Infectious Disease

Question 1

5th disease

Answer 1

Parvovirus B19
mother-fetus
fetal hydrops/death
<15yrs
fever, pharyngitis 1wk before rash
slapped lacelike cheek rash
can go to school

Question 2

Kawasaki

Answer 2

<5yrs, asian
heart disease
fever 5 days and
exanthema, conjunctival inj w/o exudate, beaus lines
changes in lips/mouth
cervical lymphadenopathy 
can give aspirin

Question 3

After igiv for kawasaki avoid what vaccines

Answer 3

varicella measels

Question 4

rocky mountain spotted fever

Answer 4

rickettsia
tick on for 4-6 hours
abd pain like appy
palms/soles rash
dx:indirect flourescent antibody(IFA)
doxy;NO SULFA

Question 5

Mononucleosis triad

Answer 5

fever, pharyngitis, adenopathy
^LFTs, hepatosplenomegaly
may last 1yr
positive after 2nd wk of exposure/7days after sx
avoid spleenic trauma/use stool softener

Question 6

mononucleosis tx w strep

Answer 6

macrolide

PCN=RASH!

Question 7

Measles (rubeola) 3 c’s

Answer 7

cough, conjunctivitis, coryza

Question 8

measles sx

Answer 8

can’t return to school until 4 days after rash

kopek spot-blue/white spots in mouth

Question 9

measles mgmt

Answer 9

live vaccine w.in 72hrs

IG w.in 6 days to contacts

Question 10

Roseola

Answer 10

<3yrs dt herpes6 (HHV6)
spreads while febrile-rash comes after
children still playful/eating

Question 11

Rubella

Answer 11

starts on face and spreads
^serious complications w congenital rubella (1yr contagious)
no school for 7 days after rash onset
live vaccine given w/in 3 days of contact
pregnant exposure-abort

Question 12

Varicella Chicken pox

Answer 12

breakthrough chicken pox possible after vaccine
most contagious 2 days before rash-crusted rash
tx-antiviral

Question 13

Herpes zoster (shingles)

Answer 13

if <50 consider HIV testing
give antiviral w/in 48hrs
shingrix in 50yrs+ 2-6mo apart

Question 14

Cellulitis organisms

Answer 14

staph a, strep pyogenes

Question 15

Erysipelas

Answer 15

B hemolytic strep

Question 16

Erysipelas differentiating features

Answer 16

clear line of demarcation
affected area is elevated
lymphangitic streaking*

Question 17

Cellulitis Erysipelas tx >6yrs

Answer 17

cephalexin

dicloxacillin

Question 18

cellulitis should get ___ vaccine

if no improvement or spreads consider

Answer 18

tetatnus

MRSA

Question 19

Community Acquired MRSA presentation

Answer 19

Furnucles or carbuncles
folliculitis, pustular lesions
looks like insect bite

Question 20

CAMRSA tx <5cm

>5cm

Answer 20

<5cm I&D
>5cm add abx
tmp-smx
doxy
clinda

Question 21

meningitis causes organisms

Answer 21

strep pneumococcal
neisseria meningitidis
h.flu
listeria
viral: entero, coxsackie, polio, echo, herpes

Question 22

Bacterial meningitis signs

tx

Answer 22

positive kernig and brudzinski signs

3rd gen ampicillin, cephalosporin, aminoglycoside

Question 23

pertussis tx

Answer 23

macrolide: azithromycin/clarithromycin
abx for contacts
tmp-sulfa if cant tolerate