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Neo Board Review > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Most common site of origin of osteomyelitis

A

Metaphysis
Femur>Humerus>Tibia
Can spread to epiphysis because of blood supply

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2
Q

Most common site for GBS osteo

A

Humerus

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3
Q

Most common site for GBS septic arthritis

A

Hip

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4
Q

Most common GBS serotype?

A

Serotype 3

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5
Q

Indications for GBS IAP

A
  1. Previous infant with GBS disease
  2. GBS bacteriuria during current pregnancy
  3. Positive GBS screening culture during pregnancy (unless planned C/S)
  4. GBS unknown status, delivery<37 weeks, ROM>18 hours and maternal fever
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6
Q

Infective organism associated with placental microabscesses?

A

Listeria

*gram positive rod, present in unpasteurized dairy and deli meats

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7
Q

Chocolate colored or ‘meconium-like’ stained amniotic fluid is associated with which organism?

A

Listeria -> early onset disease with small papular rash (granulomas on histopath)

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8
Q

How long are ‘snuffles’ in congenital syphilis infective?

A

Until after 24 hours of treatment

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9
Q

Which infection can have an unexplained large placenta?

A

Treponema/syphilis

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10
Q

Type of rash in syphilis?

A

Desquamating maculopapular rash

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11
Q

3 most common types of infections with gonorrhea in neonates?

A
  1. Conjunctivitis with copious purulent discharge, can lead to corneal ulceration. Needs ceftriaxone x1
  2. Scalp abscess if scalp electrode is used
  3. Arthritis

Systemic disease needs 7 days Rx, 10-14 if meningitis

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12
Q

Most common cause of infectious conjunctivitis?

A

Chalmydia.. Also most common manifestion of neonatal chlamydia.
Typically B/L.
Prophylactic erythromycin does not prevent (only prevents gonorrheal)

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13
Q

Triad of congenital HSV infection

A
  1. Brain: microcephaly, intracranial calcifications, hydranencephaly, seizures, hypertonicity
  2. Eyes: Chorioretinitis, cataracts, blindness
  3. Skin: vesicular rash

Also presents with IUGR

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14
Q

Which virus replicates within RBCs

A

Parvovirus B19

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15
Q

Retic count and type of anemia with Parvo?

A

Aplastic anemia, so low retic

Can lead to hydrops, congestive heart failure

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16
Q

Which pathogen has a primary reservoir outside of human and primates?

A

Toxoplasma

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17
Q

What causes granulomatosis infantiseptica?

A

Listeria

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18
Q

Which clinical factor has the highest sensitivity for maternal chorio?

A

Maternal fever

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19
Q

Which GBS serotype is most commonly associated with meningitis?

A

GBS serotype 3

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20
Q

How long after infection are osteomyelitis bony changes detectable on X-ray?

A

7-10 days.

By MRI you can see them within 24-48 hours

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21
Q

What is Wimberger sign?

A

Destruction of metaphysis of tibia, and is seen with congenital syphilis

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22
Q

Which virus replicates within RBC precursors?

A

Parvovirus

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23
Q

During what time period is there greatest risk of VZV infection in infant?

A

Between 5 days before delivery until 2 days after.

There is insufficient time for protective antibodies to cross to the fetus

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24
Q

At what time period is there highest risk of congenital varicella infection?

A

Between 8 and 20 weeks gestation

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25
Q

Indications for VariZIG

A
  1. Infant with mother who develops infections between <5 days prior to delivery until 2 days after
  2. <28 weeks or <1000g if significant exposure
  3. > 28 weeks if significant exposure and mother is seronegative
  4. Term healthy infant if exposed within 2 weeks post delivery and mom is seronegative
  5. If infant is exposed between 2-7 days postnatally
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26
Q

At what gestational age is the highest risk of congenital anomalies with rubella?

A

Weeks 1-12

100% of fetuses will have deafness and congenital cardiac abnormalities

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27
Q

After which week of gestation are congenital anomalies from rubella rare?

A

Week 20

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28
Q

Hallmarks of congenital rubella?

A

Hydrops in utero
Sensorineural hearing loss, microcephaly
Cataracts, salt and pepper chorioretinitis
Blueberry muffin rash
Cardiac anomalies (PDA most common -> PPS)
Long bone radiolucencies

29
Q

Mechanism of blueberry muffin rash

A

Dermal extramedullary hematopoiesis

30
Q

Most common intrauterine infection?

A

CMV

31
Q

Intranuclear and cytoplasmic inclusions are seen with which virus?

A

CMV

32
Q

What does hearing loss in CMV correlate with?

A

Presence of periventricular calcifications

33
Q

Type of hearing loss in CMV?

A

Progressive sensorineural, often bilateral, moderate to profound

34
Q

Treatment for congenital CMV and what do you monitor?

A

Oral valganciclovir for 6 months

Monitor for neutropenia and GI disease

35
Q

Which outcomes does oral valganciclovir have an effect on in congenital CMV?

A

Improves hearing and neurodevelopmental outcomes

36
Q

What are cortical calcifications seen with?

A

Toxoplasmosis

37
Q

Which cells does HIV infect?

A

Helper T lymphocytes and macrophages

38
Q

Most common infection in children in the US leading to diagnosis of HIV?

A

Pneumocystis carinii pneumonia

39
Q

Test of choice to diagnose HIV in infants?

A

HIV-1 DNA PCR
If positive in first 2 days of life, infection transmitted in utero
If between 2-6 weeks, then infected during intrapartum

40
Q

Which fungal infection is associated with lipid emulsions?

A

Malassezia

41
Q

Test medium to diagnose chlamydia

A

Giemsa stain

42
Q

Test medium to diagnose Neisseria

A

Thayer Martin

43
Q

Test medium to diagnose pertussis

A

Bordet Gengou

44
Q

Test buzzword to diagnose pseudomonas

A

Oxidase positive, catalase positive

45
Q

Test buzzword to diagnose rubella

A

Hemagglutination inhibition

46
Q

Organisms causing chorioretinitis?

A 
CHoRioreTinitiS
CMV, Candida
Herpes
Rubella
Toxoplasmosis
Syphilis (early congenital)
47
Q

Listeria findings

A

Think hot chocolate made with unpasteruized milk
Chocolate colored amniotic fluid
Microabscesses and granulomas ‘marshmallows’,

48
Q

What are the non treponemal tests and what do they detect?

A

RPR, VDRL
Test cell membrane cardiolipin IgG Ab
Used for screening, assessing response to treatment and determining reinfection
Positive if titer is 4x that of mom

49
Q

What’s the treponemal test and what does it detect?

A

FTA-ABS
Detects specific antibody. Used to establish presumptive diagnosis.
Reactive for life

50
Q

What causes a positive treponemal test?

A

Antinuclear antibodies

51
Q

Asymptomatic, positive PPD or IGRA, negative sputum, CXR, and contact with contagious person

A

INH and pyridoxine for 9 months

52
Q

Active TB disease in pregnant mother

A

INH, rifampin, ethambutol for 6-9 months

Add pyridoxine to prevent B6 deficiency

53
Q

Asymptomatic neonate, mother with positive PPD and active disease

A

Start INH for 3-4 months in neonate, if positive PPD continue for total 9 months
if negative PPD -> d/c INH and follow serial PPDs

Isolate from mom is symptomatic

54
Q

Asymptomatic neonate, mother with positive PPD, negative CXR

A

No need to separate

No treatment

55
Q

Most common congenital viral disease?

A

CMV
Also most common cause of sensorineural hearing loss
Hearing loss is usually bilateral, moderate to profound
Treatment with ganciclovir will reduce severity of hearing loss

56
Q

Most common congenital parasitic disease?

A

Toxoplasmosis

Kittens more likely to transmit the disease
Infants may develop learning and visual impairments later in life, asymptomatic at birth
Rx with pyrimethamine and sulfadiazine and folinic acid for 1 year

57
Q

Which GBS serotype is associated with EOS and LOS?

A

Type 3

58
Q

Which vaccines should an HIV positive baby not receive?

A

MMR
Varicella
Oral polio
BCG

59
Q

Congenital infections increasing risk of stillbirth?

A

Parvovirus
Listeria
Syphilis

60
Q

At which time point during pregnancy would varicella infection lead to greatest risk to fetus?

A

5 days before and 2 days after delivery (insufficient time for immunoglobulins to pass)
Give the baby VZIG

61
Q

Transmission of syphilis at which time during pregnancy leads to more severe disease?

A

Later in pregnancy

62
Q

Which congenital infection has a U-shaped distribution of transmission?

A

Rubella. More severe if earlier

63
Q

Limb hypoplasia is characteristic of which infection?

A

Congenital varicella

64
Q

Characteristic features of congenital varicella?

A

Limb hypoplasia and cicatricial scarring
Cataracts
Chorioretinitis
Brain abnormalities

65
Q

Most common organisms for omphalitis? And most common complication?

A

Polymicrobial with skin flora

Most common complication is sepsis

66
Q

Recommended treatment for syphilis during pregnancy?

A

A single intramuscular (IM) dose of benzathine penicillin G

Eradicates maternal disease and prevents congenital syphilis

67
Q

Treatment options for congenital syphilis

A

Aqueous crystalline PCN IV for 10 days
Procaine PCN IM for 10 days
Benzathine PCN IM x1 (only if all tests are negative)

68
Q

When is screening for vertical HCV done?

A

Antibody testing is done at 18 months (because maternal antibodies can be present till then)
You test NAAT at 3 years to determine whether to treat. Treatment isnt approved before 3 years

Neo Board Review (16 decks)

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