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Undeleted > Peds ID > Flashcards

Peds ID Flashcards

1
Q

2 parts of immune system and their components

A
  1. innate
    - barriers
    - complement
    - macros and neutros
  2. adaptive
    - humoral
    - cell
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2
Q

how is immune system not fully developed in infants

A
  1. no specific adaptive immunity - no ABs
  2. T-cell indep responses weak prior to 24 months - no humoral system
  3. T-cell dep. is well dev. from birth
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3
Q

what are 2 maternal factors

A
  1. IgG in gestation

2. IgA in milk

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4
Q

def. transient hypogammaglobunemia

A

period when Moms Ig gone and haven’t got all of their own yetr

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5
Q

3 ways anatomy is diff.

A
  1. airways narrow
  2. eustachian tube angle
  3. may have malformation
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6
Q

how is fetal gut diff.

A

sterile

- reduces attachement of more pathogenic bacteria

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7
Q

what is key in fever

A

vast majority will resolve, but need to be ableto find those that are serious

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8
Q

def. fever w/o source

A

acute febrile illness in which the etiology is not known after throurough exams

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9
Q

def. serious bact. infection

A

sterlie site infection

- menigitis, bone and joint, sepsis, UTI

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10
Q

def. toxic appearance

A

clinical picture consistent with sepsis

- 15-20% chance of serious infection

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11
Q

mgmt to toxic child

A
  1. full workup-
    - CBC
    - urinanalysis
    - LP
    - CXR
  2. empiric ABs
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12
Q

3 life threatening bact.

A
  1. GBS
  2. E coli
  3. listeria
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13
Q

2 life threatening virus

A
  1. HSV

2. enteroviruses

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14
Q

what is ABs for no menigitis

A

ampi (for listeria) and gentamycin or cefotaxime

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15
Q

what is ABs for meningitis

A

ampi + cefotaxime

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16
Q

what to give for HSV

A

add acyclovir

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17
Q

what is cause and effect of GSB in

A

vertical

- dissemniated - pneumonia, septicemia

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18
Q

what is cause and effect of GSB in >7day

A

vertical or horizontal

- focal - meningitis, osteomylitis, sepsis

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19
Q

mgmt of neonatal GBS

A

ampi +/- gentamycin

  • IV fluids
  • ionotrops
  • ventilation
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20
Q

indication of post-partum AB prophylaxis

A 
mom is GBS +
if unknown
- previous infant with GBS
- GBS bacteruria in preg.
- delviery 18hrs
- intrapartum fever
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21
Q

what is maternal AB for prophylaxis

A

pen G every 4 hours until delviery

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22
Q

mgmt of infant at risk of GBS

A

if sick - full sepsis work up and treat

if well, but risk factors - do CBC - WBC >5 observe, WBC

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23
Q

when to consider HSV

A

should always keep in mind, even if mom had no lesions

24
Q

3 HSV presentation

A
  1. skin,eye, mouth
  2. encephalitis
  3. disseminated
25
Q

diagnosis and mgmt of HSV

A

PCR or culture - LP is neccesary

treat - IV acyclovir

26
Q

what is risk of serious infection in well appearing BB with no risk factors

A

3-6%

27
Q

what is approach to well appearing neonate (0-28day) with fever

A

full workup and empiric treatment

28
Q

2 times of bacterial infections in 29-90day old

A
  1. perinatal (vertical)

2. env.

29
Q

3 perinatal infections in 29-90day

A
  1. GBS
  2. E coli
  3. listeria
30
Q

4 env. infections in 29-90

A
  1. strep pnemoniae
  2. neisseria meninigitis
  3. staph. aureus
  4. group A strep
31
Q

7 criteria for low risk baby

A
  1. previously healthy
  2. non toxic
  3. no focal infection
  4. leukocytes 5-15
  5. absoulte band count
32
Q

what to do with high and low risk 29-90 day old

A

high - admit and treat

low - outpatient

33
Q

approach to fever in 3-36 month old

A

maybe do tests, acetominophen

come back in 48 hours if fever persists

34
Q

see AB therapy table

A

do it

35
Q

meningitis bact. in 0-28 days

A
  1. GBS
  2. E coli
  3. listeria
36
Q

meningitis bact. in 29-90 days

A

same but some overlap with older

37
Q

meningitis bact. in >90 days

A
  1. strep pneumonia

2. neise=seria

38
Q

Sx and signs of meningitis in infants

A

can be very non-specific

  • bulgin fontanelle
  • dimished activity
  • petechiale rash
39
Q

kernig and brud signs

A

kernigs - leg lift

bruds - head lift

40
Q

ABs for meningitis at each age

A

neonate- ampi + cefotaxime
1-3month - ampi + cefotaxime +- vanco (for strep resistant)
>3 month - ceftriaxone + vanco

41
Q

what does botulism do

A

stops the release of Ach

42
Q

3 botulism forms

A
  1. food borne - preformed toxin
  2. wound - contamination of wound with spores
  3. infant - ingestion of spores
    - honey and construction
43
Q

clinical picture of botulism

A

floppy child

44
Q

diagnosis of bot.

A

mouse assay

45
Q

Mgmt of botulism

A
  1. supportive care
    - airway, nutrition, stool softener
  2. human botulism Ig
46
Q

def. of streptococcal toxic shock syndrome

A

hypotension + 2 of

  • renal impariment
  • DIC
  • hepatic abnormlaity
  • adult RSD
  • scarlet fever rash
  • soft tissue necrosis
47
Q

patho of strep toxic shock

A
  1. superantigen mediated release
  2. activation of large number of T cells
  3. cytokine storm
48
Q

mgmt of strep toxic shock

A
  1. support
  2. ABs - pen. + clindamycin
  3. IVIg
  4. surg for nec. fascitis
49
Q

5 strep syndromes

A
  1. resp tract
  2. skin and soft tissue
  3. deep and systemic
  4. toxin mediated
  5. non-suppurative
50
Q

incidence of CMV

A
  • most common congential infection

- most common cause of aquired hearing loss

51
Q

2 types of CMV

A

symptomatic at birth -10-15%

asymptomatic at birth

52
Q

2 outcomes of CMV

A

brain and eye disease

53
Q

CMV epidemiology

A
  • less common in dev. countries and high SES

- transmission through saliva

54
Q

CMV diagnosis and mgmt

A

diagnosis - detect in urine or saliva

treat - gancyclovir

55
Q

HIV manifestation in infants

A
  • opp. infections
  • recurrent bact infections
  • trush
  • failure to thrive
  • chronic diarrhea
  • dev. delay
56
Q

3 ways to prevent HIV transmission to BB

A
  1. ARV
  2. elective C-section if VL>100 copies
  3. exclusive formula feeding

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