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pretest +uworld peds > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

Neonate with poor feeding and lethargy, suspect….

A

neonatal sepsis
JACL PT
-jaundice, abnormal WBC count (high or low), CNS (lethargy, irritable, apnea), left shift (bandemia), poor feeding, temp instability (fever or hypothermia)

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2
Q

neonate with hypothermia, lethargy, poor feeding. What is the order of treatment/diagnostic steps

A
  1. take blood, urine, CSF cultures first
  2. empiric antibiotics: ampicillin (listeria), gentamycin (Gm -), enterococci until cultures return

-if neonate is acutely ill, admin antibiotics first

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3
Q

Encapsulated bacteria

A

Please-pseudomonas
SHINE-strep pneumo, h flu, influenza, neisseria, e.coli
my
SKiS-salmonella, klebsiella, strep group b

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4
Q

sickle cell pt with fever, chills.

  • diagnosis
  • what is the likely bug
  • RX
A

sepsis
Encapsulated: esp strep pneumo (even when vaccinated)
RX: penicillin+always take penicillin prophylaxis

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5
Q

Kid develops a maculopapular rash a week after receiving the MMR vaccine

A

live attenuated vaccine type measles=does not equal wild type measles

  • milder form, still contagious so avoid contact with immunocomp people
  • RX: self-limited, reassurance
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6
Q

papular lesion+ipsilateral lymphadenopathy+cat exposure

A

Bartonella

rx: macrolide (azithromycin)

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7
Q

LAD in the RLQ+abdominal pain

A

Mesenteric adenitis
-salmonella-contact with turtles
-yersenia
-

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8
Q

bacterial sinusitis #1 predisposing risk factor

A

viral URI

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9
Q

kid with rhinorrhea, cough, congestion for 10 days followed by prurulent discharge…

A

viral infection that led to bacterial sinusitis

  • viral illness causes mucosal inflamm preventing ciliary clearance
  • Rx: amoxicillin+clavulonate
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10
Q

swelling anterior to the ears that obscures the angle of the mandible…..

A

parotitis

  • Mumps
  • -parortitis, orchitis, aseptic meningitis, otalgia (ear pain)
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11
Q

complications of otitis media

A

facial n. palsy

mastoiditis

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12
Q

Cat bites vs Cat scratches

  • organism
  • rx
A

cat bite-pasteurella, treat with amoxicillin clavulonate

cat scratch-bartonella, treat with macrolide (azithromycin)

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13
Q

meningitis+petechial rash

A

Neisseria meningitides

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14
Q

acute otitis media vs serous otitis media

A

acute otitis media
-acute inflamm signs: fever, bulging tympanic membrane

serous otitis media

  • no acute inflamm signs (no bulging TM), no fever
  • effusions
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15
Q

tetracyclines should be avoided in kids under age

A

under age 8 and pregnant women

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16
Q

peds drug of choice for lyme disease

A

amoxicillin or cefuroxime

-avoid tetracyclines under 8 yrs of age bc of risk of teeth discoloration

17
Q

4 yo girl with vaginal and anal pruritis at night

A

Entomeba vermicularis

  • Dx: tape test on anus
  • RX: albendazole or pyrantel pamoate
18
Q

girl with vaginal and anal pruritis throughout the day and night, bleeding, ecchymosis

A

lichen sclerosis
-thinning skin
-

19
Q

baby with hypoplastic nails and digits

A

fetal hydantoin syndrome-phenytoin teratogen

20
Q

kid with history of neglect, abuse now in adopted and doesn’t respond emotionally to them

A

reactive attachment disorder

  • kid with hx of neglect, institutionalization, many foster homes
  • seldom seek comfort and don’t respond when caregivers give comfort to them
21
Q

when are arterial lines used

A

arterial lines

  • BP monitoring
  • Drawing for labs
  • NOT FOR: fluid resuscitation
22
Q

discuss the types of IV lines that can be used for emergency fluid resuscitation

A 
#1 peripheral IV line
#2 interosseus (IO) line
- big bones i.e. tibia-->advantage, it's away from the sternum (in case of cv resusc)
-contraindications: cellulitis over the area, fracture, bone fragility (osteogenesis imperfecta)
23
Q

primary amenorrhea causes

  • no uterus:
  • yes have a uterus
A

no uterus: do a karyotype
-mullerian agenesis: normal female testosterone levels,
46 XX
-androgen insensitivity syndrome:male testost levels,
46XY

yes have uterus: do pelvic ultrasound to rule out GU anatomy issues
-turners syndrome

24
Q

teenage girl who is anemic loses her period. why

A

calorie restriction=functional hypothalamic amenorrhea–>(-) hpo axis–>dec LH, FSH,

25
Q

girl taking corticosteroids develops cushings and experiences amenorrhea. why

A

steroids (-) GnRH–>dec LH, FSH

26
Q

tourette syndrome

  • characteristics
  • RX
A

-both motor and vocal tics (don’t have to occur concurrently)
RX
-habit reversal training (behavioral0
-antidopaminergic (best pharm therapy): tetrabenazine (dopamine deleter), antispychotic (DA receptor blocker)
-alpha adrenergic:guanfacine, clonidine (don’t work as well)

27
Q

Teenage girl with tender breast lump right before menses

  • what is it
  • Dx
A

Fibroadenoma: single, solitary, mobile mass inc pain/size before menses

Dx: re-examine @ menses to see if the mass decreases in size/tenderness. If yes–>re-assure

28
Q

criteria for primary amenorrhea

A

> 13 yo, no secondary sex charact.

>15 yo, yes secondary sex charact.

29
Q

another name for Plan B

A

levonorgestral=Plan B

  • can give to teen girls to prevent pregnancy (this is not abortion)
  • most states allow Plan B for teens
30
Q

most states allow confidential care for teens for what…

A

STIs, pregnancy, prevention of pregnancy (plan B, contraception)

31
Q

brick dust/pink stain in a neonae’s diaper

A

Uric acid crystals-uric acid levels are higher at birth. NORMAL

32
Q

at what age does imaginative play occur

A
  • ages 3-6 yrs, but throughout elementary school is normal
  • consists of:imaginary friends, storytelling, play dress up
  • does NOT interfere with making friends
33
Q

Teen girl with abnormally heavy periods that only occur every few months.

A

immature HPA axis ca.uses inadequate hormone secretion causing no ovulation–>no CL so no progesterone, only estrogen–>inc proliferation leading to breakthrough bleeding

34
Q

Teen girl with abnormally heavy periods that only occur every few months

  • DX
  • RX
A

estrogen injections or combo estrogen/progesterone pills-estrogen will stop bleeding and maintain the endometrium

35
Q

Characteristics of Rett Syndrome

A
  • X linked MEP2 gene, in girls
  • developmental regression at 1 yr
  • stereotypic hand movements
  • gait issues
  • head growth deceleration
36
Q

Tourette syndrome highest assoc comorbidities

A

Tourettes, OCD, ADHD

37
Q

Mullerian agenesis (Mayer Rokitansky syndrome)

A
38
Q

what followup should be done in androgen insensitivity syndrome

A

Gonadectomy-remove the testes to prevent malignancy

Gender identity counseling

39
Q

mild cramping during ovulation

A

Mittelschmerz-ovarian rupture causing follicular fluid to release and irritate the peritoneum

pretest +uworld peds (6 decks)

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