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Laughing Your Way > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Common bacterial organisms for neonates (< 1 mo)

A

GBS
E. coli
Strep pneumo
Staph aureus

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2
Q

Common bacterial organisms for infants (1-12 mo)

A

GBS
E. coli
Strep pneumo
Staph aureus
Salmonella

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3
Q

Common bacterial organisms for immunocompromised

A

Gram-negative bacilli
(Pseudomonas, E. coli, Klebsiella)
Staph

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4
Q

Common bacterial organisms for asplenic patients

A

Encapsulated organisms
(strep pneumo, H flu, N meningitidis)

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5
Q

Usual bugs for neonatal meningitis

A

GBS
Listeria
E. coli
Enterovirus (spring/summer)

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6
Q

Usual bugs for meningitis in young children

A

Strep pneumo
N meningitis
Enterovirus
Borrelia
Rickettsia

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7
Q

Most common reportable STD in US

A

Chlamydia trachomatis

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8
Q

Newborn
Afebrile
Staccato cough
Tachypnea
Intracytoplasmic inclusion bodies

A

Chlamydia trachomatis

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9
Q

Diagnostic test and management for Chlamydia trachomatis

A

PCR

PO erythromycin or azithromycin

Erythromycin eye ointment for Chlamydia conjunctivitis ppx

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10
Q

Diagnostic test for chlamydiphilia pneumonia and management

A

Immunoflourescent antibodies

Azithromycin x 5 days
Or
Erythromycin x 14 days

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11
Q

Purpuric macular rash that starts on wrists/ankles or palms/soles and spreads centrally
Thrombocytopenia
Hyponatremia
Occurs in spring and summer
Most common fatal tick-borne disease in US

A

Rocky Mountain Spotted Fever

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12
Q

Diagnosis and management for RMSF

A

Direct immunofluorescence of skin biopsy

Doxycycline (even for < 8 yo)

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13
Q

Similar to RMSF
No rash
Leukopenia
Elevated LFTs
Inclusion bodies

A

Human erlichiosis

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14
Q

Neonatal sepsis
Childhood meningitis
Periorbital cellulitis
Pyogenic arthritis
Epiglottitis
Unimmunized

Management

A

H flu type B

Tx ceftriaxone or cefotaxime
Steroids can decrease risk of hearing loss

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15
Q

Prophylaxis for Hib exposure

A

Rifampin

If anyone in household is < 12 mo who has not received primary series of Hib vaccine or < 4 yo who is partially immunized or immunocompromised

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16
Q

Post exposure management for Hib

A

Unimmunized or incompletely immunized should receive Hib vaccine and proceed with regular vaccine series

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17
Q

Stage of pertussis

Typical cold-like symptoms
1-2 weeks

A

Catarrhal

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18
Q

Stage of pertussis

Paroxysms of coughing
Inspiratory whooping
4 weeks

A

Paroxysmal

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19
Q

Stage of pertussis

100 day cough
Waning symptoms
1-2 mo

A

Convalescent

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20
Q

Unimmunized
Coughing
Respiratory distress/failure
Lymphocytosis

A

Pertussis

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21
Q

Diagnosis and management of pertussis

A

PCR

Erythromycin, clarithromyxin, or azithromycin

Pertussis vaccine boosters: pregnant women, teenagers, all adults in contact of newborn infant

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22
Q

Post-exposure ppx

A

Asymptomatic close contacts

Erythromycin, clarithromycin, or azithromycin

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23
Q

Loose watery diarrhea
Vomiting
Abdominal
Cramps
Fever
Summer picnic

A

Salmonella

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24
Q

Carriers of salmonella

A

Chicken
Egg
Red meat
Unpasteurized milk and ice cream
Raw fruits and vegetables
Turtles, snakes, hedgehogs

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25
Q

Management for uncomplicated (non-invasive) Salmonella gastroenteritis

A

Supportive

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26
Q

Indications for salmonella treatment

Treatment

A

< 3 mo
Hemoglobinopathies
Malignancies
Severe colitis
Immunocomprmised

Ceftriaxone, azithromycin, quinolones

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27
Q

Headache
Abdominal pain
Malaise
High fever
HSM
Red or rose spots
Fever pulse dissociation
Immigrant

Management

A

Typhoid fever

Cefotaxime and ceftriaxone

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28
Q

Watery/bloody diarrhea
Fever
Seizure
Left shift on CBC
Pools, hot tubs, lakes, oceans

A

Shigella

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29
Q

Management for Shigella

A

Oral rehydration

Treatment only recommended for severe disease, dysentery, immunosuppressive
-ceftriaxone, azithro in children
-Cipro in non-pregnant > 18 yo

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30
Q

Osteomyelitis/osteochondritis
Puncture wounds
Otitis externa
Mechanical ventilators
Immunocompromised
CF

A

Pseudomonas

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31
Q

Management for pseudomonas

A

Zosyn
Gentamicin

Carbapenems and ceftazidime (pulmonary)

Cipro
Levo

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32
Q

Unpasteurized milk and dairy products
Exposure to cattle, sheep, goat
fever
Malaise

Management

A

Brucellosis

Tetracycline or Bactrim

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33
Q

Bloody/watery diarrhea
Recent antibiotic use
Pseudomembranous colitis

A

C diff

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34
Q

Diagnosis and management for c diff

A

Enzyme immunoassay

PO flagyl or PO vancomycin

Soap and water
Alcohol does not kill c diff

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35
Q

Sunburn-like sandpaper rash that blanches
Spares the face, palms, soles
Pastia lines
Perioral pallor

A

Scarlet fever

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36
Q

Skin rash
We’ll-defined borders
Develops quickly

A

Erysipelas

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37
Q

Skin rash
Ill-defined borders
Develops slowly

A

Cellulitis

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38
Q

Sore throat
Fever
Erythema/edema of posterior pharynx
Palatal petechiae
Strawberry tongue

A

Strep pharyngitis

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39
Q

Fever
Pharyngeal exudate
LAD
rash
No palatal petechiae or strawberry tongue

A

Arcanobacterium harmolyticum

Tx: erythromycin, azithro, clarithro
Not pencillin

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40
Q

Rapidly evolving rash
Erythema
Marked inflation
Bullous formation
Pain out of proportion

A

Necrotizing fasciitis

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41
Q

Well known risk factor for invasive GAS and necrotizing fasciitis

A

Varicella

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42
Q

Fever
Nausea, vomiting
Diarrhea
Erythroderma
Shock, organ failure

A

Toxic shock syndrome

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43
Q

Management for hospital acquired MRSA

A

Vancomycin

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44
Q

Management for community acquired MRSA

A

Bactrim or clindamycin

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45
Q

Management for MRSA abscesses < 5 cm

A

I&D only
No antibiotics

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46
Q

Three types of botulism

A

Food-borne
Wound
Infantile

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47
Q

6 Ds of Botulism

A

Diploplia
Dysphagia
Dysarthria
Dying to pee and poop (retention)
Dysphonia
Descending symmetrical paralysis

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48
Q

Pathophysiology of botulism toxin

A

Blocks release of acetylcholine into the synapse

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49
Q

Anaerobic, gram positive, spore forming rods

A

Clostridium tetani, botulinum, perfringens

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50
Q

Management for botulism

A

Supportive

Antibiotics not indicated
Aminoglycosides can potentiate paralytic effect

Antitoxin for infant botulism

Penicillin or Flagyl for wound botulism

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51
Q

Painless indurated ulcer (chancre)
Erythematous, rounded slightly raised
Clean edges/base

A

Primary syphilis

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52
Q

Polymorphic rash that includes palms and soles
Mucocutaneous lesions
LAD
Condylomata lata

A

Secondary syphilis

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53
Q

Gumma
Neurosyphylis

A

Tertiary syphilis

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54
Q

Testing for syphilis

A

RPR
VDRL

If history of syphilis +/- treatment, FTA-ABS positive for life

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55
Q

Management for syphilis

A

Penicillin G
(Cross placenta)

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56
Q

When to treat newborn if mother who was treated for syphilis during pregnancy

A

If mother treated within 1 mo of delivery
If mother treated with anything other than penicillin
If baby’s tigers higher than mother’s

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57
Q

Snuffles
Bullous lesions
Osteochondritis
Pseudoparalysis
Hutchinson triad (interstitial keratitis, CN 8 deafness, Hutchinson teeth)

A

Congenital syphilis

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58
Q

Membranous nasopharyngitis
Bloody nasal discharge
Bull neck
Irregular staining, gram positive, non spore-forming, nonmotile, pleomorphic bacillus

A

Corynebacterium diphtheria

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59
Q

Treatment for C diphtheria

A

Erythromycin or PCN x 14 days
Plus
Single dose of equine antitoxin

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60
Q

Gram positive cocci in chains
Neonatal and catheter associated bacteremia

Management

A

Enterococci

Ampicillin and vancomycin

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61
Q

Gram negative coccobacilli
Suppurative arthritis
Osteomyelitis
Bacteremia

Management

A

Kingella kingae (moraxella)

Cephalosporin or Unasyn

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62
Q

Facultative anaerobic, nonspore forming, motile, gram positive bacillus
Multiplies intracellularly
Food borne (lunch meat, cheese, ice cream)
Pregnant women
Advanced age
Newborns
Immunocompromised

Management

A

Listeria monocytogenes

IV ampicillin + aminoglycoside (gentamicin)

Not cephalosporins

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63
Q

Aerobic, nonmotile gram negative catalase and oxidase positive diplococci
Grown in chocolate or blood agar
Meningitis
Petechial/purpuric rash

Management

A

Neisseria meningitidis

Cefotaxime or ceftriaxone

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64
Q

Risk factors for N meningitidis

A

Dormatories
Military boot camps
Terminal complement component deficiencies
Asplenia
Overcrowding
Poverty
Malnutrition

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65
Q

Meningococcal prophylaxis criteria and treatment

A

Household contacts
Child care/preschool within 7 days of illness
Direct exposure to secretions within 7 days
Slept in same area within 7 days
Prolonged contact in close proximity within 7 days
Health care workers exposed directly to secretions without mask in first 2 days of therapy

Rifampin

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66
Q

Most common cause of bacterial gastroenteritis in the developed world

A

Campylobacter jejuni

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67
Q

Blood diarrhea
Spiral-shaped
Daycare centers
Animals
Improperly cooked poultry
Untreated water
Can mimic intussusception and appendicitis

Management

A

Campylobacter jejuni

Hydration + Azithromycin

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68
Q

Bloody diarrhea
Pseudoappendicitis

Management

A

Yersinia enterocolitis

Supportive
Bactrim, cefotaxime, aminoglycosides if < 1 yo or with predisposing condition

69
Q

Cat scratch
Swollen, tender LAD
Several cutaneous papules
Parinaud occuloglandular syndrome

A

Bartonella henselae
Cat Scratch Disease

70
Q

Diagnosis and management for cat scratch disease

A

Serologic testing
Enzyme immunoassay
Or immunofuorescent antibody test

Supportive +/- azithromycin
Antibiotics if HSM, large painful LAD, or immunocompromised

71
Q

PPD, quantiferon, or T spot positive
CXR negative

A

Latent TB ( aka TB infection)

72
Q

PPD, quantiferon, or T spot positive
CXR positive

A

Pulmonary TB disease

73
Q

Manage my for Latent TB (TB infection)

A

Isoniazid x 9 mo

Rifampin x 6-9 mo (if INH not tolerated)

Isoniazid + Rifapentine weekly x 12 wks (> 12 mo age)

74
Q

Side effect of isoniazid

A

Peripheral neuritis
Seizure

Prevented by B6 (pyridoxine)

75
Q

Classic symptoms of pulmonary TB

A

Low grade fever
Weight loss
Cough +/- hemoptysis

76
Q

Management for TB disease

A

Rifampin
INH
Pyrazinamide
Ethambutol

77
Q

Non-TB mycobacteria

SSTI

Lymphadenitis, pulmonary, disseminated

A

M marinum

M avium complex (MAC)

78
Q

Respiratory distress
Ground glass opacities
Perihilar/interstitial infiltrates
Immunocompromised/HIV

Management

A

Pneumocystis jiroveci (carinii) pneumonia

Bactrim (ppx)

79
Q

Chronic diarrhea
Immunocompromised
Swimming pools
Livestock
Child care

A

Cryptosporidium

80
Q

Measurement of aminoglycoside effectiveness and toxicity

A

Effectiveness = peak levels

Toxicity = trough levels

81
Q

Adverse effects of aminoglycosides

A

Ototoxicity
Nephrotoxicity

82
Q

Mechanism of action for penicillins

A

Beta-lac ram antibiotics
Bind to penicillin-binding proteins on bacteria
Inhibit bacterial cell wall formation

83
Q

Mechanism of action for clindamycin

A

Bacteriostatic
Binds to 50S subunit of bacterial ribosomes
Inhibits protein synthesis

84
Q

Target bacteria for macrolides

A

Mycoplasma
Chlamydia
Legionella

85
Q

Indications for Rifampin

A

Meningococcal or Hib exposure ppx
Invasive/resistant staph
TB

86
Q

Indication for tetracycline/doxycycline

A

RMSF
Lyme

Caution in < 8 yo - risk of teeth staining

87
Q

Dysentery
Tenesmus
Liver, brain abscesses
Lung disease

A

Entamoeba histolytica

88
Q

Diagnosis and management of E histolytica

A

Enzyme immunoassay in stool
Stool exam may identify hematophagous trophizoites or cysts
Liver US - liver abscess

Symptomatic: Flagyl or tinidazole + iodoquinol

Asymptomatic: iodoquionol

89
Q

Fever, chills
Sweats, rigors
Tropical areas

Management

A

P. Falciparum (malaria)
Most deadly parasite in the world

Quinidine

90
Q

Diagnosing malaria

A

Peripheral smear
Visualizing plasmodia within the erythrocytes

91
Q

Microcephaly
Hydrocephaly
Chorioretinitis
Diffuse Cerebral calcifications
Jaundice
Thrombocytopenia
HSM

A

Congenital toxoplasmosis

92
Q

Treatment for HSV

93
Q

Fever
Tonsillitis
LAD
HSM
Atypical lymphocytosis

A

Infectious Mono (EBV)

94
Q

Confirmatory test for EBV in > 4 yo

A

Heterophile antibody test

95
Q

EBV infection

Viral capsid antigen positive
Early antigen positive
EBNA negative

A

Acute infection

96
Q

EBV infection

Viral capsid antigen positive
Early antigen low
EBNA positive

A

Convalescent/past infection

97
Q

EBV infection

Viral capsid antigen positive
Early antigen high
EBNA positive

A

Reactivation

98
Q

Complications of EBV infection

A

Lymphoma
Lymphoproliferative disorders

99
Q

Rash after ampicillin/amoxicillin

A

Infectious mono

100
Q

Leading nongenetic cause of sensorineural hearing loss in children in US

101
Q

Thrombocytopenia
Blueberry muffin baby (petechiae/purpura)
HSM, jaundice
SGA, microcephaly
Periventricular calcifications
Chorioretinitis

A

Congenital CMV

102
Q

Definitive diagnostic study for congenital CMV

A

Urine culture or PCR for CMV in urine or saliva within first 3 weeks of life

103
Q

Chorioretinitis
Cerebral calcifications (periventricular)
Urine culture
Sensorineural hearing loss

Management

A

CMV

ganciclovir

104
Q

Like mono
But not EBV

A

Acquired CMV

Diagnose with viral culture and PCR

105
Q

3-5 days of high fever
Followed by maculopapular rash
Palpebral/periorbital edema
Bulging fontanelle

A

Roseola (HHV6)
Exanthem subitum

106
Q

Low grade fever
Cataracts
PDA
Reddish-pink spot (Forchheimer spots) on soft palate

107
Q

Confluent macular papular rash
Koplik spots
Conjunctivitis
Fever
Cough
Coryza
Photophobia

A

Measles (Rubeola)

108
Q

Post exposure management for measles

A

Immune globulin if within 6 days to infants < 12 mo, pregnant, immunocompromised

Vaccine within 3 days if incomplete immunization

109
Q

Time period between IM immunoglobulin and measles vaccine

A

5 months
(Must be > 12 mo age)

110
Q

Complication of measles

A

Subacute sclerosing panencephalitis

111
Q

Fever, headache, malaise
Muscle aches
Unilateral facial swelling anterior to ear
Difficulty opening mouth

A

Mumps
(Paramyxovirus)

112
Q

Complications of mumps

A

Parotitis
Meningitis/encephalitis
Orchitis
Epididymoorchitis (most common)
Pancreatitis

113
Q

Parotid tenderness and swelling
High grade fever
Toxic

A

Bacterial parotitis

114
Q

Parotid tenderness and swelling
Low grade fever
Not toxic

115
Q

Parotid tenderness
Intermittent swelling

A

Salivary gland stone

116
Q

Hydrops fetalis
Aplastic crisis in sickle cell disease
Polyarthropathy

A

Erythema infectiosum
(Parvovirus B19)

117
Q

Management for immunocompromised exposed to varicella

A

Varicella zoster immuno globulin (VZIG)

118
Q

Most common complication of varicella

A

Superinfection with staph aureus

119
Q

Indication for VZIG in newborn

A

If mother develops chickenpox between 5 days before delivery through 2 days after

120
Q

Management for varicella

A

Acyclovir or valacyclovir

if unvaccinated > 12 yo, immunocompromised, chronic cutaneous or pulmonary disorders, long-term salicylate therapy, chronic corticosteroids

121
Q

Indications for palivizumab (Synagis)

A

CLD
Preterm
CHD

122
Q

1-2 days fever
Watery stools
Intermittent vomiting
Dehydration

123
Q

Chronic weight loss, fevers, night sweats
Recurrent or persistent thrush

A

HIV

Lentivirus in the retrovirus family

124
Q

Most common mode of transmission of HIV in kids

A

Vertical transmission

125
Q

Preventing neonatal HIV if
Mother has HIV

A

Maternal ART
Intrapartum maternal zidovudine (AZT)
Neonatal AZT
Not breastfeeding
Routine maternal HIV screening
C-section

126
Q

Gold standard HIV testing < 18 mo old

A

HIV DNA PCR

127
Q

Gold standard HIV test > 18 mo old

A

Enzyme immunoassay

128
Q

Infectious contraindications to breastfeeding

A

Maternal HIV
Active TB
Active HSV lesion in nipple

129
Q

High fever
Rash
Viral meningitis in the summer
Myocarditis

A

Coxsackie virus

130
Q

Conjunctivitis
Pharyngitis
LAD
otitis media
Hemorrhagic cystitis

A

Adenovirus

131
Q

Rabies prophylaxis

A

4 dose rabies vaccine series
HRIG infiltrating the wound

Only if animal is suspected of being rabid

132
Q

Undercooked pork
Severe eye pain

A

Trichinella spiralis

133
Q

Traveling from endemic area
Bowel obstruction or abdominal pain
Pica or ingesting dirt

Management

A

Ascaris lumbricoides

Albendazole
Ivermectin
Pyrantel pamoate

134
Q

Loeffler syndrome

A

Ascaris lumbricoides
Cough
Transient pneumonia
Larva moving through lungs

135
Q

Hypochromic Microcytic anemia
Growth/developmental delay
Seroiginous, papulovesicular rash

A

Necator americanus (hookworm)

136
Q

Immigrant
Seizures
Multiple cystic lesions with calcifications on CT head

A

Neurocysticercosis

T solium (pork tapeworm)

137
Q

Eating dirt
Eosinophilia
Exposure to dogs/cats
Fever
Hepatomegaly
Wheezing

A

Visceral larval migrants

Toxocara canis

138
Q

Eating dirt
Eosinophilia
Exposure to dogs/cats
Visual disturbances

A

Ocular larval migrans

Toxocara canis

139
Q

Eating dirt
Eosinophilia
Exposure to dogs/cats
GI symptoms
Pruritus, rash

A

Covert toxocariasis

140
Q

Diagnosis for visceral larva migrans and management

A

ELISA

Albendazole
Mebendazole

141
Q

Perianal or perivulvar itching

A

Enterobius vermicularis (pinworm)

142
Q

Diagnose and management for pinworm

A

Direct visualization of adult worms or scotch tape test 2 to 3 hours after child is asleep

Pyrantel pamoate
Albendazole

143
Q

Most likely cause of mild candidal infection

A

Antibiotic use

144
Q

Most likely cause of chronic or systemic candidiasis

A

Immunosuppression

145
Q

Management for candida

A

PO nystatin - oral candida in immunocompetent host

Fluconazole/itraconazole - immunocompromise

IV Amphotericin- neonates with invasive disease

146
Q

Encapsulated yeast
Pulmonary and CNS disease
AIDS
Bird (pigeon) dropping

A

Cryptococcosis

147
Q

Diagnosis and management for cryptococcosis

A

India ink stain
Narrow base budding

Amphotericin B + PO flucytosine or fluconazole

148
Q

Southwest US
Fever, night sweats, headaches
Chest pain, muscle aches

Management

A

Coccidiomycosis

Amphotericin B, fluconazole, or itraconazole

149
Q

Worsening asthma symptoms
Eosinophilia

A

Aspergillosis

150
Q

Diagnosis and management for aspergillosis

A

Positive serum galactomannan

Voriconazole (invasive)
Amphotericin B (neonates)

151
Q

Ohio, Missouri, Mississippi River valleys
Hilar or mediastinal LAD
HSM
Bird droppings
Cave exploring

Management

A

Histoplasmosis

Supportive care (immunocompetent)
Amphotericin B +/- fluconazole (disseminated or immunocompromised)

152
Q

Most common infectious causes of bloody or serosanginuous vaginal discharge and vulvovaginitis

A

Shigella flexneri
Shigella sonnet
Group A strep

153
Q

Ring abscess formation in cornea

A

Bacillus cereus

154
Q

Papular purpuric gloves and socks syndrome

A

Parvovirus B19

155
Q

Most common bacteria in discitis

A

Staph aureus

156
Q

Most common bacteria recovered from
Breast abscesses in newborns

A

Staph aureus

157
Q

Juvenile recurrent respiratory papillomatosis
Vocal cord lesion

158
Q

Microcephaly
Cataracts
Hypoplastic extremities

A

Congenital varicella syndrome

159
Q

Papular acrodermatitis

160
Q

Spaghetti and meatballs appearance on scrapings

A

Malassezia
Tinea (pityriasis) versicolor

161
Q

Treatment of choice for tularemia

A

Gentamicin or streptomycin

162
Q

Antibiotic for Listeria

A

Penicillin
Ampicillin

163
Q

Chemoprophylaxis for close contact of meningococcal meningitis

A

Single dose of ciprofloxaxin (> 1 mo)

164
Q

Management for cat scratch disease

A

Azithromycin

165
Q

Serpiginous
Migratory
Caribbean, Mexico, south/central americas, southeastern US

A

Cutaneous larva migrans
(Dog/cat hookworms)

166
Q

Side effect of erythromycin

A

Hypertrophic pyloric stenosis

167
Q

Protracted nasal congestion
Thick yellowish nasal discharge
Low grade fever
Tender anterior cervical LAD
1-3 yo

A

Streptococcal fever (GAS)

168
Q

Most common bacteria in septic arthritis for children < 5 yo

A

Kingella kingae

169
Q

Sulfur granules
Beaded, branching
Gram positive bacilli

A

Actinomyces israelli

Laughing Your Way (34 decks)

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