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Congenital Heart > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

antibiotics for AOM

A

< 24 yo

  • poor risk of f/u
  • chronic illneses
  • recurrent, severe, perforate dAoM
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2
Q

treatment of AOM?

A

amoxicillin = 1st line
-if no improvement w/in 48 hrs
(2nd line = amox-clavulanic, oral 2nd/3rd gen cephalosporin, IM ceftriaxone)

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3
Q

complication of AOM?

A

otitis media with effusion

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4
Q

when to place ear tubes?

A

OME persisting more than 3 weeks

  • +4 episodes of AOM w/in 6 mo
  • 5 episodes w/in 12 mo
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5
Q

copmlications of AOM?

A

excessive scarring / tympanosclerosis
cholestatoma formation
chronic suppurative AOM
rarely: mastoiditis

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6
Q

presentation of acute bacterial sinusitis

A

1) persistent respiratory symptoms > 10-14 days w/o improvement + nasal d/c (clear/purulent) & daytime cough
2) severe symptoms of high fever / purulent nasal d/c for > 3 days

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7
Q

complications of acute bacterial sinusitis

A

-bony erosion, orbital cellulitis, intracrnial extension

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8
Q

what are complications of group A strep?

A
  • suppurative (peritonsillar / retropharyngeal abscess)

- nonsuppurative (rheumatic fever, post-strep glomerulonephritis)

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9
Q

treatment of group A strep

A

10-day course of oral penicillin / single-dose IM benzathine penicillin G

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10
Q

treatment of scarlet fever

A

same as GAS pharyngitis

-10 day oral penicillin / single-dose Im benzathine penicillin G

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11
Q

GAS treatment for penicillin allergy

A

erythromycin, azithromycin, clindamycin

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12
Q

diagnostic criteria for acute rheumatic fever/

A

JONES criteria
Major: carditis, polyarthritis, chorea, erythema marginatum, subQ nodules
Minor: fever, arthralgia, elevated ESR/CRP, prolonged PR interval
Other: +throat culture/rapid antigen test / incr. ASO titers

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13
Q

EBV + misdiagnosis & amoxi/amp?

A

skin rash = maculopapular, on face/trunk

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14
Q

eval of EBV?

A

leukocytosis

  • lymphocytes >50% of leukocytes
  • heterophile antibody test = rapid EBV detection
  • no detectable heterophile antibodies
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15
Q

croup presentation?

A

upper airway obstruction - hoarse voice/barky-seal-like cough + inspiratory stridor –> respiratory distress

  • laryngotracheal inflammation
  • parainfluenza virus, influenza, RSV
  • more pronounced in 6-36 mo (narrow airway)
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16
Q

croup treatment

A

1) cool air / humidity
2) expect resolution w/in 4-7 days
3) nebulized racemic EPI; oral/IV/IM corticosteroids

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17
Q

bronchiolitis

A
  • acute viral lower respiratory tract infection –> obstruction of peripheral airways
  • lymphocytic infiltrate into peribronchial/peribronchiolar epithelium –> submucosal edema
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18
Q

bronchiolitis pathogen

A

typically RSV

  • nov-april
  • > 50% younger than 1 yo
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19
Q

clinical bronchiolitis signs

A
  • neonates - at risk for apnea

- resolve w/in 5-10 days

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20
Q

CXR consistent w/ RSV

A
  • lung hyperinflation
  • peribronchial thickening/cuffing
  • incr. interstitial markings
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21
Q

indications for palivizumab?

A

prophylaxis for pts > 2 yo

risk for severe disease (premature infants / children w/ bronchopulm dysplasia, req . O2)

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22
Q

what is palivizumab?

A

IM RSV monoclonal antibody

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23
Q

what is respigam?

A

IV polyclonal immunoglobulin + high RSV antibody concentration

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24
Q

pertussis presentation

A

afebrile, prolonged cough (2-8 wks)

  • catarrhal phase - follows 7-10 day incubation (1-2 wks of low grade fever, cough, coryza)
  • paroxysmal phase - intense coughin spasms + sudden inhalation
  • convalescent phase
25
Q

pertussis eval

A

-detected by fluorescent antibody staining, PCR, culture

26
Q

treatment of pertussis

A
  • hospitalization of young infants w/ severe disease

- erythromycin / macrolides - shorten duration of illness, if given in catarrhal phase & dec. infectivity

27
Q

what are causes of PNA in children?

A
  • viruses = most common
  • chlamydia trachomatis - 2-3 mo
  • s. pneumo = community-acquired
28
Q

school aged PNA

A
  • mycoplasma pneumo / chlamydia pneumonai

- not common if < 5 yo

29
Q

unusually causes of PNA?

A

nontypeable H. flu, m. catarrhalis, S. aureus, N. meningitidis, GAS

30
Q

risk factors for bacterial PNA

A

chronic lung disease (CF/asthma)
neuro impairment (swallowing dysfunction / NMJ disease)
GERD w/ aspiration
Upper airway anatomic defects (tracheoesphageal fistula/cleft palate)
Hemoglobinopathy (sickle cell)
Immunodeficiency/immunosuppresion

31
Q

most common signs of PNA in id?

A

tachypnea / dyspnea out of proprtion to fever

32
Q

pulm exam findings of viral/atypical PNA

A
  • diffuse wheezing / crackles = multiple areas involved

(m. pneumo, c. pneumo, c. trachomatis)

33
Q

pulm exam findings of bacterial PNA

A

focal crackles / dec. breath sounds
dullness to percussion
egophony
bronchophony

34
Q

outpt treatment of bacterial PNA

A

amoxicillin or amoxi-clavulanic acid

35
Q

walking PNA

A

m. /c pneumo

- treat w/ macrolides 9erythromycin, clarithromycin, azithromycin)

36
Q

IV a/b for PNA

A

ampi-sulbactam
clindamycin
cefuroxime, ceftriaxone, azithromycin, vanco

37
Q

causes of mengingitis < 1 mo

A

GBS, e. coli, gram neg bacili, HSV, listeria, strep pneumo

38
Q

meningitis 1-2 mo

A

e. coli
s. pneumo
enteroviruses
h. influenza
GBS

39
Q

2mo - 6 yr - meningitis

A 
strep pneumo
n. meningitidis
enteroviruses
borrelia burgdorferi
h. influ type b
40
Q

school age/adolescent meningitis

A

s. pneumo
n. meningitidis
enteroviruses
b. burgdoreferi

41
Q

features of lyme meningitis

A

low grade fever, headache, stiffneck, photophobia

?cranial nerve palsies

42
Q

signs of meningitis on PE

A

kernig (flexion of leg at the hip + subsequent pain on knee extension)
brudzinski (involuntary leg flexion on passive neck flexion)

43
Q

CSF findings for bacterial meningitis

A

WBC > 1000
neutrophils > 75%
protein: incr.!!
glucose (down)

44
Q

CSF findings for viral meningitis?

A

WBC < 500
lymphocytosis
protein: nL
glucose: nL

45
Q

CSF findings for lyme meningitis

A

WBC < 100
neutrophils: < 30%
protein nL/incr.
glucose: nL

46
Q

IV a/b for meningitis - infants / adolescents?

A

vanco + 3rd gen cephalosporin (cefotaxime / ceftriaxone)

10-14 days

47
Q

neonate meningitis treatment

A

amp - GBS / Listeria
cefotaxime - gram - pathogens
14-21 days

48
Q

special considerations for meningitis treatment

A

5-7 days for meningococcal meningitis

-lyme - 14-28 days

49
Q

most common causes of bacterial GI

A

salmonella, shigella, e. coli,yersinia enterocolitica, campylobacter jejuni, v. cholera

50
Q

signs of bacterial diarhea

A

fever, abdominal cramping, malaise, tenesmus

stools w/ mucus + blood

51
Q

complications of salmonella bactermia

A

osteomyelitis / meningitis

52
Q

erythema nodosum

A 
yersinia enterocolitca infxn - 30%
speudoappendicitis picture (localizes to RLQ)
53
Q

when to use a/b for salmonella diarrhea?

A

a/b prolongs salmonella shedding

reserve for bactermia / extraintestinal dissemnation for (< 3 mo / immunocompromise) w/ noninvasive gastroenteritis

54
Q

treatment of shigellosis

A

TMP-SFX

55
Q

C. jejuni treatment

A

erythromycin

56
Q

treatment of epiglotttis + presentation

A

toxic appearance + drooling
severe, progressive respiratory distress
-endotracheal intubation + direct visualization

57
Q

transmission of HAV/HEV?

A

fecal oral

58
Q

transmission of HB/C/DV

A

bodily fluids

Congenital Heart (12 decks)

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