Immunodeficiency/ FUO/ infections in immunocompromised/ infections associated with medical devices/ health advice for travelers Flashcards
when will you evaluate the immune function of your patient?
- with CM of specific immune disorder
- (+) fam hx or early infant death
- recurrent infections such as..
a. >1 systemic bacterial infection (sepsis/meningitis)
b. >2 serious respi or documented bacterial infection (cellulitis, abscess, draining OM, pneumonia, lymphadenitis) within 1 year
c. serious infection occuring in unusual sites (liver/brain abscess)
d. infection with unusual pathogen (pneumocystis jiroveci, aspergillus, serratia marcescens, nocardia, burkholderia cepacia)
e. infections with common childhood pathogen but unusual severity - failure to thrive with or w/o chronic diarrhea
- persistent infection after receiving live vaccine
- chronic oral or cutaneous moniliasis
Evaluation of immune function should be initiated in those rare infants or children who do have clinical manifestations of a specific immune disorder and in all who have a positive family history of early infant death or a known immunodeficiency disorder, unusual, chronic, or recurrent infections such as
A. 1 or more systemic bacterial infections (sepsis, meningitis)
B. 1 or more serious respiratory or documented bacterial infections (cellulits, abscesses, draining otitis media, pneumonia, lymphadenitis) within 2 years
C. Mild infections occurring at unusual sites (liver, brain abscess)
D. Infections with uncommon childhood pathogens but of usual severity
A. 1 or more systemic bacterial infections (sepsis, meningitis)
A simple screening test for B-cell defects is
A. Measurement of serum immunoglobulin (Ig)G
B. Measurement of serum immunoglobulin (Ig)E
C. Measurement of serum immunoglobulin (Ig)A
D.Measurement of serum immunoglobulin (Ig)M
C. Measurement of serum immunoglobulin (Ig)A
Characteristic clinical pattern of leukocyte adhesion defect
A. Hypocalcemia, unusual facies and ears, heart disease
B. Delayed umbilical cord detachment, leukocytosis, recurrent infections
C. Persistent thrush, failure to thrive, pneumonia, diarrhea
D. Bloody stools, draining ears, atopic eczema
B. Delayed umbilical cord detachment, leukocytosis, recurrent infections
Usually present as a common clinical feature of immunodeficiency.
A. Hepatosplenomegaly
B. Failure to thrive or growth retardation for infants or children
C.Recurrent bronchitis or pneumonia
D. Paucity of lymph nodes and tonsils
D. Paucity of lymph nodes and tonsils
Should be suspected if a patient has recurrent staphylococcal abscesses or gram-negative infections. A. Killing defects of phagocytic cells B. Complement defects C. T-cell disorder D. B-cell disorder
A. Killing defects of phagocytic cells
True of Severe Combined Immunodeficiency.
A. All patients with SCID have very large thymuses
B. Lymph nodes, tonsils, adenoids, and Peyer patches are present or overdeveloped
C. Absence of all adaptive immune function
D. Not a true pediatric emergency
C. Absence of all adaptive immune function
Functional deficiency of Ataxia-telangiectasia
1/1
A. Absence of T- and B- cell functions
B. Selective IgA deficiency, T-cell deficiency
C. Marked deficiency of CD8 T cells; combined B- and T-cell defects
D. Failure of macrophages and other cells to produce TNF-alpha in response to IFN-gamma
B. Selective IgA deficiency, T-cell deficiency
Presumed pathogenesis of adenosine deaminase deficiency.
A. Impaired mitochondrial energy metabolism and leukocyte differentiation
B. Abnormal signaling downstream of gamma c
C. Defective V(D)J recombination
D. Accumulation of toxic purine nucleosides
D. Accumulation of toxic purine nucleosides
Combined immunodeficiency (CID) is distinguished from SCID by
A. Absence of all adaptive immune function
B. Lack of B cells and natural killer (NK) cells
C. Presence of low but not absent T-cell function
D. Lack T cells
C. Presence of low but not absent T-cell function
The most effective therapy for the autosomal dominant hyper-IgE syndrome is:
A. Long-term administration of therapeutic doses of a penicillinase-resistant antistaphylococcal antibiotic
B. Early antiviral treatment for herpes simplex, CMV, and varicella-zoster viral infections
C. Topical and nonabsorbable antimicrobial agents
D. Corticosteroids and immunosuppressive agents
A. Long-term administration of therapeutic doses of a penicillinase-resistant antistaphylococcal antibiotic
Most common serious bacterial infection in infants 1 to 3 months of age. A. Pneumonia B. Pyelonephritis C. Meningitis D. Sepsis
B. Pyelonephritis
Most common pathogen identified in bacteremic infants 1 to 3 months of age. A. Staphylococcus aureus B. Salmonella infections C. Group B Streptococcus D. Escherichia coli
D. Escherichia coli
Effective initial antimicrobial regimen for ill-appearing infants without focal findings. A. Meropenem + Gentamicin B. Piperacillin-Tazobactam + Amikacin C. Ampicillin + Cefotaxime D. Penicillin G
C. Ampicillin + Cefotaxime
Risk factors indicating increased probability of occult bacteremia in infants 3 to 36 months of age. A. Temperature >39C B. WBC <15,000 C. Normal ESR or CRP D. Low absolute neutrophil count
A. Temperature >39C
