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GEN PEDS > INFECTIOUS DISEASES > Flashcards

INFECTIOUS DISEASES Flashcards

1
Q

Multiple erythematous macules and petechiae on palms and soles of a patient with headache and malaise

What is the infectious condition?

A

Rocky Mountain spotted fever (RMSF)

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2
Q

What is the electrolyte abnormality associated with RMSF?

A

Hyponatremia

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3
Q

Abrupt onset of fever, chills, malaise, then with ulcerated skin lesion and tender regional lymph node

What is the infectious agent?

A

Franciscella tularensis

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4
Q

Retroauricular, posterior cervical, and posterior occipital lymphadenopathy in an unvaccinated patient

What is the diagnosis?

A

Rubella (aka German measles)

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5
Q

What is the unique oral finding in rubella?

A

Reddish-pink spots on soft palate

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6
Q

Rashes involving the axilla, groin, antecubital areas in patients with fever.

What is the diagnosis? Causal organism?

A

Scarlet fever

Caused by group A strep

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7
Q

Treatment of E.coli O157:H7 (Shiga-toxin producing)

A

Supportive care with fluid and electrolyte management

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8
Q

Toddler with weeks of progressive hoarseness, recurring wheezing, found to have stridor.

What is the diagnosis? Causal organism?

A

Juvenile laryngeal papillomatosis

Caused by HPV type 6 or 11

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9
Q

What are the causal organism and XR finding of juvenile laryngeal papillomatosis?

A

Caused by HPV type 6 or 11

XR finding: soft tissue lesion at the level of vocal cords

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10
Q

First line in pertussis-exposure prophylaxis

A

Azithromycin

(second line = Bactrim for age > 2 months)

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11
Q

Treatment of Salmonella diarrhea

A

Supportive care - NO antibiotics (unless patient has hemoglobinopathies, immunocompromised, or critically ill)

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12
Q

Stridor, throat pain, difficulty swallowing - XR shows a prominent prevertebral soft tissue swelling displacing the trachea forward

What is the condition? The most common causal organism?

A

Retropharyngeal abscess

Most common = Group A Strep (Strep pyogenes)

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13
Q

Treatment for suspected meningitis in neonate < 7 days

A

Ampicillin + Cefotaxime

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14
Q

Which organism children with persistent complement component deficiency are at risk for ?

A

Neisseria meningitidis

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15
Q

Treatment of cat-scratch disease

A

Azithromycin

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16
Q

What are main side effects of isonazid ? (3)

A

1 - Hepatitis / elevated LFTs
2 - Peripheral neuritis
3 - Hypersensitivity

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17
Q

What are main side effects of rifampin? (2)

A

1 - Discoloration of urine (orange)
2 - Render oral contraceptives ineffective

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18
Q

Most common complication of mumps in males?

A

Epididymo-orchitis
- acute onset of fever and severe testicular pain from swelling and erythema of scrotum

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19
Q

Mouth infection with beaded, branching chains of gram-positive rods and “sulfur” granules

What is the organism?

A

Actinomyces

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20
Q

Chronic draining lesions after water exposure
What is the organism?

A

Mycobacterium marinum

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21
Q

Perceptual distortions and lymphadenopathy

What is the syndrome? What is the causal organism?

A

Alice-in-Wonderland syndrome

Part of infectious mononucleosis (EBV)

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22
Q

XR of a young child with indolent back pain shows disc space narrowing and irregularity of the vertebral end plates.

What is the condition? What is the most common organism causing this?

A

Discitis

Most commonly caused by Staph aureus

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23
Q

Who should received prophylaxis for meningococcal exposures?

A

Individuals with close contacts WITHIN 7 days prior to onset of disease

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24
Q

Most common cause of swimming-related conjunctivitis

A

Adenovirus

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25
Q

Most common cause of bacterial conjunctivitis

A

Strep pneumo

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26
Q

Erythematous rash eruption over face and trunk 3-5 days after fever, child is otherwise well

What is the most likely diagnosis? Organism?

A

Roseola
HHV-6 or HHV-7

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27
Q

Persistent lymphadenitis, not improving despite appropriate cephalexin and/or clindamycin.

What is the most likely organism?

A

Mycobacterium avium-intracellulae

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28
Q

Unique lab finding associated with Chlamydia trachomatis infection in children?

A

Eosinophilia

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29
Q

Behavioral changes + involvement of temporal lobe on MRI

What is the diagnosis?

A

Herpes meningoencephalitis

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30
Q

First line treatment for UTI children > 2mo who is relatively well, no allergies

A

Cephalexin
(first-generation cephalosporin)

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31
Q

First line treatment for UTI children > 2mo who is relatively well, allergic to penicillin

A

Ciprofloxacin

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32
Q

Suboccipital lymphadenopathy and morbilliform rash in a patient with conjunctivitis

What is the diagnosis?

A

Rubella

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33
Q

Non-purulent conjunctivitis, posterior cervical lymphadenopathy, otitis media

What is the organism?

A

Haemophilus influenzae

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34
Q

Conjunctivitis, exudative pharyngitis, vesiculopapular rash

What is the condition?

A

Herpangina / Hand-foot-mouth

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35
Q

Non-purulent conjunctivitis, exudative pharyngitis, preauricular lymphadenopathy

What is the organism?

A

Adenovirus

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36
Q

Acute peripheral facial neuropathy and an erythematous vesicular lesions in ear canal

What is the diagnosis? What is the causal organism? Treatment?

A

Ramsay-Hunt syndrome
VZV
Acyclovir + steroids

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37
Q

Animal exposure, swollen ulcerative lesion with associated eschar formation

What is the diagnosis? Treatment?

A

Tularemia

Gentamicin (or streptomycin)

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38
Q

Animal exposure, swollen ulcerative lesion with associated eschar formation

What is the diagnosis? Treatment?

A

Tularemia

Gentamicin (or streptomycin)

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39
Q

Infant with eosinophilia and a cough

What is going on?

A

Chlamydia trachomatis infection

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40
Q

Generalized, confluent, erythematous, finely papular rash especially in groin and axilla.

What is the organism?

A

Group A strep

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41
Q

What is first line treatment for Lyme arthritis?

A

Doxycycline x 28 days

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42
Q

What are skin findings in cat-scratch disease (Bartonella)

A

Several cutaneous papules/pustules develop at the inoculation site.

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43
Q

Bluish-white papules covering the buccal mucosa

What is this finding ? What is the underlying agent?

A

Koplik spots

Measles

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44
Q

Swelling of joints and a reticular rash

Which virus causes this ?

A

Parvovirus B19

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45
Q

Prophylaxis for close contacts of individuals with invasive meningococcal disease

A

Rifampin x 2 days

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46
Q

What is the organism caursing discitis?
What is the blood cutulre finding ? WBC ? ESR/CRP?

A

Staph aureus

Usually negative blood culture
Usually NORMAL WBC
Elevated inflammatory markers ESR/CRP

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47
Q

Painful, grouped, deep-seated vesicles with clear fluid on erythematous base on finger.

What is the diagnosis? What is the organism? Treatment?

A

Herpetic whitlow
HSV-1
Oral acyclovir

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48
Q

Neonate with microcephaly, hydrocephalus, microphthalmia, chorioretinitis, generalized cerebral calcifications

What is the congenital infection?

A

generalized cerebral calcification = Toxoplasma gondii

(CMV presents with periventricular intracranial calcifications)

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49
Q

Neonate with microcephaly, hydrocephalus, microphthalmia, chorioretinitis, periventricular intracranial calcification

What is the congenital infection?

A

periventricular intracranial calcification = CMV

(generalized calcification = Toxoplasma)

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50
Q

Neonate born with severe limb malformations and microphthalmia

What is the congenital infection?

A

Varicella embryopathy

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51
Q

Neonate born with smooth philtrum, thin upper limp, small palpebral fissures, and growth restrictions, microcephaly

What is going on?

A

Fetal alcohol syndrome

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52
Q

Sandpaper-like rash

What is the condition? Causal organism?

A

Scarlet fever

Group A strep pharyngitis

53
Q

Multiple grouped vesicles and ulcers involving the tongue and buccal mucosa with gingival erythema

What is the condition? Causal organism?

A

Herpetic gingivostomatitis

HSV

54
Q

What is CBC finding commonly seen in pertussis?

A

Lymphocytosis

55
Q

What are the 3Cs of measle?

A

Cough, coryza, conjunctivitis

56
Q

What is the post-exposure prophylaxis for children exposed to measles?

A

MMR vaccine within 72 hours

57
Q

Spiral- or helical-shaped gram negative organism that causes bacterial diarrhea

What is the organism? What is the treatment?

A

Campylobacter jejuni

Macrolides (azithromycin)

58
Q

What are long-term complications of Campylobacter jejuni infections? (2)

A

Reactive arthritis
Guillain-Barre syndrome

59
Q

Decolonization therapy for community-acquired MRSA carriers

A

Topical mupirocin to anterior nares twice daily x 5 days

60
Q

Blue-berry muffin rash in a neonate

What is the diagnosis? What is the most common cardiac anomaly?

A

Congenital rubella syndrome

Patent ductus arteriosus (PDA)

61
Q

Gram-positive diphtheroid-like organism in blood culture

What is the organism? What is the first line treatment?

A

Listeria

Penicillin or ampicillin
(NOT vancomycin)

62
Q

Gram-negative diplococci grew from CSF culture

What is the organism? The patient should be screen for which condition?

A

Neisseria meningitides
(meningococcal)

screen for terminal complement component deficiecy (check CH50)

63
Q

Sharply definied, slightly elevated, distinct border skin rash

What is the organism?

A

Group A Strep
(Strep pyogenes)

64
Q

What are the criteria for diagnosing acute bacterial sinusitis ? (At least 1 of 3)

A

1 - Persistent nasal discharge of any quality or daytime cough with no improvement > 10 days
2 - Worsening symptoms AFTER initial improvement of typical viral URI that lasted 5-6 days (“double sickening”)
3 - Fever > 102 F ( >39 C) with either purulent nasal discharge or facial pain for >3 consecutive days in an ill-appeariung child

65
Q

Penetrating eye injury with ring abscess formation in the cornea

What is the possible organisms? (3)

A

Ring abscess:
1 - Bacillus cereus
2 - Pseudomonas
3 - Proteus

66
Q

Eye infection due to direct contact lenses, or swimming with contact lenses

What is the organism?

A

Acanthamoeba

67
Q

Most common etiology of brain abscess in infant?

A

Citrobacter
(gram-negative rod)

68
Q

Most common location of adenitis in non-tuberculosis mycobacterial disease (NTM)

A

Submandibular

69
Q

What are 2 organisms causing pneumonia in patients with recent influenza?

A

1 - Streptococcus pneumoniae
2 - Staphylococcus aureus

70
Q

Otitis externa in patient with diabetes

What is the treatment to cover for which specific organism?

A

Ciprofloxacin PO

to cover for Pseudomonas

71
Q

Most common cause of aseptic meningitis in children?

A

Enterovirus

72
Q

How to distinguish enterovirus from HSV CNS infection in children?

A

HSV usually causes meningoencephalitis, not just isolated meningitis. Looks for mental status change

73
Q

Unilateral non-purulent conjunctivitis with an ipsilateral preauricular lymphadenitis

What is the organism? What is treatment?

A

Bartonella henselae
(this is an atypical presentation of catscratch disease)

Treatment = azithromycin

74
Q

Neonate with chorioretinitis/conjunctivitis, microcephaly, and skin vesicles / scarring

What is the congenital infection?

A

HSV

75
Q

Bloody or serosanguinous vaginal discharge / vulvovaginitis

What are the most common agents? (2)

A

1 - Shigella
2 - Group A Strep

76
Q

Changes with breastfeeding if mom has mastitis?

A

No change! Continue breastfeeding from both breasts

77
Q

Which pathogen can cause invasive disease in patients who receive cochlear implant

A

Strep pneumoniae

78
Q

Growth restriction, hearing loss associated with developmental delay, cataract, and cardiac findings in a newborn

What is the congenital infection?

A

Congenital rubella syndrome

79
Q

Frontal bossing, saddle nose, interstitial keratitis, hearing loss, intellectual disabilities

What is the congenital infection?

A

Congenital syphilis
(Treponema pallidum)

80
Q

Most common cause of subacute bacterial endocarditis?

A

Viridan strep

81
Q

Most common cause of acute bacterial endocarditis?

A

Staph aureus

82
Q

Osteomyelitis of the calcaneus

What is the most likely organism?

A

Pseudomonas
(after a nail puncture)

83
Q

What is the first line treatment of pertussis?

What is a potential complication of this treatment in young infant?

A

Macrolides

In young infant, might cause infantile hypertrophic pyloric stenosis
(azithro has less risk than erythro - therefore better choice)

84
Q

What is the first line treatment of pertussis?

What is a potential complication of this treatment in young infant?

A

Macrolides

In young infant, might cause infantile hypertrophic pyloric stenosis
(azithro has less risk than erythro - therefore better choice)

85
Q

Most common cause of congenital sensorineural hearing loss in infants

A

CMV

86
Q

What is eye finding frequently seen with roseola?

A

Palpebral and periorbital edema

(NOT bulbar conjunctivitis - which should raise concern for Kawasaki)

87
Q

What is the common eye finding in bacterial endocarditis?

A

Conjunctival and retinal hemorrhages

88
Q

Non-blanching, linear, brownish-reddish lesions located beneath nail bed

What is the finding called? Underlying condition?

A

Splinter hemorrhages

Bacterial endocarditis

89
Q

Tender, pea-sized, intradermal nodules located within the pads of fingers / toes

What is the finding called? Underlying condition?

A

Osler nodes

Bacterial endocarditis

90
Q

Erythematous papules on foot, with brownish-red, well-demarcated serpiginous plaques extend from each papule

What is the disease? What is the source? Treatment?

A

Cutaneous larva migrans

  • the larval stages of dog/cat hookworms

treat with oral albendazole

91
Q

Non-purulent conjunctivitis with an associated enlarged preauricular lymph node, with biopsy showing necrotizing granuloma.

What is the diagnosis? Causal organism?

A

Parinaud oculoglandular syndrome

Innoculation of Bartonella henselae into / around the eye

92
Q

Non-purulent conjunctivitis with an associated enlarged preauricular lymph node, with biopsy showing necrotizing granuloma.

What is the diagnosis? Causal organism?

A

Parinaud oculoglandular syndrome

Innoculation of Bartonella henselae into / around the eye

93
Q

Maternal infections that are contraindications for breastfeeding in the US ? (4)

A

1 - HIV
2 - HTLV-1
3 - HTLV-2
4 - untreated TB

94
Q

Which children should get renal & bladder ultrasound after 1st UTI ? (3)

A

1 - Children < 2 years
2 - those with hypertension or failure to thrive
3 - not responding to initial therapy

95
Q

What are clinical signs and symptoms of toxic shock syndrome (TSS) ? (5)
What is the causing organism?

A

1 - Fever
2 - Hypotension
3 - Altered mental status
4 - Intensely erythematous generalized rash (erythroderma)
5 - Mucous membrane inflammation

Caused by S.aureus toxin

96
Q

Treatment of Rocky Mountain spotted fever?

A

Doxycycline

97
Q

Lethargy, vomiting after taking aspirin.
What is going on?

A

Reye syndrome

98
Q

What is the first line treatment for enterococcus?

A

Ampicillin

(2nd line = vanco)

(tends to resistant to cephalosporins of all generations!)

99
Q

Management of cat-scratch disease in immunocompetent patients?

A

Can confirm diagnosis with serology, then observe

100
Q

1st line of therapy for cat-scratch disease in immunocompromised patient?

A

Azithromycin

101
Q

What is the measles postexposure prophylaxis for infants < 6-month-old ?

A

IVIG (or IMIG) within 6 days of exposure

102
Q

What is the measles postexposure prophylaxis for infants 6-month-old to 11 month-old ?

A

MMR vaccine within 72 hours (or IVIG within 6 days of exposure)

(MMRV vaccine is not for < 12 month old)

103
Q

Which medication to absolutely avoid in patient with chicken pox?

A

Aspirin (can cause Reye syndrome)

104
Q

What is the prophylaxis for meningococcal exposure? (include correct dose)

A

Rifampin 10 mg/kg/dose x 2 days

105
Q

What is the prophylaxis for Hib exposure? (include correct dose)

A

Rifampin 10 mg/kg/dose x 4 days

106
Q

Management of children < 5 years old who are exposed to TB ? (2 steps)

A

1 - Start therapy for LTBI (“window prophylaxis”) until TB screening is negative
2 - Get a CXR

107
Q

How long to wait to place PPD or send IGRA after MMR vaccine? Why?

A

4-6 weeks after

because measles vaccine may temporarily suppress TB screening reactivity

108
Q

Treatment of chlamydial conjunctivitis in neonate?

A

Erythromycin or azithromycin

109
Q

XR findings of osteochondritis or periostitis in an infant
What is the congenital infection?

A

Congenital syphillis

110
Q

Tetanus prevention:
Wound is dirty and either (1) < 3 immunizations or (2) unknown immunization

A

Tetanus immunoglobulin + vaccine

111
Q

Tetanus prevention:
Wound is clean and immunization up-to-date (>=3 shots, <10 years since last)

A

No treatment
(if > 10 years since last, give vaccine only)

112
Q

Tetanus prevention:
Wound is dirty and immunization up-to-date (>=3 shots, <5 years since last)

A

No treatment
(if > 5 years since last, give vaccine only)

113
Q

Symmetric, erythematous swelling of hands and feed, sharply dermacated at the wrists and ankles - with painful papules or petechiae

What is the condition? What is causal organism?

A

Papular purpuric gloves and socks syndrome (PPGSS)

Parvovirus B19

114
Q

Diarrhea after uncooked hot dogs and goat chesse

What is the most likely organism?

A

Listeria

115
Q

What is the most common cause of neonatal breast abscess?

A

Staph aureus

116
Q

Infant presents with sudden onset of irritability, poor feeding, and unilateral facial swelling, with postauricular lymphadenopathy.

What is the condition? What is the causal organism? Treatment?

A

Cellulitis-adenitis syndrome

caused by Group B Strep (Strep agalactiae)

Empiric therapy with amp + gent + vanc

117
Q

Giemsa stain of a patient with asplenia who has fever

What is the diagnosis?

A

Babesiosis (casued by Babesia)

(Maltese cross sign)

118
Q

Spreading pattern of rash in scarlet fever

A

“Sand-paper” rash starts chest/neck -> trunk/extremities

119
Q

Spreading pattern of rash in measles

A

Hairline -> downward/outward

120
Q

Spreading pattern of rubella

A

Face->downward

121
Q

Spreading pattern of Rocky Mountain spotted fever

A

Flexor surfaces of ankles/wrists -> palms/soles -> inward

122
Q

What is the most common long-term sequela of acute bacterial meningitis ?

A

Hearing loss

123
Q

“Strawberry tongue” associated with which diseases? (2)

A

1 - Scarlett fever
2 - Kawasaki disease

124
Q

Erythematous tonsils with membrane formation and petechiae at the junction of the hard & soft palate

What is the causal mechanism?

A

EBV

125
Q

What are 3 ways that neonatal HSV can present?

A

1 - Skin, eye, mucous membrane (SEM)
2 - Disseminated infection
3 - CNS-limited infection

126
Q

How to differential Chlamydia vs Gonorrhea ophthalmia neonatorum in neonate?

A

Onset

Onset of N.gonorrhea conjunctivitis usually 2-5 days of delivery, Chlamydia 5 - 12 days

127
Q

Malaria prophylaxis for areas known to be resistant to chloroquine

A

Doxycycline

128
Q

Empiric antibiotics treatment for acute epiglotitis

A

Ceftriaxone + Vancomycin

129
Q

What are the two most common causes of osteomyelitis in sickle cell disease (2, in right order)

A

1 - Staph aureus
2 - Salmonella species

GEN PEDS (16 decks)

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