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Neo Review > ID > Flashcards

ID Flashcards

1
Q

What are major pathogens in late-late onset sepsis?

A

Candida, Coag negative Staph

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2
Q

Most common site of origin in Osteomyelitis?

A

Metaphysis
(Femur, humerus, tibia, radius, maxilla)

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3
Q

How can osteo spread between epiphysis?

A

Blood supply between metaphysis and epiphysis is connected in infants.

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4
Q

Is there greater risk of permanent deformity with Osteo or septic arthritis?

A

Septic arthritis
but you can see decreased growth with osteo due to growth plates

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5
Q

What sites would require surgical drainage of septic arthritis vs just aspiration?

A

if hip and shoulder are involved.

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6
Q

Most common cause of Omphalitis?

A

Staph Aurues

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7
Q

How do you treat Nesseria eye infection

A

3rd generation cephalosporin

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8
Q

How do you treat Chlamydia eye infection?

A

oral erythromycin 14 days

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9
Q

Chorioretinitis finding syphilis

A

“salt and pepper” fundus

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10
Q

Chorioretinitis finding Herpes

A

yellow, white exudates and retinal necrosis

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11
Q

Chorioretinitis finding rubella

A

BILATERAL diffuse granular pigmented areas “salt and pepper”

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12
Q

Chorioretinitis finding CMV

A

yellow-white fluffy retinal lesions with hemorrhage

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13
Q

Chorioretinitis finding Toxo

A

retinal scars involving macula

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14
Q

Chorioretinitis finding Candida

A

Fluffy White balls

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15
Q

Difference between EOS GBS and Listeria Sepsis?

A

Listeria can be acquired by transplacental route

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16
Q

What might placenta look like with Syphilis in infection?

A

LARGE

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17
Q

What kind of rash do you see in neonate with Syphilis?

A

desquamating maculopapular rash (palms and soles)

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18
Q

Why do use non-treponemal tests (VDRL and RPR)?

A

to use for screening, assessing response to treatment, and determining re-infection

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19
Q

How do non-treponemal tests work?

A

detect a cell membrane cardiolipin non specific IgG

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20
Q

What is FTA-ABS test used for?

A

detects specific Ab (IgG or IgM) to Treponema

if it is reactive, it is reactive FOR LIFE

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21
Q

When would FTA-ABS be positive but VRDL negative?

A

Lyme disease

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22
Q

When do you follow up treatment for Syphilis in neonate?

A

2, 4, 6, 12 months
titers should decrease by 3 months, and become non-reactive by 6 months

if increasing titers or persistent 6-12 months of age, re-evaluate and treat with another 10 day course

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23
Q

What CBC finding will you see in chlaymydia?

A

Eosinophilia

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24
Q

How long do you treat infant exposed to maternal TB?

A

INH until 3-4 months of age, and then place PPD to determine further management

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25
Q

What are EMG findings in Botulism infection?

A

incremental response at high frequency, abnormal spontaneous activity, abundant, brief, small action potentials

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26
Q

Difference between Staph epi, and staph aureus?

A

Staph epi is coag-negative
staph aureus is coag positive

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27
Q

What is transmission breakdown of HSV infections?

A

Intrapartum (85%)
Postnatal (10%)
In Utero (5%)

28
Q

What is most common incidence of HSV infection?

A

SEM, about 45% and presents on DOL 6-9

29
Q

How would you diagnose in utero HSV infection?

A

elevated cord IgM levels

30
Q

What is treatment for HSV infection?

A

10 days asymptomatic
14 days SEM
21 says CNS
oral acyclovir for 5 months after

31
Q

At what point in pregnancy is infant most likely to develop congenital rubella?

A

11 weeks

32
Q

What are some clinical signs of congenital Rubella Syndrome?

A

Extramedullary hematopoieses (blueberry muffin)
jaundice

cardiac, ophthalmologic, auditory, neurologic

33
Q

Difference between congenital and neonatal varicella

A

congenital
trauterine growth restriction, ocular defects, scarring skin lesions, limb abnormalities, and central nervous system abnormalities.

neonatal
pneumonia, hepatitis, and meningoencephalitis.

34
Q

Features of congenital Varicella

A

limb hypoplasia, cutaneous scarring (optic nerve atrophy, cataracts, chorioretiniits) damage to CNS
intellectual disability, microcephaly, hydrocephalus, seizures

35
Q

how do you test for syphilis?

A

VRDL and RPR
(RPR not appropriate for CSF)

36
Q

how do you treat chlamydia infection?

A

Azithromycin or erythromycin

37
Q

how do you treat toxoplasmosis?

A

pyrimethamine, sulfonamide, and leucovorin

it inhibtis folate metabolism

38
Q

How long are antiviral HIV meds indicated for infant to compliant mother with HIV?

A

6 weeks

39
Q

Transplacental syphilis infection, more likely in early or late maternal infection?

A

40% if early latent infection
8% if late maternal infection

40
Q

What histopathologic changes do you see in syphilis in placenta?

A

umbilical cord is edematous with spiral stripes of blue and red discolration alternating with streaks of white (barber pole)
concentric perivascular infiltrate with calficications.

41
Q

What is positive syphilis test in neonate?

A

4 fold titer higher than mom
neonate 1:32, mom (1:8)

42
Q

What is treatment of tetanus in infant?

A

Flagyl

43
Q

What organisms are isolated from peritoneal fluids in a SIP?

A

Candida, Coag negative Staph

44
Q

What virus is associated with Lissencephaly?

A

CMV

45
Q

What is treatment for infant born to mother with active gonnorhea

A

Ceftriaxone, and erythromycin ointment

46
Q

What infections require both airborne and contact precautions?

A

TB and varicella

47
Q

What time period are infants most susceptible to varicella infection?

A

to a mother who develops varicella between 5 days before and 2 days after varicella infection.

48
Q

What medication can preserve hearing loss in CMV?

A

ganciclovir

49
Q

Syphilis more severe if acquired earlier or later in pregnancy?

A

Later
(transmission can occur at any time)

50
Q

When do you evaluate infant born to mother with active HSV lesions?

A

> 12 hours after birth

51
Q

When will maternal IgG disappear from infant’s blood?

A

By 9 months

52
Q

What clinical presentation is unique to Varicella amongst TORCH infections?

A

Limb hypoplasia, cicatricial scarring

53
Q

What is initial drug of choice for presumed systemic fungal infection in neonate?

A

Amphotercin B (has superior penetrance through blood brain barrier.
can switch to flucanazole once sensitivities are back.

54
Q

At birth B-cells higher or lower in infants compared to adults?

A

Similar proportion, but infants have absolute higher number

55
Q

What is order of activation in classic pathway?

A

C1 C4 C2 C3

56
Q

Where do classic and alternative pathway converge?

A

c3

57
Q

Erythromycin drops protect against what infection?

A

Neisseria

58
Q

What is treatment for asymptomatic neonate, unremarkable lab workup born to mother with HSV lesion first infection?

A

10 days IV acyclovir

59
Q

How Does SCID screening work?

A

measure TRECS (t-cell receptor excision circles)

60
Q

Where is mutation in LAD deficiency?

A

B2 integrin

61
Q

What bacteria resistant to cephalasporin?

A

Enterococci

62
Q

List 4 functions of spleen

A

Assists in functional maturation of antibodies
recycles iron
produces IgM and complement
removes rbcs and platelets from circulation
supports proliferation of T-cells

63
Q

What does negative NBT test mean?

A

Neutrophils isolated, stimulated, undergo a burst, an dye converted to blue
negative means, no conversion to BLUE

64
Q

What is typical skin lesion seen with congential syphilis infection?

A

Vesiculobullous mucocutaneous lesions, involves palms and soles

65
Q

Difference between Benzathine PCN G or Aqueous IV PCN G?

A

1 time BCN IM can be given in absence of positive disease (positive non-treponemal titers only)

otherwise treat active disease with IV for 10-14 days

66
Q

what are PRESENTING symptoms of CMV

A

Petechiae, juaundice, and hepatosplenomegaly..

can also see chorioretinitis, hearing loss, and hemolytic anemia

67
Q

What is a Cohort Study?

A

Neo Review (18 decks)

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