Peds Infectious Disease

Question 1

Which vaccines are live-attenuated?

Answer 1

1. MMR
2. Varicella

*don’t give to pregnant ladies or immunocompromised

Question 2

Who should not get the influenza or yellow fever vaccine?

Answer 2

egg or chicken allergy

-this is old info

Question 3

Hep B

Answer 3

3 shots

• Birth
• 2months
• 6-9 months

life threatening allergy to baker’s yeast

Question 4

Rotavirus

Answer 4

oral live attenuated

• 2month
• 4month
• 6month

contraindications: intusseception, immunocompromised

Question 5

DTap

Answer 5

5 shots

• 2month
• 4month
• 6month
• 15-18 month
• 4-6 years

Question 6

Tdap

Answer 6

1 shot

• 11-12 years old
  contraindication: seizure or encephalopathy, or allergy to latex

Question 7

Hib

Answer 7

4 shots

2 month
4 month
6 month
12-15 month

contraindication: <6 weeks old

Question 8

Pneumococcal PCV 13

Answer 8

4 shots

2month
4month
6month
15-18 month

Question 9

Pneumococcal PPSV23

Answer 9

1 shot

HIGH RISK >2 years old

Question 10

IPV (Polio)

Answer 10

4 shots

2month
4month
6-18 month
4-6 years old

contraindicated for allergy to neomycin, streptomycin, polymyxin b

Question 11

MMR

Answer 11

2 shots (live)*

• 12-15 months
• 4-6 years old

contraindication: neomycin, gelatin allergy

Question 12

Varicella

Answer 12

2 shots (live)*

• 12-15 months
• 4-6 years old

Question 13

Hep A

Answer 13

2 shots

• 12 months
• 18 months

*required in AZ daycare

Question 14

HPV (Gardasil)

Answer 14

3 shots

11-12 years old

• 1 month later
• 6 months later

Question 15

Menigococcal MCV4

Answer 15

2 shots

• 11-12 years old
• Booster 16 years

**vaccinate all college freshman living in dorms, asplenia, complement deficiency

contraindications: anaphylaxis to diptheria toxoid

Question 16

Palivizumab

Answer 16

RSV immunoprophylaxis

-give to high risk children <2 years

Question 17

Who gets the inactive flu vaccine?

Answer 17

anyone >6 months old

Kids getting vaccinated the first time need 2 shots

Question 18

Who is elligible for the intranasal flu vaccine?

Answer 18

2-49 years old

Question 19

What are the abnormal vaccine reactions

Answer 19

1. Inconsolable crying for >3 hours
2. Fever >104-105
3. Seizure
4. Neurological abnormalities
5. Anaphyalxis

Question 20

Which Ig is inherited from Mom?

Answer 20

IgG

Question 21

Primary immunodeficiency

Answer 21

-family history of PID

Question 22

IgA deficiency

Answer 22

MC immunodeficiency

• can diagnose after age 4
• Asymptomatic*

Question 23

Common Variable Immunodeficiency

Answer 23

• Poor vaccine response**
• Low IgG, IgA, IgM*
• seen at puberty

Question 24

Severe combined immunodeficiency

Answer 24

• Severe T-cell deficiency/dysfunction
• No treatment will die by year 1
• X-linked so affects males only
• NO live vaccines

Question 25

DiGeorge Syndrome

Answer 25

-Chromosomal deletion (22q11.2) - Cardiac defects - Immune dysfunction (hypoplastic thymus gland*, tcell deficits) - Cleft palate - Hypocalcemia (parathyroiid hypoplasia-->tetany, seizure)

Question 26

Ataxia-Telangiectasia

Answer 26

- Chromosomal mutation on 11q22-23 - Progressive cerebellar ataxia**, oculocutaneous telagiectasias Complications: malignancy (mostly lymphoma)

Question 27

Bacterial Meningitis

Answer 27

-opisthotontos posturing** (arched back, straight arms)

Question 28

Bacterial meningitis: TX

Answer 28

0-29 days: Ampicillin +/- gentamicin 1-2 months: Ceftriaxone + vanomycin **ABO tx within 1 hour**

Question 29

Bacterial arthritis

Answer 29

-hip and knee <3 months: Group B strept 3 months to 3 years: Group A strep >3 years: Group A strep

Question 30

Myocarditis

Answer 30

-viral in kids Ex. enterovirus (Coxsackie group B), adenovirus, parvovirus B19, Epstein-Barr virus, cytomegalovirus, Human herpes virus 6

Question 31

Which GI infections are bloody?

Answer 31

``` E. coli Salmonella Shigella Campylobacter C. diff ```

Question 32

Hemolytic uremic syndrome

Answer 32

E.coli 1. Acute renal failure 2. Microangiopathic hemolytic anemia 3. Non-immune thrombocytopenia

Question 33

Sinuses

Answer 33

Present at birth: Ethmoid, Maxillary Present after birth: Frontal, Sphenoid

Question 34

Which pathogens cause rhinosinusitis infections in kids

Answer 34

1. Haemophilus influenzae 2. Strep pneumo 3. Moraxella catarrhalis

Question 35

TX for sinus infection

Answer 35

Augmentin

Question 36

How is mastoiditis dx?

Answer 36

CT with contrast

Question 37

Treatment for periorbital cellulitis?

Answer 37

Ceftriaxone IM + Augmentin

Question 38

Orbital cellulitis tx?

Answer 38

Ceftriaxone, Vancomycin, Clindamycin, Antifungal IV

Question 39

Cellulitis and abscess

Answer 39

-staphylococcus aureus | Tx: drainage and Clindamycin

Question 40

Necrotizing fasciitis

Answer 40

- Pain out of proportion** - GAS or beta-hemolytic streptococci - fever, crepitus edema Tx: Cabapenem + Vancomycin + Clindamycin -Immediate surgery consult**

Question 41

Mastitis Tx

Answer 41

Well appearing >2 months: Keflex, Clindamycin Ill appearing >2 months: IV antibiotics Clindamycin or Vancomycin *need surgical consult, don't I&D this

Question 42

Neonatal mastitis: Tx

Answer 42

Vancomycin IV, Nafcillin

Question 43

Dog and Cat bite: pathogen

Answer 43

Pasteurella species

Question 44

Human bite: pathogen

Answer 44

Eikenella

Question 45

Bite tx:

Answer 45

Augmentin

Question 46

Croup: cause

Answer 46

Parainfluenza virus

Question 47

Epiglottitis: cause

Answer 47

Haemophilus influenzae type B

Question 48

When to suspect bacterial tracheitis?

Answer 48

If acute onset airway obstruction in setting of viral infection with - fever - appear toxic - poor response to tx with epi or glucocorticoids

Question 49

Bronchiolitis: cause

Answer 49

RSV

Question 50

PNA: community acquired antibiotics

Answer 50

6mo to 5yrs: Strep pneumo Tx: Amoxicillin >5yrs: Mycoplasma pneumoniae, Chlamydia pneumoniae Tx: Azithromycin

Question 51

Pertussis: During which stage are children most contagious

Answer 51

1. Incubation 2. Catarrhal*** (rhinorrhea, malaize, fever, sneezing) 3. Paroxysmal 4. Convalescent

Question 52

Who usually gets Pertussis?

Answer 52

unvaccinated kid, under 10 *nasal discharge remains watery

Question 53

What lab would raise suspicion for pertussis?

Answer 53

Leukocytosis with lymphocytosis >20,000, and >50 percent lymphocytes

Question 54

Pertussis treatment:

Answer 54

hospitalize and start azithromycin

Question 55

Rickettsial infection: presentation

Answer 55

rash on hands, ankles, wrists and spreads to trunk

Question 56

Rickettsial infection: Tx

Answer 56

Doxycycline

Question 57

Parvovirus B19 causes what

Answer 57

Erythema infectiosum (Fifth disease) - slapped cheeks - lacy rash on trunk and extremities TX: supportive

Question 58

Roseola

Answer 58

- Human herpes virus 6 - 3-5 days of fever that exceed 40 degrees Celsius followed by rash - starts on neck and trunk Tx: supportive

Question 59

Chicken pox: rash

Answer 59

head then trunk then extremities

Question 60

Measles

Answer 60

- Morbillivirus - Koplik spots - Diarrhea is most common complication

Question 61

Mumps

Answer 61

- paramyxovirus - parotitis - self-limited - orchitis, or oophoritis

Question 62

Rubella

Answer 62

-Rash begins on face and spreads downward

Question 63

Hand, Foot, Mouth Disease

Answer 63

- Coxsackie virus A16 - rash on hands, feet, mouth - mouth and throat painful Tx: pain control, oral hydration

Question 64

Molluscum contagiosum

Answer 64

-central umbilicated lesion | Tx: leave it alone

Question 65

Malaria

Answer 65

- cyclic fevers | - if traveling