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[MS] ID Flashcards

1
Q

What are the reasons for Staphylococcus aureus to have pathogenicity?

A

Enterotoxin, Endotoxin, Coagulase, and PV leukocidin

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2
Q

What is the gene that confers methicillin-resistance?

A

mecA

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3
Q

What are the common findings of Bullous Impetigo?

A

Flaccid, coalescent pustules with bullae on previously normal skin

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4
Q

What does a positive D-test indicate when treating a skin infection?

A

Do NOT use Clindamycin to treat the S. aureus infection

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5
Q

What patients are at risk for Staphylococcus aureus infections of the CNS?

A

Severe congenital cyanotic heart disease due to septic emboli
Patients post-neurosurgery

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6
Q

When do patients with toxic shock syndrome show desquamation of the hands/feet?

A

1 to 2 weeks after onset

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7
Q

What are the criteria to diagnose toxic shock syndrome?

A

Temperature greater than 38.9 Centigrade
Systolic blood pressure less than 90 (or 5th percentile)
Rash with subsequent desquamation
Involvement of more than 3 organ systems
Negative serology for RMSF, measles, and leptospirosis

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8
Q

Which type of toxic shock syndrome typically has positive blood cultures?

A

Streptococcal

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9
Q

What is the treatment for streptococcus-induced toxic shock syndrome?

A

Penicillin + Clindamycin with or without IVIG

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10
Q

What is the cause of Staphylococcal Scalded Skin Syndrome?

A

Exfoliative toxins A and B

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11
Q

What are the common presenting symptoms of Staphylococcal Scalded Skin Syndrome?

A

Fever with Nikolsky sign (a rash that causes removal of the superficial epidermis with minimal friction)

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12
Q

What is the most common cause of food poisoning?

A

Staphylococcus aureus

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13
Q

What is the typical course for Staphylococcal food poisoning?

A

Incubation period of less than 4 to 6 hours

Duration of 1 to 2 days

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14
Q

What antibiotics are most strains of Staphylococcus epidermidis resistant to?

A

Methicillin

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15
Q

What type of infection dose Staphylococcus saprophyticus cause?

A

UTIs in adolescent females

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16
Q

What is the most common cause of late-onset sepsis in preterm infants?

A

Coagulase-negative Staphylococcus

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17
Q

What serotype of pneumococcus currently causes the most amount of invasive disease?

A

19A

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18
Q

What are the symptoms of post-splenectomy pneumococcal sepsis?

A

Flu-like symptoms, purpura, and DIC

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19
Q

What are the symptoms associated with Streptococcus pyogenes pharyngitis?

A

Temperature greater than 100 degrees Fahrenheit
Tender cervical lymphadenopathy
Exudative pharyngitis

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20
Q

How many days should antibiotics be started by in order to reduce the risk of Acute Rheumatic Fever?

A

Within 9 days

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21
Q

What is the common presentation of Scarlet Fever?

A

Fine, diffuse, red rash with acute streptococcal pharyngitis

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22
Q

What is the difference between Erysipelas and Impetigo?

A

Erysipelas is tender and involves deeper layers of the skin

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23
Q

What is the treatment of choice for an Erysipelas infection?

A

Surgical debridement
Penicillin
Clindamycin

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24
Q

What is the most common reason for Penicillin failure when treating Streptococcus pyogenes infections?

A

Non-adherence to the regimen

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25
Q

What are the key defining differences in post-Streptococcal glomerulonephritis and IgA nephropathy?

A

Post-Strep GN occurs roughly 21 days post-illness

IgA Nephropathy occurs within 5 days post-illness

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26
Q

What bugs are treated by Ampicillin in neonatal infections?

A

Group B Streptococcus
Listeria
Enterococcus

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27
Q

What are the associated factors seen with early-onset GBS infection in neonates?

A 
Within 7 days of birth
History of obstetric complications
History of prematurity
Septecemia is the most common presentation
Fatality rates between 5% and 15%
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28
Q

What is the most common presentation of group C Streptococcus infection?

A

Outbreaks of pharyngitis in college students

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29
Q

What are the classic symptoms of a diphtheria infection?

A 
Upper respiratory tract infection
Gray-white pharyngeal membrane
Hoarseness and sore thorat
Low-grade fever
Bull-neck sign
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30
Q

What is the treatment for diphtheria?

A

Diphtheria equine antitoxin

Erythromycin

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31
Q

What are the symptoms of an Arcanobacterium hemolyticum infection?

A

Fever, pharyngitis, and a desquamative rash but no petechial palatal hemorrhages or strawberry tongue

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32
Q

What are the three most common presentations of Anthrax?

A

Cutaneous
Gastrointestinal
Pulmonic (“wool-sorters” disease)

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33
Q

What are the symptoms of cutaneous Anthrax?

A

Painless papule to painless vesicle to painless ulcer to painless black eschar with painless induration

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34
Q

What is the prophylaxis of choice for Anthrax?

A

Ciprofloxacin or Doxycycline

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35
Q

What is the typical facial feature of a tetanus infection?

A

Risus Sardonicus – raised eyebrows, narrowed palpebral fissures, downward angles of the mouth, and pressure of the upper lips into the teeth

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36
Q

What is the treatment of tetanus?

A

Human Tetanus Immune Globulin

Metronidazole

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37
Q

What is the next step for the following patient:

Marla has a clean injury and a minor wound from a staple. Her tetanus status is unknown, but the mother feels that it is less than three vaccines total.

A

Give Tdap if 7 years or older
Give DTaP if less than 7 years
Do not do anything if more than 3 vaccines have been given with the most recent within 10 years

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38
Q

What is the next step for the following patient:

Marla steps on a nail covered in cow feces. Her dog attempts to lick the wound clean. Her immunizations are known.

A

If less than 3 immunizations, then give Tdap/DTaP and Human TIG
If 3 or more immunizations but greater than 5 years ago, give Tdap/DTaP
If more than 3 immunizations and 5 or less years ago, then do nothing

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39
Q

Who should receive prophylaxis when exposed to a person with Neiseria meningitidis?

A

Household contacts
Daycare contacts
Close intimate contacts
Passengers seated directly next to the index case on a flight lasting greater than 8 hours

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40
Q

What are the various stages of eye discharge in the neonatal period typically associated with?

A

0 to 48 hours – chemical irritation
2 to 7 days – Gonorrhea
7 to 14 days – Chlamydia

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41
Q

What bacteria should be considered after a nail puncture wound through a tennis shoe?

A

Pseudomonas aeruginosa

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42
Q

What is the classic presentation of infantile shigella infections?

A

An infant that presents with a seizure and has a large bloody stool during the lumbar puncture

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43
Q

What is a known complication of Shigella infections?

A

Seizures

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44
Q

When may kids with Shigella return to daycare?

A

When the diarrhea has stopped for more than 24 hours and the stool cultures are negative

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45
Q

What is the most common reservoir for Yersinia enterolitica?

A

Pigs

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46
Q

What are the most common locations for patients to develop Legionairre’s disease symptoms?

A

GI tract - diarrhea
Brain - CNS disease
Kidney - AKI

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47
Q

What are the major types of Brucella infections?

A

Culture negative endocarditis
Thyroiditis
Sacroiliitis

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48
Q

What is the typical reasoning for recurrence of Brucella infections?

A

Premature discontinuation or monotherapy

Resistance is not a factor

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49
Q

What are the morphologic and geographic characteristics of Tularemia?

A

Small, gram-negative pleomorphic bacillus

Found mostly in Arkansas, Missouri, and Oklahoma

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50
Q

What are the two diseases that are caused by Bartonella henselae?

A 
Cat Scratch Disease (immunocompotent)
Bacillary Angiomatosis (immunocompromised)
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51
Q

What is the presentation and cause of the Oculoglandular Syndrome of Parinaud’s?

A

Presents with conjunctivitis with ipsilateral preauricular lymphadenitis. Caused by Bartonella henselae.

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52
Q

What is the typical treatment for Cat Scratch disease?

A

Symptomatic with or without Azithromycin

53
Q

What infection most commonly causes Guillan-Barre syndrome?

A

Campylobacter

54
Q

What are the typical vectors for Campylobacter infections?

A

Puppies and kittens

55
Q

What is the treatment of choice for Campylobacter infections?

A

Azithromycin or Erythromycin

56
Q

What is a common complication of Citrobacter infections?

A

Brain abscess

57
Q

What is the cause of Rocky Mountain Spotted Fever?

A

Rickettsia rickettsii (gram-negative coccobacillus)

58
Q

What is the mnemonic for Q fever?

A

Cattle
Cats
Conception
Coxiella (Q fever)

59
Q

What other organisms can be seen in coinfections with Erlichia?

A

Babesia microti

Borriela burgdorferi

60
Q

What is the treatment for the most commonly tested gram-variable organism?

A

Metronidazole to treat Gardnerella vaginalis

61
Q

What is the primary treatment for lymphadenitis from MAC in immunocompetent hosts?

A

Node excision

62
Q

What is the 4-drug regimen for treatment of tuberculosis?

A

Rifampin + Isonazid + Pyrazinamide + Ethambutol

63
Q

What is the most common side effect of Ethambutol?

A

Decrease in visual acuity with early decreased color perception

64
Q

What is the most common means of transmission for Leptospirosis?

A

Dog or rat urine

65
Q

What is the classic description of a Candidal diaper rash?

A

Bright red, fiery rash with sharp borders and pinpoint “satellite” papules/pustules

66
Q

What are the two treatment options for a Candidal urinary tract infection?

A

Fluconazole

Removal of an indwelling Foley catheter

67
Q

What is the best test to perform to evaluate for sequelae from Candidal sepsis?

A

CT scan to look for hypodense abscesses

68
Q

What is the treatment for Candidal sepsis?

A

Removal of the catheter
Amphotericin B (neonates) or Fluconazole/Micafungin (immunocompotent)
Resection of all suppurative veins

69
Q

What are the findings associated with Cryptococcus infections?

A

Contact with pidgeon droppings
Pulmonary cavitary lesions
Peripheral “cannonball” skin lesions

70
Q

What is the most severe form of Cryptococcal infection and how is it treated?

A

Cryptococcal meningitis
Treated with Amphotericin B and 5-Flucytosine
Can treat less ill patients with Fluconazole

71
Q

What is the most common complaint in immuncompromised patients with esophageal Candidaisis?

A

Pain with swallowing

72
Q

What are the most important data regarding Coccidiodes infections?

A

Located in the US Southwest (“Valley Fever”)
Disease presents weeks after inhalation
Presents as a self-limited flu-like illness

73
Q

What is the most important data regarding Histoplasma infections?

A

Located in the Mississippi and Ohio River valleys
Presents as an asymptomatic interstitial pneumonia, palatal ulcers, and splenomegaly
Treat symptomatically or with Itraconazole and Amphotericin B

74
Q

What is the most important data regarding Blastomyces infections?

A

Located in Arkansas and Wisconsin hunters/loggers (“Beaver Dam” exposure)
Presents similar to Histoplasma, but with skin crusted lesions and bony lesions
Treat with Itraconazole and Amphotericin B

75
Q

What is the hallmark sign of an invasive Aspergillus infection?

A

Angioinvasion with thrombosis and dissemination, likely secondary to the fumigatus or flavus strains

76
Q

What is the classical morphology of Aspergillus seen underneath the microscope?

A

Branched and septate hyphae on KOH preparation

77
Q

What is the treatment of choice for invasive Aspergillosis?

A

Voriconazole (Amphotericin in neonates)

78
Q

What is the organism that causes tinea versicolor and what is the more severe disease it causes?

A

Caused by Malassezia furfur. It can present as a fever and bilateral pulmonary infiltrates in NICU babies receiving TPN

79
Q

What types of people typically contract Sporotrichosis and what is the treatment?

A

Rose gardeners contract it. Treat with Itraconazole.

80
Q

What are the features seen with severe congenital toxoplasmosis?

A

Microcephaly, hydrocephalus, hepatosplenomegaly, thrombocytopenic purpura, chorioretinitis, and widespread intracranial calcifications

81
Q

What is the postnatal treatment for congenital toxoplasmosis?

A

Pyrimethamine, sulfadiazine, and leucovorin for 12 months

82
Q

What is the treatment for cryptosporidium-induced diarrhea?

A

Nitazoxanide

83
Q

Where are cryptosporidium outbreaks most likely to arise from?

A

Swimming pools

84
Q

What are the differences between Cryptospora and Isospora?

A

Isospora is seen in HIV patients, and is large and oval
Cryptospora is small and round
Treat Isospora with TMP-SMX

85
Q

What is the usual source of Cryptospora infections?

A

Imported food from developing countries

86
Q

What is the most diagnostic finding consistent with falciparium Malaria?

A

“Banana” gametocytes on peripheral blood smear

87
Q

What type of malaria is most commonly associated with nephrotic syndrome?

A

P. malariae

88
Q

What is the treatment for malaria?

A

Chloraquine with Primaquine for P. vivax and P. ovale to eradicate hypnozoites

89
Q

What are the main reasons for malaria in the US?

A

Not taking Chloraquine prophylaxis

Stopping the prophylaxis too soon

90
Q

What is the prophylaxis regimen for malaria?

A

1 to 2 weeks before leaving

4 to 6 weeks after returning

91
Q

What are the defining features of Babesiosis?

A

Febrile
Hemolytic anemia
“Maltese cross” in the blood cells

92
Q

What is the most common disease-causing parasite in the US?

A

Giardia lamblia

93
Q

What is a common infectious cause of pruritis ani?

A

Pinworms (Enterobius vermicularis)

94
Q

What is the most common complication from Varicella infections?

A

Secondary bacterial infections

95
Q

How long are children potentially contagious after being exposed to Varicella zoster?

A

Day 10 to 21 post-exposure

96
Q

What is the treatment of choice for symptomatic congenital CMV infection?

A

IV Ganciclovir

97
Q

What is the most common side effect of Foscarnet?

A

Reversible renal failure

98
Q

How long should patients with EBV-induced splenomegaly avoid contact sports?

A

1 to 3 months

99
Q

What are the symptoms associated with Roseola (“sixth disease”)?

A

Fever for 3 to 5 days followed by an abrupt cessation of fever and development of a maculo-to-maculopapular rash

100
Q

What are the classic findings associated with Rubella (“German Measles”)?

A

Postauricular and occipital lymphadenopathy
Rash spreading from face to trunk
Low-grade fever

101
Q

What two congenital infections are associated with a “blueberry muffin” baby?

A

Rubella

CMV

102
Q

What are the symptoms associated with Rubeola (“Measles”)?

A

Cough
Coryza
Conjunctivitis (with photophobia)
Koplik spots on the buccal mucosa (before the rash)
Rash starting at the hairline and spreading downward

103
Q

What is the preferred intervention for cases of measles outbreaks?

A

Measles vaccine given within 72 hours of exposure to those as young as 6 to 11 months. If otherwise at risk, give immunoglobulin.

104
Q

What type of influenza vaccine can children with mild egg allergies be given?

A

Trivalent Inactivated Vaccine

105
Q

What is the next step if a non-Hawaiian child wakes up with a bat in their room?

A

Prophylaxis against raibes

106
Q

What are the symptoms of rabies?

A

Restlessness
Excitement
Severe spams of the larynx when looking at water

107
Q

What is the rash associated with erythema infectiosum?

A

Slapped cheeks that turns lattice-like when exposed to sun or hot water

108
Q

What are the symptoms of Dengue fever?

A

Severe myalgias with high fevers

Retro-orbital pain leading to a rash over the body and ending with a recurrence of the fever

109
Q

What strains of HPV cause cervical cancer?

A

16, 18, 31

110
Q

What are the symptoms of subacute sclerosing panencephalitis?

A

Dementia, myoclonus, and new-onset seizures from a mealses infection at less than 2 years of age

111
Q

What therapies have successfully reduced the mother-to-child transmission of HIV?

A

ART during pregnancy
Zidovudine during delivery
6 weeks of twice daily Zidovudine in newborns
No breastfeeding

112
Q

What is the means of diagnosis of HIV in children older than 18 months?

A

EIA Test
Westen blot (confirmation)
HIV DNA PCR (earliest sign)

113
Q

What are the key side effects of Zidovudine?

A

Bone marrow suppression

Myopathy

114
Q

What is the most common side effect of Didanosine?

A

Pancreatitis

115
Q

What is the most concerning side effect of Abacavir?

A

Fatal hypersensitivity reaction

116
Q

What is the utility of testing HIV viral load?

A

Good, long-term predictor of outcome

117
Q

Which combinations of antiretrovirals are INCORRECT when exposed to HIV?

A

Zidovudine + Didanosine combined
Zalcitabine as an option
Single-drug therapy

118
Q

Which situations do NOT require postexposure prophylaxis to HIV?

A

Intact skin exposure

Urine source exposure

119
Q

Which vaccines should HIV-exposed children be given?

A

All vaccines, but only give Live vaccines if the CD4+ count is greater than 15%

120
Q

What causes the neoplasia of blood vessels in HIV patients (Kaposi sarcoma)?

A

HHV-8

121
Q

What are the symptoms of acute retroviral syndrome?

A

Mononucleosis-like syndrome that occurs 2 to 4 weeks after exposure and lasts 1 to 2 weeks

122
Q

What are the Duke criteria for endocarditis?

A

Major - Positive Blood Culture or Abnormal Echo
Minor - Predisposing Condition, Fever, Vascular Phenomenon, Immunologic Phenomenon, Blood Culture Positive
Diagnosis - 2 Major, 1 Major + 3 Minor, or 5 Minor

123
Q

What organism should be considered to cause meningitis in patients who swim in brackish water?

A

Naegleria fowleri

124
Q

What nerve palsy classically manifests with Tuberculosis meningitis?

A

CN XI

125
Q

What is the most common cause of encephalitis in the United States?

A

Arbovirus

126
Q

What are the potential antimicrobial therapies for entertoxigenic E. coli induced diarrhea?

A

Azithromycin
Quinolone
TMP-SMX

127
Q

What is the common presentation of Mycobacterium marinum?

A

Non-healing ulcer in patients who work around fish tanks

128
Q

When may children with Salmonella diarrhea return to daycare?

A

When the diarrhea resolves and after 3 negative stool cultures

Pediatric Boards (15 decks)

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