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Pedia > Infectious > Flashcards

Infectious Flashcards

1
Q

Caused by HHV6
Peak at 6-9m
95% of children have been infected by 2 mos

Saliva transmission from entry to oral nasal or conjunctivs

Supress cellular lineages in bone marrow

Fever in first 3-5 days and rash

A

Exanthem subitum
Roseola
Sixth disease

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2
Q

Most conmon type of roseola

A

Type B

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3
Q

Fever in 3-5d with fusiness 90%
Rash in 12-24 h of fever resolution

Asians: ulcer in uvulopalatoglossal junction called

A

Nagayama spot

Roseola

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4
Q

Where is the koplik spot best appreciated

A

Opposite lower molar

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5
Q

RNA virus from paramyxoviridae by droplet aerosol in prodromal period

Incubation 8-12 d

Period of comm is 4 days before and 4 days after onset of rash

A

Measles

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6
Q

Causes necrosis of respi epithelium
Small vessel vasculitis in skin and mucous membrane

Pathognomonic of
(multinucleated giant cells)

A

Measles

Warthin Finkeyldey giant cells

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7
Q

High grade fever with conjunctivitis and colds 3-5 d

A

Measles prodrome

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8
Q

Enanthem Grayish white dot with red border opposite lower molar 1-4d prior onset of rash

Rash at height of fever

A

Koplik spots

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9
Q

Rash fades downward in same seq which it appears

Rash: cephalocaudal with branny desquamation in 7-10d

A

Measles

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10
Q

Rash in Roseola

A

starts at trunk and then grows peripheral

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11
Q

Give to prevent complications in measles

A

Vitamin A: single 100,000 IU for 6-1 yr
200,000 IU for >1
OD x 2 d
<6 mos: 50,000 IU

If with vit A def, repeat after 1 month

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12
Q

Measles complication

A

Otitis media
Pneumonia
SSPE

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13
Q

Delayed chronic complication due to persistent infection with virus

A

SSPE

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14
Q

Ulcers in uveopalatoglossal junction

A

Nagayama spot

Sixth disease

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15
Q

Painful enlargement of parotid glands as usual presenting sign

by RNA virus of paramyxoviridae

Period of comm: 1-2 d before onset of parotid swelling till 5 days after onset of swelling

Respiratory droplet

A

Mumps

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16
Q

Pain and swelling of one or both parotids (1-3d)
Fills the space bet posterior border of mandible and mastoid
Pushes earlobe upward and outward and angle of mandible no longer seen
Swelling subsides in 7d
Edema of homolateral pharynx and soft palate displacing tonsil medially
Edema of larynx and manubrium

A

Mumps

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17
Q

Most freq complication of mumps

A

Meninggoencephalitis in 5 days

Others
Orchitis and epididymitis (infertility rare)
Oophoritis
Dacryoadenitis
Optic neuritis
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18
Q

3 day measles
Caused by RNA from Togaviridae
Spreads by oral droplet of transplacental to fetus
Risk for congenital defects and disease greatest with primary maternal infection during 1st tri

Period of comm: 5d before until 6d after onset of rash

A

Rubella

German measles

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19
Q

Most prominent Characteristic of rubella

A

Retroauricular
Posterior cervical
Postoccipital LAD (24h before rash till 1 week)

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20
Q

enanthem in Rubella

discrete rose spots on soft palate

A

Forscheimer spots

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21
Q

Rubella in older girls present with

A

Polyarthritis

No photophobia

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22
Q

Pertussis is causes by

A

Bordetella pertussis Gram neg

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23
Q

Secretion from RT of infected person

Transmission by close contact with large aerosol drops

A

Pertussis

Whooping cough

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24
Q

Most infectious stage of pertussis/whooping cough

A

Catarrhal stage

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25
Q

Stages of Pertussis

3 lasting 2 weeks each stage

A

Catarrhal
Paroxysmal -explosive outbursts of cough in 5-10 series in one expiration and ending in high pitched whoop associated with suffusion of face, popping out of eyes and vomiting
Convalescent

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26
Q

In between paroxysms of pertussis,

A

child may look well

conjunctival or petechial hemorrhage on upper body

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27
Q

Tx for pertussis

A

Erythromycin 40-50 mg/kg/day q6 PO or IV
Placed in respiratory isolation for at least 5 days after initiation of antibiotics

Beyond this nininfectious

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28
Q

Results in lifelong latent infection of sensory ganglion neuron

A

Primary Chickenpox

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29
Q

Caused by neurotropic human herpes virus
Transmission: oropharyngeal secretion by airborne spread and direct contact

Period of comm: 1-2d before onset of rash till 3-7d after rash until ALL has crusted

A

Varicella

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30
Q

Rash pattern in varicella

A

Starts on scalp, face or trunk with rapid progression

Simultaneous presence of lesions in various stages

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31
Q

Varicella complications

A 
Secondary bacterial infection
Meninggoencephalitis
Pneumonia
Reye syndrome 
GN
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32
Q

Fetus infected at 6-12w of gestation with max interruption with limb development (short and malformed) covered with:

which are skin lesions with zigzag scarring assoc eith atrophy of affected limb

A

Congenital varicella

cicatrix

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33
Q

If infected at 16-20w of gestation, varicella may induce

A

eye and brain involvement in fetus

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34
Q

Lifetime risk for herpes zoster

A

10-15% with 75% of cases occuring after 45yrs

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35
Q

Due to Parvovirus B19

Transmission by large droplet spread and blood

Rash and aplastic crisis in 5-15 y o

A

Erythema infectiosum

5th disease

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36
Q

Parvo B19 target

A

erythroid cell with arrest in development of RBCs

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37
Q

Erythema infectiosum hallmark sign

A

Slapped cheek: rash erythematous facial flushing

spreads rapidly to trunk prox extremities and diffuse macular edema

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38
Q

Lacy reticulated appearance of rash on extremities esp on extensor areas

Palms and soles spared

Rash resolves without desquamation waxes and wanes in 1-3 weeks

Not infectious at presentation bec rash and arthropathy are immune mediated

A

Erythema infectiosum

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39
Q

Virus replication from Flaviviridae carried by Aedes egypti
Viremua
Ag-ab complex
Complement cascade and Hagemab factor activation
Extravasation of fluid
Shock

A

Dengue

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40
Q

Dengue fever rash:

A

Transient macular generalized rash blanching under pressure seen during first 24-48h of fever

41
Q

Generalized maculipapular rash appearing which spares the palms and soles and disappears in 1-5 days with desquamation

A

Hermann’s rash

42
Q

Day 1-4 illness dx of dengue

A

Dengue NS1

43
Q

End of acute phase dengue dx

A

Serology

IgM by day 5
IgG low titer at end of first week of illness even after several months
If secondary infection IgG first week to 10 mos

44
Q 
Dengue endemic area with fever + any 2 of ff:
headache
myalgia
Arthralgia
Retroorbital pain
Body malaise
Nausea and vomiting
Anorexia diarrhea flushed skin
And

CBC with leukopenia with or without thrombocytopenia

A

Probable dengue

45
Q

Dengue endemic + fever lastinf 2-7d plus any one

Abdominal pain
Mucosal bleed
Persistent vomiting
Lethargy, restlessness

Liver enlargement
Dec or no urine output within 6h
Labs: inc in hct and dec platelet count

A

With no warning

But if with liver enlarge: with warning

46
Q

Dengue endemic + fever in 2-7d + dengue with or without warning signs plus any one:

A 
Shock
Fluid accumulation with respiratory distress
Liver AST or ALT >1000
CNS: seizure, impaired consciousness
Heart: myocarditis
Kidneys: renal failure

Severe Dengue

47
Q 
Fever
Dehydration
Normal Hct
Normal platelet
High viral load: NS1 (viremia)
A

Febrile phase

48
Q 
Afebrile
Shock
Bleeding
Organ impairment
DECREASED HCT
DECREASED PLATELET COUNT

IgM +

A

Critical Dengue phase

49
Q

Reabsorption
Fluid overload
Platelet
IgM/IgG

A

Recovery Dengue phase

50
Q

Recovery phase in dengue is characterized by

A

Diuresis

Monitor UO

51
Q

Caused by Corynebacterium
Transmission: direct contact via airborne respiratory droplet
Period of communicability: variable

A

Diptheria

52
Q 
Organism in superficial layers of skin
Produce exotoxin
Inhibits protein synthesis and causes necrosis 
Gray grown adherent pseudomembrane
May cause paralysis of palate
Bukl neck appearance
Leather like adherent membrane
A

Diptheria

53
Q

Diptheria vs strep

A

Lack of fever

Non exudative throat

54
Q

Diptheria dx

A

Culture from nose and throat from beneath membrane including the membrane

Negative results do not rule out

55
Q

Diptheria tx

A

Pen G IM/IV 100,000 - 150,000 U/kg/day q6 for 14 d

Erythromycin 40-50mg/kg/day if allergic also to eradicate nasopharyngeal microbe

56
Q

Asymptomatic case contact of diptheria pxs

A

Benzathine Pen G
600,000 U IM for younger 6
1.2M IM for 6 yrs

Or Erythromycin 40-50mg/kg/day for 10d

57
Q

Complication of diptheria:

A

Toxic cardiomyopathy

Toxic neuropathy

58
Q

Most common complication of mumps

A

Meningoencephalitis

59
Q

Most common complication of congenital rubella syndrome

A

sensorineural hearing loss

60
Q

Most debillitating complication of shingles

A

neuropathic pain

61
Q

Most common dermatome involved in shingles

A

Thoracic

Lumbar

62
Q

DOC for neuropathic pain

A

pregabalin

gabapentin

63
Q

Pregabalin and gabalin binds to

A

Alpha 2 delta subunit of voltage gated channel (a2d)

64
Q

Only FDA approved for trigeminal neuralgia

A

Carbamazepine

65
Q

FDA approved for DM neuropathy

A

duloxetene

Level A: Pregabalin

66
Q

HLA in chinese that predilects risk for SJS

A

HLA B1502

67
Q

Most common drugs causing SJS

A

Sulfonamide
Phenytoin, Phenobarb, CBZ
Allopurinol

68
Q

Preferred tx for pertussis

A

Azithromycin

69
Q

Infant <1
With pyloric stenosis: palpable olive
Hx of cardiac problem (QT)
Avoid

A

macrolide

70
Q

Ingestion of food or water contaminated by S typhi

Period of comm: throughout excretion in feces

A

Typhoid fever

71
Q 
High grade fever
Gen myalgia
Abdominal pain
Hepatosplenomegaly
Rose spots in 25% lower chest and abdomen
A

Typhoid fever

72
Q

Complications of typhoid

A

Intestinal hemorrhage

Intestinal perforation

73
Q

Typhoid fever dx

A

Blood culture - 1st week of illness
Urine
Stool - after 1st week

74
Q

Typhoid fever tx

A

Uncomplicated and sensitive: Chloramphenicol 50-75mg/kg/day

Amoxicillin x 14d

75
Q

Excretion of S typhi for more than 3

mos

A

Chronic carrier

76
Q

Aerobic nonspore forming

Coagulase +

A

Staph aureus

77
Q

Staph coag neg

A

Epidermidis
Saprophyticus
Hemolyticus

78
Q

Secondary to exfoliative toxin A&B

Rash preceded by malaise, fever, irritability, exquisite skin

A

Staph scalded skin syndrome

79
Q

Secondary to enterotoxin

Severe nausea, vomiting, abd pain, watery diarrhea

A

Staph food poisoning

80
Q

Necrotizing pneumonia
Pneumatocoele
Pleural effusion
Empyema

A

Staph pneumonia

81
Q

Major cause of bacterial pharygitis

Petechisl mottling of soft palate

A

Group A Beta hemolytic strep

82
Q

Dx of strep pharyngitis

A

throat culture

serology

83
Q

DOC for strep pharygitis

A

Penicillin V
<60 lbs 250 2-3x/day
>60 lbs 500 2-3x/day

10 days, start before first 10 days of treatment
prevent RHF

Erythromycin 10d if allergic

84
Q

Causes by pyrogenjc exotoxin or erythrogenic toxin

Fever, vomiting; toxicity

A

Scarlet fever

85
Q

scarlet fever rash

A

gooseflesh or sandpaper rash

86
Q

Erythematous indurated with advancing margins with raised firm borders

A

Erysipelas

87
Q

Rheumatic fever

GN

A

both by GAS

88
Q

Sudden OCD
Tic disorder
Autoimmune antibody in response to GAS crossreacting with brain tissue

A

PANDAS

89
Q

In children most common valves affected in RHD are

A

Mitral valve

Aortic valve

90
Q

Most common symptom in polyarthritis

responds to

A

Polyarthritis

ASA

91
Q

Diagnosis of RF can be made without following guidelines if presence of the ff

A

Chorea
Indolent carditis
Recurrent RF

92
Q

toxin for splitting of skin by SSS

A

exfoliatin a, b

93
Q

toxin for pneumatocoele

A

panton valentin leukocidin

94
Q

Responsible for golden yellow colonies or pigment of staph

A

Staphyloxanthin

95
Q

Most severe form of SSS

A

Ritters disease

96
Q

Parenchymal lung pattern of Pseudomonas

A

Fleur de lis pattern

97
Q

Striking whitish necrotic center

A

Fleur de lis pattern of pseudomonas

98
Q

Rash in scarlet fever

A

boiled lobster appearance

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