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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
Q

Who needs prophylaxis for H. flu and how to ppx?

A

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

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26
Q

When is H. flu ppx indicated in nursery setting?

A

If there are 2 or more cases of invasive flu within 60 days, then all immunocompromised or unimmunized children should get rifampin.

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27
Q

When to ppx for pertussis?

A

All household and close contacts, with azithromycin or doxycycline

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28
Q

Watery, loose stools, fever and vomiting 1-2 days after a picnic. Tx?

A

Supportive care. Infants <3 mos and immunocompromised patients tx with ceftriaxone or cefotaxime

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29
Q

Child on dairy farm with fever, HSM, and myalgias. Tx?

A

Brucellosis. Tx with bactrim and rifampin, or tetracycline

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30
Q

Strep meningitis in patient with cephalosporin allergy. Tx?

A

Vancomycin and Rifampin

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31
Q

Rash that blanches easily and spares face, palms and soles, red lines in skin folds. TX? What if pt is allergic to PCN?

A

Azithro, or clindamycin, or cephalexin

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32
Q

Pathophysiology of botulinum toxin? How to tx infantile botulism?

A

Blocks release of Ach into the synapse

Tx with antitoxin/supportive care (DO NOT give abx, which cause lysis of spores)

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33
Q

When do you need to treat a newborn for syphilis if the mother has it during pregnancy?

A

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

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34
Q

Which syphilis test stays positive for life? Which one becomes negative eventually?

A

FTA-ABS is positive for life (F is forever). VDRL goes down eventually.

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35
Q

What are screening tests for syphilis? Confirmatory tests?

A

Screen with VDRL/RPR, Confirm with FTA-ABS or MHA-TP

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36
Q

Patient ate rabbit meat, now with fevers, HSM, rash. TX?

A

Francisella tularemia (gram negative). Tx with Gentamicin

37
Q

Exposure to dead animals, now with swollen painful LNs. What is dx? Tx?

A

Yersinia pestis (bubonic plague). Tx with Gentamicin

38
Q

Bloody diarrhea, signs of appendicitis, exposure to raw meat or unpasteurized milk. Tx?

A

Yersinia enterocolitica. Supportive care, unless immunocompromised (tx with bactrim or azithro)

39
Q

How to diagnose CMV in neonatal period?

A

Urine culture within first 3-4 weeks of life

40
Q

When can a child with mumps return to school?

A

9 days after onset of parotitis

41
Q

When can a child who parents refuse to immunize return to school when there has been a mumps outbreak?

A

26 days after the last person in class developed parotitis due to mumps

42
Q

When is rubeola (measles) most contagious?

A

5 days before to 5 days after the rash appears

43
Q

Child with rhinitis, cough, fever, confluent macular papular rash from developing country. How to diagnose?

A

Rubeola (measles) Dx with serum IgM

44
Q

When to give prophylaxis for measles exposure

A

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
Q

Mother with HSV, has c-section. Is newborn at risk?

A

Yes, can still ascend

46
Q

Most sensitive test for HIV in <18 months. When to screen?

A

PCR for HIV DNA. At birth, 2, 4, and 6 months

47
Q

Which vaccines should be avoided in HIV patients?

A

MMR, varicella, and live influenza (can receive the inactivated flu)

48
Q

When are varicella patients contagious? What is the most common complication?

A

From 1-2 days before rash until all lesions are crusted over. Most common complication is superinfection with strep and flu

49
Q

Treatment of newborn exposed to varicella? When should it be given?

A

VZIG if the mother developed chickenpox 5 days before to 2 days after delivery. Must be given within 96 hours

50
Q

Tx of rabies exposure indications and time frame? How to tx?

A

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
Q

What parasite to think about in a patient who traveled or immigrated with sings of acute abdominal obstruction? How to tx?

A

Ascaris lumbricoides

Tx with Albendazole or Mebendazole or Ivermectin

52
Q

Drug of choice for E. histolytica for asymptomatic patients? For symptomatic patients or patients with extraintestinal disease?

A

Asymptomatic can get paramomycin or iodoquinol. Symptomatic get flagyl followed by paramomycin/iodoquinol.

53
Q

Child with abdominal pain, wheezing, exposure to cats/dogs, hepatosplenomegaly, was seen eating dirt. How to dx? Tx?

A

Toxocariasis (roundworm) aka visceral larva migrans. Dx with ELISA and stool cx. Tx with mebendazole.

54
Q

Tx of tapeworm, shistosoma, liver fluke?

A

Praziquantel

55
Q

History of exposure to bird droppings, meningitis. Tx?

A

Cryptococcus. Tx Amphotericin

56
Q

Tx of aspergillosis

A

Voriconazole or ampho B

57
Q

History of exposure to bird droppings, hepatosplenomegaly. Tx?

A

Histoplasmosis, tx with ampho B

58
Q

Which diseases require airborne precautions?

A

Aspergillus, TB, Measles, varicella, and disseminated zoster

59
Q

Waterpark visit, diarrhea after. Tx?

A

Cryptosporidium. Tx. paramomycin

60
Q

Teenager with purple enlarged LN. Tx?

A

Non TB mycobacterium. Tx with excisional bx

61
Q

Pork chitterlings

A

Yersinia

62
Q

When is an infant to old for the first rotavirus vaccine?

A

Must get 1st vaccine by 14 weeks of age

63
Q

Infant with pneumonia, very low saturations, low WBC. Dx? Tx?

A

PCP pneumonia. Dx with BAL, Tx with bactrim

64
Q

Tx vibrio cholerae

A

Azithromycin or doxycycline

65
Q

What does a positive galactomannin indicate?

A

Fungal aspergillosis

66
Q

What is used to monitor disease activity in coccidiomycosis?

A

Complement fixation titers

67
Q

Treatment of cocci meningitis? Duration?

A

Lifelong fluconazole

68
Q

Child from Ohio with fever, cough, adenopathy, hepatosplenomegaly

A

Histoplasmosis

69
Q

How to dx histoplasmosis/blastomyces?

A

Culture of tissue or sputum (serology is unreliable)

70
Q

How does BCG affect TST?

A

NOT a contraindication. RARELY >10mm, and wanes in 3-5 years

71
Q

When is a skin test of >=5mm considered positive?

A

Close contacts to TB, Immunocompromised, or CXR/findings consistent with TB

72
Q

Tx active TB

A

RIPE x 6 months, then IR x 4 months

73
Q

Tx TB meningitis

A

RIPE x 2 months + daily streptomycin (or ethambutol), then IR x 10 months

74
Q

Side effects of INH

A

Rash, hepatitis (monitoring only in high risk patients), pyridoxine (B6) deficiency causing peripheral and optic neuropathy

75
Q

Side effects of rifampin

A

Orange fluids, leukopenia, thromboctyopenia

76
Q

Child with back ache, limp, refusal to walk, decrease in disc space on XR. Tx?

A

Discitis; Tx with anti-staphlococcal abx

77
Q

What is the tx for congenital CMV and how do you follow virus load?

A

Ganciclovir; Monitor via quantitative PCR

78
Q

Looks like congenital CMV but also with heart problems

A

Rubella (associated with PDA, pulmonary artery stenosis)

79
Q

Neonates exposed to Hep B should receive what tx and within what time period? When to repeat?

A

HBIG AND Hep B vaccine within 12 hours. Repeat at 1 month and 6 months

80
Q

When do you test a neonate for a definitive diagnosis of Hep B?

A

After 18 months of age, once they have completed the immunization series

81
Q

Best diagnostic test to determine if neonate is HIV infected?

A

HIV DNA PCR (all babies will be HIV EIA+ until 18 months of age 2/2 to maternal antibodies)

82
Q

TX congenital toxoplasmosis

A

Pyrimethamine and sulfadiazine

83
Q

What tx is recommended for all children with measles

A

Vitamin A

84
Q

True or False: A person with active shingles can cause chicken pox in an unvaccinated person.

A

True

85
Q

Wrestler with 20 vesicular lesions on neck on erythematous base, started 2 days ago. Dx?

A

Herpes gladiatorum

86
Q

Tx sporotrichosis

A

Oral potassium iodide

87
Q

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?

A

Congenital syphilis

88
Q

Definition of chronic suppuritve otitis media? Most common pathogens?

A

> 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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