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Pedia > Infectious, Nelson + Misc > Flashcards

Infectious, Nelson + Misc Flashcards

1
Q

condition seen in using erythromycin as treatment of pertussis in infants less than 1 month

A

infantile hypertrophic pyloric stenosis

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2
Q

bacteria associated with miller fisher syndrome

A

campylobacter jejuni

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3
Q

characteristic skin lesion of pseudomonas

A

echthyma gangrenosusm

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4
Q

acute angulation of the chin and larynx cause by weakness of the hyoid muscle due to Polio

A

rope sign

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5
Q

called the first disease

A

measles (rubeola)

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6
Q

called second disease

A

scarlet fever

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7
Q

it is called the third disease

A

rubella

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8
Q

fourth disease is called

A

filatov-dukes disease (atypical scarlet)

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9
Q

6th disease is called

A

roseola infantum / exanthem subitum

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10
Q

incubation period of hepatitis A

A

15-50 days

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11
Q

bacteria with appendicitis like symptom diarrhea

A

yersinia enterocolitica

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12
Q

triad of EBV

A

fatigue, generalized lymphadenopathy, pharyngitis

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13
Q

the atypical lymphocytes characteristic of mononucleosis

A

cd8 t lymphocytes

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14
Q

x linked lypmhoproliferative syndrome of Duncans syndrome is associated with what disease

A

EBV infection

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15
Q

this type of lymphadenopathy is suggestive of infectious mononucleosis

A

epitrochlear lymphadenopathy

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16
Q

this happens to patients with ebv treated with ampicillin

A

ampicillin rash

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17
Q

rash on the cheek with multiple papules seen in ebv is seen in what syndrome

A

gianotti-crosti syndrome

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18
Q

diagnosis of ebv is done through __

A

specific antibody or heliotrope Ab

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19
Q

what is the most feared complication of EBV

A

splenic rupture or subcapsular hemorrhage

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20
Q

exanthem subitum or 6th disease is caused by

A

HHV-6

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21
Q

fever for 3 days then fever lyses and a pink morbilliform rash appears in the trunks the face and extremities; the rash lasts for 1-3 days and on PE; there are ulcers in the palatoglossal junction; what is the diagnosis and what do you call the ulcers

A

roseola (infantum subitum); nagayama spots

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22
Q

virus that causes kaposi sarcoma

A

HHV8

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23
Q

children aged___ can not receive influenza vaccine

A

Less than 6 months

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24
Q

how many doses in influenza vaccine

A

2 doses 1 month apart for 6-36 month

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25
Q

what is the first sign of infection in infants with rsv

A

rhinorrhea

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26
Q

Infectious diarrhea without bloody stool and wbc is caused by

A

rotavirus

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27
Q

what coagulation factor is depressed in dengue

A

factor 12 hageman factor

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28
Q

what are the criteria for dengue hemorrhagic fever

A

fever for 2-7 days, biphasic; major or minor hemorrhagic manifestations (thrombocytopenia less than or equal to 100); increase capillary permeability ( inc HCT by = 20%); pleural eff/hyoalb/ ascitis

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29
Q

what is the pathologic hallmark of rabies

A

negri bodies

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30
Q

clinical for of rabies where there is throat pain, malaise, paresthesia and pruritus in the bite site then cns manifestation and phobic spasms

A

furious or encephalitic

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31
Q

form of rabies that is characterized by fever and ascending motor weakness affecting both limbs and cranial nerves

A

paralytic or dumb rabies

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32
Q

cardinal signs of rabies

A

hydrophobia and aerophobia

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33
Q

rabies vaccine alters the course of the disease. T or F

A

false. neithere vaccine or IG can alter the course of the disease once sx appeared

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34
Q

vaccine in rabies and Ig are contraindicated once Sx develop. T or F

A

TRUE

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35
Q

pre exposure immunization for rabies

A

3 IM injections at day 0, 7, 21 or 28; if the patient had pre exposure prophy before you give 2 dose of vaccine no Ig on days 0 and 3

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36
Q

patients with this disease is resistant to malaria

A

sickle cell

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37
Q

erythrocyte without duffy antigen is resistant to what malaria sp.

A

p. vivax

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38
Q

___ are resistant to p falciparum

A

Hg F (fetal Hgb); ovalocytes

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39
Q

paroxysmal fever occur with rupture of schizonts that occurs every__ hr in p. vivax and ovale

A

42 hrs

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40
Q

paroxysmal fever occur with rupture of schizonts that occurs every__ hr in p. mlariae

A

72 hrs

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41
Q

nephrotic syndrome is associated with what malaria sp.

A

p. malariae

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42
Q

contraindication to coartem medication in malaria

A

children with prolonged QT

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43
Q

katayama fever is caused by

A

acute schistomiasis

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44
Q

cicatrial penetration of of schistosomiasis in the skin

A

swimmers itch or schisto dermatitis

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45
Q

shisto that causes hematuria

A

hematobium

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46
Q

shisto that can migrate to the brain

A

japonicum

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47
Q

shisto that causes transverse myelitis

A

hematobium; mansoni

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48
Q

laboratory test for shisto

A

microscopy of miday 10ml urine; katokatz of stool

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49
Q

tx of shisto

A

praziquantel 40mg for hematobium, mansoni, intercalatum; prazi 60 mg for japonicum and mengkongi; oxaminiquine for mansoni

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50
Q

taenia that causes neurocysticercosis

A

taenia solium

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51
Q

tx for taenia

A

albendazole

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52
Q

tx for ascariasis

A

albendazole

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53
Q

tx for trichuris

A

mebendazole

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54
Q

whipworm causes

A

trichuriasis

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55
Q

what is the diagnosis of pin worm or enterobius

A

cellophane tape in the morning

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56
Q

produces deep blue punctate rash

A

toxoplasmosis

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57
Q

dx of malaria

A

giemsa stain; thin smear allows for positive identification of malaria sp

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58
Q

poor prognostic indicator of severe malaria

A

respiratory distress

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59
Q

patients with measles are infective from

A

3 days before rash until 4-6 after onset of rah

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60
Q

pathognomonic for rubeola ( measles)

A

warthin-finkeldey giant cell

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61
Q

virus shedding begins in what phase of measles

A

prodromal phase

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62
Q

viral replication subside on the onset of __

A

rash

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63
Q

pathognomonic SIGN of measles

A

koplik spot

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64
Q

this appears 1-4 days prior to appearance of rash in measles

A

koplik spot

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65
Q

lab findings in measles

A

decrease in total wbc count with lympho decreased more than neutrophils; normal esr and crp

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66
Q

measles igm is detectable in blood when

A

1-2 days after the onset of rash ( 72 hrs)

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67
Q

morbidity and mortality is greatest in measles in what age group

A

less than 5 and more than 20

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68
Q

most common cause of death in measles

A

pneumonia ( giant cell pneumonia)

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69
Q

most common bacterial pathogen in pneumonia of measles

A

PIA; pneumoniae, influenzae, aureus

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70
Q

most common complication of measles

A

otitis media

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71
Q

csf findings in measles encephalitis

A

lymphocytosis and elevated protein

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72
Q

what protein is missing in measles virus in sspe patients

A

M protein

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73
Q

manifestation of sspe begins at what age

A

7-13 yrs after primary infection

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74
Q

in stage 1 of sspe – there is temper tantrums; in the second phase what is the hallmark

A

massive myoclonus

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75
Q

diagnostic criteria of sspe

A

1 of the ff: measles antibody in csf, eeg with suppression burst, brain tissue biopsy of sspe

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76
Q

vit A treatment in measles

A
  • 6m-2 yrs with complication (50,00iu for 6m-1yr and 100,000iu in more than 1yr OD)
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77
Q

you should avoid immunization of measles in what condition

A

severe hypersensitivity to neomycin and gelatin

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78
Q

vaccine is effective in modification of measles if pre exposure prophylaxis is given when

A

within 72 hr of exposure

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79
Q

measles Ig may be given up to __ days after exposure to prevent or modify infection (0.25 in immunocompetent and 0.5 immunocompromised)

A

6 days

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80
Q

virus shedding for rubella starts when

A

10 days after infection

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81
Q

highest infectivity for rubella is seen when

A

5 days before rash and 6 days after rash

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82
Q

in congenital rubella infection, what trimester results in severe defects

A

1st 8 wks of pregnancy

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83
Q

rash begins in the hairline then trunk extremities then palms

A

measles (rubeola)

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84
Q

rash begins in face that spreads centrifugally (trunk to extremities)

A

rubella [THINK Centri-petal = center seeking, centri-fugal = center fleeing]

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85
Q

rose colored lesion seen in rubella

A

forschheimer spots

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86
Q

the sspe counter equivalent in rubella

A

PRP progressive rubella panencephalitis

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87
Q

single most common finding in infants with CRS (congenital rubella syndrome)

A

deafness

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88
Q

most serious eye finding in CRS (congenital rubella syndrome) and what is the most common ocular abnormality

A
  • cataract; * salt and pepper retinopathy
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89
Q

most common heart defect in CRS

A

PDA

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90
Q

most devastating result of polio

A

paralysis

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91
Q

paralysis in polio appears when

A

3-8 days after initial symptom

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92
Q

occurs in the 2nd phase of polio with severe muscle pain asymmetric flaccid paralysis with paresis commonly involving 1 leg

A

spinal paralytic polio

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93
Q

polio after IM injection

A

provocation paralysis

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94
Q

rope sign, dysfunction of cranial nerves, palatal and pharyngeal weakness , ascending paralysis. what disease

A

bulbar polio

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95
Q

diagnosis of polio

A

2 stool exam 24-48 hrs apart

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96
Q

vaccine associated paralytic polio

A

polio after receiving oral polio 7-14 days before

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97
Q

hand and foot mouth disease is caused by

A

cocksakie A16

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98
Q

enterovirus that causes myocaridtis and pericarditis

A

cocksackie B

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99
Q

most common cause of meningitis in mumps immunized population

A

enterovirus

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100
Q

enterovirus that does not grow in culture

A

cocksackie A

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101
Q

cause of 5th disease or erythema infectiousum

A

parvovirus b19

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102
Q

this virus affects the erythroid cell line and has no effect on myeloid thus causes aplastic crisis

A

parvovirus B19

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103
Q

virus associated with hydrops fetalis

A

parvovirus b19

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104
Q

slapped cheek

A

5th disease - parvovirus b19

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105
Q

what is the most common manifestation of parvovirus b19 in immunocompromised

A

chronic anemia

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106
Q

syndrome of parvovirus b19 that is characterized as purpuric rash in hands and feet

A

papular purpuric sock and gloves syndrome

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107
Q

what is not used as a treatment of parvovirusb19 induced arthropathy

A

IVIG

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108
Q

where does latent hsv and VZV lays dormat

A

in the sensory ganglion neuron

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109
Q

leading cause of fatal encephalitis in children

A

hsv encephalitis

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110
Q

hallmark of hsv infection

A

skin vesicles and ulcers

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111
Q

6 mos - 5yrs, painful vesicles in the mouth , drooling, sudden onset. what is the diagnosis

A

herpetic gingivostomatitis

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112
Q

herpes from rugby playing

A

scrumpox

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113
Q

herpes from wrestling

A

herpes gladiatorum

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114
Q

hsv of the paronchia seen in patients who suck their thumb

A

whitlow

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115
Q

csf analysis of this disease shows moderate mononuclear, erythrocytes, protein increase and normal to low glucose

A

hsv encephalitis

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116
Q

hsv, recurrent aspetic meningitis called

A

mollaret meningitis

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117
Q

most common aseptic meningitis

A

HSV (other: coxsackie b)

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118
Q

fever is uncommon in this type of encephalitis

A

hsv enceph

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119
Q

the best test for hsv infection

A

viral detection by pcr or virus isolation

120
Q

tx for hsv

A

acyclovir

121
Q

tx of herpes labialis

A

oral valacyclovir

122
Q

in hepes gladiatorum what meds can prevent recurrence

A

oral valacyclovir

123
Q

hsv associated erythema multiforme is treated with antivirals T or F

A

false, it has no effect

124
Q

chicken pox is infective during

A

1-2 days before vesicles and 3-7 days after when they are crusted

125
Q

illness of varicella being __ days after exposure

A

14-16 days

126
Q

incubation period of varicella

A

10-21 days

127
Q

simultaneous presence of lesion in various stage is characteristic of what infection

A

varicella

128
Q

distribution of rash in varicella is __

A

centripetal [THINK Centri-petal = center seeking, centri-fugal = center fleeing]

129
Q

varicella that occurs in person vaccinated more than 42 days before rash

A

breakthrough disease caused by wild type of varicella

130
Q

if the mother has varicella __ days prior to delivery she may pass the virus to the child but it is attenuated since there is Ab of the mother passed also.

A

more than 5 days

131
Q

maternal varicela IgG can pass through the placenta at what aog

A

by 30 wks

132
Q

neonate with cicatrical skin scarring with limb hypoplasia and neurologic manifestation

A

congenital varicella syndrome

133
Q

leukopenia is low in the first __ of varicella infection

A

72 hrs

134
Q

varicella vaccine is given when

A

total of 2 dose on 12-15 months and 4-6 year old; pag catch up na less than 12 – 2 dose 3 months apart and pag more than 12, 2 dose na 1 month apart

135
Q

post exposure prophy for varicella can be given if exposure is

A

3- 5 days after exposure

136
Q

new borns whose mother has varicella 5 days before delivery or 2 days after delivery should be given

A

1 vial of Varicella Ig

137
Q

amphotericin is inactive in this sp of candida

A

c. lusitanea

138
Q

fluconazole is inactive againts this strain of candida

A

c. krusei and some gabrata

139
Q

what is the most common clinical syndromes associated with m. pneumoniae infection

A

tracheobronchitis and bronchopneumonia

140
Q

lobar infiltrates with necrotizing pneumonia with normal wbc but elevated esr

A

m. pneumoniae infection

141
Q

tx for m pneumoniae infection

A

claryth or azith

142
Q

bacteria that is the most common infectious agent in SJS

A

m. pneumoniae

143
Q

treatment for NGU (ureaoplasma and m. hominis)

A

1 dose azith and doxy for 7 dyas

144
Q

the absence of ___ differentiates c trachomatis pneumonia from rsv

A

fever and wheezing

145
Q

blood result of c trachomatis infection shows increased

A

peripheral eosinophilia

146
Q

the most common cause of pyogenic skin and soft tissue infection

A

s. aureus

147
Q

TSS caused by staph aureus is associated with

A

mensturation and focal staph infection

148
Q

food poisoning caused by s. aureus is caused by ingestion of ___

A

preformed toxin

149
Q

tx of life threatening s aureus infection

A

vanco plus genta or vanco plus rif

150
Q

tx for non life threatening aureus infection

A

nafcillin or oxacillin; clindamycin

151
Q

tx for mrsa

A

vanco + genta or ; vanco + rif

152
Q

drug test that confirms effectivity of clinda for aureus infection

A

D-test

153
Q

diagnosis of tss is based on __

A

clinical manifestation

154
Q

major criteria of TSS caused by aureus in which all are required

A

REMEMBER: HAR-Tss – hypotension, acute fever, rash

155
Q

scarliniform rash with desquamation of the hands and soles associated with shock, strawberry tongue

A

TSS aureus

156
Q

most common cause of nosocomial bacteremia associated with vascular catheter

A

CONS particularly s. epidermidis

157
Q

most common cause of shunt meningitis

A

CONS

158
Q

most common cause of uti in sexually active females

A

saphrophyticus

159
Q

DOC of CONS

A

vanco

160
Q

the second most common cause of meningitis in children

A

strep pnemoniae

161
Q

round pneumonia with 2 day hx of cough and spiking fever. there is also leukocytosis. what is the dlt

A

strep pneumonia, culture, cefotaxime ceftri clinca vanco

162
Q

if erythromycin is resistant to streo pneumo and clinda is sensitive what should you do

A

do a D-test of clinda, if it is positive you can not use it anymore since resistance with clinda can be induced by the organism

163
Q

the most common cause of osteomy and suppurative arthritis in children

A

s. aureus

164
Q

penicillin prophylaxis is often administered for at least ___ after splenectomy

A

2 yrs after or upto 5 yrs of age

165
Q

pneumococcal vaccination is given

A
  • 3 doses 1 month apart for 2-6 mos then booster at 12 to 15 months * 2 doses 2 months apart for 7-11 mos with booster on 12-15 mos * if more than 1 year old 2 doses no booster
166
Q

what strep pyogenic exotoxin is responsible for the rash of scarlet fever

A

toxin A,B,C

167
Q

patient has upper respiratory tract infection and on after 24- 48 hrs punctate rash on the neck spreading to the trunk which blanches on pressure. the skin is rough and has goose pimple feel. no rash on the face after 3 days the rash desquamates cephalocuadally. there is strawberry tongue appearance

A

scarlet fever caused byGAS

168
Q

swollen red tender superficial bleb on the skin that has slightly elevated border involving the deeper layer of the skin

A

erysepelas caused by GAS

169
Q

the most common cause of prepubertal vaginits

A

GAS

170
Q

criteria of strep tss

A

clinical criteria: hypotension plus 2 of CHARGS - coagulopathy- hepatic involvement - ards - generalized rash - renal impairment - soft tissue necrosis; definitive case: culture form sterile site

171
Q

the most common cause of acute paryngitis

A

virus

172
Q

most common cause of bacterial phayrngitis

A

GAS

173
Q

DOC of GAS

A

penicillin

174
Q

bacteria associated with PANDAS ( neurospsychiatric disease ) TiC,tourettes, chorea

A

GAS

175
Q

if treatment is started within _ days of onset for GAS infection, rheumatic fever is prevented

A

9 days

176
Q

major jones criteria

A

SPECC - subcutaneous nodules - polyarthritis - erythema marginatum - chorea - carditis

177
Q

minor jones criteria

A

CAPE FP - crp elevated - arthralgia - phase reactants - esr - fever - prolonged pr interval

178
Q

positive result in jones criteria

A

2 major or 1 major 2 minor

179
Q

may occur as the only manifestation of acute rheumatic fever

A

chorea

180
Q

the only manifestation of acute rheumatic fever months after having acute rheumatic fever

A

carditis

181
Q

the joints affected in ARhF

A

larger joints (WEAK) - wrist - elbows - ankles - knees

182
Q

True or False

A

TRUE

183
Q

most serious manifestation of ArhF

A

carditis ( particularly Endocarditis) and chronic rheumatic heart disease

184
Q

major consequence of rheumatic carditis

A

valvular stenosis

185
Q

erythematous,serpinginous macular lesion with pale centers that are non puritic seen in trunk and extremities only. it is seen in ArhF

A

erythema marginatum

186
Q

tx for ArhF

A

10 days of pen G or 1 dose of IM Benz PenG then start long term prophylaxis

187
Q

in patients with carditis in ARhF what meds should you start aside from pen G

A

aspirin, prednisone

188
Q

DOC for syndenhams chorea

A

Phenobarbital, if not effective you give haloperidol or chlorpromazine

189
Q

antibiotic prophlaxis for ARhF should continue for how long

A

for 5 yrs or until 21 yrs old whichever is longer

190
Q

what is the prophy antibiotic regimen for ARhF

A

600,00IU in

191
Q

duration of treatment for RF with carditis

A

10 yrs or until 21 yrs which ever is longest

192
Q

duration of treatment for RF with residual heart disease or valvular disease and carditits

A

10 yrs or until 40 yrs which ever is longer ( sometimes lifelong treatment is needed)

193
Q

late onset GBS infection presents in __ days

A

more than 7 days

194
Q

more common serotypes in late onset GBS

A

serotype III

195
Q

the most common manifestation of early onset GBS is

A

sepsis

196
Q

the most common manifestation of late onset GBS is

A

bacterimia and meningitis

197
Q

late onset GBS infection is more severe than early onse. True or False

A

TRUE

198
Q

syndromes common in childhood GBS disease beyond early infancy

A

bacteremia and endocarditis

199
Q

doc of GBS

A

Penicillin

200
Q

duration of treatment for GBS ventriculitis and oseteomyelitis

A

4 weeks

201
Q

duration of treatment for bacteremia without focus in GBS

A

10 days

202
Q

duration of treatment for GBS meningitis

A

2-3 weeks

203
Q

periventricular leukomalacia and dev delay are complications of what disease causing meningitis

A

GBS

204
Q

corynobacterium that is urease positive

A

C. ulcerans

205
Q

most common site of diptheria

A

pharynx and tonsils; the second is nose and larynx

206
Q

the universal early sx of diptheria

A

sore throat

207
Q

bull neck appearance

A

diptheria

208
Q

tissue affected by diptheretic toxin

A

heart and CNS

209
Q

tx of diptheria

A

diphtheria antitoxin; erythromycin for carriage

210
Q

when an asymptomatic carrier is identified prophylaxis for diptheria is given for how many days

A

10-14 days then give dt if no booster as been given within 1 yr

211
Q

the only contraindication for tetanus and diptheria toxoid

A

hx of neurologic or severe hypersensitivity reaction to previous dose

212
Q

Diptheroid toxin should be not be given frequently than every __

A

10 yrs

213
Q

umbrella type formation in medium is characteristic of what bacteria

A

listeria

214
Q

the only mode of transmission of listeria

A

maternal fetal transmission only

215
Q

most common manifestation of late onset listeriosis ( >/= 5 days)

A

neonatal meningitis

216
Q

manifestation of early onset listeria

A

neonatal sepsis

217
Q

history of oral trauma/ dental procedure; painless slow growing mass with fistula; what is it called and is the etiologic agent

A

lumpy jaw; actinomycosis

218
Q

the hallmark of actinomycosis

A

spread that fails to respect tissue or facial planes

219
Q

the pathogenic strain of n. meningitidis

A

A,B,C, W-135 and Y

220
Q

what age is the highest incidence of meninggococal disease

A

less than 1 yr old

221
Q

what are the clinical hallmark of severe meningococcal sepsis

A

activating coagulation, bleeding, stimulating cytokine

222
Q

the severity of meninggococcal disease is related to the level of exotoxin in the bloodstream; true or false

A

false, endotoxin related

223
Q

diffuse adrenal hemorrhage without vasculitis seen in fulminant meningococcemia is called what syndrome

A

waterhouse-friderchisen syndrome

224
Q

a meningococcemia that progresses from without sx to shock in several hours and purpura

A

fulminant meninggococcemia

225
Q

diagnostics of meningo and treatment

A

culture of blood csf or synovial fluid; penicillin ampi ceftri

226
Q

most common neurologic sequelae of meningo meningitis

A

deafness

227
Q

prophylaxis for Neisseria carriage

A

rifam 15- 10mgkg for 2 days a cipro one dose

228
Q

meninggo vaccine recommendation

A

one dose at 11-19 yrs old booster after 5 yrs; if high risk group 2 dose 2 months apart

229
Q

most common sexually transmitted infection in sexually abused children

A

n gonorrhea

230
Q

cause PID in post pubertal females

A

gonorrhea

231
Q

dissemination of gonorrhea from fallopian tube through the peritoneum to the liver capsule causing perihepatitis is seen what syndrome

A

fitz hugh curtis syndrome

232
Q

initial sx of disseminated gonorrhea

A

acute onset poly arthralgia with fever

233
Q

tx of gonorrhea

A

ceftriaxone (even in pregnant and for neonates )IM single dose or cefixime single dose

234
Q

doc of H influenza

A

amoxicillin

235
Q

what are the most common cabteria of otitis media? otitis externa?

A
  • PIM - s. pneumoniae, h. influ, moraxella * pseudomonas
236
Q

prophylaxis for h influ exposure

A

rifampicin for 4 days

237
Q

painful genital ulceration (chancroid) is caused by

A

h. ducreyi

238
Q

buboes are formed by

A

h ducreyi

239
Q

tx for chancroid

A

azith OD or Ceftri IM OD

240
Q

severe coughing episodes with extreme gasps for air followed by vomiting

A

pertussis

241
Q

neither natural disease nor vaccination provides complete or lifelong immunity against this bacteria. protection wanes 3- 5 yrs after vaccination

A

pertussis; DTaP protective until adolescence

242
Q

Contraindications to DTaP

A

-immediate anaphylactic reaction, encephalopathy, CNS complication w/in 7 d –> give DT instead of DTaP (adverse reactioins attributed to pertussis component of vaccine)

243
Q

__- marks the start of paroxysmal stage of pertussis

A

coughing

244
Q

infants __ age does not manifest the classic stage of pertussis – sudden onset of reddening of face, choking, gagging and gasping (ALTE)

A

less than 3 months

245
Q

leukocytosis is seen in what stage of pertussis

A

cattarhal stage

246
Q

not a manifestation of pertussis

A

eosinophilia

247
Q

tx of pertussis

A

macrolide (azith is preferred) x 14 days – catarrhal stage; hospitalize infant

248
Q

machine gun-like cough

A

pertussis

249
Q

Stages of whooping cough

A

1) catarrhal stage: congestion & rhinorrhea; 2 wks 2) paroxysmal stage: coughing + gasping for air + vomiting + burst of eye blood vessels; 3o days 3) convalescent stage: decreased cough freq; 2 wks

250
Q

-CXR: “butterfly pattern”(clouded mid lung fields)

A

pertussis

251
Q

Whooping cough, Retinal hemorrhage, child stroke

A

pertussis

252
Q

1 child preventable dz

A

pertussis

253
Q

the most common clinical presentation of salmonellosis

A

acute enteritis

254
Q

tx of salmonella AGE

A

ceftri, cefotox, ampi ceficime

255
Q

incubation of typhoi

A

1-2 wks

256
Q

rash in typhoid

A

rose spot in trunk on 7th day of illness

257
Q

most common extra intestinal manifestation of bacillary dysentery (shigella)

A

neurologic

258
Q

most common complication of shigellosis

A

dehydration

259
Q

tx of shigellosis irrespective of age

A

ciprofloxacin

260
Q

e coli that causes bloody diarrhea

A

invasive and shiga toxin

261
Q

antibiotic should not be given to this type of e coli because it may increase the risk of HUS

A

STEC

262
Q

most severe form of cholera

A

cholera gravis

263
Q

DOC for severe cholera

A

doxycycline or tetracycline; alternative is erythromycine

264
Q

syndrome associated with campylobacter

A

GBS

265
Q

yersinia enterocolitica is associated with what vasculitis

A

kawasaki

266
Q

ecthyma gangrenosum ( gangrenous skin lesion with eschar ) is caused by

A

pseudomonas

267
Q

prominent symptom of infant botulism

A

loss of head control

268
Q

antibiotic therapy is not part of the treatment of this disease

A

infant botulinism – toxin is intracellular

269
Q

clinical hallmark of botulism

A

fatiguability with repetitive muscle activity

270
Q

__source of botulism, not a safe food for children less than 1 yr

A

honey

271
Q

localized tetanus involving bulbar musculature is called

A

cephalic tetanus

272
Q

poor prognosis in tetanus is onset of trismus in less than 7 days and onset of tetanic spasm in __-

A

less than 3 days

273
Q

flesh eating bacteria

A

gas

274
Q

measles Ig is given until how many days post exposure

A

vaccine is given 72 hrs; Ig is given until 6 days

275
Q

what complement is decreased in dengue

A

c3

276
Q

rash of dengue

A

morbilliform rash that spares the palms and soles

277
Q

criteria for dengue hemorrhagic fever

A

fever, major/minor bleeding, thrombocytopenia (= 100), increase permeability (hct >20%), effusion (ascitis/pleural eft), hypoalbuminemia

278
Q

dengue shock criteria

A

criteria of hemorrhagic + hypotension, narrow pulse, poor perfusion, tachycardia

279
Q

h/o vaccination delinquency; hot potato voice(muffled); fever; drooling in tripod position; refuses to lie flat

A

Epiglotitis

280
Q

T/F Epiglotitis is a life-threatening emergency

A

T

281
Q

T/F In Epiglotitis, do not inspect airway

A

T, bronchospasm may completely obstruct the airway

282
Q

what agent causes epiglottitis

A

unimmunized-haemophilus influenza type B; immunized-streptococcus spp

283
Q

acute onset high fever,Respiratory distress: drooling, dysphagia, inspiratory retractions, neck hyperextension, sniffing dog position, leaning forward

A

Epiglotitis

284
Q

Xray is the initial diagnostic test for epiglotitis

A

F

285
Q

how to treat epiglottitis

A

-intubation in OR(initial!) -tracheostomy(2ndary) -ceftriaxone for 7-10 days -rifampin to all close contacts!

286
Q

Definitive diagnosis of epiglottitis

A

fiberoptic visualization of cherry red epiglottis

287
Q

floppy epiglottis, disproportionately small soft larynx; noisy breathing, worse with lying on back (gravity); larygoscopy: collapse of laryngeal structures during inspiration; no treatment needed, resolves by 18 months

A

traceomalacia/laryngomalacia

288
Q

MCC of stridor in children

A

traceomalacia/laryngomalacia

289
Q

what does the steeple sign specify in resp tract imaging

A

croup (LTB), represents SUBGLOTTIC narrowing

290
Q

what causes croup

A

parainfluenza virus 1 & 2 (mcc); RSV(2nd mcc)

291
Q

barking cough!; coryza; INSPIRATORY stridor; worse dyspnea upon lying down + possible hypoxia (not in epiglottitis!, develops later)

A

croup (LTB)

292
Q

how to dx croup (LTB)

A

1) clinical(initial) 2) XR: steeple sign!; not initial next step!

293
Q

Treatment of Croup based on severity

A

1) mild: cool mist tx, fluids 2) moderate: supp O2, IM corticosteriods, nebulized racemic epinephrine 3) severe: nebulized racemic epinephrine-racemic (not intubation (for epiglottitis)!)

294
Q

inflammation of the larynx w/in the sub-glottic space

A

croup (LTB)

295
Q

Seal-like cough

A

Croup

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