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1. Pediatrics > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

k[Inf/Virus/Influenza]

High Risk age group for Influenza Complications
Thus Recommended for Antiviral Treatment of Suspected or
Confirmed Influenza

Children < ___ years old (Especially < ___ )

A

Children <5 (Especially <2)

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2
Q

[Inf/Bacteria/GI/C.Diff]

Treatment for C difficile infection

Mild to moderate: __
Severe (with fever and leukocytosis): __

A

Mild to Mod: Oral metronidazole (30 mg/kg per day) every 6 hours for 10 days
Severe: Oral vancomycin (40 mg/kg per day) every 6 hours for 10 days

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3
Q

[Inf/Bacteria/GI/C.Diff]

Complications of C difficile infection? (3)

A

Hypotension or shock
Pseudomembranous colitis on endoscopy
Ileus, or toxic megacolon

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4
Q

[Inf/Bacteria/Tick/Lyme]

Lyme disease
Indication of prophylaxis?
Choice of drug for tick bite?

A
  • Indication:
    When tick attached ≥ 36 hours and removed ≤ 72 hours
  • Choice of drug:
    Doxycycline single dose for all ages and pregnant women
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5
Q

[Inf/Basic/Antibiotics]

Bacteriostatic agents?

E
C
S
T

A

Erythromycin
Clindamycin
Sulfonamide
Trimethoprim, Tetrachyclines

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6
Q

[Inf/Antibiotics/Cell Wall]

Antibiotics for cell wall synthesis inhibitor? (3)

A
  1. β-lactams: penicillin, cephalosporins, carbapenems, monobactams
  2. Vancomycin
  3. Daptomycin
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7
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Class of β-lactams antibiotics (4)?

A

Penicillin
Cephalosporin
Carbapenem
Monobactam

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8
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Which bacteria for natural penicillins (Pen G, Pen V) (3)?

A
  1. Streptococcus (Group A, Group B, Viridans, Pneumococcus)
  2. Listeria
  3. Treponema pallidum (syphilis)
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9
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Examples of cephalosporin groups?

1st generation (2): ___
2nd generation (3): ___
3rd generation (2): ___
4th generation (1): ___

A

1st generation (2): cefazolin, cephalexin
2nd generation (3): cefuroxime, cefoxitin, cefotetan
3rd generation (2): ceftriaxone, ceftazidme
4th generation (1): cefepime

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10
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

1st generation cephalosporin (cefazolin, cephalexin)

Susceptable bacteria (3)?
Indication (2)?

A
  • Bacteria:
    Staphylococcus: MSSA
    Streptococcus: most aerobic
    Enterobacteriaceae (PEcK): Proteus, E. Coli, Klebsiella
  • Indication:
    Skin and soft tissue infections
    Most surgical prophylaxis (cefazolin)
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11
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Which bacteria for 3rd generation cephalosporin (ceftriaxone, ceftazidime) (4)?

S
H
E
N

A

Strep pneumococcus
Haemophilus
Enterobactericeae (PEcK): Proteus, E. Coli, Klebsiella
Neisseria

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12
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Pseudomonas covering antibiotics

Penicillin (1): ___
Cephalosporin (2): ___

A

Penicillin (1): piperacillin/tazobactam
Cephalosporin (2): ceftazidime (3rd), cefepime (4th)

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13
Q

[Inf/Antibiotics/Cell Wall/β-lactams/carbapenem]

Imipenem toxicity? (2)

A

Lowering seizure threshold
Nephrotoxicity

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14
Q

[Inf/Antibiotics/Protein Synthesis]

Class of antibiotics for protein synthesis inhibitor (5)?

A

Aminoglycoside: gentamicin, tobramycin, amikacin
Macrolides: erythromycin, clindamycin
Tetrachyclines: doxycycline, minocycline
Clindamycin
Oxazolidinones: Linezolid

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15
Q

[Inf/Antibiotics/Protein Synthesis]

Side effect of Oxazolidinones (Linezolid) (4)?

A

Reversible bone marrow suppression (anemia, thrombocytopenia)
Irreversible neuropathy (optic neuritis)
Lactic acidosis
Serotonin syndrome

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16
Q

[Inf/Antibiotics/DNA Synthesis]

Class of antibiotics for DNA synthesis inhibitor (4)?

A

Fluoroquinolone: ciprofloxacin, levofloxacin, ofloxacin,
Rifampin
Trimethoprim/Sulfamethoxaxole (TMP/SMX)
Nitrofurantoin

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17
Q

[Inf/Antibiotics/DNA Synthesis/Fluoroquinolone]

Side effect of fluoroquinolone (2)?

A

Akilles tendon rupture
QT-interval prolongation

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18
Q

[Inf/Antibiotics/DNA Synthesis/TMP/SMX]

Indications for TMP/SMX in pediatrics (2)?

A

UTI outpatient
Pneumocystis jiroveci pneumonia

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19
Q

[Inf/Antibiotics/DNA Synthesis/TMP/SMX]

Side effect of TMP/SMX (3)?

A

Bone marrow suppression
Hypersensitivity reactions (Stevens Johnson syndrome)
Jaundice in < 2 months

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20
Q

[Inf/Antibiotics/Lactation]

Safe antibiotics for lactating women (4)?

A

Amoxicillin
Cephalosporin
Macrolides: erythromycin, azithromycin
Aminoglycosides: gentamicin

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21
Q

[Inf/Fever without source]

Initial workup for up to 28 days

A

Regardless of appearance: ill-appearing, well-appearing

< 8 days: Full sepsis workup and early sepsis management
8 to 21 days: Full sepsis workup +/- HSV
22-28 days: Partial sepsis with UA +/- LP depending on risk factor and prelim workup

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22
Q

[Inf/Fever without source]

Initial workup for 29 days to 90 days

A

If ill-appearing: full sepsis workup

If well-appearing: Invasive Bacterial Infection (IBI) Risk factor
- Low risk
- 29-60 days: CBC, BCx, inflammatory markers, UA
- 60-90 days: UA and UCx
- With risk factor
- 29-60 days: Full sepsis workup
- 60-90 days: CBC, Blood culture, inflammatory markers, UA

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23
Q

[Inf/Fever without source]

Initial workup for 3 to 36 months

A

Incomplete, unimmunized, if fever > 102.2 F (39C)
CBC, procalcitonin

+/- UA and UCx depending on risk factor

Blood culture if procal ≥ 0.5, WBC ≥ 15K, ANC ≥ 10K
CXR if WBC ≥ 20K

Completely immunized (3 doses of PCV, complete Hib 2-3)
+/- UA and UCx depending on risk factor

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24
Q

[Inf/Fever without source]

Initial workup for 3 to 36 months
UTI risk factors for UA/UCx investigation (5)

Boys - Circumcised ≤ ___ months
Boys - Uncircumcised ≤ ___ months
Girls ≤ ___ months
Prolonged fever > ___ hours
Children with ___

A

Boys - Circumcised ≤ 6 months
Boys - Uncircumcised ≤ 12 months
Girls ≤ 24 months
Prolonged fever > 48 hours
Children with prior UTI, urogenital anomaly,

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25
Q

[Inf/Lymphadenopathy]

Bacterial cause?

Cat: ___
Rabbit: ___
Rose throne: ___
Marine: ___
Shellfish: ___
Fishermen/meat handlers: ___

A

Cat: Bartonella
Rabbit: Francisella
Rose throne: Sporothrix
Marine: Mycobacterium marinum
Shellfish: Vibrio
Fishermen/meat handlers: Erysipelothrix rhusiopathiae

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26
Q

[Inf/CNS infection]

Cause?

CSF finding:
Mild to moderate WBC elevation
Monocytic predominance
High protein
Low glucose
High opening pressure
CT scan: basilar enhancement

A

Tuberculous meningitis

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27
Q

[Inf/CNS infection]

Cause?
Treatment?

CN 7 (facial palsy)
Foot drop
Mild to moderate WBC elevation
Lymphocytic predominance

A

Lyme meningitis

  • Treatment:
    Ceftriaxone for 21 days
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28
Q

[Inf/CNS infection]

Cause?
Treatment?

Recent immigrant from latin America
New onset seizure
Ring enhancing lesion on CT scan

A

Neurocysticercosis

  • Treatment:
    Albendazole
    +/- steroid
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29
Q

[Inf/GI infection]

Traveler’s diarrhea

Most common cause?
Treatment?

A

EnteroToxigenic E. Coli

  • Treatment:
    Azithromycin
    (No treatment for EHEC, Shiga toxin)
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30
Q

[Inf/GI infection]

Treatment for Campylobacter (2)?

A
  1. Microlides: erythromycin, azithromycin
  2. TMP/SMX
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31
Q

[Inf/UTI]

Positive CFU for urine culture?

Bagged sample: ___
Clean void: ___
Catheter specimen: ___
Suprapubic: ___

A

Bagged sample: only rule out when negative
Clean void: > 100K CFU/mL
Catheter specimen: > 50K CFU/mL
Suprapubic: any growth of uropathogen

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32
Q

[Inf/Osteomyelitis]

Drug of choice for osteomyelitis?

A

Ceftriaxone + vancomycin

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33
Q

[Inf/Endocarditis]

Subacute bacterial endocarditis
HACEK organism?

A

Haemophilus
Aggregatilbacter actinomycetemcomitans
Cardiobacterium hominis
Eikenella
Kingella

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34
Q

[Inf/Endocarditis]

Modified duke criteria?
2 major, 1 major + 3 minor, 5 minor

Major (2)
Minor (5)

A

Major (2)
1. Positive blood culture, 2 separate, 12 hours apart
2. Abnormal echocardiogram

Minor (5)
1. Predisposing condition
2. Fever > 100.4 F
3. Vascular phenomena (Janeway lesions, conjunctival hemorrhages)
4. Immunologic phenomena (Osler nodes, Roth spots)
5. Positive blood culture (not meeting major criteria)

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35
Q

[Inf/Prevention/When to return]

When to return to school

Measles returns ____ after onset of rash
Mumps returns ____ after onset of parotid swelling
Rubella returns ____ after onset of rash
Varicella returns ____ after onset of rash
Hep A returns ____ after onset of illness

A

Measles returns 4 days after onset of rash
Mumps returns 5 days after onset of parotid swelling
Rubella returns 7 days after onset of rash
Varicella returns 6 days after onset of rash
Hep A returns 7 days after onset of illness

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36
Q

[Inf/Prevention/When to return]

When to return to school

Strep pharyngitis ___ after antibiotics started
Impetigo returns ___ after starting antibiotics
Pertussis returns ___ after antibiotics are completed

A

Strep pharyngitis 12 hours after antibiotics started
Impetigo returns 24 hours after antibiotics started
Pertussis returns 5 days after antibiotics are completed

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37
Q

[Inf/Prevention/Transmission]

Airborne transmission agents? (3)

A

Mycobacterium tuberculosis
Measles
Varicella

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38
Q

[Inf/Prevention/Transmission]

Infectious agents expressed in breast milk? (3)

A

HIV
HTLV (Human T cell lymphotropic virus)
Brucellosis

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39
Q

[Inf/Prevention/Transmission]

Mothers with ___ can express milk (3)

A

TB
HSV
Varicella

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40
Q

[Inf/Bacteria/G(+) Cocci]

Examples of Gram (+) Cocci and classification?

A

Staphylococcus
- Coagulase (-): S. aureus
- Coagulase (+): S. epidermidis, S. saprophyticus
Streptococcus
- α-hemolysis: S. pneumoniae, Viridans
- β-hemolysis: Group A (S. pyogenes), Group B (S. agalactiae)
- γ-hemolysis: Enterococci, S. bovis

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41
Q

[Inf/Bacteria/G(+) Cocci]

Treatment for Coagulase negative Staphylococci (CNS, S. epi) for prosthetic device infection?

A

Vancomycin +/- Rifampin

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42
Q

[Inf/Bacteria/G(+) Cocci]

Treatment for S. pneumoniae meningitis?

A

Vancomycin + Ceftriaxone till susceptibility

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43
Q

[Inf/Bacteria/G(+) Cocci]

Diangosis?
Mechanism?

Sandpaper rash, starting from neck and chest to palms and soles followed by desquamation
Acute pharyngitis with strawberry tongue, circumoral pallor
Pastia lines (petechial lines in folds)

A

Scalret fever

  • Mechanism:
    Pyrogenic exotoxin
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44
Q

[Inf/Bacteria/G(+) Cocci]

Treatment for streptococcal pharyngitis

A

Penicillin V potassium (PCN VK)

Or
Pen G IM, amoxicillin PO

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45
Q

[Inf/Bacteria/G(+) Rods]

Examples of Gram (+) Rods?

L
A
B
C
C

A

Listeria
Arcanobacterium (Corynebacterium) haemolyticum
Bacillus cereus, B. anthrax
Corynebacterium diphtheriae
Clostridium difficile, botulinum, tetani, perfringens

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46
Q

[Inf/Bacteria/G(+) Rods]

Which bacteria
Treatment?
Prophylaxis?

Low fever
Pharyngitis with whitish membrane
Cervical lymphadenitis (bull neck)
Conjunctivitis

A

Corynebacterium diphtheriae (Diphtheria)

  • Treatment:
    Equine antitoxin
    PO Erythromycin or IV/IM PCN
  • Prophylaxis:
    Close contacts, regardless immunization status
    PO Erythromycin or IM PCN
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47
Q

[Inf/Bacteria/G(+) Rods]

Toxin-mediated effects for Corynebacterium diphtheriae (2)?

A

Myocarditis within the first week
Neural involvement: Guillain-Barre syndrome or peripheral nerve palsies

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48
Q

[Inf/Bacteria/G(+) Rods]

Which bacteria?
Treatment?

Acute pharyngitis
Scarlatiniform rash
Lymphadenopathy without palatal petechiae/strawberry tongue
similar to S. pharyngitis, Not improved with penicillin

A

Arcanobacterium haemolyticum

  • Treatment:
    Macrolides (Erythromycin, azithromycin)
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49
Q

[Inf/Bacteria/G(+) Rods]

Which bacteria?
Treatment?
Prophylaxis?

Painless pruritic papule becomes painless ulcer with black eschar
Fever, myalgia
Painful lymphadenopathy

A

Bacillus anthracis
(Cutaneous anthrax)

  • Treatment:
    Amoxicillin or ciprofloxacin
    Plus Antitoxin
  • Prophylaxis for aerosol exposure:
    Ciprofloxacin or doxycycline for 60 days
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50
Q

[Inf/Bacteria/G(+) Rods]

Gas gangrene treatment for Clostridium perfringens?

A

High dose penicillin G

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51
Q

[Inf/Bacteria/G(+) Rods]

Treatment for Clostridium tetani?

A

Human tetanus immunoglobulin TIG
Plus
Metronidazole (or Pen G)

52
Q

[Inf/Bacteria/G(-) Cocci]

Examples of Gram (-) Cocci (2)?

A

Neisseria
Moroxella

53
Q

[Inf/Bacteria/G(-) Cocci]

Indications for meningococcus prophylaxis (2)?

___ days prior of onset

A

7 days prior of onset

  1. Close contacts
    Living together, flight > 8 hours,
    Attending same child care
  2. Direct exposure
    Invasive procedure like intubation, suction
54
Q

[Inf/Bacteria/G(-) Cocci]

Treatment options for meningococcus prophylaxis (3)?

A

Rifampin for 2 days
Ceftriaxone IM 1 dose
Ciprofloxacin 1 dose (>18 years old)

55
Q

[Inf/Bacteria/G(-) Coccobacilli]

Examples of Coccobacilli (11)?

A

Haemophilus influenza
Camplyobacter

Ellas (except Kleb/Sal/Shi)
Bordetella pertusis
Kingella kingae
Yersinia pestis
Francisella tularensis
Legionella pneumophila
Coxiella burnetii
Brucella
Bartonella
Pasteurella

56
Q

[Inf/Bacteria/G(-) Coccobacilli]

Treatment and prophylaxis for Bordetella pertussis?

A

Treatment:
Macrolide (Azithro for infants)

Prophylaxis:
Macrolide +/- Tdap (Eligible, infant, pregnancy)

57
Q

[Inf/Bacteria/G(-) Coccobacilli]

For Haemophilus influenzae

Prophylaxis indication: ___
Prophylaxis options: ___

A

Prophylaxis:
Rifampin x 4 days

  • Indication:
    Close contacts, child care, unimmunized or incompletely immunized, immunocompromised
    Child care center ≥ 2 patients within 60 days
58
Q

[Inf/Bacteria/G(-) Coccobacilli]

Treatment options for Kingella kingae?

A

Penicillin

59
Q

[Inf/Bacteria/G(-) Coccobacilli]

Diagnosis?
Which bacteria?

Exposed to cattle placenta/birth product
Fever, malaise, pneumonia
Infective endocarditis

A

Q fever
Coxiella burnetii

60
Q

[Inf/Bacteria/G(-) Coccobacilli]

Which bacteria/disease?
Treatment?

GI: Diarrhea
CNS: Headache, delirium, confusion
Renal: azotemia, hematuria
Pulm: pneumonia

A

Legionella pneumophila
Legionellosis
(Pontanic fever for milder, without pneumonia)

  • Treatment:
    Azithromycin
61
Q

[Inf/Bacteria/G(-) Coccobacilli]

Which bacteria/disease?
Treatment?

Unpasteurized milk
Heart: endocarditis
GU: orchitis, abortion
Endocrine: thyroiditis, adrenal insufficiency, SIADH
Lung/GI: pneumonia diarrhea

A

Brucella
Brucellosis

  • Treatment:
    Doxycycline + aminoglycoside
    Or
    Doxycycline + Rifampin
62
Q

[Inf/Bacteria/G(-) Coccobacilli]

Which bacteria/disease?
Treatment?

Cat scratch or bite
If near eye: conjunctivitis, preauricular lymphadenopathy, ocular granuloma

A

Bartonella henselae
Catscratch disease
(Parinaud oculoglandular syndrome for near the eyes)

  • Treatment:
    Azithromycin
63
Q

[Inf/Bacteria/G(-) Rods]

Examples of G(-) Rods (6)?

A

Pseudomonas aeruginosa
Helicobacter pylori
Klebsiella
Salmonella
Shigella
Escherichia coli

64
Q

[Inf/Bacteria/G(-) Rods]

Which bacteria/disease?
Treatment?

Nail-puncture wound in the shoe
Endocarditis in IV drug user
Ecthyma gangrenosum (round black lesion, central ulceration)

A

Pseudomonas aeruginosa

  • Treatment: pseudomonas covering antibiotics
    Penicillin: Piperacillin/tazobactam
    Cephalosporin: Ceftazidime, cefepime
    Carbapenem: imipenem, meropenem
    Aminoglycosides
    Quinolones
65
Q

[Inf/Bacteria/G(-) Rods]

Which bacteria/disease?

Slowly rising fever with relative bradycardia
Abdominal pain and constipation
Rose spots
Leukopenia

A

Salmonella Typhi
Typhoid fever

66
Q

[Inf/Bacteria/Atypical]

Classes of atypical bacteria (4)?

A

Mycoplasma
Chlamydia
Spirochetes: syphilis, lyme, leptospirosis
Rickettsiae: Rickettsiae, Ehrlichia

67
Q

[Inf/Bacteria/Atypical]

Which bacteria?
Treatment?

Exposed to birds (parrots, parakeets, pigeon)
High fever > 105F
Pneumonia
Splenomegaly

A

Chlamydia pisttaci

  • Treatment:
    Macrolides
68
Q

[Inf/Bacteria/Atypical]

Which bacteria?
Treatment?

Exposure to ticks in Arkansas, Georgia, Oklahoma
Rash starting from wrists/ankles, spread to trunk, palms/soles
Petechial to purpuric
Myalgias, arthralgias, diarrhea, photophobia
Hyponatremia, thrombocytopenia

A

Rickettsia rickettsii
Rocky Mountain Spotted Fever

  • Treatment:
    Doxycycline (Even < 8 years old)
69
Q

[Inf/Bacteria/Atypical]

Which bacteria?
Treatment?

Exposure to ticks in Arkansas, Oklahoma
+/- rash
Viral syndrome
Hepatitis
Pancytopenia
Morulae in WBC

A

Ehrlichia
(Human monocytic ehrlichiosis)
Or
Anaplasma
(Human granulocytic anaplasmosis)

  • Treatment:
    Doxycycline
70
Q

[Inf/Bacteria/Gram-variable]

Example of gram variable bacteria (1)?

A

Gardnerella vaginalis

71
Q

[Inf/Bacteria/Anaerobes]

Examples of anaerobes (4)?

A

Fusobacterium
Actinomyces
Peptostrepcoccus
Bacteroides

72
Q

[Inf/Bacteria/Anaerobes]

Which bacteria?
Diangosis?
Treatment?

Pharyngitis
Internal jugular vein thrombophlebitis
Septic lung emboli

A

Fusobacterium necrophorum
Lemierre syndrome

  • Treatment:
    Ceftriaxone plus metronidazole
73
Q

[Inf/Bacteria/Anaerobes]

Which bacteria/disease?
Treatment?

After dental procedure
Yellow sulfur granule/abscess

A

Actinomyces
(Actinomycosis)

  • Treatment:
    Penicillin
74
Q

[Inf/Bacteria/Acid-Fast]

Examples of Acid-Fast bacteria (2)?

A

Mycobacterium (tuberculosis, leprae, avium complex)
Norcadia

75
Q

[Inf/Bacteria/Acid-Fast]

Diagnostic test for TB by age?

A

< 2 years of age: Tuberculin skin testing
≥ 2 years of age or BCG recipients: Interferon gamma release assay (IGRA)

76
Q

[Inf/Bacteria/Acid-Fast]

Tuberculin skin test reading
≥ 4 years of age without any risk factors

Positive when induration ≥ ___ mm

A

≥ 4 years of age without any risk factors

Induation ≥ 15 mm

77
Q

[Bacteria/Acid-Fast]

Tuberculin skin test reading

< 4 years of age
Increased risk:
- Co-morbidities (DM, CKD)
- Travel to high prevalence regions
- Exposure to high risk adults (HIV, homeless)

Positive when induration ≥ ___ mm

A

Positive when induration ≥ 10 mm

< 4 years of age
Increased risk:
- Co-morbidities (DM, CKD)
- Travel to high prevalence regions
- Exposure to high risk adults (HIV, homeless)

78
Q

[Inf/Bacteria/Acid-Fast]

Tuberculin skin test reading

Close contact with active case
HIV infection or immunosuppressive conditions
Clinical signs or positive CXR

Positive when induration ≥ ___ mm

A

Positive when induration ≥ 5 mm

Close contact with active case
HIV infection or immunosuppressive conditions
Clinical signs or positive CXR

79
Q

[Inf/Bacteria/Acid-Fast]

Tuberculin skin test reading
Who is positive when induration < 5 mm (1)

A

HIV infection plus close contact of active case
(any reading is positive)

80
Q

[Inf/Bacteria/Acid-Fast]

Latent TB infection treatment options (3)?

A
  1. Isoniazid and rifapentine 1/week for 3 months
  2. Isoniazid and rifampin daily for 3 months
  3. Rifampin daily for 4 months
    (Discouraged isoniazid for 9 months due to compliance)
81
Q

[Inf/Bacteria/Acid-Fast]

TB infection treatment?

A

RIPE for 2 months and RI for 4 months

R: Rifampin
I: Isoniazid
P: Pyrazinamide
E: Ethambutol or streptomycin

82
Q

[Inf/Bacteria/Acid-Fast]

Side effects of TB antibiotics?

R: Rifampin: ___
I: Isoniazid: ___
P: Pyrazinamide: ___
E: Ethambutol: ___

A

R: Rifampin: Orange discoloration
I: Isoniazid: Liver toxicity
P: Pyrazinamide: N/V/abdominal pain, hypersensitivity
E: Ethambutol: decreased in visual acuity

83
Q

[Inf/Bacteria/Atypical/Spirochetes]

Which bacteria?
Diagnosis?
Treatment?

Swim in the pond with dogs, rats
Fever, myalgia
Conjunctival suffusion
Hepatitis (disproportionally high bilirubin)
Renal failure

A

Leptospirosis
Weil disease

  • Treatment:
    PO doxycycline for mild
    IV doxy or pen G, ceftriaxone for severe
84
Q

[Inf/Bacteria/Atypical/Spirochetes]

Stages of lyme disease (3)?

A
  1. Early localized
    erythema migrans
  2. Early disseminated
    heart block, nerve palsy
  3. Late disseminated
    arthritis
85
Q

[Inf/Fungi]

Coccidioides vs Histoplasma vs Blastomyces

From Arizoma
Flu-like illness
Arthralgias, erythema multiforme/nodosum
Pulmonary coin lesion

A

Coccidioides
(Valley fever)

86
Q

[Inf/Fungi]

Coccidioides vs Histoplasma vs Blastomyces

From Kansas, Missouri
Soil with bat and bird
Calcified granuloma, interstitial pneumonia
Splenomegaly
Pancytopenia

A

Histoplasma

87
Q

[Inf/Fungi]

Coccidioides vs Histoplasma vs Blastomyces

From Minnesota, Michigan, Canada
Exposed to decaying wood
Fever, myalgia, cough, nonspecific symptoms

A

Blastomyces

88
Q

[Inf/Fungi]

Which fungus?

Pricked by rose thorn

A

Sporotrichosis (Sporothrix)

89
Q

[Inf/Parasite/Protozoa]

Protozoa classes and their examples (3)?

Protozoa: single cell, eukaryocyte
Helminth: multicells (worms)

A

Protozoa
1. Sporozoa:
Toxoplasma, Cryptosporidium, Cyclospora, Plasmodium, Babesia
2. Ameba:
Entamoeba
3. Flagellates:
Giardia, Trichomonas, Trypanosoma, Leishmania

90
Q

[Inf/Parasite/Protozoa]

Which parasite?
Treatment?

Contaminated water park, swimming pool outbreaks
Watery diarrhea for 1-2 weeks
Stool O&P: small round oocytes

A

Cryptosporidium

  • Treatment:
    nitazoxanide
91
Q

[Inf/Parasite/Helminth]

Helminth classes and their examples (2)?

Protozoa: single cell, eukaryocyte
Helminth: multicells (worms)

A

Helminth
1. Nematodes (Roundworms):
Pinworms, hookworms, whipworms, Trichinella, Strongyloides, Ascaris
2. Platyhelminths:
Cestodes (tapeworms), trematodes (flukes)

92
Q

[Inf/Parasite/Protozoa]

Which parasite?

Fever, vomiting, myalgia
Jaundice, splenomegaly

A

Plasmodium falciparum (Malaria)

93
Q

[Inf/Parasite/Protozoa]

Which parasite?

Especially in asplenic patients
Tick from rodents in Northeast (NH, Vermont)
Fever
Hemolytic anemia, hemoglobinuria

A

Babesiosis

94
Q

[Inf/Parasite/Protozoa]

Which parasite and its treatment?

Especially in anal sex, IgA deficiency, cystic fibrosis patients
Watery, smelly diarrhea, flatulence

A

Giardia

Treatment: Metronidazole

95
Q

[Inf/Parasite/Protozoa]

Which parasite?
Diagnosis?

From Mexico, South America
Heart block, heart failure
Achalasia, megacolon
Unilateral firm edema of the eyelids (Romana sign)
Generalized lymphadenopathy

A

Trypanosoma

T. Cruzi: Chagas disease
(T. brucei: sleeping sickness)

96
Q

[Inf/Parasite/Protozoa]

Which parasite?

Cutaneous: cigarette paper scar
Mucosal: granulomatous inflamation
Visceral: hepatosplenomegaly

A

Leishmania

97
Q

[Inf/Parasite/Helminth]

Which parasite?

Abdominal: diarrhea, anorexia
Respiratory: migratory infiltrates (Loffler syndrome), hemoptysis

A

Ascaris lumbricoides (round worm)

98
Q

[Inf/Parasite/Helminth]

Which parasite?
Treatment?

Anal pruritus
Adhesive tape test

A

Enterobius vermicularis (Pinworm)

  • Treatment:
    Albendazol for all household members
99
Q

[Inf/Parasite/Helminth]

Which parasite?

Walking barefoot
Cutaneous larva migrans

A

Necator americanus (Hookworm)

100
Q

[Inf/Parasite/Helminth]

Which parasite?

Undercooked pig/bear meat
Muscle pain, calcification in x-ray
Myocarditis, periorbital edema, eosinophilia

A

Trichinella spiralis

101
Q

[Inf/Parasite/Helminth]

Which parasite?

Pica
Migratory pneumonia
Hypergammaglobulinemia, eosinophilia
Visceral larva migrans, ocular larva migrans
Larva currens (Itchy, serpiginous, erythematous tracks)

A

Strongyloides stercoralis

102
Q

[Inf/Parasite/Platyhelminths/Cestodes]

Which parasite?

Multiple cysts, calcified granulomas

A

Neurocysticercosis

103
Q

[Inf/Parasite/Platyhelminths/Trematodes]

Which parasite?
Treatment?

Swimming in the contaminated water
Hematuria

After 2 months of inoculation, serum-sickness like symptoms (LAD, diarrhea, HSM)

A

Schistosoma haematobium (hematuria)

Acute schistosomias (Katayama fever)

  • Treatment: praziquantel for 1 day
104
Q

[Inf/Virus/Herpesviruses]

Which virus?

Neurologic: Alice in Wonderland syndrome
Skin: papular acrodermatitis (Gianotti-Croti syndrome)

A

Epstein-Barr virus (EBV)

105
Q

[Inf/Virus/Herpesviruses]

Which virus and its disease?

Fever then erythematous rash
Febrile seizure with febrile stage
Erythematous papules in the soft palate, uvula (Nagayama spots)

A

Human Herpersvirus 6 (HHV-6)

Roseola, exanthem subitum, roseola infantum, sixth disease

(Parvo: Erythema infectiosum, fifth disease)

106
Q

[Inf/Virus/Herpesviruses]

Which virus and its disease?

Children: Slapped cheek rash, Fever, Arthritis
Adolescents, adults: papular purpuric gloves and sock syndrome

A

Parvovirus B19

Erythema infectiosum, fifth disease
(HHV6: roseola infantum, sixth disease)

107
Q

[Inf/Virus/Herpesviruses]

Which virus’s complication?

Subacute sclerosing panencephalitis:
Dementia, myoclonus, new-onset seizures at 10 years of age

A

Measles (Rubeola)

108
Q

[Inf/Virus/Herpesviruses]

Which virus?

Floria, Puerto Rico
High fever, polyarthralgia, +/- maculopapular rash
Lymphopenia, thrombocytopenia, elevated LFTs, elevated Cr

A

Chikungunya virus

(Dengue: retro-orbital pain, saddle back fever, hemorrhage, shock)

109
Q

[Inf/Virus/Herpesviruses]

Which virus?

Mexico, South America, Puerto Rico
Saddle back fever (biphasic)
Severe myalgias, arthralgias, headaches, conjunctivitis
Retro-orbital pain, macular rash
Hemorrhagic, or shock

A

Dengue virus

(Chikungunya: severe joint pain, conjunctivitis, no hemorrhage or shock)

110
Q

[Inf/Virus/Herpesviruses]

Which virus?

Desert Southwest
Severe hemorrhagic pneumonia
Thrombocytopenia, increased hematocrit

A

Hantavirus

111
Q

[Inf/Virus/Herpesviruses]

Which virus?

Congo
Fruit bats
Fever, myalgia, diarrhea, headache
Hiccups, conjunctival injection, dar red discoloration of the palate
Leukopenia, thrombocytopenia, elevated LFTs, coagulopathy, CKD

A

Ebola

112
Q

[Inf/Virus/HIV/Complications]

Which causal organism?

Fever, cough, hypoxia
Elevated LDH, normal LFT
X-ray of diffuse bat-wing infiltrates

A

Pneumocystis jiroveci pneumonia (PJP)

113
Q

[Inf/Virus/HIV/Prophylaxis]

Indications for PJP prophylaxis

  1. All HIV-infected asymptomatic infants until from ____ to ___ of age (until confirm negative)
  2. HIV-infected (1-5 years of age) if CD4 count is <___ cells/pL
  3. HIV-infected (> 6 years of age) if CD4 count is <___ cells/pL
  4. History of prior PJP infection
A
  1. All HIV-infected asymptomatic infants until 1 year of age
  2. HIV-infected (1-5 years of age) if CD4 count is <500 cells/pL
  3. HIV-infected (> 6 years of age) if CD4 count is <200 cells/pL
  4. History of prior PJP infection
114
Q

[Inf/Virus/HIV/Immunization]

live vaccine candidates
extra immunization?

A
  1. Live vaccines:
    1-13 years: CD4+ T-cell > 15%
    >13 years: CD4+ T-cell > 200/µL
  2. Rota vaccines: can be given regardless CD4 counts
  3. PCV23 after 24 months
  4. Menacwy after 2 months
115
Q

[Inf/Virus/HIV/Treatment]

All infants born to mothers with HIV infection should receive ___ therapy for ___ weeks.

If an HIV-positive woman has not received antepartum antiretroviral therapy (ART) or received ART only at delivery, 3 doses of ___ is also given in the 1st week of life along with ZDV.

A

All infants born to mothers with HIV infection should receive zidovudine therapy for 4-6 weeks (before test results).

If an HIV-positive woman has not received antepartum antiretroviral therapy (ART) or received ART only at delivery, 3 doses of nevirapine is also given in the 1st week of life along with ZDV.

116
Q

[Inf/Virus/exanthem]

Which virus?

Postauricular, suboccipital lymphadenopathy
Maculopapular rash, coming from face down
Soft palate petechiae and reddish spots (Forchheir sign)

A

Rubella (German measles, three day measles)

117
Q

[Inf/Bacteria/Atypical]

Which bacteria and treatment??

Infant between 4 and 12 weeks of age
Staccato-like cough, nasal stuffiness
Afebrile, tachypnea, rales in the absence of wheezing
Eosinophilia
CXR Hyperinflation interstitial infiltration

A

Chlamydia trachomatis

Treatment: erythromycin (even for infants)

118
Q

[Inf/Bacteria/G(-) Coccobacilli]

Which bacteria?

Immunocompromised hosts or excessive iron storage (sickle cell disease, β thalassemia)
Undercooked pork
Diarrhea, abdominal pain after 4-7 days

A

Yersinia enterocolitica gastroenteritis

Treatment:
Supportive
If severe, ciprofloxacin for adults, ceftriaxone for children

119
Q

[Inf/Prevention/precuations]

Which precautions/isolation?
Contact/Droplet/Airborne

Multidrug-resistant bacteria, Shigella species, and Staphylococcus aureus (cutaneous infection or draining abscesses)
Herpes simplex virus, respiratory syncytial virus, parainfluenza virus, enteroviruses
Scabies

A

Contact precautions

120
Q

[Inf/Prevention/precuations]

Which precautions/isolation?
Contact/Droplet/Airborne

Influenza, parvovirus B19 (before the onset of rash), rhinovirus, mumps, and adenovirus (pneumonia)
Pertussis, Neisseria meningitidis (invasive)

A

Droplet precautions

121
Q

[Inf/Prevention/prophylaxis]

Indication for Varicella-zoster immune globulin (VZIG) (3)?

A
  1. Immunocompromised
  2. Pregnant ladies
  3. Newborns with mother infected 5 days before through 2 days after delivery
    (If VZIG not available, give IVIG)
122
Q

[Inf/Prevention/prophylaxis]

Hep A postexposure prophylaxis:

≥ 12 months: ___
< 12 months: ___

A

≥ 12 months: Hep A vaccine
< 12 months: Hep A immunoglobulin
(within 2 weeks of exposure)

123
Q

[Inf/Prevention/prophylaxis]

TB postexposure prophylaxis indications (2)?

A

< 5 years old
Immunocompromised

(TB test first, start chemoprophylaxis, discontinue after 8-10 weeks of retest)

124
Q

[Inf/Virus/EBV]

Serology early and/or past infection

EBV VCA IgM: ___
EBV VCA IgG: ___
EBV nuclear antigen (EBNA): ___

A

EBV VCA IgM: early infection
EBV VCA IgG: early and/or past infection
EBV nuclear antigen (EBNA): past infection

125
Q

[Inf/Bacteria/G(+)]

Which disease?

Severe malabsorption, arthritis, polyserositis, CNS symptoms
PAS positive granules in the lamina propria
Gram positive Actinomycete

A

Whipple disease
(Tropheryma whipplei)

1. Pediatrics (22 decks)

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