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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
What are EMG findings in Botulism infection?
incremental response at high frequency, abnormal spontaneous activity, abundant, brief, small action potentials
26
Difference between Staph epi, and staph aureus?
Staph epi is coag-negative staph aureus is coag positive
27
What is transmission breakdown of HSV infections?
Intrapartum (85%) Postnatal (10%) In Utero (5%)
28
What is most common incidence of HSV infection?
SEM, about 45% and presents on DOL 6-9
29
How would you diagnose in utero HSV infection?
elevated cord IgM levels
30
What is treatment for HSV infection?
10 days asymptomatic 14 days SEM 21 says CNS oral acyclovir for 5 months after
31
At what point in pregnancy is infant most likely to develop congenital rubella?
11 weeks
32
What are some clinical signs of congenital Rubella Syndrome?
Extramedullary hematopoieses (blueberry muffin) jaundice cardiac, ophthalmologic, auditory, neurologic
33
Difference between congenital and neonatal varicella
congenital trauterine growth restriction, ocular defects, scarring skin lesions, limb abnormalities, and central nervous system abnormalities. neonatal pneumonia, hepatitis, and meningoencephalitis.
34
Features of congenital Varicella
limb hypoplasia, cutaneous scarring (optic nerve atrophy, cataracts, chorioretiniits) damage to CNS intellectual disability, microcephaly, hydrocephalus, seizures
35
how do you test for syphilis?
VRDL and RPR (RPR not appropriate for CSF)
36
how do you treat chlamydia infection?
Azithromycin or erythromycin
37
how do you treat toxoplasmosis?
pyrimethamine, sulfonamide, and leucovorin it inhibtis folate metabolism
38
How long are antiviral HIV meds indicated for infant to compliant mother with HIV?
6 weeks
39
Transplacental syphilis infection, more likely in early or late maternal infection?
40% if early latent infection 8% if late maternal infection
40
What histopathologic changes do you see in syphilis in placenta?
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
What is positive syphilis test in neonate?
4 fold titer higher than mom neonate 1:32, mom (1:8)
42
What is treatment of tetanus in infant?
Flagyl
43
What organisms are isolated from peritoneal fluids in a SIP?
Candida, Coag negative Staph
44
What virus is associated with Lissencephaly?
CMV
45
What is treatment for infant born to mother with active gonnorhea
Ceftriaxone, and erythromycin ointment
46
What infections require both airborne and contact precautions?
TB and varicella
47
What time period are infants most susceptible to varicella infection?
to a mother who develops varicella between 5 days before and 2 days after varicella infection.
48
What medication can preserve hearing loss in CMV?
ganciclovir
49
Syphilis more severe if acquired earlier or later in pregnancy?
Later (transmission can occur at any time)
50
When do you evaluate infant born to mother with active HSV lesions?
> 12 hours after birth
51
When will maternal IgG disappear from infant's blood?
By 9 months
52
What clinical presentation is unique to Varicella amongst TORCH infections?
Limb hypoplasia, cicatricial scarring
53
What is initial drug of choice for presumed systemic fungal infection in neonate?
Amphotercin B (has superior penetrance through blood brain barrier. can switch to flucanazole once sensitivities are back.
54
At birth B-cells higher or lower in infants compared to adults?
Similar proportion, but infants have absolute higher number
55
What is order of activation in classic pathway?
C1 C4 C2 C3
56
Where do classic and alternative pathway converge?
c3
57
Erythromycin drops protect against what infection?
Neisseria
58
What is treatment for asymptomatic neonate, unremarkable lab workup born to mother with HSV lesion first infection?
10 days IV acyclovir
59
How Does SCID screening work?
measure TRECS (t-cell receptor excision circles)
60
Where is mutation in LAD deficiency?
B2 integrin
61
What bacteria resistant to cephalasporin?
Enterococci
62
List 4 functions of spleen
Assists in functional maturation of antibodies recycles iron produces IgM and complement removes rbcs and platelets from circulation supports proliferation of T-cells
63
What does negative NBT test mean?
Neutrophils isolated, stimulated, undergo a burst, an dye converted to blue negative means, no conversion to BLUE
64
What is typical skin lesion seen with congential syphilis infection?
Vesiculobullous mucocutaneous lesions, involves palms and soles
65
Difference between Benzathine PCN G or Aqueous IV PCN G?
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
what are PRESENTING symptoms of CMV
Petechiae, juaundice, and hepatosplenomegaly.. can also see chorioretinitis, hearing loss, and hemolytic anemia
67
What is a Cohort Study?

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