ID Flashcards
(63 cards)
What dx?
Newborn with afebrile Staccato cough?
W or wo eye discharge
Chlamydia trachomatis
Dx with intracytoplasmic inclusion bodies, (definitivie) PCR
How do you tx chlamydia conjunctivitis?
Oral erythromycin or sulfa
Dx?
Patient in May is purpuric macular rash progression to petechial that started on ankles, wrists, palms, soles with headache.
Also seen with hyponatremia, depression of 1-3 cells lines on CBC.
RMSF
Once thought of RMSF, most imp next step; test or tx?
Treat with doxy 7 days or until fever resolves for at least 3
What lab differences will u see between ehrilicia and RMSF
Ehrlicia: leukopenia and elevated LFTs
RMSF: thrombocytopenia and hyponatremia
Asplenic pt or from developing country w GN pleomorphic organism.
Bug and tx?
H influenzae
T.mx w rocephin, cefotax
What is prophy for hib with contact younger than 12mo wo primary immunization series
Rifampin
When do you use rifampin prophy for hib ?
If One household contact younger than four who is incompletely immunized,
immunocompromise child even if over four
If two or more cases within 60 days and unimmunized or in completely immunized then children/attendees/workers at childcare facility should get it
NO prophy if all members are immunocomponent and immunized OR if non typable h flu
Patient was at a picnic 1-2 days prior then Got watery loose stools with vomiting, abdominal cramps and fever.
What bug?
Salmonella
Dx stool cx
Tx only needed if infant younger than 3 or immunocompromised (tx w rocephin)
Initial presenting sign of typhoid and tx
Constipation
Rocephin or cefotax
Patient with watery diarrhea and fever several days after ingestion. Once the fever subsides then bloody diarrhea
Dx?
Shigella
(WBC or RBC in stool)
Only treat with Bactrim or amp (if susceptible) in severe disease or immunocompromised
Dx ?
Fever of unknown origin?
Patient with fever and malaise, exposure to cattle sheep or goats and unpasteurized milk or cheese
Brucellosis. Treat with Bactrim or tetracycline
What is treatment for CDIff
Metronidazole
What is the purpose in treating strep throat
Prevent rheumatic fever
What is the treatment for infantile botulism
Supportive care, unless presented with antitoxin
If mother was treated for syphilis during pregnancy, do you treat them
No if she was treated with penicillin more than a month before delivery,
yes if she was treated with in the last month of pregnancy,
yes if she was treated with erythromycin,
yes if babies titers are higher than mothers titers
What might you see in and traded infants with syphilis after two years of age
Hutchinson Triad:
interstitial keratitis,
eighth cranial nerve deafness Hutchinson teeth or Peg shaped notched central incisors
Infant with sniffles or copious nasal secretions, bolus lesions, osteochondritis and pseudo-paralysis of the joints
Congenital syphilis
May also see lymphadenopathy, Nico cutaneous lesions, pneumonia, Adema, low platelets, HSM, humility anemia, jaundice, maculopapular rash at birth or within 4 to 8 weeks of age
What is Drug of choice for king Ella
Penicillin
How to treat penicillin allergic patients with listeria
Desensitization
What is treatment of the N.meningitidis
Initial therapy with vanc and Rocephin
Then definitive tx a pen g, amp or rocephin
Who should get meningogocal prophylaxis and what is drug
HouseholdContacts especially younger than two
Preschool contacts at any time during seven days before onset of illness
Direct exposure to secretions are kissing toothbrushes or utensils at any time seven days prior to onset of illness
Anyone with mouth-to-mouth recess or Indo tracheal intubation seven days prior to illness
Passengers seated directly next to on flights lasting more than 8 hours
Slept in same house 7 days prior to onset
Rifampin
Patient with recent handling of dead animals now has painful swollen inguinal nodes.
Dx?
Bubonic plague
Patient with bloody diarrhea right lower quadrant pain and elevated white blood cells
History of drinking and pasteurize milk or eating Chitterlings
Yersinja
