

Question 1

what is cryptosoridium?

Treatment?

Answer 1

Protozal - leading cause of diarrhea worldwide
ususally self limiting in healthy children

Niatozoxanide for 3 days

Question 2

how does cryptosporidium effect immune compromsed pt?

Answer 2

chronic diarrhea - malnutrition...
fever
RUG pain
pancreatitis
NV
resp symptoms

Question 3

What is the treatment for giadia?

Answer 3

Tinidazole
Nitazoxanide
or flagyl

Question 4

what is the gold standard test for giardia?

Answer 4

duodenal Bx

but we do 3 stools and 95 % reliable

Question 5

What populaton is at higher risk of giardia?

Answer 5

CF
chronic pancraetitis
Humoral def - hypogamma, Xlinked agamma

Question 6

what is the plague?

Answer 6

Yersinia pestis

febrile lymphadenitis, sepsis, pneumonic or meningeal

Question 7

what are the 3 types of yersinia?

Answer 7

Y. enterolitica
Y. pseudotuberculosis
Y. pestis

Question 8

how do steroids and immunosuppressive drugs effect ability to fight infections

Answer 8

T cell activation is decreased

at risk of Pneumocystisjirovecii, toxo and intracellular bugs -salmonella, listeria and mycobacterium

Question 9

what are risk factors for line infections?

Answer 9

prematurity
burns and skin disorders
neutropenia
ID

Question 10

what bugs cause catheter related infections?

Answer 10

Staph aureus
coag neg staph
enterococcus
GN: E.Coli, klebsiella, Pseudomonas
candida - if receiving Abx or TPN

Question 11

what is the most common cause of peritonitis for pt undergoing peritoneal dialysis?

Answer 11

coagulase-negative staphylococci (30-40%),
S. aureus (10-20%),
streptococci (10-15%),
Escherichia coli (5-10%),

Question 12

who should get their indwelling cathter removed if infected

Answer 12

if + bld culture 72 hrs post Abx start
if clinical deterioration
severe sepsis, 
suppurative thrombophlebitis, 
endocarditis

Question 13

what is the initial Abx choice for line infection

Answer 13

ceftriaxone + Vancomycin

Question 14

what bugs can cause VP shunt infection?

Answer 14

Streptococcus pneumoniae,
Staph
Neisseria meningitidis, and
Haemophilus influenzae type b,

Question 15

what are the side effects of septra

Answer 15

neutropenia
anemia
thrombocytopenia, pancytopenia, 
transient rise in creatinine (due to impaired secretion by TMP
hyperkalemia

Question 16

how do we treat pinworms?

Answer 16

Enterobius vermicularis,

Albendazole

Question 17

when is a TST + if 0-4mm

Answer 17

less than 5 yrs and high risk of TB infection

Question 18

when is a TST >= 5mm +

Answer 18

HIV infection
close contact with active contagious case
healed TB on CXR
organ tranplant
TNF alpha inhibitor
othe immunosuppressive drugs - steroid >15mg/da for > 1mo
ESRD

Question 19

when is a TST >= 15mm +

Answer 19

all others AND
TST convesion within 2 yrs
DM
malnutrition
heme malignancies

Question 20

what are causes of false negative TST

Answer 20

ACTIVE TB
technique
young
malnutriton
Measles/mumps/rubella infection
recent measles vaccine
corticosteroids
immunodef

Question 21

what are side effects of zidovudine

Answer 21

anemia

high lactate

Question 22

what vaccines should a child with HIV receive

Answer 22

MMR if well
VZV if well and CD4 percentage > 25%
NO BCG & oral polio vaccine 
Annual influenza vaccine
Polysaccharide pneumococcal vaccine (after Prevnar 13)
Meningococcal vaccine (Menactra, 4CMenB)

Question 23

what are risk factors for severe influenza?

Answer 23

Chronic pulm disease - asthama…
Chronic disease
chronic care facilities

Question 24

who can receive antiviral for ? influenza

Answer 24

1.if mild illness, no risk factors, 1-4 yrs - consider if