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infectious disease Flashcards

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1
Q

What is the proper treatment in a septic newborn born to a mother with flu like symptoms and white nodules on placenta?

A

Amp and gent for listeria

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2
Q

What is the infectious etiology associated with rose spots in the skin?

A

Salmonella typhosa

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3
Q

What is the infectious etiology associated with ecthyma gangrenosum (large pustules on indurated inflamed base)?

A

Pseudomonas

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4
Q

What is the infectious etiology of non blanching rash and petechiae?

A

Neisseria

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5
Q

What is the common benign side effect of rifampin?

A

Orange secretions

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6
Q

What is the prophylactic drug of choice for meningococcemia?

A

Rifampin

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7
Q

What are the indications for meningococcemia prophylaxis?

A

Persons with contact to oral secretions

Household contacts or close contacts outside the house

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8
Q

What should you consider in a patient with elevated d dimer, low platelets and low fibrinogen?

A

DIC

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9
Q

What etiology should you consider in septic shock and how should you empirically treat?

A

Vancomycin and ceftriaxone to cover meningococcemia

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10
Q

What are the likely causes of meningitis in the neonate?

A

GBS
Listeria
E. coli
Enterovirus

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11
Q

What are the common causes of meningitis in young children?

A 
Strep pneumo
Neisseria meningitidis
Enterovirus
Borrelia burgdorferi
Rickettsia
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12
Q

What complications of meningitis should be monitored for?

A

Focal deficits and SIADH

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13
Q

When does primary peritonitis occur?

A

Without an obvious intraabdominal source in patients with nephrotic syndrome or cirrhosis

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14
Q

What is the treatment for pneumococcal peritonitis ?

A

Third generation cephalosporin PLUS aminoglycoside

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15
Q

What type of abdominal infection is the likely source in a child with nephrotic syndrome? Why?

A

Encapsulated organism such as pneumococcus due to loss of IgG

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16
Q

What is the likely source of infection in a child with secondary peritonitis?

A

Gram negative organisms and anaerobes

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17
Q

What should you consider as a diagnosis in a dialysis patient with fever and abdominal pain ? What infectious etiology would you consider ?

A

Secondary peritonitis due to perforated bowel - due to staph epidermidis

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18
Q

What is the most common cause of vp shunt infection?

A

Staph epidermidis

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19
Q

What organisms does latex agglutination test for?

A

GBS
H. Flu
Neisseria meningitidis
Strep pneumo

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20
Q

When is latex agglutination helpful?

A

When partially treated infections are unreliably detected by culture

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21
Q

When can latex agglutination give false positives?

A

After HIb vaccine or with cross reactivity of E. coli

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22
Q

What is the treatment of choice in an immunocompromised child with fever or neutropenia ?

A

Zosyn + aminoglycoside OR

Ceftazidime (gram negative coverage)

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23
Q

What is used for prophylaxis against PcP?

A

Bactrim

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24
Q

What diagnosis should you consider in a patient with ground glass appearance on X-ray?

A

Pcp and HIV

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25
Q

What is the treatment for cryptosporidium ?

A

Nitazoxanide

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26
Q

What are the symptoms of cryptosporidium ?

A

Diarrhea that is severe, non bloody, watery lasting up to 10 days

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27
Q

What bacteria should you consider in a patient with intracytoplasmic inclusion bodies on scraping ?

A

Chlamydia pneumonia

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28
Q

What diagnosis should you consider in a patient with afebrile staccato cough, tachypnea and eye discharge?

A

Chlamydia pneumonia

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29
Q

How is chlamydia definitively diagnosed?

A

Chlamydia trachomatis - PCR

Chlamydia pneumoniae - microimmunofluotescent antibody test

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30
Q

How would you treat a chlamydia conjunctivitis ?

A

Oral erythromycin or Sulfonamides (do not treatment with topical)

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31
Q

How would you treat chlamydia pneumonia?

A

Azithromycin x 5 days

Erythromycin x 14 days

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32
Q

How would you treat an uncomplicated chlamydia genital infection ?

A

Doxycycline x 7 days

Azithromycin 1 gram x 2

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33
Q

A teenager presents with cough and low grade fever, chest x-ray shows scattered perihilar infiltrates. You want to choose mycoplasma on the exam but that option is not available, what is the diagnosis?

A

Chlamydia pneumonia

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34
Q

What disease should you consider if fever, myalgia, headache and petechiae rash that starts on hands and feet then spreads centrally? What “bug” is the culprit?

A

Rocky Mountain spotted fever - rickettsia rickettsii

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35
Q

What are the peak times for Rocky Mountain spotted fever?

A

May and June

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36
Q

What do you do when a patient presents with suspicion for Rocky Mountain spotted fever?

A

Treat with doxycycline x 7 days (even if child is under 8) – then order direct immunoflourescence. TREAT FIRST

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37
Q

What is the difference between Rocky Mountain spotted fever and ehrlichiosis?

A

Ehrlichiosis may cause leukopenia and elevated LFTs

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38
Q

What are the symptoms of human ehrlichiosis ? And what disease presents with the same symptoms?

A

Fever, headache, myalgia
Thrombocytopenia and hyponatremia
Same as Rocky Mountain spotted fever

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39
Q

What is the treatment of Q fever?

A

Doxycycline

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40
Q

What are symptoms of Q fever?

A

Flu like symptoms followed by respiratory symptoms and pneumonia (no rash)

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41
Q

How is Q fever transmitted?

A

Inhalation of infected particles

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42
Q

What is the appropriate treatment for cat scratch disease with draining lymph node?

A

Nothing! Unless immunocompromised, hepatomegaly or large painful adenopathy

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43
Q

What is the bacteria that causes cat scratch disease ? How is it diagnosed ?

A 
Bartonella henselae
Serologic testing (enzyme immunoassay or immunofluorescent antibody test)
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44
Q

Which antibiotics would be appropriate for cat scratch disease?

A

Azithromycin
Cipro (if >18)
Bactrim
Rifampin

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45
Q

What should NoT be done for treatment of cat scratch disease?

A

Penicillins

I&D

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46
Q

What should you use to treat cellulitis after a cat bite? What if penicillin allergic patient?

A 
Augmentin --> if allergic, use:
Doxycycline 
Azithromycin
Bactrim
Cefuroxime (if not severe PCN allergy)
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47
Q

What bacteria should you consider if described as a pleomorphic gram negative organism?

A

Haemophilus influenza

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48
Q

What disease should you consider in a patient from another country with peri orbital cellulitis or Pyogenic arthritis?

A

Haemophilus influenza

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49
Q

What bacteria should be considered in a non-immunized patient with bacterial meningitis?

A

Heamophilus influenza

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50
Q

What is the appropriate treatment if invasive haemophilus influenza infection is suspected?

A

Ceftriaxone or cefotaxime (if allergic, use chloramphenicol or merrem)

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51
Q

What 3 encapsulated organisms should be considered in patients without functioning spleen?

A

Strep pneumo
Neisseria meningitidis
H. Flu (non typable)

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52
Q

When is prophylaxis for H Flu contacts indicated?

A

If any household members who are immunocompromised or unvaccinated then all household members need rifampin prophylaxis

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53
Q

What is the appropriate prophylaxis for non typable h flu infection in household member?

A

None!! Prophylaxis Only in typable h flu

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54
Q

When do all nursery children need to be treated prophylactically for H. Flu?

A

Only if 2 or more cases within 60 days!

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55
Q

What are the three phases of pertussis?

A

Catarrhal
Paroxysmal
Recovery

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56
Q

How is diagnosis of pertussis confirmed?

A

PCR (DFA not used)

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57
Q

What is the treatment for pertussis? How does it help?

A

Erythromycin, azithromycin or clarithromycin
Bactrim can also be used

Decreases period of communicability but does not shorten the paroxysmal stage!

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58
Q

When should prophylaxis against pertussis be given?

A

Anyone exposed to someone with pertussis regardless of immunization status needs azithromycin

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59
Q

What should you consider in a preschool age child wth cough and elevated wbcs with high lymphocytes?

A

Pertussis

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60
Q

What is the appropriate diagnosis and treatment in a patient who ate chicken salad at a picnic and then developed vomiting and diarrhea?

A

Salmonella - supportive therapy

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61
Q

When should treatment for salmonella be given? What treatment is appropriate in those cases?

A

If under age 3 months, immunocompromised or with hx of colitis - give ceftriaxone

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62
Q

What is the treatment for invasive typhoid fever?

A

Broad spectrum cephalosporins

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63
Q

What should you consider as a diagnosis in a patient with diarrhea, malaise, fever and “rose spots”?

A

Typhoid serotype of salmonella

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64
Q

What infection should you consider when a nail goes through a shoe?

A

Pseudomonas osteomyelitis

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65
Q

In what population does pseudomonas cepacia cause pneumonia and death?

A

Cystic fibrosis

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66
Q

What should you consider in a child on a dairy farm who presents with fevers and myalgias?

A

Brucellosis

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67
Q

How do you treat brucellosis?

A

Prolonged treatment with tetracycline or bactrim and rifampin

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68
Q

How would you choose to treat pseudomonas?

A

Piperacillin/tazobactam and gentamicin

Ceftazidime for pulmonary infections

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69
Q

What are the most common antibiotics that cause clostridium difficile?

A

Clindamycin

Cephalosporins

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70
Q

What is the most appropriate first line treatment for pseudomembranous colitis?

A

Metronidazole

Vancomycin PO is only used if flagyl does not work

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71
Q

What is the appropriate treatment for strep pneumo meningitis?

A

Vancomycin + ceftriaxone (or cefotaxime)

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72
Q

What are red lines in the skin folds and what infection are they associated with?

A

Pastia lines - scarlet fever and strep pharyngitis

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73
Q

What does treatment of strep throat prevent? What does it not prevent?

A

Prevents rheumatic fever

Does not prevent glomerulonephritis

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74
Q

What is the appropriate treatment for strep throat?

A

PCN or amoxicillin

If allergic, azithromycin, clindamycin or first generation cephalosporin

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75
Q

What is the name of strep cellulitis causing red streaks and lymphangitis?

A

Erysipelas

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76
Q

What diagnosis should you consider in a patient with rapidly evolving erythema and inflammation after minor trauma?

A

Necrotizing fasciitis

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77
Q

What infections can cause toxic shock syndrome?

A

Staph
Epstein Barr virus
Coxsackie
Adenovirus

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78
Q

How does late gbs infection occur?

A

Focal infection at 1-3 months

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79
Q

The CDC recommends prophylaxis for GBS under what conditions?

A

Previous infant with GBS.
GBS bacteriuria during current pregnancy
Positive GBS screen (35-37 wk)
Unknown GBS with preterm labor, ROM>18 hr or fever >38

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80
Q

How does the infantile form of botulism develop in infants?

A

Spores are ingested and they germinate in the underdeveloped GI tract

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81
Q

What condition should you consider in an infant with poor sucking/feeding, hypotonia with descending paralysis and ptosis?

A

Botulism

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82
Q

What condition should you consider in a 6 month old infant with constipation, urinary retention, weak cry and absent gag reflex?

A

Botulism

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83
Q

How is botulism caused in adults?

A

Ingestion of botulism toxin from poorly canned goods

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84
Q

How do you diagnose botulism?

A

Presence of toxin in stool or serum, PCR is not used.

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85
Q

How does the botulism toxin cause symptoms?

A

Toxin blocks release of acetylcholine into the synapse

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86
Q

What is the appropriate treatment for botulism and why?

A

Supportive care only!

Antibiotics cause lysis or spores and release of neurotoxins

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87
Q

What is the difference between botulism and myasthenia gravis?

A

With MG, tensilon is positive and onset is gradual

With botulism, tensilon is negative and onset is rapid

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88
Q

What is the worst choice of antibiotics for botulism?

A

Aminoglycoside potentiate the toxin

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89
Q

Under what conditions do you need to treat an infant for syphillis?

A

If mother treated within the last month of pregnancy or if she was treated with erythromycin; if baby’s titers are higher than mothers

90
Q

What disease should you consider in a newborn with maculopapular rash, hepatosplenomegaly and peeling skin?

A

Syphilis

91
Q

Which syphilis screens are nonspecific nontreponemal antibody tests?

A

VDRL

RPR

92
Q

What conditions may cause false positive VDRL and RPR?

A

Epstein Barr
Hepatitis
Varicella

93
Q

What test for syphillis remains positive for life and what type of test is it?

A

FTA ABS - treponemal test used to verify positive screen

94
Q

What is the appropriate treatment for congenital syphillis ?

A

Penicillin

95
Q

What should you consider in an infant with poor feeding, sniffles, bullous lesions and osteochondritis of joints?

A

Syphillis

96
Q

What hepatic defects are associated with congenital syphilis?

A

Hydrops fetalis
Hepatosplenomegaly
Hemolytic anemia

97
Q

What type of skin findings are associated with congenital syphillis ?

A

Maculopapular rash

Bullous lesions

98
Q

What should you consider in a patient with diarrhea, low platelets and anemia?

A

HUS

99
Q

What is the treatment for campylobacter fetus ?

A

Broad spectrum cephalosporins or gentamicin

100
Q

What is the treatment for campylobacter jejuni?

A

Azithromycin

101
Q

Tularemia is caused by what type of bacteria? What is the appropriate antibiotic for tularemia ?

A

Gram negative francisella tularensis.

Gentamicin (second line: tetracycline, ciprofloxacin, streptomycin)

102
Q

How does a child become infected with tularemia?

A

Consumption of rabbit meat - fever, hepatosplenomegaly, rash and lymphadenopathy

103
Q

What disease is caused by yersinia pestis?

A

Bubonic plague

104
Q

What is the best choice of treatment for bubonic plague?

A

Streptomycin and gentamicin

May also use doxycycline, chloramphenicol and tetracycline

105
Q

What should you consider in a young child with bloody diarrhea and elevated WBC with hx of ingesting unpasteurized milk or raw meat?

A

Yersinia enterocolitica

106
Q

What is the appropriate treatment for yersinia enterocolitica?

A

None unless immunocompromised, then give bactrim, Aminoglycosides or cefotaxime

107
Q

What disease should you be concerned about in a patient with swollen painful lymph nodes and hx of exposure to a dead animal?

A

Bubonic plague

108
Q

What is the appropriate first line treatment for MSSA?

A

Beta lactamase resistant agents such as oxacillin or nafcillin

109
Q

What is considered a coagulate negative staph infection and when does it occur?

A

Staph epidermitis - with IV lines or catheter

110
Q

What is the appropriate treatment for a carbuncle/furuncle?

A

Incision and drainage (if >5cm, treat for MRSA)

111
Q

What is the treatment for hospital acquired MRSA ?

A

Vancomycin

112
Q

What antibiotics are community acquired MRSA infections sometimes susceptible to?

A

Bactrim
Gentamicin
Doxycycline

113
Q

When are peak and trough levels measured with Aminoglycosides?

A

Peak - 30 minutes after dose

Trough - 30 minutes before next dose

114
Q

Why is it important to prevent high peak levels of Aminoglycosides ?

A

Ototoxicity

115
Q

How do penicillins work?

A

Interfere with cell wall synthesis

116
Q

What is “special” about beta lactamase bacteria?

A

They produce penicllinase which cleaves PCN - therefore penicillinase resistant antibiotics are required

117
Q

How are MRSA infections resistant to methicillin?

A

They interfere with PCN binding proteins therefore the antibiotic can’t bind to the organism

118
Q

What is the dose of amoxicillin for otitis media, pneumonia or sinusitus?

A

80-90 mg/kg/day

119
Q

What limitations are associated with use of first generation cephalosporins?

A

Do not penetrate the CSF

Not effective against listeria or enterococcus

120
Q

What are first generation cephalosporins good for? What are the available oral Medications available in this class?

A

Gram positive cocci (including MSSA).

Cephalexin, cefadroxil

121
Q

What is the fourth generation cephalosporin and what is it used for?

A

Cefepime - gram negatives (pseudomonas) and gram positives (staph)

122
Q

What classes of infection are covered by clindamycin ?

A

Aerobic and anaerobic gram positives, anaerobic gram negatives cocci, chlamydia and Protozoa

123
Q

What are the oral third generation cephalosporins?

A

Cefpodozime and cefdinir

124
Q

What types of infections have good coverage with third generation cephalosporins?

A

Meningitis
Sinusitis / respiratory infections
Uti

125
Q

What types of infections are covered by macrolides?

A 
Mycoplasma 
Moraxella / H. Flu
Strep pyogenes
Chlamydia
Pertussis
 legionella 
Nontuberculous mycobacterium
126
Q

What types of infections can be treated with rifampin?

A

Staph osteomyelitis or endocarditis

TB

127
Q

When would quinolones be indicated in children ?

A

Multiresistance
Pseudomonas
Anthrax

128
Q

What interferes with quinolone absorption?

A

Antacids with aluminum, mag or calcium

129
Q

When are tetracyclines contraindicated?

A

In children <8 unless Rocky Mountain spotted fever

130
Q

What antibiotic increases risk for cardiac arrhythmia?

A

Quinolones

131
Q

What should be used to treat enterococcus infection?

A

Ampicillin plus vancomycin (unless VRE)

132
Q

What is the appropriate treatment for neisseria gonrrhea?

A

Ceftriaxone IM x 1

133
Q

What 4 types of infections are treated with metronidazole?

A

Trichomonas
Syphilis
Gardnerella
H. Pylori

134
Q

What test can be used to screen and to verify diagnosis of mono?

A

Heterophile antibody
If negative, confirm with serum IgM
There is high false positive rate of screening test in children <4

135
Q

What is the diagnostic study for cmv?

A

Urine culture within first 3-4 weeks of life

136
Q

What disease should you consider in an infant with chorioretinitis, periventricular cerebral calcifications and sensorineural hearing loss?

A

CMV

137
Q

What TORCH infection causes petechiae and outputs secondary to thrombocytopenia (blueberry muffin baby)?

A

CMV

138
Q

How is CMV infection spread?

A

Virus is shed in urine, saliva or genital secretions

139
Q

A patient presents with mono type infection but mono testing is negative…what should you consider?

A

CMV

140
Q

What is the treatment for CMV and what is the major side effect?

A

Ganciclovir - marrow suppression

141
Q

What type of infections are caused by arboviruses and when do they typically occur?

A

Encephalitis - late spring and early summer

142
Q

What are the csf findings in arbovirus encephalitis?

A

Mild pleocytosis and elevated protein

143
Q

How is west Nile encephalitis diagnosis confirmed ?

A

IgM in serum or CSF or Fourfold elevation of serum IgG during acute infection

144
Q

What diagnosis should you consider when a patient presents with high fever, rash and viral meningitis during summer?

A

Coxsackie (enterovirus)

145
Q

How is an enterovirus infection confirmed ?

A

PCR

146
Q

When can unimmunized children return to school if there is a measles outbreak in a local school?

A

Give the vaccine prior to return to school (or the booster if not completed) OR
Wait 26 days after the last person developed parotitis

147
Q

When can a child with mumps return to school?

A

9 days after the onset of parotitis

148
Q

What are the 4 complications of mumps infection?

A

Parotitis
Meningitis/encephalitis
Orchitis
Pancreatitis

149
Q

What diagnosis should you consider In a patient with fever, headache, muscle aches and unilateral facial swelling anterior to the ear?

A

Mumps

150
Q

What is the difference between mumps and viral parotitis?

A

Mumps is associated with low fever and non toxic appearance in unimmunized child

Viral parotitis is associated with high fever and toxic appearing child who is fully immunized

151
Q

What should you consider in a patient with intermittent salivary gland swelling?

A

Salivary gland stone

152
Q

What is the most likely manifestation in a patient with mumps and parotitis?

A

Orchitis (but not infertility)

153
Q

What disease should you consider in a patient with high fever for 3 days followed by maculopapular rash?

A

HHV-6 aka roseola

154
Q

What should you consider in an unvaccinated hold with maculopapular rash associated with mild viral symptoms ?

A

Rubella

155
Q

What vaccine should NOT be given to pregnant women?

A

MMR

156
Q

What occurs in 50% of infant infected with rubella in their first trimester?

A

Cataracts and PDA

157
Q

What are the 7 main symptoms associated with measles ?

A 
Cough
Coryza
conjunctivitis 
Koplik spots
Confluent maculopapular rash
Fever
Photophobia
158
Q

What is measles the most contagious?

A

5 days before to 5 days after the appearance of the rash

159
Q

What is the method for measles diagnosis?

A

Serum IgM (elevated for one month)

160
Q

How can immunocompromised patients be protected after measles contact ?

A

Immunization and immunoglobulin

161
Q

What is the appropriate measles post-exposure management for incompletely immunized children ?

A

Immunoglobulin within 6 days

MMR vaccine within 3 days

162
Q

When should children receive revaccination after post exposure treatment?

A

After age 12 months and at least 5 months after immunoglobulin was given

163
Q

What is the diagnosis in a patient with slapped cheek rash that spreads to extremities?

A

Parvovirus b19 aka fifth disease

164
Q

What virus can cause hydrops fetalis? What else can this virus cause?

A

Parvovirus B19 - also causes aplastic crisis in sickle cell disease

165
Q

What is the best test for diagnosis of hsv?

A

Csf PCR

166
Q

When is acyclovir used?

A

Hsv prophylaxis and treatment

Varicella only in immunocompromised

167
Q

What is the appropriate test for HIV in children and why?

When should exposed infants be tested?

A

If <18 months, need PCR (antibodies can cross the placenta)

Birth, 2 months, 4 months and 6 months

168
Q

What are 4 buzzwords that might point toward HIV infection in a child?

A

Recurrent bacterial infection
Hepatosplenomegaly
Failure to thrive
Developmental delay

169
Q

When should testing for HIV be performed after any form of exposure to HIV?

A

At time of exposure

6 weeks, 12 weeks and 6 months

170
Q

How can HIV vertical transmission be reduced?

A

Zidovudine and nevirapine during the perinatal period

171
Q

Which vaccines are contraindicated in children with HIV?

A

Measles and varicella (only contraindicated if severely immunocompromised )

172
Q

Why do children with HIV develop recurrent bacterial infections?

A

Increased production of nonfunctional antibodies

173
Q

When can children with zoster return to school?

A

Once lesions can be covered or are crusted over

174
Q

What are the only indications for use of Foscarnet?

A

CMV retinitis in immunocompromised
Severe mucocutaneous HSV resistant to acyclovir
Zoster

175
Q

What should be the treatment for immunocompromised children exposed to active chicken pox infection?
When should it be given?

A

Varicella zoster immune globulin (also indicated for newborns)
Within 96 hours or exposure

176
Q

How does adenovirus typically present in the summer?

A

Conjunctivitis, pharyngitis and otitis media

Intussusception or diarrhea

177
Q

What test confirms RSV infection?

A

Immunofluorescence

178
Q

How can you diagnose rotavirus infection?

A

rotazyme antigen test of the stool

179
Q

What diagnosis should you consider in an infant with 1-2 days of fever, several episodes of watery stool and vomiting ?

A

Rotavirus

180
Q

What should you do in a patient exposed to a bat but not bitten by it?

A

Treat for rabies - immunoglobulin plus rabies vaccine within 7 days

181
Q

What are possible treatment options for ascaris lumbricoides infection?

A

Albendazole x 1
Mebendazole x 3
Ivermectin x 1

182
Q

What diagnosis should you consider in a patient with recent travel from a tropical region who presents with signs of acute abdominal obstruction?

A

Ascaris lumbricoides

183
Q

What is the antibiotic of choice for entamoeba histolytica?

A

Flagyl

184
Q

What medications should Never be given to people with amebiasis?

A

Corticosteroids or anti motility agents

185
Q

What infection should you consider in a patient with 1 week of abdominal pain, tenesmus and bloody diarrhea as well as liver or brain abscess?

A

Entamoeba

186
Q

What is seen on stool culture in amebiasis?

A

Hematophagous trophozoites

187
Q

What is the recommended treatment for intraluminal entamoeba infection?

A

Amebicide (iodoquinol, paramomycin, diloxanide)

188
Q

What infection should you consider in a child with hepatomegaly, abdominal pain and wheezing?

A

Toxocara canis

189
Q

Exposure to what animal may lead to toxocariasis?

A

Dogs and cats

190
Q

What signs and symptoms are present in visceral larval migrans?

A

Fever, hepatomegaly and wheezing

191
Q

What form of toxocariasis presents with visual problems ?

A

Ocular larval migrans

192
Q

What symptoms are seen with covert toxocariasis?

A

GI symptoms plus pruritis and rash

193
Q

How is toxocariasis diagnosed?

A

Elisa

Stool cultures should still be done to rule out other parasitic infections

194
Q

What is the treatment for visceral larval migrans?

A

Mebendazole or thiabendazole

195
Q

What is the treatment of giardia?

A

Flagyl, tinidazole and nitazoxanide

196
Q

What is the treatment for tapeworm?

A

Praziquantel

197
Q

What is the treatment for strongyloides?

A

Thiabendazole

198
Q

What is the treatment for enterobius vermicularis?

A

Mebendazole, Albendazole or pyrantel (given once then repeated in 2 weeks)

199
Q

What is permethrin 1% used for?

A

Lice ( the 5% must be used to treat scabies)

200
Q

How should anti-malaria medication be taken when traveling to a chloroquine resistant region?

A

Chloroquine x 1, one week prior to travel, weekly during travel and for 4 weeks after travel

201
Q

Which fungal infection is an encapsulated yeast?

A

Cryptococcus

202
Q

What infection is associated with pigeon droppings ?

A

Cryptococcus

203
Q

What is the treatment of cryptococcal infection?

A

Amphotericin b PLUS Fluconazole

204
Q

What medication should be added to the recommended treatment for cryptococcosis when the infection is resistant?

A

Flucytosine

205
Q

What infection should be considered in a patient with aids who develops severe pulmonary disease or meningoencephalitis?

A

Cryptococcus neoformans

206
Q

What infection should you consider in a patient with flu like symptoms from California, Arizona or Texas?

A

Coccidioidomycosis

207
Q

What is the treatment for coccidioidomycosis?

A

Amphotericin, Fluconazole or Ketoconazole

208
Q

What infection should you consider in an asthmatic with worsening symptoms with eosinophils or infiltrates on CXR?

A

Aspergillosis

209
Q

What is the treatment for invasive aspergillosis ?

A

Voriconazole or amphotericin B

210
Q

What infection should you consider in a patient with flu like symptoms and hepatosplenomegaly ?

A

Histoplasmosis

211
Q

What is the treatment for histoplasmosis ?

A

Amphotericin

212
Q

What regions of the country is histoplasmosis found in?

A

Ohio, Missouri and Mississippi River valleys

213
Q

What animal is associated with histoplasmosis ?

A

Pigeon droppings

214
Q

What infection causes an ulcer on the skin with a chain of nodules parallel to the drainage lymphatic channel which may also cause joint involvement ?

A

Sporotrichosis

215
Q

What are possible side effects of amphotericin ?

A

Fever
Hypokalemia
Nephrotoxicity

216
Q

What medication should be given to an immunocompromised patient with low neutrophils who is not responding to antibiotics ?

A

Amphotericin

217
Q

What is Fluconazole used for?

A

Candida albicans (used once daily for resistant oral thrush)

218
Q

What type of contact precautions are needed for RSV?

A

Direct contact - hand washing for transmission prevention

219
Q

What type of precautions are needed for mumps, rubella and pertussis?

A

Droplet precautions (no special ventilation system needed)

220
Q

What type of precautions are needed for legionella, candida and pseudomonas?

A

Droplet precautions (no special ventilation system needed)

221
Q

What type of precautions are needed for aspergillosis, measles and varicella?

A

Airborne transmission (special hospital ventilation system needed)

222
Q

What is the etiology of septicemia in a child 1-12 months?

A 
GBS
E. coli
Strep pneumo
Staph aureus
Salmonella

US Pediatric Boards Edited (23 decks)

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