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PEDS UWORLD > Infectious Disease in kid > Flashcards

Infectious Disease in kid Flashcards

1
Q

Congenital syphilis early manifestations

A 
Jaundice: anemia
maculopapular rash (palms of soles)
lymphadenopathy
rhinitis
chorioretinitis
hepatosplenomegaly
Osteochondritis
congenital nephrosis
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2
Q

Late manifestations of congenital syphilis

A 
saber skins
keratitis
Hutchinson teeth
saddle nose
deafness
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3
Q

mc predisposing factor for acute bacterial sinusitis

A

Viral URI

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4
Q

Complications of sinusitis

A

orbital cellulitis w/ intracranial extension

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5
Q

First line Rx for acute bacterial sinusitis

A

amoxicillin plus Clavulanic acid

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6
Q

Herpangina is what

A

Coxsackie A virus

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7
Q

typical age of herpangina and what season

A

3-10 yrs

Summer/early fall

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8
Q

C/F of herpangina

A

Fever, pharyngitis

gray vesicles/ulcers on posterior oropharynx

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9
Q

Rx of herpangina

A

supportive management

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10
Q

Herpetic gingivostomatitis is what? age?

A

HSV1

6 months to 5 yrs

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11
Q

HSV1 C/F

A

fever, pharyngitis
Erythematous gingiva
clusters of small vesicles on anterior oropharynx/lips

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12
Q

Rx herpetic ging….

A

acyclovir

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13
Q

Stept pyogenes c/f in pharyngitis

A

fever, pharyngitis
tender anterior cervical LAD
tonsillar exudates!

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14
Q

2 year old kid has comes in with respiratory distress, hypotensive, 37.7C, coughing, 98% saturation RX with o2. DX is laryngotracheobronchitis, he begins to decline and 92% sat with 40RPM….
whats the next step?

A

Give racemic epinephrine in cases of croup before intubation

Epi: acts by a adrenergic(reduce bronchial secretions/ mucosal edema) and beta adrenergic (relax smooth muscle)

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15
Q

Immunizations in kids should be given according to

A

chronological age

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16
Q

Standard Inactivated (killed) Pediatric vaccine (2)

A

Polio

Hep A

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17
Q

Standard Toxoid (inactivated toxin) Ped vaccine (2)

A

Diptheria

tetanus

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18
Q

Standard Subunit/conjugate Peds Vaccine (7)

A 
Hep B
Pertussis
Haemophilus Influenzae type b
Pneumococcal
Meningococcal
HPV
Influenza (injection)
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19
Q

Live attenuated standard ped immunization (4)

A

Rotavirus
MMR
Varicella
Influenza (nasal)

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20
Q

Preterm newborn is good to receive vaccines according to (1) but one exception (2)

A
  1. chronologic age

2. weight should be above 2 kg before 1st hep b vaccine

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21
Q

Neonatal tetanus general onset

A

Onset w/in first 2 weeks

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22
Q

Neonatal tetatnus signs and symptoms

A

poor suckling and fatigue

followed by rigidity, spasms and opisthotonus

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23
Q

Mortality in tetanus is due to

A

1st week: apnea

2nd week: septicemia

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24
Q

Child with painful non-itchy pustules and honey crusted lesions

A

Non-bullous Impetigo

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25
Q

Child with Rapidly enlarging flaccid bullae with yellow fluid; “collarette” of scale at the periphery of ruptured lesions

A

Bullous Impetigo

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26
Q

Treatment of Impetigo

A

Non-bullous: topical antibiotic: mupirocin

Bullous: oral anti: cephalexin, dicloxacillin, or clindamycin

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27
Q

Impetigo cause

A

S. Aureus (both)

S. pyogenes(non- bullous)

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28
Q

Epiglottitis classic presentation

A

High grade fever
sudden-onset resperiratory distress
dysphagia and drooling
Stridor (tripoding- leaning forward)

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29
Q

Rx of acute epiglottitis

A

OR- endotracheal intubation

unsucceful- Emergency tracheotomy

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30
Q

Differentiate btw periorbital and orbital cellulitis

A

Periorbital is before the orbital Septum; Orbital cellulitis:

  • Opthalmoplegia,
  • Pain w/ mvt
  • Proptosis
  • vision impairments
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31
Q

Anterior uveitis c/f

A

Red eye, pain and blurry vision

also Pupil defects, corneal precipitates and leukocytes

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32
Q

Causes of anterior uveitis

A

trauma
infection
AI disease

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33
Q

rx orbital cellulitis

A

IV antibiotics to cover s. aureus

may require drainage

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34
Q

Conjunctivits C/f

A

inflammation of conjunctiva: erythema, exudate

No proptosis, pain w/ mvt, or vision loss

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35
Q

Congenital Toxoplasmosis (7)

A 
Hydrocephalus, microcephaly
chorioretinitis
Intracranial calcifications
hepatomegaly
diffuse LAD
jaundice
diffuse petechiae
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36
Q

risk of transmission during pregnancy increase as pregnancy progresses but severity of…

A

neonatal disease decreases

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37
Q

Congenital syphilis C/F (6)

A 
intermittent fever
osteitis osteochondritis
mucocutaneous lesions
LAD
hepatomegaly
persistent rhinitis
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38
Q

Congenital rubella (3ish)

A 
Oko, ucho i serducho
Congenital glaucoma
sensorineural deafness
cardiac anomalies(PDA, ASD)
microcephaly, microphthalmia, meningoencephalitis
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39
Q

Congenital Herpes (3)

A

encephalitis
chorioretinits
disseminated disease

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40
Q

Neonatal conjunctivitis: first 24 hrs

A

Chemical prob from Silver nitrate

Rx: supportive management

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41
Q

Neonatal conjunctivits day 2-5

A

Gonococcal

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42
Q

Gonoccocal conjunctivitis findings

A

Marked eyelid swelling/exudates

Profuse purulent discharge

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43
Q

Gonococcal conjunctivitis Rx

A

IV or IM ceftriaxone or cefotaxime

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44
Q

Nenatal conjunctivitis day 5-15

A

Chlamydial infection

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45
Q

Chlamydial conjunctivitis C/F

A

Mild to moderate swelling of eyelids
thickened, injected conjunctivae (chemosis)
Watery or mucopurulent eye discharge
Blood stained eye discharge is highly characteristic
Conjunctival pseudomembrane

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46
Q

Rx chlamydial conjunctivitis

A

oral erythromycin

only macrolide used for chlamydial conjunctivitis

47
Q

Risk of infant who recieves oral erythromycin

A

infantile hypertrophic pyloric stenosis

48
Q

three stages of Pertussis

and what are the C/F in them?

A 
Catarrhal : 1-2 wks
-mild cough, rhinitis
Paraxysmal: 2-6 wks
- coughing paraxyms w/ inspiratory "whoop"
-posttussive emesis
- apnea, cyanosis (infant)
Convalescent (wks-months)
-symptoms resolve gradually
49
Q

Rx pertussis

A

Macrolides

vaccine

50
Q

Complications of Pertussis

A 
Pneumonia
weight loss
subconjunctival hemorrhages
pneumothorax
RF
death (infants)
51
Q

Tinea Corporis or ringworm in kids Rx

A

Topical Antifungals

52
Q

Ringworm C/f

A

erythematous, scaly, pruritic lesion

Red ring w/ central clearing

53
Q

Ringworm exposure

A

infected animals, people, and public places

54
Q

Cellulitis C/F

A

painful, erythematous, and indurated

Not scaly or itchy

55
Q

Cellulitis Rx

A

IV antistaphylococcal antibioitic

Nafcillin

56
Q

Erysipelas

A

Begins small erythematous patch
then red, indurated, tense and shiny plaqes
Presence of a raised, sharply demarcated margin is classic
may have LAD indicating lymphatic involvement

57
Q

Mom right before birth is Dx with Hep B; kid delivered what do you do?

A

Give Hep B IG and Hep B vaccine

58
Q

If mom has HBeAG negative or positive? risk for kids to develop chronic hepatitis

A

negative 20%

positive: 90%

59
Q

Cystic fibrosis related pneumonia gram-negative rod

A

Pseudomonas Aeruginosa
burkholderia cepacia complex
stenotrophomonas maltophilia

60
Q

Cystic fibrosis pneumo gram neg coccobacilli

A

nontypeable H.influenzae

61
Q

CF pneumonia gram positive cocci in chains

A

Strept pneumoniae

62
Q

CF pneumonia gram+ cocci in clusters

A

Staphylococcus aureus

63
Q

Rabies clinical features

A 
Encephalitic:
Hydrophobia
Aerophobia
Pharyngeal spasm, spastic paralysis
Agitation
Paralytic: ascending flaccid paralysis
64
Q

Rx of Rabies

A

Rabies immune globulin and rabies vaccine

65
Q

Enterobius vermicularis

pinworm Rx

A

Albendazole or pyrantel pamoate

for patient and all household contacts (highly contagious)

66
Q

Chagas disease Rx

trypanosoma cruzi

A

Benznidazole or nifurtimox

67
Q

Stronygloidiasis: uritacaria, abd pain, resp problems

Rx?

A

Ivermectin

68
Q

Scarlet fever C/F

A

Initial: Fever, chills, toxicity, abd pain, pharyngitis

12-48 hrs: rash neck, axillae, groin and generalizes w/in 24 hrs

69
Q

Rash in scarlet fever

A

punctate or finely papular texture: Sandpaper like

70
Q

Pharynx in scarlet fever

A

erythematous, swollen, possibly gray-white exudates

mouth:circumoral pallor

71
Q

Rx: of Scarlet fever

A

DOC: Penicillin V
allergy: erythromycin, clindamycin, 1st gen cephalosporin

72
Q

Viral symptoms in pharyngitis

A

Cough, rhinorrhea, conjunctivitis, oral ulcers

73
Q

MC organisms for acute bacterial rhinosinusitis (3)

A

S. pneumoniae 30%
H. influenzae 30%
Moraxella Catarrhalis 10%

74
Q

dacryostenosis

A

nasolacrimal duct obstruction

newborn: chronic tearing often unilateral
rx: massage gently

75
Q

Lyme Disease rx in kid

A

Oral amoxicillin or cefuroxime

kids

76
Q

MC organism for osteomyelitis in infants and children

A

Both: S. Aureus MC
Infants: GBS + E.coli
Children: S.pyogenes

77
Q

cat bite kid, Rx w/?

A

Amoxicillin/clavulanate

worried about pasteurella multocida: cellulitis

78
Q

Waterhouse-friderichsen syndrom is characterized by

A

sudden vasomotor collapse
Skin rash: purpura + petechiae
Due to adrenal hemorrhage

79
Q

Viral meningitis in kids, organisms

A

90% enteroviruses: echovirus, coxsackievirus

80
Q

Pertussis prophylaxis in family with child sick

A

Prescirbe a macrolide antibiotic for household contacts

age1 month: azitho 5 days; clarithryo 7xdays; erythro 14xdays

81
Q

erythromycin in neonate is assoc with

A

pyloric stenosis

82
Q

Pertussis sick child should be on antibiotics therapy for (1) days and what else

A

5 days
respiratory isolation for first 5 days with antibioitics
kept at home
infants

83
Q

Lymph node becomes tender, erythematous and becomes enlarged (3-6 cm in size); Dx?

A

lymphadenitis

84
Q

Mc pathogen for lymphadenitis

A
  1. S. aureus

2. GAS

85
Q

Unilateral subacute-chronic LADl kid

A

Nontuberculous mycobateria lymphadenitis

86
Q

acute unilateral lymphadenitis; older child with periodontal disease; dx?

A

peptostreptococcus lymphadenitis

anaerobic bacteria

87
Q

mcc of neonatal jaundice are (4)

A

breastfeeding jaundice
breast milk jaundice
hematologic conditions
sepsis

88
Q

Acute Otitis media pathogens

A

S. Pneumo
Nontypeable H.influenzae
Moraxella catarrhalis

89
Q

AOM c/f

A

Acute onset
middle ear effusion
bulging tympanic membrane

90
Q

AOM rx:

A

Initial: Amoxicillin- 10 days
2nd: Amox + clavulanic acid
Amox allergy: azithryomycin

91
Q

Complications of AOM

A

Conductive hearing loss
mastoiditis
meningitis

92
Q

Recurrnet AOM despite appropraite anitbiotic rx; do what next

A

Tympanocentesis and culture during myringotmy w/ tympanostomy tube placement

93
Q

Laryngeal inflammation that results in hoarseness, barkin cough, varing degrees of respiratory distress over time; lateral xray subglottic narrowing, Dx?

A

Croup

Parainfluenza virus

94
Q

Long term sequelae assoc w/ bacterial meningitis (5)

A 
Hearing loss
Loss of cognitive function(neuronal loss in dentate gyrus of hippocampus)
Seizures
Mental Retardation
Spasticity or paresis
95
Q

Edema, erythema and thick otorrhea, significan pain of outer ear, conductive hearing loss
preauricular nodes; Dx?

A

Otitis externa

96
Q

Rx Otitis externa

A

topical otic preparations+/- steroids

97
Q

Otitis externa pathogens

A

mc: P.aeruginosa

2nd mc: S.aureus

98
Q

Rx of acute mastoiditis

A

Myringotomy and IV antibiotics

99
Q

cyst like growth w/in middle ear r temporal bone; lined by keratinized stratified squamous epithelium; malodorous discharge

A

Acquired cholesteatoma

100
Q

Rx cholesteatoma

A

Tympanomastoid surgery

101
Q

Dx sinusitis (3)

A

Nonspecific complaints: nasal congestion, discharge, fever, cough
Persistent URI symptoms w/ou improvement for at least 10 days
Purulent discharge and fever (at least 102) for 3 consecutive days

102
Q

Asymptomatic, scattered erythematous macules, papules and pustules throughout the body (spares palms/soles)

A

Erythema toxicum neonatorum

Rx: none

103
Q

low grade Fever, postauricular adenopathy, conjunctivitis, LAD, fine truncal rash starts at forehead and moves down, patchy erythema on soft palate; Dx?

A

Togavirus: Rubella

104
Q

High fevers up to 40C (104), coryza, malaise, rash spread gradually includes hand and feet, reddishbrown, conjunctivitis; Dx?

A

paramyxovirus: Measles

105
Q

Follicular conjunctivitis and pannus (neovascularization) formation in the cornea, inflamed eye; Dx?

A

Trachoma; Chlamydia trachomatis infection

106
Q

HSV keratitis c/f

A

Pain, photophobia, decreased vision
Dendritic ulcer MC presentation
minute clear vesicles in corneal epithelium

107
Q

C/I for DTaP vaccine

A

Immediate anaphylaxis
unstable neuro disorders
encephalopathy w/in a wk of administration

108
Q

post-antibiotic rash is

A

typically polymorphous and maculopapular

109
Q

Inability to extend the neck and widened prevertebral space suggest a dx of

A

Retropharyngeal abscess

110
Q

RPA organisms

A

polymicrobial:
S.pyogenes
S.aureus
anaerobes

111
Q

RPA antimicrobial rx

A

Ampicillin-sulbactam and clindamycin
If not working: Vanco and Linezolid
Also surgical drainage of course

112
Q

Congenital CMV

A 
IUGR
Periventricular calcification
Chorioretinitis
Microcephaly
Hepatosplenomegaly, jaundice
Thrombocytopenia- petechiae
113
Q

which antibiotic is used to prevent vertical transmission of toxoplasmos from mother to fetus?

A

spiramycin

macrolide concentrates in placenta

114
Q

Congenital VZV

A 
zig zag skin lesions
microphthalmia: small eyes
extremity hypoplasia
cataracts
chorioretinits

PEDS UWORLD (9 decks)

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