Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Peds Boards ID
Green C2- MedStudy Board Review 2011, Infectious Disease
| Question | Answer |
|---|---|
| #1 cause of osteomyelitis in patients with sickle cell | Salmonella |
| #1 cause of osteomyelitis in patients without sickle cell | Staph aureus |
| In the stem is a patient with hx of flu and new-onset pneumonia... bacteria? | Staph pneumonia, staph sepsis |
| MRSA in the blood... drug of choice? | Vancomycin |
| Treatment of non-MRSA staph toxic shock syndrome _______. | Oxacillin + Clinda +/- IVIG |
| Treatment of strep toxic shock syndrome ______. | High dose IV PCN + Clinda +/- IVIG |
| Child with temp >102, Hypotension, Rash with desquamation (esp palms/soles), >3 organ systems | Toxic Shock Syndrome |
| #1 bacterial cause of Otitis Media = ____. | Strep pneumoniae |
| #1 bacterial cause of Meningitis, pneumonia, occult bacteremia without focus = _____. | Strep pneumoniae |
| 2yr old with low grade fever, decreased feeding, abdominal pain or vomiting, thick purulent nasal discharge _______. | Streptococcosis AKA "strep fever" due to Group A Strep pyogenes. |
| Skin infection, very tender, well-demarcated line between infected and uninfected skin, "leading edge" cultures | Strep pyogenes (group A) - Erysipelas |
| Treatment of necrotizing fasciitis (remember very fast, severe pain and swelling) | IV PCN and IV clinda +/- IVIG |
| Major cause of newborn pneumonia, meningitis, bacteremia, UTIs in pregnant mothers | Strep agalactiae (Group B Strep) |
| Early onset GBS from ____ hours to ____ days. Most common serotypes _____. | 1hour to 6 days; 1a, 1b, II, III, V most common. |
| Early onset GBS: Which is more common: Meningitis or Sepsis/Pneumonia? | Sepsis (45%)/Pneumonia (40%) more common. Meningitis only 10%. |
| Late onset GBS: ____ days to ___ days. Most common serotypes ____. | 7 days to 90 days. Serotype III causes 90%. |
| Late onset GBS: Which is more common: Meningitis/Bacteremia or Osteo/Cellulitis | Meningitis (40%)/Bacteremia without focus (50%). Osteo/cellulitis <10%. |
| Late-late onset GBS: Usually preterm or term infants? | Usually pretermers with hx of or currently with IV lines. "bacteremia without a focus" |
| Gold standard for diagnosis of GBS: | Blood cultures (serum or CSF only! NOT URINE). |
| True or False. You can get rheumatic fever only from pharyngeal strains of GAS. | True. You dont get it from impetigo or the like. |
| True or False. You can get post-strep glomerulonephritis only from skin strains of GAS. | False. Can get from skin or pharyngeal strains. |
| Describe treatment of GBS for: 1.) Pneumonia/sepsis. 2.) Meningitis 3.) Septic arthritis/osteo | IV PCN/AMP +gent initially: then: 1.) pneumonia/sepsis: 10 days total PCN G. 2.) Meningitis: minimum 14days PCN G. 3.) osteo/arthritis: 3-4 weeks generally |
| Newborn, + bld cx with "diptheroid": contaminant or concern? | Listeria! NOT a contaminant. -Highest incidence in newborn period, colonized from mother. TX: Amp or PCN +/- gent if severe. or TMP/SMX if PCN allergic. |
| Adolescent with Listeria: potential environmental or food sources? | Sheep/goats/poultry. Contaminated milk, soft cheese, pate, uncooked hotdogs |
| Unvaccinated child, hoarse, sorethroat, low grade fever, myocarditis/polyneuritis: ____ | diphtheria: Cornyebacterium; grey-white pharyngeal membrane |
| TX of diphtheria: | Erythro or PCN + antitoxin |
| 6 year old, sore throat, "scarlet fever like" rash, strep negative: Bacteria? _____ , Treatment? _____ | Arcanobacterium haemolyticum, treat with Erythromycin, tetracycline, PCN |
| Painless papule to painless ulcer to painless black eschar, nonpitting edema, induration, swelling. Cause? | Bacillus anthracis. 95% are cutaneous. usually from handling hids and wool |
| True or false, anthrax pneumonia is spread human to human. Treatment? Typical xray finding? | FALSE. (smallpox and pneumonic plague ARE). Tx with Cipro or doxy. WIDENED MEDIASTINUM on Xray. |
| Main toxin in all species of Clostridium? | Alpha toxin |
| Dirty wound: Concern of tetanus. What 2 Indications for TIG + vaccine? | 1.) unknown vacccine history. 2.) Less than 3 tetanus immunizations |
| Dirty wound: Concern of tetanus but vaccines are uptodate. If less than 5yrs since last, what to do? If greater than 5yrs, then what to do? | If <5yrs, no treatment. If >5yrs, give Tdap if over 7yrs if hasnt had booster, if did, Td. ONLY GIVE DTaP IF <7yrs of age. |
| Clean wound: Concern of tetanus. Treatment plan? | If uptodate and <10yrs, no treatment. If uptodate and >10yrs, give Tdap if >7yr, DTaP if <7. |
| Nail puncture wound through a tennis shoe. | Pseudomonas |
| Hot tub rash | Pseudomonas |
| Round, indurated black lesion with central ulceration | Pseudomonas |
| 3rd most common cause OM, sinusitis. Cause? Treatment? | Moraxella catarralis. Tx with amox, amox-clav, eryhtro, Tmp/smx, cefuroxime |
| Pet iguana, baby chicks, turtles, kids collecting eggs | Salmonella Non-typhi. |
| Treatment of salmonella typhi- typhoid fever: | TMP/SMX, cipro, ceftriaxone |
| Rose spots, 1 week into fever, on trunk, low WBCs, contaminated food/milk/water | Salmonella typhi |
| Daycare, contaminated pool/lake, diarrhea, rectal prolapse, bandemia, seizures. Cause? Tx? | Shigella. Tx with IV 3rd gen ceph or PO Azith. |
| regional adenopathy, FUO, cat at home. Cause? Treatment? | Bartonella henselae. TX: none or Azith (shrinks nodes faster). dont aspirate the nodes! |
| Neonate with fever; citrobacter in blood. What 2 tests order next? | Spinal tap and CT of head. worry about brain abscess. |
| N. meningitidis prophylaxis for who ? With what? | Rifampin: household contacts, day care, "significant others", healthcare worker with close contact (intubate, mouth-mouth) Ceftriaxone: pregnant in categories above |
| N. meningitidis treatment? | PCN G |
| Who should receive the conjugated, MCV4 vaccine? | Age 2-55, at 11-12r visit, or entry to high school or 15yr (whichever first); dorm residents, asplenia, complement def |
| What is the finding of gonorrhea on gram stain? | Gram neg diplococci; in males = diagnostic, in females = suggestive but need culture |
| What is seen with gonoccocal ophthalmia? (when, symptoms, workup, treatment) | 2-7 days post delivery; bloody/green/serosang discharge; gram stain discharge then septic workup; treat with Ceftriaxone 125mg x1 if eye only |
| If baby develops eye discharge at days 7-14 life what is the usual cause? | Chlamydia trachomatis (Less than 2 days usu chemical reaction, 2-7 usu gonococcal) |
| Newborn eye ointments are given to prevent what infection? | Gonococcal. not chlamydia. |
| cause and treatment of "traveler's diarrhea"? | ETEC: enterotoxigenic E coli: watery diarrhea: Tx with TMP/SMX |
| Hemolytic uremic syndrome : Which E coli, common causes | EHEC (enterohemorrhagic) or STEC: O157:H7 induces HUS: undercooked beef, unpasteurized milk, apple juice |
| Hemolytic uremic syndrome : which agar, antibiotics? | Sorbitol-enhanced agar, NO ANTIBIOTICS. |
| Hemolytic uremic syndrome: triad of symptoms | Renal failure, thrombocytopenia with purpura, hemolytic anemia |
| 3 yr old with fever >103, dysphagia, drooling, "cherry red" epiglottis :diagnosis? cause? treatment? | Epiglottitis: H. influenzae, 3rd gen cephalosporin |
| H. influ occult bacteremia: 30-50% risk of ?. If only one + blood cx do you treat? | 30-50% risk of meningitis or deep, focal infection, ALWAYS TREAT even if only 1 + |
| Most common sequelae to bacterial meningitis? | Hearing loss |
| Plauge: caused by? transmitted by? | Yersinia pestis, wild rodents - transmitted by fleas |
| Plague: name the 2 types | Bubonic: lymphadenopathy that suppurates. Pulmonic: very contagious by coughing (remember anthrax pneumonia not contagious to others) |
| Plague: diagnosis? treatment? | Dx: aspirate the lymph nodes; Tx: streptomycin, chloramphenicol, doxycycline |
| Tularemia: found in? mode of spread? | Rabbits, deer, ticks; tickbite, eating infected animals, inhalation, self inoculation |
| Tularemia: diagnosis? Tx? | Dx: serology: DONT aspirate; tx: streptomycin, gentamicin, tetracycline |
| Rocky Mountain Spotted Fever: cause, mode of spread? | Rickettsia, tick exposure |
| Rocky Mtn Spotted Fever: sy/sx? | Rash (distal plams, soles) maculopapules to petechiae, fever, arthralgias, hyponatremia |
| Rocky Mtn Spotted Fever: Dx? Treatment? | Dx: serology (specific IFA assay), immunofluorescent staining of biopsy of lesion. Tx: doxycycline, chloramphenicol |
| Ehrlichia: where, mode, dx, tx | Tick borne; Southeast, south central, midwest, flu-like, pancytopenia, dx: serology; tx: doxy |
| Difference in the xray of pulmonary TB disease in primary infection vs months to years after initial infection? | Primary initial infection occurs as lower-lobe disease, disease occuring months to yrs more commonly upper and apical lobes. |
| TB Pleural effusions: high or low glucose? elevated or decreased protein? AFB smear negative or positive? | TB pleural effusions low glucose, elevated protein and LDH, almost always AFB smear negative |
| TB Memingitis most common in what age? MRI findings? | 6months to 4 yrs, basal ganglia or posterior enhancement on MRI, SIADH common |
| Skin testing TB: 5mm is postive in what 5 conditions? | 1. HIV or cell-mediated dysfunction 2.fibrotic changes on CXR 3.close contact with documented case 4.organ transplant recipient 5. on >15mg/day prednisone x 1 month |
| Skin testing in TB is positive in a healthy 12yr old at what mm? | 15mm |
| Skin testing in TB is positive in a healthy 3 yr old at what mm? | 10mm (10mm positive in <4yrs, diabetics, recent immigrants, prednisone <15mg/day, healthcare workers, etc) |
| Skin testing in TB is positive in a healthy 5 month old at what mm? | Trick question. Skin testing not reliable in kids < 6months of age. |
| Tx of active TB disease? | INH/RIF/PZA +/- ethambutol or streptomycin |
| What bacteria can cause draining facial lesions (cervicofacial swelling from dental source) or PID if IUD present? tx? | Actinomyces PCN/amp or tetracycline |
| And afebrile 3 mos old with "persistant staccato" cough. Dx? Tx? | Chlamydia pneumonia, tx: oral erythromycin |
| A teenager goes swimming with his dog... in Hawaii. Dx? How to Dx? Tx? | Leptospirosis. In early dz (<7days): blood culture. In late dz (>7days): urine culture. Tx with PCN or doxycycline. |
| Name 3 predisposing conditions to invasive Malassezia > | LBW (<1000g), IV catheter, Lipid hyperalimentation |
| A NICU baby (950g) becomes septic, increased WBCs, decreased plts, increased vent settings, on TPN with lipids. Think of: | Invasive Malassezia. -- sometimes asymptomatic. Fever, resp distress, thrombocytopenia, HSM, increased WBCs |
| Dx of Malassezia blood cultures require what special addition? | Olive oil overlay on Sabourauds medium |
| Treatment of Malassezia? | Remove catheter, stop lipids, AmphoB (1mg/kg/day) |
| A child is out picking berries with his family. 3 weeks later nodular lesion that ulcerates on his hand. Dx? | Sporotrichosis, dx by culturing the organism. single lesion ulcerates 1-12 weeks later, then subQ nodules over days to weeks. |
| Tx of lymphocutaneous sporotrichosis? | Potassium iodine 5 drops tid PO increased by 1drop/day to daily 120-150drops/day for 4 weeks after lesion healed. Or itraconazole. |
| Tx of extracutaneous sporotrichosis? | Ampho B or itraconazole. |
| Cat litter box | Toxoplasma |
| Maltese cross | Babesia microti (intra RBC protozoan) |
| Citywide outbreak of diarrhea | Cryptosporidium |
| Expected course of crypto in immunocompetent patient? | Watery, self-limited, lasts 1-2 weeks, 3 day course of nitazoxanide |
| Expected course of crypto in immunosuppressed patient? | persists indef, paromomycin + azith then paromomycin alone |
| South Texas to Central America. Raspberries. Dx/Tx | Dx: Cyclospora, tx: TMP/SMX |
| Transmitted by Anopheles mosquito | Plasmodia. |
| Recent travel, on blood smear see banana shaped gametocytes, many infected RBCs on slide. Dx ? | P. falciparum, most fatal type |
| Which Plasmodium has widespread chloroquine resistance? | P. falciparum |
| Duffy RBC antigen | P. vivax |
| Prophylaxis of malaria that can have side effects of crazy dreams. | Mefloquine (or chloroquine if sensitive area) 1/week for 3 weeks prior and 4 weeks after. |
| Prophylaxis of malaria that can increase sun exposure risk. | Doxycycline: daily for 1-2 days before arrival and continue 4 weeks after |
| Prophylaxis of malaria, shorter course of treatment than others | Atovaquone/proguanil (malarone) daily 1-2 days before and 7 days after. |
| Child in Nantucket in the late summer, develops hemoglobinuria, emotial lability. Dx/carrier? | Babesia microti, Ixodes tick from rodents/deer. febrile hemolytic anemias, |
| Tx of mild and severe Babesia microti | Mild: clinda + quinine or atovaquone + aztih Severe: Exchange transfusion then abx. |
| Entamoeba histolytica- Do a liver aspirate or no for diagnosis with liver abscess? | Liver aspirate of liver abscess shows no ameba or WBCs, Diagnosis: serology for liver abscesses |
| Tx of Entamoeba histolytica | Metronidazole followed by iodoquinol or paromomycin |
| Difference in acute and chronic Giardia? | Acute: Watery,smelly diarrhea, flatulence. Chronic: Flatulence, sulfuric belching, soft stools |
| Dx of Giardia? | Fresh stool O&P, Giardia-specific antigen on stool, string test |
| Tx of Giardia? | Metronidazole, Nitazoxanide, Furazolidone, tinidazole |
| Increased risk of Giardia? | Campers, travelers, daycare, IgA deficiency |
| New onset heart block in an adoptee | Lyme dz or chagas dz |
| CXR with infiltrate, later CXR with infiltrate in different spot, high eos count | Roundworm (ascaris), Loffler syndrome: shifting infiltrates, 30-35% eos. |
| Test for, tx of Pinworms | symptoms: rectal itching, test: scotch tape test, tx: mebendazole, albendazole. |
| Child is diarrhea, abdominal pain, rectal prolapse: top 2 diagnoses? | Shigella, Whipworms |
| The only helminthic organism that replicates in the body | Nematodes/Strongyloides (3% of kids positive), Eosinophilia, persist decades, Tx Ivermectin, thiabendazole |
| Kid seizes, MRI = cyst | Cestodes: cysticercosis, ingested pork, eggs hatch, oncospheres into blood to CNS/eye, form cysticerci, when cysts die, CNS- seizures |
| Tx of Flatworms (cestodes) | Albendazole, praziquantel with steroids if neuro |
| Shistosomiasis Dx, tx | Dx: eggs in stool. liver dz but no ascites, no hx alcohol. Tx with Praziquantel |
| Incubation period of varicella? | 10-21 days (up to 28days if VariZIG was given) |
| Most common complication of varicella? | secondary bacterial infection with S aureus or S pyogenes (TSS or Nec Fasc!) |
| Varicella and pregnancy: weeks of most worry? What defects? | Birth defects if infected with primary varicella during 8-20 weeks. Limp atrophy, microceph, cortical atrophy, SZs, chorioretinitis, cicatricial skin scarring. |
| If seronegative pregnant exposed: VariZIG or vaccine or both or neigther? | VariZIG if within 4 days exposure. NEVER give vaccine (give before become pregnant!!). |
| If mother within 5 days prior to or within 2 days after delivery develop varicella: | HIGH risk for severe infection, give VariZIG |
| Tx of chickenpox in children | Acyclovir 20mg/kg/dose 4x/day for 5 days |
| Tx of chickenpox in adolescent/adult, pregnant, pneumonia: | Acyclovir 800mg po 5x/day for 7 days, Acyclovir 10mg/kg IV TID for 5 days, Valacyclovir 1g TID for 5 days |
| Tx of chickenpox in Immunocompromised: | Acyclovir 10mg/kg IV q 8 hrs |
| CMV: Serious dz in 2 circumstances: | 1. transplacental infection of fetus, 2. Immunocompromised patients (AIDS, organ/bone marrow transplant) |
| Mother with 1st CMV infection during pregnancy: severe form | "Blueberry muffin" baby, microcephaly, cerebral atrophy, chorioretinitis, hearing loss, intracerebral calcifications that circumvent ventricles, IUGR, HSM |
| EBV associated with which -omas? | African Burkitt lymphoma, B-cell lymphoma, nasopharyngeal carcinoma |
| After infection virus persists in which cells for life? | B lymphocytes |
| EBV Serology: IgM VCA+ = ____. EBNA + = ____. IgG VCA+ = ____. | IgM VCA+ = acute primary or very recent past infection. EBNA+ = convalescent or post-EBV infection. IgG VCA+ = positive for life |
| Cause of roseola | HHV-6 |
| Cause of Kaposi sarcoma in AIDS pts | HHV-8 |
| Child with large postauricular lymph node, fever, red rash. | German measles-rubella. Forchheimer spots- in mouth |
| 1st trimester rubella | 90% risk infection with cataracts, cardiac, glaucoma, hearing loss, neuro |
| 2nd trimester rubella | 25-30% risk infection, hearing or neuro problems |
| 3rd trimester rubella | 60-100% risk but no sequelae |
| Child with hx of congenital rubella- increased risk of ___? | IDDM 4x normal by age 10, IDDM 10-20x normal by adulthood, increased risk of thyroiditis |
| Nonimmunized kid with cough, coryza, conjunctivitis. | Measles |
| Describe measles rash | starts at hairline, spreads caudally, red maculopapular, Koplik spots, |
| Increased risk of intussusception in diarrhea due to which virus? | Adenovirus 40 & 41 |
| Hematuria, not post-strep GN, which virus potentially? | Acute hemorrhagic cystitis due to Adenovirus 11/21. |
| Fever, sore throat, conjunctivitis, runny nose, cervical adenitis | Adenovirus 3 |
| Recent travel to Asia, fever, chills, myalgia, headache. | SARS- coronavirus- resp symptoms 2-7 days after start of illness (SOB, cough) |
| Which viruses cause the most croup? | Parainfluenza virus 1 -4 |
| Which viruses cause hand-foot-mouth? | Coxsackievirus A16, A5, A10, also enterovirus type 71 |
| Difference in CNS onset of polio vs GBS? | Guillan Barre Synd (GBS) starts distal and goes proximal, polio starts proximal and goes distal. |
| Asymmetric, flaccid paralysis without reflexes, and aseptic meningitis | Polio |
| 15-35% of postpubertal males with mumps get ___ | epididymoorchitis (unilateral) |
| 31% of adolescent females get _____ and 7% get ___________ in polio | 31% get mastitis and 7% get oophritis |
| Adolescent in New Mexico with thrombocytopenia, increased HCT, hemorrhagic pneumonia | Hantavirus, cotton rat is reservoir |
| What bacteria should you think of in a patient with prior head trauma and meningitis | S. pneumoniae |
| Think of complement deficiencies, think of what cause of meningitis? | N. meningitidis |
| Think of splenectomy, think of what cause of meningitis? | S. pneumoniae, H. influenzae, N. meningitidis, Enterovirus |
| Think of sickle cell disease, think of what cause of meningitis? | S. pneumoniae, H. influ |
| Think of HIV, think of what cause of meningitis? | Cryptococcus, Toxoplasma gondii, Histoplasma, TB, syphilis |
| CSF findings of bacterial meningitis? | 500-10,000 WBC, >90% neutro, <40 glucose, >150 protein |
| CSF findings of aseptic/viral meningitis | 10-500 WBC, Early= >50% neutrophils, Late= < 20% neutrophils, Normal glucose, <100 protein |
| CSF findings of TB meningitis | 50-500 WBC, Early= >50%neutrophils, Late=<50% neutrophils, <30 glucose, >150 protein |
| CSF findings of syphilitis meningitis | 50-500 WBC, <10% neutrophils, <40 glucose, <100 protein |
| >1 month of | |
| CSF findings of aseptic/viral meningitis | 10-500 WBC, Early= >50% neutrophils, Late= < 20% neutrophils, Normal glucose, <100 protein |
| CSF findings of TB meningitis | 50-500 WBC, Early= >50%neutrophils, Late=<50% neutrophils, <30 glucose, >150 protein |
| CSF findings of syphilitis meningitis | 50-500 WBC, <10% neutrophils, <40 glucose, <100 protein |
| meningitis treatment for child >1 month of age and no organism seen on gram stain and for empiric therapy | 3rd gen ceph: ceftriaxone, cefotaxime, etc. AND VANCOMYCIN |
| Treatment for meningitis, gram stain shows gram positive diplococci: | 3rd gen ceph and VANC until sensitivities known (if PCN sensitive, change to IV PCN) |
| Treatment for meningitis, gram stain shows gram negative diplococci: | IV PCN or 3rd gen ceph |
| Treatment for meningitis, gram stain shows gram negative "pleomorphic" rods | Dexamethasone followed by 3rd gen ceph |
| Treatment for meningitis, gram stain shows gram positive rods: | Amp and gent |
| Treatment for meningitis, gram stain shows gram negative rods | 3rd gen ceph |
| N. meningitidis has lower or higher mortality rates? | Lower (10%) |
| Most common sequela of bacterial meningitis survivors? | Deafness (6-10%) |
| Drug of choice for PROPHYLAXIS of contacts with meningitis due to H. influenzae? what if pregnant? | rifampin for children <18yrs, Ceftriaxone if pregnant. Cipro is acceptable alternative to rifampin in nonpreg adults. |
| Majority of viral etiology of aseptic meningitis is what family of viruses? | Enteroviruses (also could be arbovirus, mumps, HSV) |
| Swimming in cow pond, now with meningitis | Amebic meningitis |
| Chronic neutrophilic meningitis | Nocardia, Actinomyces, fungal |
| TB meningitis- which nerve palsy? | 6th |
| Lyme meningitis | Bells Palsy or foot drop |
| What is empiric therapy for brain abscesses? | Ceftriaxone + metronidazole (add vanco if MRSA suspected) |
| Most common cause of bacterial diarrhea? | E coli (think no blood, no WBCs, children in and travelers to developing countries) |
| 12 yr old with underlying liver disease, scratched by crab... cause? | Vibrio vulnificus |
| Cholera pandemics, crab/oyster outbreaks | Vibrio cholerae |
| Shellfish outbreaks | Vibrio parahaemolyticus |
| Turkey on thanksgiving... diarrhea for next few days... | Yersinia enterocolitica |
| Test for C.dif colitis? | Stool for WBCs, Stool toxin with one of 3 available assays: PCR, EIA, cytotoxicity assay |
| Difference in C dif colitis severity? | Mild/Mod: <15,000 WBC and Cr <1.5 x normal ; Severe >or= 15000 WBC and Cr >or= 1.5 x normal |
| describe complicated C dif colitis | complicated: hypotension, shock, partial ileus, megacolon |
| Treatment of C dif colitis if mild/mod or severe? | Mild/Mod: metronidazole 500mg TID x 10-14days; Severe: vancomycin 125mg QID po x 10-14 days |
| Treatment of C dif colitis if complicated? if complicated with complete ileus? | Complicated: Vanc 500mg QID PO or NG + IV metronidazole 500mg TID x 10-14days. If complete ileus add rectal vanc |
| If first recurrence of C dif colitis how treat? | Same drug as 1st time, only if first recurrence. |
| If severe recurrent relapses of C dif colitis? | Vanc in pulsed doses over 42 days or Vanc x14days then rifampin x 14days |
| Diarrhea on cruise ship with widespread outbreak? what if limited to only a few that ate the buffet? | widespread: norovirus/norwalk if only a few: salmonella |
| Who should be treated for Salmonella diarrhea? | Do not treat unless severe immunocompromised or infant <3 mos |
| Who should be treated for asymptomatic bacteruria? | Pregnant, Neutropenic, Transplant patients |
| 5 yr old boy fell off his bike, stitches on his knee, now with osteo- which bacteria? | S. aureus (acute, most common boys <6yr, history trauma or intercurrent URI) |
| Puncture wound in a tennis shoe | Pseudomonas |
| Osteomyelitis in a sickle cell patient | Salmonella, S. aureus |
| Osteomyelitis in a neonate | GBS, gram negatives, S. aureus |
| 5 yr old boy fell off his bike 3 days ago, stitches on his knee, now with suspected osteo- if you dont see on xray should you treat | yes- takes 10-14 days to see plain xray findings. if negative bone scan, would exclude osteo. |
| Treatment of septic arthritis? | Drain, IV abx 3-6 weeks |
| Treatment of Osteo- acute hematogenous | IV abx x 5-14 days then oral abx for 4-8 weeks total therapy |
| Rabbit for a pet | Tularemia |
| 5 diseases you can get from mice/rats | Plague, Typhus, Babesiosis, Hantavirus, Leptospirosis |
| 2 disease you can get from gerbils | Salmonella, Leptospirosis |
| 6 diseases you can get from guinea pigs, hamsters | LCM = lymphocytic choriomeningitis, salmonella, Yersinia, Campylobacter, pasteurella, Leptospirosis |
| Turtles | Salmonella |
| Iguanas, snakes, lizards | Salmonella |
| 6 yr old with ferret for a pet: fever, diarrhea | Campylobacter (also salmonella, rabies, influenza, cryptosporidosis, tuberculosis) |
| 14 year old, lives on a dairy farm, fevers, headaches, chills, pneumonia, enlarged spleen | Q fever- coxiella burnetti |
| Describe microscopic findings in Q fever | gram negative pleomorphic coccobacillus, intracellular pathogen |
| how to treat Q fever? | most resolve without tx, tetracycline or doxycycline |
| How do humans acquire Psittacosis? | by inhalation of aerosols of dried avian excreta, or handling sick birds (NOT by food borne transmit of eating infected poultry) |
| Treatment of Psittacosis | Tetracycline |
| 60-75% of normal cats carry what in their mouth (answer is not dead mice) | Pasteurella |
| Top two organisms in cat wound infections | Pasteurella, S. aureus |
| How to treat cat bites? | Treat ALL cat bites: Amox/Clav + cipro or TMP/SMX (if PCN allergy- clinda + TMP/SMX) |
| Cause of cat-scratch disease | Bartonella henselae |
| Toxoplasma gondii host? | cats |
| How Dx toxoplasma? | Acute IgM antibody positive. |
| name 4 types of Toxoplasma | 1.)asymptom/mild: self limited. 2.)Pregnancy acquired 3.) CNS disease- multiple mri lesions 4.) Ocular: yellow/white cotton patches |
| Fetal risk of infection with Toxoplasma increases or decreases as progress along in pregnancy? | Increases - 3rd trimester 65%. However the severity decreases as fetus is older (the inverse) |
| Newborn with microcephaly, purpura, scattered cerebral calcifications on MRI | Toxoplasma |
| Tx of newborn with toxoplasma? | Pyrimethamine, sulfadiazine, leucovorin |
| Postexposure to rabies: | Rabies immunoglobulin: 20IU/kg with as much as possible into the wound, Rabies vaccine 1ml IM into delt on days 0,3,7,14 |
| Teenager working on a ranch cleaning out stalls, conjunctival suffusion, jaundice | Leptospirosis, skin or mucous membranes come in contact with contaminated urine of infected animal (rats, dogs, livestock, wild mammals, cats) |
| 3 yr old with hx of pica, have pets at home, on CBC eosinophils of 40-50%, fever, cough | Toxocara - intestinal roundworms of dogs/cats, eggs excreted found in dust, cracks of floors, under rugs: visceral larva migrans |
| Treatment of toxocariasis | Albendazole or mebendazole |
| Dog that sleeps in the same bed with boy, found to have fleas, now child with abdominal pain, diarrhea | Tapeworm (Dipylidium), tx with praziquantel or niclosamide |
| Treatment for West Nile virus? | Supportive |
| 18 yr old, visiting from Europe, develops dementia | Think of CJD - remember Bovine Spongiform Encephalopathy |
| Is oral PCN effective for Pseudomonas? | NO - NOT even Amox/Clav |
| Best treatment for Ehrlichia | Doxycycline or tetracycline |
| Abx for infected central line | Vanco - if gram negative suspected, add Pseudomonas coverage (ceftaz, pip-tazo, aminoglycoside--- not ceftriaxone |
| After vancomycin, patient develops flushing- can patient receive again | Red man syndrome- not a true allergy, can use again, slow down dose and give benadryl |
| Treatment of patient with Lyme disease and 3rd degree heart block | Ceftriaxone and pacemaker |
| Swimming in a pond with a dog- what abx of choice if spirochete? | Likely leptospirosis - Doxycycline or PCN |
| When see Listeria, think of what antibiotic? | Ampicillin |
| When see Enterococci, think of what antibiotic? | Amp or vanc with/without aminoglycoside if severe |
| Can you treat pneumococcal pneumonia with Cipro> | no. |
| Which can you use Ketoconazole? Itraconazole? Fluconazole? | Fluconazole. Both others need acid environment in stomach to be absorbed. |
| Aztreonam treats: Gram Positives or gram negatives? | Gram negative aerobic infections |
Created by:
KTClimbs
Popular Medical sets