Safdar Notes Flashcards
Measles, complication after many years?
Subacute panencephalitis
“100% mortality”
Vaccine associated w/Guillian Barre syndrome
Influnza vaccine
Pregnant + Hep B +ve + gave birth, what to give baby?
Immunoglobulin + Hep B vaccine
regardless of baby weight
Type of transfusion in thalssaemia patients, & WHY?
- Washd RBC.
- Because of chronic transfusion, to allow all (live & killed) vaccines to be given at all times
when to give Killed Vaccine (ie; Hep A) after blood transfusion?
same time, no need for defering.
Pt received Blood transfusion + Epidemic, can live vaccine be given
yes, measles & MMR
Most imp vaccine in cystic fibrosis:
Influnza + Pneumococcal
Pedia + multiple enlarged lymph nodes (bull neck), which vaccine not taken?
Diphtheria
Dtap, contraindicated in:
uncontrolled seizure or neurological disease, but can be given in febrile seizure
Pt + Post splenectomy, which vaccine to give?
pneumococcal + Meningococcal.
IF both choices are there, go with pneumococcal.
- 9 month vaccine
- 12 month vaccine
- M&Ms: MCV4 & measles
- POMM: PCV, OPV, MMR, MCV4
Remember, that MMR can’t be given before one year because of the presence of mumps.
Best way to precent nenoatum tetanum?
Dtap at 28wks.
Asthma patient, how to decrease asthma exacerbation?
Influnza vaccine
Pt w/hx of still birth + want to get pregnant, what vaccine to give?
Rubella,
The only contraindication to Influnza vaccine?
Anaphylaxis after flu vaccine
Medications used & duration of tx for Brucellosis in Pediatrics <8 yrs
TMP/SMX + Rifampin for
- 3-6m if there’s cardiac/CNS involvement
- 6wks if No cardiac/CNS involvement
Best Inv for brucellosis:
Agglutination test.
Stool culture takes too long.
Cough + Deep inspiration in between each cough + age >3m, Dx
Staccato cough: Adenovirus.
Mx of chlamydia or pertussis infection:
Macrolide
Conjunctivitis + Gastroenteritis + pneumonia + Age <3m, Dx?
chlamydia, give macrolide.
MC organism after dental extraction:
S.Aureus.
MC organism for IE in
- patient with damaged valve:
- Prosthesis:
- Virdians
- Epidermidis
IE + Prosthetic valve, Mx:
Vancomycin, Rifampicin, Gentamycin.
“think of MRSA infection in Epidermidis”
Neonatal meningitis Mx
1- Ampicillin: GBS+ Listeria
2- Gentamycin: gram -ve
3- Cefotaxime: gram -ve
3d neonate + B-Hemolyisis bacteria +
catalase +ve, Ab to give?
Ampicillin
GBS
7Yr + Meningitis, Mx:
- Steroid: for hemophilus influnza.
- Ceftrixone
- Vancomycin
MC organism in viral meningitis
Enterococcus
7yr + Meningeal signs + Headache + Fever + Family came from africa + Sore throat + lymphadenopathy, CSF: lymphocytosis only. Dx?
EBV
fever 6d + Tender spleenomegaly, culture needed?
Blood cultures
“Septicemia, typhoid, bruceloosis, IE”
meningitis + papilladema, complication?
hearing loss
3m baby + Mc bacterial cause of meningitis
Strep pneumonia
Contact management in GABHS, Pertussis, Nisseria, Hemophillus
- GABHS: No need
- Pertusis: Macrolide
- Nisseria: Rifampin
- Hemophillus: Rifampin
MC virus of otitis media:
RSV - Rhinovirus.
BUT mc is bacterial cause, don’t forget
Child + Fever + Knee pain & swelling, Most imp inv
always joint aspiration
Septic arthritis MC organism:
Staph aureus.
Pedia + Eczema + treated by steroid + now itching & Pustular leison, grape like pattern, Organism?
Staph Aureus.
“impetigo”
Mx of Impetigo
Topical Mupicin
3 Yrs + Crying + Red current jelly stool + Vomitting, X-ray findings.
Susage mass
recurrence rate of intussuption
After enema is 10%, After surgical reduction 5%, after resection <1%
1st Mx of intussuption
ABCD.
Hydration
Best Confirmatory & initial Inv of Intussption
- Confirmatory: Enema
- Initial: US
When to opt for surgery in Intussuption
After 3 Failed attempts of reduction
MC site for intussuptio
Ileocolic
5wks old+ Non-billous vomitting + mass at epigastric area, Dx?
Pyloric stenosis
Time of sx of duodenal atresia:
At birth.
SE of erythromycin use in babies.
Pyloric stenosis
Pyloric stenosis Mx:
Initital: Hydration with KCL
Def: Pyloromyotomy
Pedia + Eat out + Abdo pain + diarrhea after 8 hrs, Organism?
Staph aureus. “30min to 8hrs”
other infection w/short IP: Cholera & perferngies. “2hrs to 48hrs”
9m baby + weight not increasing from 6m, initial test?
Celiac disease (6m introduction of food)
- Initial: Tissue transglutiminase
- Best: Dudeonal biopsy
Food to be avoided in celiac disease:
Barly, wheat, Rye, Oats
Celiac disease Pt + Anti endomysal Ab +Ve + anti-transglutiminase test +ve, Next step?
Gluten free diet.
Two antibodies No need for biopsy. if one only, do biopsy.
if you did the biopsy & findings inconclusive: do challenge test & repeat biopsy
Celiac patient + Rash, dx?
Dermatitis herpitformis
Celiac patient + Pruritic rash in extensor, back & buttock + Biopsy +ve IgA immunofluroscence, Mx?
Gluten free diet + Dapsone cream (Dermatitis herpitformis)
Malignancy that can decrease by gluten free diet in celiac disease?
Intestinal lymphoma.
1 Yr + Vomitting + Diarrhea + Greenish stool + Mx?
hydration
1 Yr + Vomitting + Diarrhea + Greenish stool + MC organism?
Rota virus (Viral gastroenteritis)
5Yr + Vomitting + Diarrhea + Bloody stool + Mx?
Bacterial Gastroenteritis, give hydration
When to consider Ab in bacterial gastroenteritis
- According to organism: Shigella, Clostridium difficile
- According to Condition: illness >1w, severe dehydration
- According to patient: immunocompromised
HUS, organism
Sheiga toxin in E-coli
10 Yr + Amoebic abscess + Mx?
Oral metronidazole followed by paromomycin
Inv of sheigella
Stool culture
15yr + Lower abdominal pain + Blood with mucus in stool + fever, Initial & best diagnostic test:
This is amoeba infection
- Initial: Stool analysis showing cyst pr trophozoite
- Best: Serology PCR or ELISA
2m + deep jaundice + Pale stool + Healthy & growing well, Dx?
Billiary atresia. (obstruction)
Direct bilirubn >20% of total.
Dx of meckel diverticulum
Nuclear scan
Pedia + billous vomitting + bloody stool, dx? (Recuurrnt obstruction & bleeding)
Volvulus
Volvulus sign in x-ray
Coffee bean sign
9m + abdominal distension + small amount stool + meconium passed at 2nd day of life, best test
This is herschspurgr disease; suction Biopsy
14d baby + abdo distension + billous vomitting + passed meconium in first day of life + passing pellet stool, dx?
Herschspurge
2m + excess crying + diarrhea + mom shifted cow milk to soy milk + face exzema + still excessive crying, dx?
Cow milk allergy
“They usually have coexistent allergy against soy milk”
Hilar lymphadenopathy + on and off cough + hypercalcemia + biopsy shows non- caseating granuloma
this is sarcoidosis - give steroid if symptomatic
Sudden scrotal pain + high testis + tender + erythmatous, mx?
Surgical exploration
Elderly + hypertensive + gradual decr in cognitive function + MRI showed periventricular white matter hyper intensity
Vascular dementia
Trauma + wide mediastinum + hypotension + trachea shifter, dx?
Ruptured aortic root
