WEEK 2 Flashcards
ARF is caused by which of the following organism?
S. pyogenes
Which of the following streptococci are considered non-groupable either could be alpha or non-hemolytic streptococci?
a. S. pyogenes
b. S. agalactiae
c. S. pneumoniae
d. Viridans
Viridans
A drug of choice for this causative agent of syphilis is treated with penicillin, which species cause the disease?
Treponema pallidum
Which of the following is a gram negative, diplococci, oxidase positive, non spore forming, ferments glucose and maltose?
N. meningitidis
Which medication can be given post exposure prophylaxis in pregnant woman with meningococcemia?
Ceftriaxone
Lowel is a 15 year-old male with a history of wading flood water 2 weeks ago. He was brought to the ER for fever and headache. On PE, he had generalized jaundice, icteric sclerae and palpable liver enlargement. What condition does lowell have?
Leptospirosis
Which organism is characterized gram positive cocci, catalase negative, optochin positive and a positive Quellung reaction?
S. pneumoniae
A 10 y.o. brought to the ER for chronic non bloody diarrhea. He has a history of eating freshwater fish. Stool specimen showed peanut shaped ova with bipolar plugs. ( C. philippinensis) Drug for this helminth?
Mebendazole
Drug of choice for Syphilis, Leptospirosis, Meningococcemia and Streptococcus pneumoniae infection?.
Penicillin
A 7 year old female child was immediately brought to the ER for severe dehydration for family went on vacation in a weekend. A night prior she developed rice watery stool, voluminous diarrhea and vomiting. Other members of the family have symptoms but not as severe as hers. What could be the possible infective agent of her diarrhea?
Vibrio cholera
A 10-year-old child came in with fever, migratory arthritis, subcutaneous nodules, inflammatory markers of ESR, with a snake-like movement, with characteristics of sydenham chorea, prolonged PR interval in the ECG. What could be the possible etiologic agent?
Gram positive in chains, catalase negative, cAMP positive, beta hemolysis (GABHS)
An 11 month old infant developed high grade fever associated with seizure and maculopapular rashes starts to erupt after the defervescence of fever. What is the etiologic agent?
Roseola
A gram negative diplococci, oxidase positive, non spore forming, non motile and ferments glucose only.
N. Gonorrhea
Identify the organism causing infective endocarditis, gram positive, catalase negative, optochin resistance, green when grown on agar?
Streptococcus viridans
Luwell is 15 y.o male with a history wading in flood around 2 weeks ago. He was brought to the ER for fever and headache. On PE, he has jaundice, interic sclerae, palpable liver enlargement. What is the diagnosis?
Weil’s disease
A 7 month old infant with inadequate immunization came to the hospital for moderate signs of dehydration. What vaccine could have prevented this condition?
Rotavirus Vaccine
Virus associated with non human fetal hydrops
Parvovirus A17 (Parvovirus B19)
3 yr old child with low grade fever, sore throat, headache, red eye and occipital lymphadenopathy and small pink macules on face spreads centrifugally to involve the torso. The examination rose color lesions on the soft palate. What condition of viral exanthem is this?
German measles/ Rubella
A 2-year-old child appears well and playful until 3 days prior to admission patient was anxious with 3 days cough followed by a machine-gun burst of uninterrupted coughing followed by whooping. What is the gold standard for diagnosis of patient’s condition?
Nasopharyngeal aspiration culture
Which statement is correct regarding treatment of salmonella gastroenteritis in children?
a. Antibiotics are recommended in infants especially above 3 months
b. No need treat dehydration since it will resolve spontaneously
c. Antibiotics are recommended….
d. Antibiotics are not recommended for isolated uncomplicated cases
Antibiotics are not recommended for isolated uncomplicated cases
The newborn in the following picture presents with hepatosplenomegaly, anemia, persistent rhinitis, and a skin rash. Which of the following is the most likely diagnosis?
Congenital syphilis
What is the recommended treatment of neurosyphilis in children older than 1 month of age?
Aqueous penicillin 200,000-3000,000 for 10 days
A 4 year old developed fever with unilateral parotid swelling and orchitis. What is the etiology?
Mumps Virus
A 5 y.o with redness of hands, sole, mouth? How to prevent?
Handwashing
A 3 year old child with cough, coryza, conjunctivitis and maculopapular rash that started to erupt along the hairline and had spread from head to toe. What is the most likely
cause?
Rubeola
What is the most common long-term sequela associated with congenital cytomegalovirus infection?
Hearing loss
First human virus to cause malignancy
Epstein Barr virus
What are the most common hematologic abnormalities involved dengue hemorrhagic fever and dengue shock syndrome?
Leukopenia, Hemoconcentration >20%, thrombocytopenia
Nagayama spots are commonly reported in Asian infants infected with which virus?
Roseola
Etiological agent of infective endocarditis.
S. aureus
Which of the following is most correct for rabies?
a. Negri bodies are pathologic hallmark
b. vaccination of humans bitten by dogs
c. spread of virus through intact skin
Negri bodies are pathologic hallmark
Creeping eruptions and cutaneous larva migrans is caused by which of the organism?
ancyclostoma bazilliense
What is the most common complication of neonatal pneumonia?
Bronchopneumonia
What is the most significant factor for the development of Staphylococcal Infections?
Intact Skin Disruption
Intrapartum GBS prophylaxis is indicated in which of the following conditions?
Previous infant with invasive GBS disease
Medical contraindication to direct breastfeeding
Untreated active TB
Male genitalia involvement such as hematoceles is common in which of the following parasitic infection?
Wuchereria bancrofti
What type of Schistosoma that is present in the superior mesenteric vein and is common in the Philippines?
S. japonicum
In which Stage of HIV virus is the patient asymptomatic?
HIV Stage 2
What is the most common etiologic agent of Hands, Foot and Mouth Disease?
Coxsackievirus A16
A 5-year-old boy presents with a sore throat and fever of sudden onset. He has difficulty swallowing associated with labored breathing. He is sitting upright and leaning forward in a tripod position. What is the appropriate next step in the management?
Direct laryngoscopy in the operating room
The pediatric clerk sought an 18-month-old boy with a chief complaint of fever and cough. His respiratory rate was 40/min, temp of 39 degrees and O2 saturation of 96% at room air. On PE, has a barky cough and stridor only when crying. He is well hydrated, able to drink, and is consolable. What is the management of this case? (Croup)
Give a dose of dexamethasone
A 20-month-old female infant has a history of rhinorrhea, pharyngitis, and low-grade fever. During the night, she wakes with barky cough, hoarseness, and inspiratory stridor. What is the most likely etiologic agent?
Parainfluenza virus
What physical finding is most helpful in differentiating croup from epiglottitis?
Barky cough
Shiela, a 24 month old child previously unimmunized, was brought to the ER by her father due to stridor and respiratory distress for a few hours associated with high grade fever. Her voice is muffled and there is drooling of saliva. She was intubated in the OR under general anesthesia. Endoscopic exam shows cherry red edematous epiglottis. What is the cause of her condition?
Haemophilus influenzae
A 4-year old girl brought by her Aunt for consultation, she has a chief complaint of sore throat and nasal discharge. She had her yearly influenza immunization. She is enrolled
in a local day care center, and most of her classmates have the same symptoms. What is the possible cause?
Rhinovirus
A mother of a 3 yr old child complain of sore throat and nasal discharge she complained that nasal discharge went from whitish to yellowish and now greenish. How will you
manage?
Reassurance-Supportive treatment
A 10-year-old child sought consult for coryza (rhinitis). Which treatment modality would be best suited to his case. Prescribe ______.
First generation antihistamines
A 14-year-old patient came to the clinic for complaints of fever, headache with purulent nasal discharge and sometimes decreased smell. On PE: there was erythema and swelling of the nasal mucosa. What is the most likely pathogen causing the infection?
Streptococcus pneumoniae
This condition describes the Pott Puffy Tumor in radiographic views:
Osteomyelitis of the frontal bone
At the OPD, a 6 year old patient was brought by her mother due to sudden onset of fever, sore throat and papular rashes. On PE, erythematous pharyngeal wall with exudative tonsils. What is the next step of the management?
Viral PCR
In patients with streptococcal pharyngitis, when antibiotics are warranted?
Previous history of rheumatic fever
What is the indication for tonsillectomy in children?
3 or more infections treated with antibiotics in the preceding year
What is the most common clinical symptom of COVID-19 in children according to the PPS-PIDSP guidelines?
Fever
Which of the following is TRUE regarding Multisystem Inflammatory Syndrome in Children (MIS-C)?
It is a post-infection complication of COVID-19
What is the typical chest x-ray findings in patients in covid-19 pediatric patients?
Bilateral ground glass opacities
A 16-year-old girl came in for a consult due to fever and cough. A temperature of 38.5°C and dysphagia which started 2 days prior to consult. On PE, bilateral exudates on tonsils. What would be your McIsaac score?
Ratio: Age = 0, Fever (Temp. > 38C) = 1, Dysphagia = 1. Total points of 2.
Clinical Scoring:
Fever (Temp. > 38C) = 1
Absence of cough = 1
Swollen, tender anterior cervical nodes = 1
Tonsillar swelling or exudate = 1
Age: (3-<15 yo=1. 15-<45 yo=0, ≥ 45 yo= -1)
Score 2
A chief complaint of a sore scratchy throat with conjunctivitis. What is the etiologic agent?
Adenovirus
Which sinus is present at 7 years old and not fully developed until adolescence?
Frontal
Which of the following is a major symptom in the diagnosis in acute sinusitis?
Fever
A 10-month-old female was brought to the clinic due to cough and difficulty breathing. Her mother noticed she initially had a runny nose with clear nasal discharge for 3 days. She now presents with cough, fast breathing, and (?) which prompted consult. She is irritable, coughing, (+) nasal flaring, (+) subcostal retractions, (+) crackles heard in bilateral lung fields, decreased breath sounds over the right lung field. What is her diagnosis?
Pneumonia
What is included in the primary treatment of pneumatocele?
a. Clarithromycin
b. Ceftriaxone
c. Clindamycin
d. Floramycin
Clindamycin
A 7 yr old female with cough, cold and fever for 2 days. PE: tachypnea and inspiratory crackles. CXR shows interstitial pneumonia. Nasopharyngeal swab is positive with Influenza A type. What is the management?
Oseltamivir
Which of these patients is labeled as non-severe PCAP?
a. 4 y.o female with cough fever, cyanosis, hypoxemia
b. 5 month old female, with no head bobbing, chest inward and retraction
c. 10 y.o male, cough and fever but with good appetite and activity O2 Sat >95%
d. 5 y.o female, cough and fever, decreased appetite and inability to take oral Cefuroxime
5 month old female, with no head bobbing, chest inward and retraction
Based on the IMCI guidelines, what is considered fast breathing in a 4 month old infant? Respiratory rate of __ BPM
> 50
2 months-12 months old—50 breaths per minute or more
12 months-5 years old—40 breaths per minute or more
A 4 month old who has contact with a family with upper respiratory tract infection. Develops fever and cough. Upon examination alar flaring l, chest indraw and bilateral wheeze. What primary treatment should you give?
Fluid and oxygen support
A 7yr old girl had a fever and cough for 3 days. It is associated with body malaise, sore throat, and headache. Upon examination, she is tachypneic. What etiologic agent is likely most in the case?
Chlamydia pneumoniae
Which statement is TRUE regarding empyema?
a. Exudative stage occurs on the 3rd day and consist of sterile effusion
b. Fibrinopurulent stage takes place on the 5th day with accumulation of large PMNS
c. Organizational stage occurs on the 10th day with formation of inelastic pleural peel
Exudative stage occurs on the 3rd day and consist of sterile effusion
A tuberculin skin test was performed on the 3-year-old. What type of immunity is demonstrated when a patient is reactive to this test?
Cell-mediated immunity
The following are cardinal signs and symptoms of tuberculosis in below 15 years old, except.
Night sweats
Diagnostic specimen of choice for a 2 yo patient with presumptive tb
gastric lavage
Which of the following is a correct drug specimen for a patient with bacteriologically-confirmed pulmonary tuberculosis?
a. 2 months of Isoniazid, Rifampicin, Pyrazinamide, Streptomycin followed by 4 months of Isoniazid, Rifampicin
b. 2 months of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol followed by 4 months of Isoniazid, Rifampicin
c. 2 months of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol followed by 10 months of Isoniazid, Rifampicin
d. 6 months of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol
2 months of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol followed by 4 months of Isoniazid, Rifampicin
What abnormal breath sounds is described as high pitched, non-musical, discontinuous and due to air movement through secretions?
Crackles
A 6yo child complained of dry cough on most days that worsens early in the morning and during activity. She has no family history of atopy nor previous exacerbation. You
decided to start to treat her as a case of asthma. What is the best treatment option for this child?
Inhaled corticosteroid
A 5-year-old child is having a wet cough for 3 weeks. He is active, feeding well, and not in respiratory distress. On chest examination, crackles were heard on both lung fields. You decided to start antibiotics. After 2 weeks of treatment, cough resolved. What could be the diagnosis for this case?
Protracted bronchitis
A 3 year old child seen in ER with high grade fever , cough and dyspnea. He has not received Hib and pneumococcal vaccine. Radiographic showed thin walled cystic lucencies. What is the etiology?
S. aureus
A 6 year old went to the ER due to dyspnea, RR 29/min, HR 115bpm, O2 sat 94%, talks in phrases, chest indrawing, wheezing. What is the best initial management?
Inhaled salbutamol with ipratropium bromide
What adventitious sound with a characteristic of a low pitch sound when a child would exhale against a closed glottis?
Grunting
Which of the following anti-TB drugs can have a red-colored urine as adverse reaction?
a. Ethambutol
b. Isoniazid
c. Rifampicin
d. Pyrazinamide
Rifampicin
A 2 yo brought by her mother with clinical complain of dry cough usually noted when laughing and mostly at night. The child has eczema and both parents are asthmatic how will this patient be managed?
Initiate inhaled corticosteroids and reassess after 2-3mo
According to Light’s criteria, which is a characteristic of exudative fluid?
LDH >2/3 of upper limit than the normal value
Child manifested fever and cough for >2 weeks. Child has very good apetite yet weight loss was noted. Given antibiotics for 3 weeks with no improvement. Next step of
management.
Xpert
3 year old child, brought to hospital was hypotensive with cold clammy hands, lethargic, RR68/min, deep breathing, absent pulse:
Hypoxemic
A 1 year old child who was seen in the health center presented with stridor. However he was calm. What would be the proper management based on IMCI?
Give the first dose of an appropriate antibiotics and refer urgently to hospital
