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Pediatrics > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Presentation of Otitis Media

A 
Fever
Cranky
Congestion
Pulling at ear
Irritable
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2
Q

Risk Factors in Otitis Media

A

Caretaker smoking
Bottle propping
Day-care attendance

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3
Q

Most Common Bugs in OM

A

Strep pneumo
H. influenza
M. catarrhalis

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4
Q

Treatment of OM

A

Amoxicillin
Ceftriaxone- IM
Azithromycin- flavored, low maintenance
Augmentin

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5
Q

Complications of OM

A 
Mastoiditis
Cavernous sinus thrombosis
Meningitis
Brain abscess
Scarring of the structures of the middle ear
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6
Q

Define Otitis Externa

A

Inflammation of the external auditory canal or auricle

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7
Q

Causes of Otitis Externa

A

Infectious
Allergic
Dermal disease

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8
Q

Risk Factors for Otitis Externa

A 
Swimming
Humid environments
Sticking things in ear to clean
Allergic eczema
Immunocompromised
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9
Q

Bacterial Culprits in Otitis Externa

A

Staph aureus
Pseudomonas aeruginosa
Proteus

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10
Q

Signs/Symptoms of Otitis Externa

A 
Otalgia
Tragus pain
Pain when auricle is pulled
Pruritis
Discharge
Hearing loss
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11
Q

Otoscopic Exam of a Patient with Otitis Externa

A

Edematous & erythematous ear canal
Yellow, brown, white, or grey debris
No middle ear fluid
TM should be mobile

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12
Q

Treatment of Otitis Externa

A

Cleaning of ear canal
Protect ear canal from water
Treatment of inflammation & infection

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13
Q

Treatment of Otitis Externa if TM Intact

A

Cortisporin
Cipro HC
Tobradex

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14
Q

Sore Throat

A

Inflammation or infection of the tonsils, uvula, soft palate, and posterior oropharynx

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15
Q

Viral Sore Throat Symptoms

A 
Coughing
Sneezing
Dripping
Fatigue
Anorexia
Abdominal pain
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16
Q

Strep Sore Throat Symptoms

A 
Toxic sensation
Muscle aches
Beefy red tonsils with exudate
Uvulitis
Plaques
Exudates
Anterior cervical lymphadenopathy
Fever
Headache
Abdominal pain
Strawberry tongue
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17
Q

Pharyngitis/Tonsillitis

A

Common in older children
Viruses
Strep pyogenes (Group A beta-hemolytic strep)

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18
Q

Complications of Pharyngitis/Tonsillitis

A

Rheumatic heart disease
Scarlet fever
Glomerulonephritis

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19
Q

How soon does Pharyngitis/Tonsillitis need to be treated?

A

Within 10 days

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20
Q

Treatment of Group A Beta-Hemolytic Strep

A

Penicillin VK
Cephalosporin
Clarithromycin
Macrolide

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21
Q

Which viruses present with beefy red tonsils plus exudate?

A

EBV
Coxsackie virus
Enterovirus
Beefreddytonsilovirus

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22
Q

EBV (Mononucleosis)

A 
Malaise
Beefy red tonsils
Exudate
Diffuse lymphadenopathy
Splenomegaly
AFEBRILE
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23
Q

Diagnostics of EBV

A

Monospot- heterophile antibody testing

CBC

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24
Q

Management of EBV

A

Education

No contact sports 6-8 weeks

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25
Q

Herpangina Culprit

A

Enterovirus

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26
Q

Signs/Symptoms of Herpangina

A

High fever
Small ulcers on erythematous base on tonsillar pillars
Soft palate
Uvula

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27
Q

Treatment of Herpangina

A

Acyclovir

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28
Q

Hand, Foot, & Mouth Disease Culprit

A

Coxsackie virus

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29
Q

Sings/Symptoms of Hand, Foot, & Mouth Disease

A

Vesicles/red papules on tongue, oral mucosa, hands, & feet
Mild fever
Malaise

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30
Q

Sore Throat Serious Infections

A

Peritonsillar abscess
Retropharyngeal abscess
Epiglottitis

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31
Q

Treatment of Peritonsillar Abscesses

A

IV antibiotics

Surgical drainage

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32
Q

Signs/Symptoms of Epiglottitis

A 
High fever
Sore throat
Stridor
Drooling
Respiratory distress
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33
Q

Main Signs of Aphthous Stomatitis (Canker Sore)

A

Small ulcers on the insides of lips or elsewhere in the mouth

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34
Q

Management of Aphthous Stomatitis (Canker Sore)

A

Topical preparations

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35
Q

Gingivostomatitis Culprit

A

Herpes Simplex

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36
Q

Signs/Symptoms of Gingivostomatitis

A

Ulcers
Fever
Tender cervical lymphadenopathy

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37
Q

Where can ulcers occur for gingivostomatitis?

A 
Buccal mucosa
Anterior pillars
Inner lips
Tongue
Gingiva
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38
Q

Management of Gingivostomatitis

A

Topical preparations

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39
Q

Treatment of Gingivostomatitis

A

Early: Acyclovir

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40
Q

Who does oral candidiasis (thrush) affect most?

A

Infants
Older children
Patients with broad spectrum antibiotics or steroids

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41
Q

Symptoms of Oral Candidiasis (Thrush)

A

Mouth soreness
Refusal of feedings
Curd-like plaques on buccal mucosa

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42
Q

Treatment of Oral Candidiasis (Thrush)

A

Nystatin oral suspension

Sterilize pacifiers

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43
Q

Pathophysiology of Sinusitis

A

Mucociliary clearance & drainage are impaired by a URI or allergic rhinitis or obstruction from some other cause

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44
Q

Signs/Symptoms of Sinusitis

A 
Persistent symptoms
Worsening symptoms following stability
Facial pain
Maxillary teeth pain
Malodorous breat
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45
Q

Treatment of Sinusitis

A

Augmentin

Amoxicillin

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46
Q

Define Croup (Laryngotracheobronchitis)

A

Infection causing inflammation of the larynx trachea and bronchi

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47
Q

Croup Culprits

A

Parainfluenza virus
RSV
Influenza
Adenovirus

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48
Q

Key Features of Croup

A

URI symptoms
Barking cough
Stridor
Low grade fever

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49
Q

Treatment of Croup

A 
Steroids
Supportive therapy
Hydration
Minimal handling
Mist therapy
Cold air
Oxygen
Racemic epi
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50
Q

Sings/Symptoms of Epiglottits

A 
Fever
Dysphagia
Drooling
"Hot potato" voice
Inspiratory retractions
Soft stridor
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51
Q

Signature Croup Sign

A

Steeple sign

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52
Q

Signature Epiglottis Sign

A

Thumb print

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53
Q

Treatment for Epiglottitis

A

Ceftriaxone
Clindamycin
Steroids
Aminoglycosides

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54
Q

Presentation of Mumps

A 
Parotid gland sweeling
Aseptic meningitis
Transietn pancreatitis
Orchitis/oophoritis
Epididymitis
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55
Q

Treatment of Mumps

A

Supportive

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56
Q

Four Keys with Group A Beta-Hemolytic Strep

A

Fever
Severe sore throat
Tender anterior cervical adenopathy
ABSENCE OF URI SYMPTOMS

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57
Q

Define Kawasaki Disease

A

Vasculitis of unknown etiology affecting medium sized arteries

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58
Q

Lab Results for Kawasaki Disease

A

Hypoalbunemia
Thrombocytosis
Elevated ESR

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59
Q

Sings/Symptoms of Kawasaki Disease

A 
Fever 5+ days
Rash
Mucous membrane involvement
Unilateral cervical adenopathy
Nonpurulent bilateral conjunctivitis
Swollen hands & feet
Strawberry tongue
Vascular aneurysms
Abdominal pain
Swollen, reddened joints
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60
Q

Complications of Kawasaki Disease

A 
Coronary vasculitis
Aneurysm formation
Arrhythmias
Infarction
CHF
Death
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61
Q

Treatment of Kawasaki Disease

A

High dose aspirin

IVIG

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62
Q

Signs/Symptoms of Rubeola (Measles)

A 
High fever
Dry cough
Rhinitis
Conjunctivitis with clear discharge
Distinctive rash
Koplik spots
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63
Q

How does rash present?

A

Head to toe

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64
Q

Why do we vaccinate against Rubella (German Measles)?

A

Pregnant women

Congenital rubella syndrome

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65
Q

Signs/Symptoms of Rubella (German Measles)

A 
Rash
Low-grade fever
Malaise
URI symptoms
Lymphadenopathy
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66
Q

Complications of Rubella (German Measles)

A

Arthritis

Arthralgia

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67
Q

Diagnostics of Rubella (German Measles)

A

Serum IgM

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68
Q

Congenital Manifestations of Rubella (German Measles)

A 
Hearing loss
Cardiac
Cerebral
Blueberry muffin rash
Growth retardation
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69
Q

Roseola Culprit

A

HHV-6

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70
Q

Sign/Symptoms of Roseola

A

High fever

Rash after fever

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71
Q

Other Names for Fifth Disease

A

Erythema infectious

Slapped cheeck disease

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72
Q

Fifth Disease Culprit

A

Parvovirus B19

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73
Q

Signs/Symptoms of Fifth Disease

A

Low-grade fever
URI symptoms
Mild malaise

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74
Q

Definition of Rash in Fifth Disease

A 
Flat
Lacy
Reticular
Pruritic
On cheeks, trunk, extremities
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75
Q

Define Varicella (Chickenpox)

A

Pruritic vesicular rash beginning on face, neck, upper trunk

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76
Q

Symptoms of Varicella (Chickenpox)

A

Fever
Malaise
Hx of contact with another infected person
Lesions

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77
Q

What are the lesions described as?

A

Dew drop on a rose petal

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78
Q

Management of Varicella (Chickenpox)

A

Supportive

Acyclovir- immunocompromised patients

79
Q

First Sign of Pityriasis Rosea

A

Herald patch

80
Q

Other Signs of Pityriasis Rosea

A

Lesions appear around herald patch

“Christmas tree” appearance

81
Q

Define Bronchiolitis

A

Inflammatory process of the smaller lower airways

82
Q

Presentation of Bronchiolitis

A

Fever
URI symptoms
Tachypnea
Wheezing

83
Q

Management of Bronchiolitis

A

Supportive care

84
Q

Viruses which cause Bronchiolitis

A

RSV
Adenovirus
Parainfluenza virus

85
Q

IM Monoclonal Antibody for Prophylaxis against RSV?

A

Palivizumab (Synagis)

86
Q

Symptoms of Bronchitis

A

URI symptoms
Cough
Malaise

87
Q

Prodrome of Pneumonia in Children

A 
Rhinorrhea
Cough
Low-grade fever
Pharyngitis
Tachypnea
88
Q

Bacteria Pneumonia Symptoms

A 
High fever
Cough
Chest pain
Shaking chills
Tachypnea
89
Q

Treatment Considerations for Pneumonia

A 
Antibiotics
Bronchodilators
Steroids
Fluids
Oxygen therapy
90
Q

Course of Pertussis (Whooping Cough)

A

URI symptoms
Slight fever
Cough (becomes whoop)

91
Q

Guidelines for Diagnosis

A

Immunization status
Classic presentation
Cough >2 weeks
Nasal swab for culture

92
Q

Treatment of Pertussis (Whooping cough)

A

Erythromycin (14 days)

Azithromycin (5-7 days)

93
Q

Bronchiectasis Characterized by:

A

Abnormal dilation and distortion of the bronchial tree

94
Q

Who is Bronchiectasis Common in?

A

CF patients

95
Q

Two Key Factors in Bronchiectasis

A

Infectious insult
Impaired mucus clearance
Impaired airway obstruction
Defect in host defense

96
Q

Define Fever of Unknown Origin

A

High fever or high temperature and defined as a rectal temp that exceeds 101 for 8 consecutive days

97
Q

Common Causes of Fever of Unknown Origin

A

Infections disease: drugs, fictitious, CNS dysfunction
Connective tissues disorders
Neoplasms: leukemia, lymphomas

98
Q

Common Bacteria that could Cause Serious Bacterial Infections

A 
S. pneumo
Meningitidis
HiB
E. coli
Salmonella
99
Q

Important for History of Fever of Unknown Origin

A 
Fever history
Fever at presentation
Current activity level
Activity level prior to fever
Current eating/drinking pattern
Appearance
Vomiting/diarrhea
Ill contacts
Medical history
Immunization history
Urinary output
100
Q

Workup for Fever of Unknown Origin

A 
CBC
CMP
Blood cultures
Sed. rates
UA
Urine cultures
Stool specimens
Rheumatoid factors
Chest x-ray
CSF
Rapid virus testing
Abdominal US
101
Q

What ages do we need to catheterize to obtain a UA?

A

Males

102
Q

Why would you order a chest x-ray in a fever of unknown origin?

A

Tachypnea
Rotractions
Focal auscultatory findings
Oxygen sat on RA

103
Q

Procedures for Fever of Unknown Origin

A

Bladder cauterization
Suprapubic aspiration
LP

104
Q

Treatment for Non-Toxic Fever of Unknown Origin

A

Patient fully immunized
No significant risk factors
Appears non-toxic
Other healthy
Parents appear reliable
Follow up in 24-48 hours-sooner if worsen
Hospital admission if findings suggest serious infection

105
Q

Treatment for Toxic Fever of Unknown Origin

A

Admit child
Obtain cultures
Administer antibiotics

106
Q

What antibiotics would we administer in Toxic Fever of Unknown Origin

A

Ceftriaxone
Cefotaxime
Ampicillin/sulbactam (Unasyn)

107
Q

What does ceftriaxone (Rocephil) cover?

A

Broad spectrum

Gram-negative

108
Q

What is cefotaxime (Claforan) for?

A

Septicemia

109
Q

What does Ampicillin/sulbactam (Unasyn) cover?

A

Skin
Enteric flora
Anaerobes

110
Q

Define Impetigo

A

Acute highly contagious gram positive bacterial infection of the superficial layers of the epidermis

111
Q

In what climates is impetigo commonly found?

A

Hot, humid climates

112
Q

What are the two types of impetigo?

A

Nonbullous impetigo

Bullous impetigo

113
Q

What are the common bacteria in nonbullous impetigo?

A

Staph aureus

Group A beta hemolytic strep

114
Q

What is the common bacteria in bullous impetigo?

A

Staph aureus

115
Q

Risk Factors for Impetigo

A

Overcrowding
Scabies
Poverty

116
Q

In what age group does impetigo usually present?

A

Children 2-5 year olds

117
Q

Factors that can modify usual skin flora

A 
High temp
Humidity
Preexisting cutaneous disease
Young age
Recent antibiotic treatment
118
Q

Common Mechanisms for Disruption of Skin that Facilitates Infection

A 
Scratching
Dermatophytosis
Herpes simplex
Scabies
Peduclosis
Trauma
Insect bites
119
Q

Impetigo Differential Diagnosis

A 
Herpetic impetigo
Pemphigus vulgaris
Follicular mucinosis
Folliculitis
Erysipelas
Insect bites
Cutaneous candidiasis
120
Q

Diagnosis of Impetigo

A

History
Clinical appearance- “honey-colored” crust
Labs

121
Q

Treatment of Impetigo

A

Local wound care

Antibiotic therapy

122
Q

Antibiotic Therapy

A

Topical: Mupirocin (Bactroban)
Oral: Cephalexin or Dicloxacillin (1st)
Erythromycin & Clarithromycin (2nd)
Bactrim, clindamycin, doxycycline (MRSA)

123
Q

Prevention of the Spread of Impetigo

A

Hand washing
Don’t scratch
Cover draining lesions
Return to school 24 hours after start of antibiotic

124
Q

Molluscum Contagiosum Virus

A

Poxvirus

125
Q

Defined Molluscum Contagiosum

A

Single or multiple
Rounded dome-shaped
Pink, waxy papules
Umbilicated

126
Q

Molluscum Presentation

A 
Asymptomatic
Contact with family member or other person
Children sharing bath
Athletes sharing gym equipment
Parents may recall public recreation
Swimming pools
Sexual activity
127
Q

Mulluscum Differential

A 
Cryptococcosis
Histoplasmosis
Aspergillosis
Keratocanthoma
Flat warts
128
Q

Mulluscum Diagnosis

A

Distinctive, central umbilication
Biopsy
STD workup

129
Q

Treatment of Molluscum

A 
Usually resolves within months
Direct lesional trauma
Antiviral: cimetidine
Topical: Imiquimod, Cantharidin
Cryotherapy with curettage
Avoid sports
Avoid physical contact between infected areas
Sexual abstinence
130
Q

Types of Pediculosis (Lice)

A

Pediculosis capitus: head lice

Pediculosis corporis: body lice

131
Q

Pediculosis Presentation

A

Parents/teachers usually discover
Pruritis
Groin/body involvment- adults

132
Q

Lice Physical Exam

A

Observation of eggs, nymphs, mature lice
Secondary infection
Examine under microscope
Wood lamp of area

133
Q

Differential Diagnosis for Pediculosis (Lice)

A 
Dandruff
Dried hairspray/gel
Acne
Impetigo
Scabies
134
Q

Treatment of Pediculosis (Lice)

A 
Permethrin (Nix) cream
Malathoin
Benzyl alcohol
Spinosad
Ivermectin
Cleaning of hair accessories, towels, bedding, clothing
Environmental control
135
Q

Where does scabies burrow?

A 
Wrist
Ankle
Finger
Webs
Axillary folds
Genitalia
Face
136
Q

Diagnosis of Scabies

A

Scrap unscratched papule

137
Q

Treatment of Scabies

A

Permethrin creme
Ivermectin
Wash everything in hot water

138
Q

What is the most common bacterial cause of a UTI?

A

Escherichia coli

139
Q

Host Factors of UTI’s

A

Age: males

140
Q

Define Vesicoureteral Reflux

A

Retrograde passage of urine from the bladder into the upper urinary tract

141
Q

Signs & Symptoms of a UTI

A 
Poor feeding
Fever
Failure to thrive (FTT)
Vomiting
Abdominal pain
Flank pain
Frequency, urgency, dysuria
Suprapubic tenderness
142
Q

Diagnosis of UTI

A

Midstream clean catch
“Clean voided” bag for collection
Bladder catheterization
Suprapubic bladder aspiration

143
Q

“Clean-voided” Bag Collection

A

Properly clean, rinse, and dry perineum before applying

Bag must be immediately removed

144
Q

Why would you do a suprapubic bladder aspiration?

A

Catheterizing is difficult
Tight foreskin
Tight labial adhesions
Significant periurethral irritation

145
Q

Labs for a UTI

A

CBC
CMP
Blood cultures
Renal function studies

146
Q

Imaging for a UTI

A 
Voiding cystourethrography (VCUG)
Renal US
147
Q

Hospitalization of UTI

A 
Toxemic or septic
Urinary obstruction
Underlying disease
Unable to tolerate adequate oral fluids/meds
Age
148
Q

Treatment of UT

A 
Amoxicillin
Bactrim
Ceftriaxone
Cefotaxime
Ampicillin
1st or 3rd cephalosporin
Amoxicillin/clavulanate
149
Q

Define Infection

A

Insult caused by any pathogen

150
Q

Define Systemic Inflammatory Response Syndrome (SIRS)

A

Widespread inflammatory response that may or may not be associated with an infection

151
Q

Define Sepsis

A

SIRS in the presence of suspected or proven infection

152
Q

Risk Factors for Pediatric Sepsis

A

Age

153
Q

Pathogens for Pediatric Sepsis

A 
Strep
Staph
Pseudomonas
Influenza
Adenovirus
RSV
Fungi
Parasites
154
Q

Signs/Symptoms of Pediatric Sepsis

A 
Fever
Racing heart
Rapid or labored breathing
Cool extremities
Color changes
Activity level
Mental status
Urine output
Immunizations
Exposures to infectious disease
Drug allergies
155
Q

Physical Exam Findings in Sepsis

A 
Subtle change in vitals
Hypotension
Mental status change
Anuria
Hypothermia
Localizing signs of infection
156
Q

Diagnostics of Sepsis

A 
CBC
PT/PTT/INR
CMP
UA
Sed. rates
Blood, urine, CSF cultures
157
Q

Imaging for Sepsis

A

CXR: infiltrates
US: abscesses
CT
Echo: endocarditis

158
Q

Management of Sepsis

A 
Aggressive fluid resuscitation
Support of cardiac output
Ventilatory support
Supplemental oxygen
Maintenance of hemoglobin
Correction of physiologic & metabolic derangements
Monitor urine ouput
159
Q

Common Antibiotics for Sepsis

A

3 months: 3rd generation cephalosporin + vanco

160
Q

Define Meningitis

A

inflammation of the meninges

161
Q

Types of Meningitis

A 
Bacterial
Viral
Fungal
Parasitic
Non infectious: CA, SLE, head injury
162
Q

Sign/Symptoms of Meningitis

A 
Fever
Headache
Neck stiffness
N/V
Sleepiness
Irritability
Delirium
163
Q

Diagnostics of Meningitis

A 
CBC
CMP
Cultures
Syphilis testing
LP
CSF analysis
CT/MRI
164
Q

Sexually Transmitted Diseases in Children

A

Unusual injury pattern/behavior
Discloses to care giver
Sexual assault

165
Q

Sexually Transmitted Diseases in Adolescents

A

Screen appropriately

166
Q

Types of STD’s

A 
Syphilis
Chlamydia
Gonorrhea
Chancroid
HPV
Herpes
167
Q

Sign/Symptoms of Syphilis

A 
Sore that forms on genitals/mouth
Fever
Sore throat
Headache
Joint pain
168
Q

Stages of Syphilis

A

Primary: 1+ painless sores
Secondary: copper penny rash hands & feet
Latent: inactive
Tertiary: severe problems with heart, brain, nerves

169
Q

Presentation of Congenital Syphilis

A 
Asymptomatic
Jaundice
Hepatosplenomegaly
Edema
Signs of meningitis
Mucocutaneous lesions
Pseudo paralysis of arms/legs
Hepatomegaly
Rash on palms/soles
Bilateral interstitial keratitis
Periosteum thickening of tibias
170
Q

Diagnostics of Syphilis

A

Darkfield microscope

Serologic testing

171
Q

Treatment of Syphilis

A

Penicllin G

172
Q

Symptoms of Chlamydia

A 
Dysuria
Vaginal discharge
Cervicitis
PID
Epididymitis
173
Q

If Chlamydia is not treated in women, it can cause what?

A

Infertility

174
Q

Labs for Chlamydia

A

UA

Culture

175
Q

Treatment of Chlamydia

A

Doxycycline
Azithromycin
Abstain from sex (7 days)

176
Q

What is the second most common bacterial STI in the US?

A

Neisseria Gonorrhea

177
Q

Sites of Gonorrhea Infection

A

Cervix
Urethra
Rectum
Pharynx

178
Q

Symptoms of Gonorrhea

A

Dysuria
White, yellow, or green discharge
Painful/swollen testicles

179
Q

Diagnostics of Gonorrhea

A

First-catch urine for NAAT
Culture
Gram stain

180
Q

Treatment of Gonorrhea

A

Ceftriaxone + Azithromycin

181
Q

Where is chancroid mainly found?

A

Developing

Third world countries

182
Q

Symptoms of Chancroid

A

Small papule which changes to ulcer in 1 day to 2 weeks
Painful ulcer
Sharply defined borders
Base bleeds easily

183
Q

Diagnostics of Chancroid

A

Gram stain

184
Q

Treatment of Chancroid

A

Azithromycin

Ceftriaxone

185
Q

Types of HPV in genital warts

A

6

11

186
Q

Types of HPV in cervical dysplasia

A

16

18

187
Q

Symptoms of HPV

A

Asymptomatic

Lesions on genitals

188
Q

Diagnosis of HPV

A

Biopsy

Pap Smear

189
Q

Treatment of HPV

A

Podofilox
Trichloroacetic acid
Cryotherapy
Laser surgery

190
Q

Vaccines Against HPV

A

Gardasil: 6, 11, 16, 18
Gardasil 9
Cervarix: 16 and 18

191
Q

Types of Herpes Viruses

A

HSV-1: oral

HSV-2: genital

192
Q

Signs/Symptoms of Herpes

A

Grouped vesicles on erythematous base
Fever
Malaise
Tender regional adenopathy

193
Q

Diagnosis of Herpes

A

Cultured vesicles from epithelial sites
Immunofluorescent stains
ELISA

194
Q

Treatment of Herpes

A

Acyclovir
Famciclovir
Valacyclovir

Pediatrics (23 decks)

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