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Pediatrics Board Exam > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Return from developing country with gradual onset abdominal pain, development of grossly bloody diarrhea, and weight loss

A

Entamoeba histolytica; Tx with Flagyl followed by Paramomycin or iodoquinol

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2
Q

Self limited, 1-5 days of watery diarrhea and fever after traveling

A

Enterotoxigenic E. coli

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3
Q

Bloody stools developing over 3-4 days after traveling

A

E. coli 0157:H7

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4
Q

Which UTI organism is associated with negative nitrites on UA?

A

Enterococcus

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5
Q

17 yo with recent hand cut on fence (didn’t seek care) presenting with hypotension, widespread rash (including mucosa), lethargy, and fever. Treatment?

A

Staph Toxic shock syndrome. Tx Vancomycin

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6
Q

Newborn with sepsis, mother with flu like sx and white nodules on placenta. Tx?

A

Listeria infection. Tx with ampicillin and gentamicin

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7
Q

Who receives ppx for meningococcemia, and with what?

A

Rifampin. All contact with patient’s oral secretions, all household contacts, and close contacts outside the house.

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8
Q

Treatment of bacterial peritonitis

A

3rd gen cephalosporin + aminoglycoside

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9
Q

Most common organism in peritonitis 2/2 dialysis?

A

Staph epidermidis

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10
Q

Most common organism in VP shunt infection

A

Staph epidermidis

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11
Q

Organisms which latex agglutination can test

A

B (group B strep), I (influenza), N (n. meningitidis), S (strep pneumo)

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12
Q

Cephalosporins with anti-pseudomonal activity

A

Cefepime (4th gen), ceftazidime (3rd gen)

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13
Q

Empiric tx of fever with neutropenia

A

Cefepime or ceftazidime, zosyn, gentamicin

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14
Q

Tx cryptosporidiosis diarrhea

A

Nitazoxanide

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15
Q

Newborn in first 2 months of life, afebrile with cough, tachypnea, with or without eye discharge. How to diagnose?

A

Chlamydia trachomatis by PCR

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16
Q

TX chlamydia genital infection

A

7 days of doxycycline or 1g PO azithromycin x 1

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17
Q

Most common adverse reaction with macrolides

A

diarrhea

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18
Q

How to dx chlamydia pneumonia in adolescent

A

Microimmunofluorescent antibody test

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19
Q

5 yo with suspected RMSF, first step? How to dx and tx?

A

First step is tx with doxycycline. Then test with microimmunofluorescent antibody

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20
Q

Rocky mountain spotted fever symptoms + leukopenia and elevated LFTs

A

Erlichiosis

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21
Q

Patient with draining lymph node after bite from cat. Tx?

A

Bartonella henselae. No tx required- self limited.

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22
Q

Immunocompromised patient with cat scratch. How to dx? Tx?

A

Dx with Direct immunofluorescent antibody. Tx with azithromycin, ciprofloxacin, or bactrim

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23
Q

Tx cat bite in PCN allergic patient?

A

Bactrim, doxycycline, or azithromycin

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24
Q

Gram negative pleomorphic organism. Tx?

A

Haemophilus influenzae. Ceftriaxone or cefotaxime

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25
Who needs prophylaxis for H. flu and how to ppx?
Rifampin. Household contacts if there is at least 1 in house that is <4 and incompletely immunized OR if there is at least 1 immunocompromised patient in the house
26
When is H. flu ppx indicated in nursery setting?
If there are 2 or more cases of invasive flu within 60 days, then all immunocompromised or unimmunized children should get rifampin.
27
When to ppx for pertussis?
All household and close contacts, with azithromycin or doxycycline
28
Watery, loose stools, fever and vomiting 1-2 days after a picnic. Tx?
Supportive care. Infants <3 mos and immunocompromised patients tx with ceftriaxone or cefotaxime
29
Child on dairy farm with fever, HSM, and myalgias. Tx?
Brucellosis. Tx with bactrim and rifampin, or tetracycline
30
Strep meningitis in patient with cephalosporin allergy. Tx?
Vancomycin and Rifampin
31
Rash that blanches easily and spares face, palms and soles, red lines in skin folds. TX? What if pt is allergic to PCN?
Azithro, or clindamycin, or cephalexin
32
Pathophysiology of botulinum toxin? How to tx infantile botulism?
Blocks release of Ach into the synapse | Tx with antitoxin/supportive care (DO NOT give abx, which cause lysis of spores)
33
When do you need to treat a newborn for syphilis if the mother has it during pregnancy?
If mother was treated less than 1 month prior to delivery, If she was treated with erythromycin (doesn't cross placenta), If the baby's titers were higher than the mother's titers
34
Which syphilis test stays positive for life? Which one becomes negative eventually?
FTA-ABS is positive for life (F is forever). VDRL goes down eventually.
35
What are screening tests for syphilis? Confirmatory tests?
Screen with VDRL/RPR, Confirm with FTA-ABS or MHA-TP
36
Patient ate rabbit meat, now with fevers, HSM, rash. TX?
Francisella tularemia (gram negative). Tx with Gentamicin
37
Exposure to dead animals, now with swollen painful LNs. What is dx? Tx?
Yersinia pestis (bubonic plague). Tx with Gentamicin
38
Bloody diarrhea, signs of appendicitis, exposure to raw meat or unpasteurized milk. Tx?
Yersinia enterocolitica. Supportive care, unless immunocompromised (tx with bactrim or azithro)
39
How to diagnose CMV in neonatal period?
Urine culture within first 3-4 weeks of life
40
When can a child with mumps return to school?
9 days after onset of parotitis
41
When can a child who parents refuse to immunize return to school when there has been a mumps outbreak?
26 days after the last person in class developed parotitis due to mumps
42
When is rubeola (measles) most contagious?
5 days before to 5 days after the rash appears
43
Child with rhinitis, cough, fever, confluent macular papular rash from developing country. How to diagnose?
Rubeola (measles) Dx with serum IgM
44
When to give prophylaxis for measles exposure
Any unimmunized child (6-12 months) should receive vaccine. If exposure within 6 days, give immune globulin. Patient with mild or asymptomatic HIV should also be given the vaccine
45
Mother with HSV, has c-section. Is newborn at risk?
Yes, can still ascend
46
Most sensitive test for HIV in <18 months. When to screen?
PCR for HIV DNA. At birth, 2, 4, and 6 months
47
Which vaccines should be avoided in HIV patients?
MMR, varicella, and live influenza (can receive the inactivated flu)
48
When are varicella patients contagious? What is the most common complication?
From 1-2 days before rash until all lesions are crusted over. Most common complication is superinfection with strep and flu
49
Treatment of newborn exposed to varicella? When should it be given?
VZIG if the mother developed chickenpox 5 days before to 2 days after delivery. Must be given within 96 hours
50
Tx of rabies exposure indications and time frame? How to tx?
If animal cannot be observed/immune status unknown, if patient wakes up in room with bat. Give RIG and rabies vaccine within 7 days
51
What parasite to think about in a patient who traveled or immigrated with sings of acute abdominal obstruction? How to tx?
Ascaris lumbricoides | Tx with Albendazole or Mebendazole or Ivermectin
52
Drug of choice for E. histolytica for asymptomatic patients? For symptomatic patients or patients with extraintestinal disease?
Asymptomatic can get paramomycin or iodoquinol. Symptomatic get flagyl followed by paramomycin/iodoquinol.
53
Child with abdominal pain, wheezing, exposure to cats/dogs, hepatosplenomegaly, was seen eating dirt. How to dx? Tx?
Toxocariasis (roundworm) aka visceral larva migrans. Dx with ELISA and stool cx. Tx with mebendazole.
54
Tx of tapeworm, shistosoma, liver fluke?
Praziquantel
55
History of exposure to bird droppings, meningitis. Tx?
Cryptococcus. Tx Amphotericin
56
Tx of aspergillosis
Voriconazole or ampho B
57
History of exposure to bird droppings, hepatosplenomegaly. Tx?
Histoplasmosis, tx with ampho B
58
Which diseases require airborne precautions?
Aspergillus, TB, Measles, varicella, and disseminated zoster
59
Waterpark visit, diarrhea after. Tx?
Cryptosporidium. Tx. paramomycin
60
Teenager with purple enlarged LN. Tx?
Non TB mycobacterium. Tx with excisional bx
61
Pork chitterlings
Yersinia
62
When is an infant to old for the first rotavirus vaccine?
Must get 1st vaccine by 14 weeks of age
63
Infant with pneumonia, very low saturations, low WBC. Dx? Tx?
PCP pneumonia. Dx with BAL, Tx with bactrim
64
Tx vibrio cholerae
Azithromycin or doxycycline
65
What does a positive galactomannin indicate?
Fungal aspergillosis
66
What is used to monitor disease activity in coccidiomycosis?
Complement fixation titers
67
Treatment of cocci meningitis? Duration?
Lifelong fluconazole
68
Child from Ohio with fever, cough, adenopathy, hepatosplenomegaly
Histoplasmosis
69
How to dx histoplasmosis/blastomyces?
Culture of tissue or sputum (serology is unreliable)
70
How does BCG affect TST?
NOT a contraindication. RARELY >10mm, and wanes in 3-5 years
71
When is a skin test of >=5mm considered positive?
Close contacts to TB, Immunocompromised, or CXR/findings consistent with TB
72
Tx active TB
RIPE x 6 months, then IR x 4 months
73
Tx TB meningitis
RIPE x 2 months + daily streptomycin (or ethambutol), then IR x 10 months
74
Side effects of INH
Rash, hepatitis (monitoring only in high risk patients), pyridoxine (B6) deficiency causing peripheral and optic neuropathy
75
Side effects of rifampin
Orange fluids, leukopenia, thromboctyopenia
76
Child with back ache, limp, refusal to walk, decrease in disc space on XR. Tx?
Discitis; Tx with anti-staphlococcal abx
77
What is the tx for congenital CMV and how do you follow virus load?
Ganciclovir; Monitor via quantitative PCR
78
Looks like congenital CMV but also with heart problems
Rubella (associated with PDA, pulmonary artery stenosis)
79
Neonates exposed to Hep B should receive what tx and within what time period? When to repeat?
HBIG AND Hep B vaccine within 12 hours. Repeat at 1 month and 6 months
80
When do you test a neonate for a definitive diagnosis of Hep B?
After 18 months of age, once they have completed the immunization series
81
Best diagnostic test to determine if neonate is HIV infected?
HIV DNA PCR (all babies will be HIV EIA+ until 18 months of age 2/2 to maternal antibodies)
82
TX congenital toxoplasmosis
Pyrimethamine and sulfadiazine
83
What tx is recommended for all children with measles
Vitamin A
84
True or False: A person with active shingles can cause chicken pox in an unvaccinated person.
True
85
Wrestler with 20 vesicular lesions on neck on erythematous base, started 2 days ago. Dx?
Herpes gladiatorum
86
Tx sporotrichosis
Oral potassium iodide
87
Very small newborn refusing to move arm. X-ray reveals evidence of osteochondritis at the wrist and periostitis of both the radius and ulna. Etiology?
Congenital syphilis
88
Definition of chronic suppuritve otitis media? Most common pathogens?
>6 weeks of otorrhea through a perforated TM. Most commonly Pseudomonas, staph, enteric gram neg bacilli

Pediatrics Board Exam (23 decks)

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