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Peds Shelf > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

What is the most common cause of neonatal septicemia

A

Group B Strep

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2
Q

Causes of occult bacteremia in neonates?

A

GBS

E. coli

Listeria

Staph aureus

Coag. neg staph and Candida = preterm

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3
Q

What are causes of occult bacteria in children?

A

Strep pneumo

Neisseria

Salmonella

S. aureus

Group A Strep

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4
Q

What is the workup for fever, leukocytosis and no obvious focus of infection?

A

Blood/urine Cx

CBC

CXR

LP if < 28 days, AMS or meningeal signs

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5
Q

Occult bacteremia

A

< 28 days = Amp and Gent +/- hospitalization

29-90 days = Low risk i.e. normal UA, WBC < 15k

High risk ceftriaxone, IV ampicillin if enterococcus or listeria

3-36 mo = Ceftriaxone if WBC > 15 or septic

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6
Q

5 year old boy presents with sudden onset of high fever, reddish-purple spots, rapidly progressing to shock.

A

Meningiococcemia

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7
Q

S/Sx of meningococcemia - N meningitidis (3)

A

Shock - endotoxin

Petechiae - purpura - ecchymoses

Adrenal hemorrhage/insufficiency

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8
Q

How do you treat meningococcemia?

A

IV penicillin

Vaccine!!!

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9
Q

Common opportunistic infections in HIV (5)

A

Toxoplasmosis

Cryptococcosis

PCP/jiroveci

MAC/MAI/kansasii

CMV

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10
Q

Toxo s/sx and treatment

A

Mononucleosis syndrome = Fever, LAD, HSM

Dx: antibodies

Tx: Pyrimethamine and sulfadiazine

*replace folic acid*

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11
Q

Cyrptococcosis - S/sx

A

Fungal lung infection

AIDS presentation = Subacute/chronic meningitis

Typical presentation = Fever, HA, malaise

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12
Q

How do you treat cryptococcosis?

A

Amphotericin B and Flucytosine

High rate of recurrence

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13
Q

How do you diagnose cryptococcosis?

A

ELISA

India ink + CSF = White halos (Yeast)

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14
Q

How does PCP present, how do you diagnose and treat it?

A

Bad pneumonia

CXR = interstitial infiltrates x2

DX: Methenamine silver staining or Giemsa stain

Tx: TMP/SMZ

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15
Q

How does MAC present? How do you dx and treat it?

A

Fever, malaise, weight loss, night sweats +/- abd. sx

Dx: Culture

Tx: Clarithromycine or Azithromycin + Rifampin or cipro etc.

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16
Q

What are 2 things rifabutin can do?

A

Dec. serum AZT and clarithromycin

Turn secretions orange

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17
Q

Who gets TMP/SMZ for PCP ppx?

A

CD4 < 200

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18
Q

Who gets rifabutin, or clarithromycin or azithromycin ppx for MAC?

A

CD4 < 50

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19
Q

How does CMV present? How do you dx and treat it?

A

Pneumonitis, retinitis, mono-like

ELISA

Enlarged cells with large intranuclear inclusions

Tx: None, IV foscarnet or ganciclovir

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20
Q

Dew drops on a rose petal

A

Chicken pox - hides in sensory ganglia cells

Crops of new clear vesicles - crust over

Multinucleated giant cells on Tzanck (herpes)

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21
Q

Koplik spots - grayish white spots in mouth

High fever, coryza rash, LAD

A

Rubeola (Measles)

Supportive Treatment

22
Q

Who shouldn’t get the measles vaccine?

A

Pregnant women

TB

Immunocompromised

Allergy to eggs or neomycin

23
Q

High fever

Mild URI

Cervical LAD

Small discrete raised lesions on trunk spreading to neck face and proximal extremities

A

Roseola

*Can trigger febrile seizures in young children*

24
Q

When is rubella contagious?

A

1 week before rash appears to 1 week after it fades

25
Q

Fever

Mild LAD - retroauricular, post. cervical

Rash on face spreads to trunk - not itchy

A

Rubella

Supportive treatment

Vaccine!

26
Q

Swelling one or both parotid glands

Orchitis, pancreatitis, thyroiditis, myocarditis, deafness

A

Mumps - paramyxovirus

Vaccine!

27
Q

When do initial lesions of untreated lyme disease fade?

A

28 days

28
Q

Erythema chronicum migrans

A

Target shaped rash of lyme disease

29
Q

What are early presenations of Lyme Disease?

A

Migrating erythematous rash

Fever

Myalgia, HA, malaise

30
Q

What are the late presentations of Lyme Disease?

A

Arthritis

Carditis

Neurologic problems

31
Q

How do you treat lyme disease

A

Amoxicillin or doxycycline

32
Q

How common are false-negative results in first 2-4 weeks of Lyme diesase

A

Commo enough

33
Q

What are weird neuro complications of lyme disease?

A

Bell’s Palsy

Meningitis, encephalitis

Carditis

AV block

34
Q

Diarrhea later changing to constipation

Rose-colored spots on trunk

HSM

Fever, malaise, HA, myalgia

A

Typhoid Fever

35
Q

How do you treat typhoid fever (salmonella typhi)

A

Culture, anemia

Amoxicillin or TMP/SMZ

36
Q

Ulcerative mouth lesions

Hand and foot lesions - hands more common

Usually on dorsal surfaces, may be on palsm/soles

A

Hand-Foot-Mouth Coxsackievirus A16

Comp: Aseptic meningitis, paralytic disease

37
Q

Rickettsia ricketsii

Rash: Extremities to trunk - blanchable macules

Palms and soles

A

Rocky Mountain Spotted Fever

38
Q

How do you dx and treat rocky mountain spotted fever?

A

Clinical - can’t wait for test results

Tetracycline or Chloramphenicol

39
Q

Who doesn’t get tetracycline?

A

Kids < 8 yo

40
Q

What are potential complications of chloramphenicol

A

Hepatotoxicity

Grey Baby Syndrome

**Still indicated in RMSF**

41
Q

What are causes of TSS?

A

Toxins from Staph aureus = Superantigens

Tampon, nasal packing, wound packing, abscess

42
Q

What lab results do you see in TSS?

A

Coagulopathy

Dec Ca, albumin

High WBC, BUN, Cre, CPK

43
Q

How do you treat TSS?

A

IVF

Source Control

IV β-lactamase-resistant-antibiotic

44
Q

How do you diagnose Coccidioidomycosis

A

History, usually self-limited

Tissue culture, nodules on CXR

inc. ESR, alk phos, eosinophil

PO Itraconazole or IV amphotericin

45
Q

Histoplasmosis

A

Flu-like, HSM

Dx: Mediastinal granulomas on CXR, inc. LFT, culture

Tx: PO Itraconazole, IV Amphotericin B

46
Q

Schistosomiasis

A

S/Sx: Malaise, cough, abdominal pain, hematuria

Dx: Eggs in stool/urine

Tx: Praziquantel

47
Q

What types of things can be caused by schistosomiasis?

A

Bladder granulomas - bladder cancer, ESRD

Ulceration of intestine/colon, bloody diarrhea

SHM, portal HTN, hematemesis

48
Q

Visceral Larva Migrans

A

Cough, fever, wheezing, seizures

HSM, rales, rash

DDX retinoblastoma

Dx: Eosinophilia + serology

Tx: Self-limited

49
Q

What is antibiotic ppx for human, cat and dog bites?

A

Amox/Clav

Clean, debride, irrigate

Tetanus

50
Q

Abrasions and lacerations

A

Clean/debride/irrigate +/- suture

Cephalexin for empiric tx - likely staph/strep

Peds Shelf (11 decks)

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