Peds ID -Junkins

Question 1

Why are neonates susceptible to infections? How does complement differ in neonates?

Answer 1

• The magnitude of the neonate’s ability to generate immunoglobulin in response to antigenic stimulation is initially decreased
• IgM levels are low at birth
• Less storage pool of neutrophils
• Complement: deficiencies greater in the alternative pathway, and they have less terminal cytotoxic components

Question 2

An 8 day old infant has developed fever, irritability, dec LOC, apnea, and a full anterior fontanelle. Prenatal lab test results are not available as the infant received no prenatal care and delivered at home at 36 weeks. What routine prophylactic intrapartum antibiotic could the mother have been treated with in order to eradicate the likely cause of the infant’s illness?

Answer 2

Penicillin (Group B strep)

Question 3

What is the only gram + organism to produce endotoxin?

Answer 3

Listeria monocytogenes

Question 4

What are the organisms normally causing early-onset neonatal sepsis? Late-onset?

Answer 4

Early:

• Group B strep
• E. coli
• Listeria

Late:

• coagulase- negative staph (vancomycin)
• staph aureus

Question 5

Which Staph is resistant to Novobiocin?

Answer 5

NO StRESs

Saphrophyticus=RESistant

Epidermidis is Sensitive

Question 6

How is the diagnosis of Clostridium botulinum made?

Answer 6

Botulinum toxin in stool cultures

Question 7

How does botulinum toxin act? How is it treated in infants

Answer 7

inhibits ACH release

human-derived botulism Ig in

Question 8

What is a Warthin-Finkelday cell? What is this found in?

Answer 8

Multinucleated giant cells with inclusion bodies in the nucleus and cytoplasm on sputum analysis

measles

Question 9

What are the virulence factors of B. Pertussis?

Answer 9

The A subunit of this exotoxin inhibits membrane-bound Galphai proteins –>accumulation of cAMP (over activates)

–> histamine sensitization, increased insulin synthesis, lymphocytosis and inhibition of phagocytosis

Question 10

What are the features of S. pneumonia? What are the 2 most common presentations due to this in children?

Answer 10

• Lancet-shaped, gram + diplococci
• encapsulated
• IgA protease

-in kids: pneumonia (in ANY age group) and bacteremia

Question 11

How many serotypes of S. pneumoniae cause most of the problems?

Answer 11

13

Question 12

H. influenzae type b most commonly causes?

Answer 12

Meningitis (50%)