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Paediatrics RACP Exam Study > Paediatric ID > Flashcards

Paediatric ID Flashcards

1
Q

Name encapsulated bacteria:

A
  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Haemophilus influenzae
  • Neisseria meningitidis
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2
Q

Name viruses in the enterovirus family:

A
  • Enterovirus
  • Coxsackievirus
  • Echovirus
  • Poliovirus
  • RSV
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3
Q

Name catalase-positive microorganisms:

A
  • Nocardia
  • Pseudomonas
  • Listeria
  • Aspergillus
  • Candida
  • E. coli
  • Staphylococcus
  • Serratia
  • Burkholderia cepacia
  • H. pylori
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4
Q

What renal issue is associated with congenital syphilis?

A

Membranous nephropathy

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5
Q

How does parvovirus cause anaemia?

A
  • Cytotoxic to erythroid progenitor cells - binds to red cell P antigen
  • reticulocytopenic anaemia
  • Generally mild unless pre-existing immunocompromise/haemolytic disease
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6
Q

What is hepcidin?

A
  • Decreases extracellular iron
  • Synthesized in liver
  • Reduces ferroportin which causes:
    1. decreased iron absorption by decreased transport across enterocytes
    2. less iron exit from macrophages
    3. reduced iron exit from the liver
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7
Q

Which drugs impair folate ABSORPTION?

A
  • phenytoin
  • primidone (barbiturate)
  • phenobarbitone (barbiturate)
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8
Q

Which drugs have ANTI-folic acid actions?

A
  • methotrexate ( binds to dihydrofolate reductase)
  • Pyrimethamine (treats toxoplasmosis)
  • trimethoprim
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9
Q

Which non-polio enterovirus is associated with paralytic disease?

A

Enterovirus 71

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10
Q

What is the risk of congenital varicella if mother gets infection during 1st/2nd trimester

A
  • 0.4% if maternal infection < 12/40

- 2% if maternal infection 13-20/40

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11
Q

Which bacteria are urease-producing?

A

mnemonic PUNCH

  • Proteus, Klebsiella - predispose to struvite stone production (UTI)
  • Ureaplasma urealyticum
  • Nocardia
  • Cryptococcus
  • Helicobacter pylori
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12
Q

What infection causes fatty acid crystals on faecal microscopy?

A

Giardia (also celiac)

Underlying: digestion/breakdown of fat OK but not being absorbed due to physical defect/metabolic cause e.g. celiac disease or infection

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13
Q

Name first-generation cephalosporins and what they are used for:

A
  • Cefazolin, cefalexin
  • skin and soft tissue infections
  • staph. aureus, group A strep
  • minimal gram -ve cover (e.coli and klebsiella if sensitive)
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14
Q

Name second-generation cephalosporins and what they are used for:

A
  • cefuroxime, cefoxitin, cefaclor
  • gram positive and gram negative cover, less cover for staph
  • chest, urinary tract, skin and soft tissue
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15
Q

Name third-generation cephalosporins and what they are used for:

A
  • ceftazidime, ceftriaxone, cefotaxime
  • meningitis and sepsis
  • won’t cover listeria, enterococcus, staph (except ceftaz)
  • ceftaz - antipseudomonal, anti-staph
  • ceftri - jaundice in neonates as displaces bilirubin from glucuronidation
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16
Q

Name fourth-generation cephalosporins and what they are used for:

A
  • cefipime
  • gram negative cover and can cover staph, strep
  • won’t cover listeria, enterococcus
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17
Q

Which antifungals are best for CNS infection?

A
  • Azoles are good for brain
  • Fluconazole has good brain and CSF concentration
  • Anidulafungin has good CSF but low brain concentration
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18
Q

Super-itchy migratory rash, “serpiginous”, may have been in contact with animal faeces:

A
  • cutaneous larva migrans, associated with cat/dog hookworms
  • ancylostoma braziliense (cat)/caninum
  • albendazole or ivermectin
  • majority self limiting
  • complications are impetigo, local and generalised allergic reactions, hypereosinophilia
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19
Q

How does staph become MRSA?

A
  • Production of altered penicillin-binding proteins (PBPs) in the bacterial cell wall
  • PBP-2A is responsible for the methicillin resistance of MRSA isolates.
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20
Q

What is the exclusion period for chicken pox?

A

Until all lesions are crusted - 6-7 days after onset of rash

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21
Q

Which immunisations are T-lymphocyte independent and what are the clinical implications?

A
  • Polysaccharide immunisations (Pneumovax 23)
  • Poor response after age 2
  • Antibodies last around 3–5 years in children
22
Q

When do you see antibody response to immunisation?

A
  • 7 to 10 days later

- IgM then IgG

23
Q

Which immunisations cannot be frozen?

A
  • DTaP/anything with DTaP components
  • Hepatitis A, B
  • HPV
  • Pneumococcal (conjugate)
  • Influenza (inactivated, split) Hib (liquid)
  • Meningitis C (polysaccharide-protein conjugate)
  • Cholera (inactivated)
  • Inactivated poliovirus
  • Typhoid polysaccharide
  • Rotavirus (liquid)
24
Q

Which immunisations can be frozen?

A
  • Hib (freeze dried prior to reconstitution)
  • Measles, mumps, rubella
  • Rotavirus (theoretically)
  • Varicella-zoster virus
  • Oral poliovirus
  • Rabies
  • Meningitis A (polysaccharide-protein conjugate)
  • Yellow fever
  • BCG
25
Q

If you see villous atrophy with infectious diarrhoea…

A

…think rotavirus, giardia

26
Q

Osteomyelitis in sickle cell disease…

A

…think salmonella (up to 70%)

27
Q

India ink stain with halo is classical for which organism?

A

Cryptococcus neoformans

28
Q

Congenital infections causing hearing loss:

A

Rubella, CMV (10% if asymptomatic), toxo (less likely)

29
Q

How do aminoglycosides work?

A
  • Inhibit bacterial protein synthesis

- All bind to sites on the 30S subunit of the bacterial ribosome, causing an alteration in codon:anticodon recognition

30
Q

Don’t give which antibiotic for pseudomonas?

A

Cefotaxime

31
Q

Enterococcus is intrinsically resistant to…

A

Cephalosporins

32
Q

Aztreonam is useful because…

A

It is not cross reactive for people allergic to penicillin/cephalosporin

33
Q

Imipenem important side effect…

A

Decreases seizure threshold/neurotoxicity

34
Q

What is the most likely mechanism of resistance to penicillin in strep pneumoniae?

A

PBP affinity alteration

35
Q

What vaccine do you avoid in HIV?

A

BCG

36
Q

No herd immunity from which type of immunisation?

A

Polysaccharide

Non human-human spread

37
Q

Contraindications to rotavirus immunisation:

A

Previous intussusception
Anaphylaxis

GI surgery, anatomical malformation, NEC are actually relative contraindications

38
Q

First line for aspergillus…

A

Voriconazole

39
Q

Which viruses are associated with Karposi Sarcoma?

A

HHV8

HIV

40
Q

Which viruses cause haemorrhagic cystitis?

A

BK/JC if immunosuppressed

Adenovirus

41
Q

What is recommended varicella prophylaxis if exposed/not previously infected?

A

Immune compromised ‐ Give VZIG / IVIG ASAP up to 10/7

Immune competent:
• vaccine within 3/7 may prevent chicken pox
• within 5/7 lessens severity of illness

For all:
• aciclovir if symptomatic

42
Q

What is the maternal/neonatal treatment for toxoplasmosis?

A
  • Maternal to prevent transmission is spiramycin
  • Maternal if foetal infection is pyrimethamine + sulphadiazine + folinic acid
  • neonatal if infected is 12/12 treatment
    Pyrimethamine, sulfadiazine and leucovorin 5‐10mg 3x weekly
43
Q

What is the most infective of the diseases we vaccinate against? (Highest R0)

A

Measles

maybe rotavirus as well…

44
Q

What is the risk of catching chlamydia if Mum has it?

A

50% overall - 30%-50% conjunctivitis, 10-20% pneumonia

45
Q

What type of ART is zidovudine?

A

Nucleotide reverse transcriptase inhibitor

46
Q

What is Gianotti-Crosti Syndrome?

A
  • a.k.a. infantile papular acrodermatitis
  • viral infections and immunizations of all types
  • typically 3-4/7 hx of non itchy 5-10mm dull/dark red spots (first on thighs/bum, then outer arms, then face)
  • evolve from deep red -> purple and become vesicular
  • well/mild fever and mild lymphadenopathy
  • fades in 2–8 weeks with mild scaling.
47
Q

What infections are associated with Gianotti-Crosti Syndrome?

A 
Hepatitis B infection
EBV
CMV
Enterovirus infections
Echo viruses
RSV
48
Q

What type of vaccination is HPV-9?

A

Recombinant subunit vaccine containing virus-like particles

49
Q

What are the HACEK organisms and what is their significance?

A 
H – Haemophilus
A – Aggregatibacter (previously Actinobacilus)
C – Cardiobacterium
E – Eikenella
K - Kingella

Fastidious gram-negatives which cause 5-10% of IE

50
Q

What is the most common viral cause of myocarditis?

A

Cocksackie B

Paediatrics RACP Exam Study (30 decks)

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