infectious disease

Question 1

Where is atypical mycobacterium usually located/found in the body?

Answer 1

atypical mycobacterium infections in children are usually located in the superior anterior cervical or in submandibular nodes

Question 2

How would you describe the nodes in pts with an atypical mycobacterium infection?

Answer 2

They are painless, firm and not erythematous

Question 3

What age group for children would you usually see atypical mycobacterium infection?

Answer 3

ages 1-5 because at this age they are more likely to put objects in their mouth that could be contaminated from soil. They also my have a lower resistance to the bacteria

Question 4

What are the common symptoms for a MAC infection?

Answer 4

Fever
Diarrhea
Weight Loss
Anemia

Question 5

At what CD4 count do you prophylax HIV pts for MAC

Answer 5

CD4 less than 50 and you use azithromycin and clarithromycin

Question 6

Is MAC transmitted from person to person?

Answer 6

No, it is present in soil and water

Question 7

How do you diagnose MAC

Answer 7

With AFB and culture

Question 8

For an immunocompetent Pt how would you treat them if they had MAC?

Answer 8

With Clarithromycin and ethambutol for at least 12 months

Question 9

How does someone become infected with Mycobacterium Marinum?

Answer 9

Think Marinum is aquarium. People get this disease by get occupational hazard. Working at an aquarium and have a puncture to the skin which allows the water to get in and the organism to inoculate.

Question 10

How do you diagnose Mycobacterium Marinum?

Answer 10

by culture

Question 11

how do you treat Mycobacterium Marinum?

Answer 11

with tetracycline, fluoroquinolones, macrolides, and sulfonamides for 4-6 weeks

Question 12

a 14-year-old boy with 3-days of sore throat, fever, and generalized malaise. On exam, he has a temperature of 102.2 F (39.0 C), BP 96/50, and a diffuse exudate on both tonsils. He also is noted to have palpable splenomegaly, swollen painful lymph nodes, and mild hepatomegaly. Labs show leukocytosis of 12,000/mm3 with 50% neutrophils, 12% monocytes, and 38% lymphocytes. The rapid pharyngeal streptococcal screen is negative.

What is the Pt presenting with?

Answer 12

Epstein barr disease

Question 13

what is the classic triad for mono?

Answer 13

Fever, pharyngitis, lymphadenopathy

Question 14

How do you diagnose mono?

Answer 14

of course the monospot but this test is called a heterophile antibody screen

Question 15

What can you do for a Pt that has mono to help relieve some of the symptoms?

Answer 15

Put them on a steroid to help decrease the tonsilor swelling

Question 16

a 5-year-old with sudden onset of fever, chills, malaise, sore throat, headache, and coryza. The child is also complaining of myalgia, especially in her back and legs. On physical exam, the patient appears lethargic, has a temperature of 102.5 F, and palpable cervical lymph nodes. Breath sounds are distant with faint end-expiratory wheezes.

What is the most likely Dx?

Answer 16

the Flu

Question 17

everyone greater than what age should get the flu vaccine?

Answer 17

everyone greater than 6months

Question 18

What is the gold standard for diagnosing the flu?

Answer 18

RT-PCR or viral culture

Question 19

What will a chest x-ray in primary influenza pneumonia show?

Answer 19

bilateral diffuse infiltrates

Question 20

What two flu medications treat both flu strain A and B?

Answer 20

Dr. OZ so Zanamivir and Oseltamivir

Question 21

a 6-year-old child who is brought to the emergency room for a complaint of high fevers and a rash. His mother reports that she thought he had “just a cold” approximately one week ago—he had a mild fever, runny nose, conjunctivitis, and cough. Then he developed a rash that started on his face and gradually spread downward. The child has no significant past medical history, however, he was adopted from Russia at age 5, and his medical history prior to adoption is unknown. On examination, the child appears lethargic and has a temperature of 104.3. There is a mild injection of his conjunctiva and a generalized macular rash. White macules are noted on his buccal mucosa.

What is the likely Dx?

Answer 21

the measles

Question 22

describe the prodrome for measles?

Answer 22

1-3 days presenting with the 3 c’s

Cough
Coryza
Conjunctivitis

Question 23

What kind of spots appear with measles?

Answer 23

Koplik spots

Question 24

a 5-year-old male is brought to the clinic with acute onset of painful swollen parotid glands. His mother reports that he was fine last night, but awoke with the swelling this morning. He has no significant past medical history, but it is documented in his chart that his mother declined the recommended standard immunizations for children because of personal beliefs. On examination, the child appears well and has a temperature of 100.8 F. His right parotid gland is slightly more swollen than the left, but they both are markedly swollen and tender.

What is likely diagnoses?

Answer 24

Mumps

Question 25

mumps is the most common cause of what in children?

Answer 25

pancreatitis

Question 26

If you were to perform a CSF analysis of someone with mumps. What do you suspect it will show?

Answer 26

increased lymphocytes and decreased glucose

Question 27

When is the MMR vaccine given?

Answer 27

at ages 12-15months then again around 4-6 years old

Question 28

a 24-year-old with an increasing cough for 3 weeks. The cough comes and goes sometimes lasting for 10 minutes and causing gasping inhalations. The cough was preceded by a mild cough and cold 2 weeks ago. She has completed all immunizations required to attend school and has no known drug allergies

What is the most likely diagnoses?

Answer 28

pertussis

Question 29

What are the signs and symptoms of pertussis?

Answer 29

a severe hacking cough followed by a high pitched intake of breath that sounds like a whoop.

Question 30

Is pertussis gram negative or positive?

Answer 30

gram negative, bordetella pertussis

Question 31

How do you diagnose pertussis?

Answer 31

nasopharyngeal swab

Question 32

What is the tx for pertussis?

Answer 32

Macrolide (azithromycin or clarithromycin) can also give some steroid or beta-2 agonists

Question 33

When do children start getting the Tdap vaccine?

Answer 33

think is 2, 4, 6, 15-18months then 4-6years old its a 5 series

Question 34

a 4-year-old is brought to the office by his mother because the daycare teachers noticed he is unusually restless at school. The mother also noticed that he has not been sleeping well lately and has started wetting the bed at night. The child is alert and cooperative but scratches his buttocks while you are interviewing

What can you do to diagnose this?

Answer 34

Apply scotch tape early in the morning to anal area and looks for the worms

Question 35

What is the treatment for pinworms?

Answer 35

albendazole or mebendazole

Question 36

If you are seeing a child between the ages of 6 months and 2 years of age and they have sudden onset of severe fever temps around 103-104 for 3 days then as they start to feel better a pink maculopapular rash appears on the trunk and spreads to the fave and legs? what is top of your differential?

Answer 36

Roseola