Pearls

Question 1

Eczema herpeticum

Answer 1

IV acyclovir - very febrile

Question 2

Superinfected eczema-severe

Answer 2

IV vancomycin

Pt at risk - hemodialysis, DM, eczema

Question 3

Varicella CP

Answer 3

In crops
Start at papulles in warm areas to dry to crusting

Vaccine - 95 % effective

Question 4

Measles CP

Answer 4

Look sick

Cough
Coryza
Conjunctivitis - bad
Concurrent fever
koplik
Cephalocaudal rash 
Cervical lymphadenopathy

Question 5

Parvovirus CP

Answer 5

Slap cheeks

Question 6

BCG vaccine SE

Answer 6

Osteomyelitis

Lymphadenitis

Question 7

Mycobacterium LN CP

Answer 7

Unilateral
Submandibular region
Toddler
Non tender
Soil found - toddlers putting stuff in mouth and teething

Treat rifampin and clarithromycin

Question 8

Periorbital cellulitis

Answer 8

From sinusitis.

Question 9

Cervical adenitis ABX

Answer 9

Cefuroxime and clindamycim

Cephazolin-new

Question 10

Causes of erythema nodosum

Answer 10

Viruses= EBV,Hep B, mumps
Fungi= Histo, blasto, coccidiodomycosis
Bacteria= GAS, TB, Yersinia, cat scratch, mycoplasma, whipple, tularemia..
Other= sarcoidosis, IBD, OCP, SLE, Behcet, hodgkin, lymphoma, sulfonamides, pregnancy, iodopathic, Sweet syndrome

Question 11

criteria for strep toxic shock syndrome

Answer 11

• Hypotension plus 2 or more of the following:
    -Renal impairment
    -Coagulopathy
    -Hepatic involvement
    - ARDS
    - Generalized erythematous macular rash
    - Soft tissue necrosis
  Definite case
   Clinical criteria + GAS from a normally sterile site
  Probable case
   Clinical criteria + GAS from a nonsterile site

Question 12

criteria for Staph toxic shock

Answer 12

MAJOR CRITERIA (ALL REQUIRED)

• Acute fever
• Hypotension
• Rash (erythroderma with convalescent desquamation)

MINOR CRITERIA (ANY 3 OR MORE)

• Mucous mb inflammation (vaginal, oropharyngeal or conjuctival hyperemia, strawberry tongue)
• Vomiting, diarrhea
• Liver abnormalities
• Renal abnormalities
• Muscle abnormalities (myalgia or high CK)
• CNS abnormalities (alt LOC but no focal neuro signs)
• Thrombocytopenia

Question 13

How do you treat Strep TSS

Answer 13

Penicillin IV PLUS
Clindamycin IV PLUS
IVIG 2 g/kg/dose IV x 1
ID Consult stat

Question 14

How do you treat Staph TSS

Answer 14

Cloxacillin IV PLUS
Clindamycin IV PLUS
IVIG 2 g/kg/dose IV x 1
ID Consult stat

Question 15

how do you treat TSS of unknown pathogen

Answer 15

CeFAZolin IV PLUS
Clindamycin IV PLUS
IVIG 2 g/kg/dose IV x 1
ID Consult stat

Question 16

Mycobacterium tuberculosis

Answer 16

Right supraclavicle node drain thorax