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Pediatrics PLE > Infectious > Flashcards

Infectious Flashcards

1
Q

Organism produces exotoxin and inhibits protein synthesis and causes gray-brown adherent pseudomembrane to bleeding edematous submucosa

A

Corynebacterium diphtheria

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2
Q

Bull neck appearance, leather like adherent membrane (pseudomembrane)

A

Corynebacterium diphtheria

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3
Q

Difference of diphtheria from strep throat

A

Relative lack of fever

Non-exudative throat

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4
Q

Period of communicability of pertussis

A

7 days after exposure to 4 weeks after onset of paroxysms

Catarrhal stage

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5
Q

Conjunctival suffusion, petechiae on upper anterior chest, clear breath sound, whooping cough

In between paroxysms child is well looking

A

Pertussis

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6
Q

Abrupt onset of fever, chills, headache, vomiting

Rapid worsening of symptoms within hours

Initially morbiliform rash becoming petechial then purpuric within hours

A

Meningococcemia

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7
Q

Drug of choice for Meningococcemia

A

Penicillin G 250000 - 300000 U/kg/day

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8
Q

CSF FINDINGS in Meningitis:

Pressure: 100-300mmHg
WBC: 100-10,000
CHON: 100-500
Glucose: <50%

A

Acute Bacterial Meningitis

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9
Q

CSF FINDINGS in Meningitis:

Pressure: 80-150 mmHg
WBC: >1,000
CHON: 50-200
Glucose: usually normal; may be low

A

Viral Meningitis

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10
Q

CSF FINDINGS in Meningitis:

Pressure: elevated
WBC: 10-500
CHON: 100-3,000
Glucose: <50

A

TB Meningitis

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11
Q

CSF FINDINGS in Meningitis:

Pressure: elevated
WBC: 5-500
CHON: 25-500
Glucose: <50

A

Fungal Meningitis

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12
Q

High grade fever, malaise, myalgia, cough, abdominal pain, hepatosplenomegaly, anorexia, diarrhea/constipation

Rose spots

Caused by S. Typhi

A

Enteric fever

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13
Q

Most commonly involved extraintestinal sites for complications of enteric fever

A

Cns and hepatobiliary

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14
Q

Mainstay of diagnosis of Enteric Fever

A

Blood culture, positive

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15
Q

Treatment for Uncomplicated Typhoid Fever

A

Fully sensitive: Chloramphenicol (14-21days) or Amoxicillin (14days)

Multidrug-resistant: Fluoroquinolone (5-7 days) or Cefixime (7-14 days)

Quinolone resistant: azithromycin (7days) or Ceftriaxone (10-14days)

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16
Q

Treatment for Severe Typhoid Fever

A

Fully sensitive: Azithromycin (14days) or Ceftriaxone (10-14 days)

Multidrug-resistant: Fluoroquinolone (10-14days)

Quinolone resistant: Ceftriaxone (10-14days)

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17
Q

Organism crosses the colonic epithelium through M Cells overlying the peyer patches

A

Shigella

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18
Q

Painful defecation, severe abdominal pain, high fever with significant dehydration

Watery voluminous diarrhea initially then into frequent small volume bloody mucoid stools

A

Shigellosis

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19
Q

Most common extraintestinal manifestation of Shigellosis

A

Neurologic manifestation

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20
Q

Definitive diagnosis of Shigellosis

A

Culture of stool and rectal swab

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21
Q

Infantile explosive diarrhea with dehydration

> 1y/o; Common in travellers

Responds to TMP-SMX

A

ETEC

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22
Q

Prolonged Nonbloody diarrhea with low grade fever

At risk for are <2y/o especially <6mos

A

EPEC

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23
Q

Shiga-toxin-producing E. Coli

Bloodr diarrhea, afebrile

6mos - 10 y/o; elderly

A

EHEC

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24
Q

Prolonged watery diarrhea that causes significant dehydration

<1y/o; Common in travellers

A

EAEC

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25
Q

Acute onset of profuse, painless, watery diarrhea with rice-water consistency and fishy odor

With vomiting; without abdominal cramps or fever

A

Cholera

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26
Q

Treatment for cholera

A

Fluid and electrolytes

Tetracycline for 3 days (not for <9y/o); Doxycycline single dose

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27
Q

Headache, restlessness, irritability followed by stiffness, trismus, sardonic smile, boardlike rigidity

A

Tetanus

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28
Q

Manifests within 3-12days of birth as progressive difficulty in feeding with associated hunger and crying; paralysis or diminished movement, stiffness to the touch, spasms with or without opisthotonus

A

Neonatal Tetanus

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29
Q

Treatment for Tetanus

A 
Give Tetanus Ig 500 U single dose
Penicillin G (DOC) 100,000 U/kg/day in 4-6hr intervals for 10-14 days

Alternative:
Metronidazole
Erythromycin
Tetracycline

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30
Q

Painless papule appears at the site of inoculation 2-6wks after inoculation with regional lymphadenitis

Clean painless ulcer with raised border that heals spontaneously w/in 4-6wks

A

Primary Syphilis

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31
Q

Clean painless ulcer with raised border that heals spontaneously w/in 4-6wks

A

Chancre

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32
Q

Untreated patients: develops a non-pruritic maculopapular rash involving the palms and soles

Becomes latent within 1-2months after the onset id the rash

A

Secondary syphilis

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33
Q

Development of nonsuppuratjve granulomas of the skin and musculoskeletal system due to host’s hypersensitivity reaction (gummatous lesions)

A

Tertiary Syphilis

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34
Q

Acute systemic febrile reaction with exacerbation of lesions in 15-20% of all patients with acquired or congenital syphilis who are treated with penicillin

A

Jarisch-herxheimer reaction

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35
Q

Treatment for Syphilis

A

Benzathine Penicillin G

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36
Q

2 phases of Anicteric leptospirosis

A

Initial or Septicemic Phase

Secondary or Immune Phase

37
Q

This phase is abrupt, with fever, chills, severe headache, severe muscular pain and tenderness

Truncal red maculopapular rash

Conjunctival suffusion with photophobia and ocular pain WITHOUT chemosis and purulent exudate

A

Initial or Septicemic Phase

38
Q

This phase follows a brief asymptomatic interlude with biphasic fever

Some with aseptic meningitis

A

Secondary or Immune Phase

39
Q

Severe form of leptospirosis

Right upper quadrant pain, hepatomegaly, increased liver enzymes, hyperbilirubinemia

Azotemia -> oliguria -> anuria

A

Icteric / Weil’s Syndrome

40
Q

Presumptive diagnosis of leptospirosis

A

Fourfold rise in Ab titer in soecimens obtained 2 or more weeks apart

41
Q

Most useful screening test for Leptospirosis

A

Microscopic slide-agglutination test using killed Ags

42
Q

Treatment for Leptospirosis

A

Penicillin G

Alternative: Tetracycline

43
Q

High grade fever with conjunctivitis and colds then appearance of rash

When the rash fades, branny desquamation and disappears within 7-10 days

A

Measles

44
Q

Grayish white spots with red border opposite the lower molars appear before the prodrome period

A

Koplik Spots

45
Q

Timing of appearance of rash in Measles

A

At the height of the fever

46
Q

Period of communicability of Measles

A

4 days before and 4 days after the onset of rash

47
Q

Post exposure prophylaxis of Measles

A

1) Measles Ig for prevention and attenuation within 6 days of exposure
2) measles active vaccine can be given for susceptible children >1 y/o within 72 hours

48
Q

Chronic complication of measles with a delayed onset due to persistent infection with an altered virus that is harbored intracellularly in the CNS

A

Subacute Sclerosing Panencephalitis

49
Q

CSF analysis in SSPE

A

Normal cells but high IgM and IgG Ab titers in >1:8

50
Q

Period of communicability of Rubella

A

5 days before and 6 days after the onset of rash

51
Q

Most characteristic sign of Rubella

A

Retroauricular, posterior cervical and postoccipital lymphadenopathy

52
Q

Discrete rose spots on the soft palate in Rubella

A

Forchheimer Spots

53
Q

How is Rubella different from Measles?

A

Low grade fever for 1-3 days, polyarthritis and No photophobia

54
Q

Diagnostic of Rubella

A

(+) IgM antibody and (+) IgG with fourfold increase in titer is diagnostic

55
Q 
Congenital profound SNHL
Salt and pepper retinopathy
IUGR
Congenital Cataracts
microcephaly
Blueberry muffin skin lesions
A

Congenital Rubella Syndrome

56
Q

Period of communicability of Mumps

A

1-2 days before the onset of parotid swelling until 5 days after the onset of swelling

57
Q

Pain and swelling in one or both parotid glands

Swollen glands push the ear lobe upper, outward and the angle of mandible is no longer visible

A

Mumps

58
Q

Most frequent complication if Mumps

A

Meningoencephalitis

59
Q

Causative agent of Roseola Infantum

A

HHV 6

60
Q

Fever for 3-5 days with fussiness, rash appears within 12-24 hours of fever resolution

Ulcers in the uvulopalatoglossal junction

A

Roseola

61
Q

Ulcers in the uvulopalatoglossal junction in Roseola

A

Nagayama Spots

62
Q

Lifelong latent infection of sensory ganglion neuron

A

Chickenpox / varicella

63
Q

Period of communicability of Varicella

A

1-2 days before the onset of rash until 3-7 days after onset of rash and all the lesions have crusted

64
Q

Rash often appear first on the scalp, face, or trunk then spread to other parts of the body

Intensely pruritic macule -> papule -> vesicle

All stages are present simultaneously

A

Varicella

65
Q

Tender vesicular lesions in the hands and feet

Ulcerative intraoral lesions

Most frequent etiology: Coxsackievirus A16

A

Hand Foot And Mouth Disease

66
Q

Sudden onset of fever, vomiting, abdominal pain, dysphagia

Small vesicles and ulcers with a red ring found mainly in the tonsillar pillars

A

Herpangina

67
Q

Also known as Fifth Disease

Due to parvovirus B19, with a primary target - erythroid cell lines

A

Erythema Infectiosum

68
Q

Low grade fever, headache, URTI, slapped cheek appearance that spreads rapidly to the trunk and proximal extremities as a diffuse macular erythema

A

Erythema Infectiosum

69
Q

Skin vesicles and shallow ulcers that resolves in 7-14 days

Most commonly affected: 6mos - 5y/o

Pain in mouth, drooling, refusal to drink or eat, fever up to 40C

A

Herpetic Gingivistomatitis

70
Q

Gold standard in diagnosing HSV infection

A

Viral Culture

71
Q

Test of choice in examining CSF of HSV

A

PCR

72
Q

Parts of the brain affected by HSV

A

Frontal lobe
Temporal lobe
Limbic System

73
Q

First virus to be associated with malignancy

A

Epstein Barr Virus

74
Q

Severe pharyngitis with marked tonsillar enlargement with petechiae at the junction of the hard and soft palate

A

Infectious mononucleosis

75
Q

Primary infection in adolescents and adults in Infectious Mononucleosis

A

Classic triad: fatigue, pharyngitis, generalized lymphadenopathy

76
Q

Most feared complication id Infectious Mononucleosis

A

Splenic rupture

77
Q

Most common congenital infection which causes the syndrome cytomegalic inclusion disease (hepatosplenomegaly, jaundice, petechiae, purpura, microcephaly)

A

CMV

78
Q

Pathognomonic of CMV

A

Strikingly enlarged epithelial or mesenchymal cells with large intranuclear inclusions

79
Q

Hearing loss or learning disability, IUGR, jaundice, purpura intracerebral calcifications, chorioretinitis

A

Congenital CMV

80
Q

Virus causes lytic infection of the respiratory epithelium that permits secondary bacterial invasion

A

Orthomyxoviridae

81
Q

Onset of symptoms is abrupt

Coryza, conjunctivitis, pharyngitis, dry cough, high grade fever, myalgia

Diagnosis is confirmed by hemagglutination inhibition

A

Influenza

82
Q

Dengue fever’s characteristic rash

A

Transient macular generalized rash that blanches under pressure seen during the 1st 24-48 hours of fever

1-2 days after defervescence: generalized maculopapular rash appears which spares the palms and soles (Hermann’s rash)

83
Q

Isles of white in a sea of red

A

Hermann’s Rash

84
Q

Most common route of transmission of Viral Pneumonia

A

Airborne droplets

85
Q

Punched out ulcers in the posterior palate

A

Herpangina/Coxsackie A

86
Q

Diagnosis of Typhoid fever is best made by

A

Isolation of S. Typhi from blood, urine or stool

87
Q

Most common etiologic agent for early onset neonatal sepsis in the newborn in the LOCAL SETTING

A

E. coli

88
Q

Most common etiologic agent for early onset neonatal sepsis in the newborn

A

GBS

89
Q

DOc for neonatal sepsis

A

Ampicillin + Gentamicin

Pediatrics PLE (8 decks)

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