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1
Q

common bacteremia bugs in neonates

A

GBS, E coli, S pneumo, Staph aureus

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2
Q

common bacteremia bugs in infants

A

GBS, E coli, S pneuo, Staph aureus, salmonella

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3
Q

Common bacteremia bugs in immunocompromised patients

A

gram neg bacilli (pseudomonas, E coli, klebsiella), staph

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4
Q

common meningitis bugs in neonates

A

GBS, listeria, E coli

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5
Q

Common meningitis bugs in young children

A

strep penumo, N mening, enterovirus, Lyme, Rickettsia rickettsii

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6
Q

staccato cough and tachypnea in newborn

A

chlamydia
intracytoplasmic inclusion bodies
dx: PCR
tx: oral erythro, even if just conjunctivities

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7
Q

risk with oral erythromycin

A

pyloric stenosis

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8
Q

silver nitrate works for?

A

GC

NOT CT

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9
Q

erythromycin ointment works for?

A

GC ppx only

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10
Q

dx of C pneumoniae

A

immunofluorescent antibodies

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11
Q

dx of RMSF

A

serologic testing via indirect immunofluorescent antibody antibody - on presentation and 2-4 weeks later
dx: 4x increase in titers

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12
Q

RMSF like presentation but with leukopenia and elevated LFTs

A

erlichiosis

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13
Q

gram negative pleomorphic organism (or GN cocci in pairs)

A

HiB

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14
Q

conjunctivitis otitis combination

A

caused by H influenze - needs augmentin for tx

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15
Q

which type of meningitis can have IV steroids

A

HiB

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16
Q

HiB PEP

A

in household with an incompletely immunized child or immunocompromised child, everyone gets rifampin
underimmunized children should get Hib vaccine

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17
Q

HiB PEP in childcare/preschool

A

if 2+ cases within 60 days and incompletely immunized children at center –> rifampin for attendees and providers
underimmunized children should get Hib vaccine

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18
Q

cough with leukocytosis to 20-40 and lymph predominance

A

pertussis

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19
Q

dx pertussis

A

PCR

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20
Q

tx pertussis

A

erythro, clarithro, azithro
tx in catarrhal stage –> improves cough
tx in paroxysmal stage –> decreases communicability period

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21
Q

pertussis PEP

A

everyone exposed needs PEP with ABx to prevent spread

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22
Q

diarrhea from chicken, eggs, unpasteurized milk, unwashed raw fruits and veggies, turtles, hedgehogs

A

salmonella

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23
Q

who to tx with uncomplicated salmonella

A

< 3mos, hemoglobinopathies, malignancies, severe colitis, immunocompromise

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24
Q

fever, diarrhea, HA, HSM, rash - red spots

A

Salmonella typhi

tx: CTX/cefotax

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25
watery diarrhea and fever --> bloody diarrhea with no fever
shigella | can have seizures, bandemia
26
tx for shigella
only if severe dz, dysentery, immunosuppression | tx: CTX, azithro, cipro
27
ABx for pseudomonas
zosyn, gent, carbapenems, ceftaz, cipro/levo
28
unpasteurized milk, cheese, cattle/sheep/goats
brucellosis | tx: bactrim or tetracycline
29
when can kid with C diff go back to child care
when diarrhea is resolved
30
tx C diff
flagyl --> PO vanc 2nd line
31
pharyngitis that mimics GAS but without palatal petechiae
arcanobacterium haemolyticum (corynebacterium haemolyticum) resp infx mimic diphtheria tx azithro, erythro, clinda
32
abscess size that only need I&D
<5cm
33
descending weakness
botulism
34
MOA of botulism
food- ingestion of preformed botulism toxin infantile - ingestion of spores and germination --> toxin prod toxin blocks ACh release at NM junction
35
dx of botulism
detection of toxin in specimen, no PCR
36
aminoglycosides and botulism
can potentiate paralysis
37
wound botulism tx
antitoxin, then PCN or flagyl
38
dx of syphilis
non treponemal tests (RPR, VDRL) --> treponemal test (FTA-ABS) definitive: darkfield microscopy or DFA of specimen
39
what viruses cause false pos on nontreponemal tests
EBV, VZV, hepatitis
40
what else should you test for in pt with syphilis
HIV
41
how long is FTA ABS pos in syphilis
forever
42
false pos treponemal tests in which dz?
lyme (but would have negative non treponemal test)
43
tx of syphilis
parenteral PCN G | if allergic need desens
44
tx of neonate with maternal syphilis
if mom got PCN >1 mo prior to delivery, then no if mom got erythro, must treat baby if baby's titers > mom's titers must treat baby
45
HSM, corneal scarring, CN VIII deafness, lymphadenopathy, pseudoparalysis, poor feeding
congenital syphilis
46
membranous nasopharyngitis with bloody nasal discharge
diphtheria
47
neck swelling with cervical lymphadenitis
bull neck = diphtheria
48
complications of resp diphtheria
airway obstruction 2/2 membrane myocarditis neuropathies (cranial and peripheral)
49
tx diphtheria
equine antitoxin
50
tx enterococcus
ampicillin, vancomycin
51
most common Kingella infections
septic arthritis, osteo, bacteremia
52
tx kingella
penicillin
53
Meningococcal PEP
all close contacts with invasive disease, generally w/in 7 days rifampin
54
farm animals, pets, untreated water, improperly cooked poultry
campylobacter bloody diarrhea can mimic intussusception or appendicitis
55
tx campy
azithro shortens duration and excretion
56
raw meat, unpasteurized milk, chitterlings, pigs
yersinia | pseudoappendicitis
57
tx yersinia
supportive unless bacteremia, immunosuppressed, hemoglobinopathies tx: bactrim, cefotax, aminoglycosides, quinolones
58
dx bartonella
serology with enzyme immunoassay or immunofluorescent antibody
59
tx bartonella
supportive | if HSM, large/painful adenopathy, or immcomp --> azithro, erythro, bactrim, rifampin
60
tx latent TB
INH monotherapy x 9 mos 2nd line: rifampin monotherapy x 6-9 mos can also do INH+rifapentine DOT x 12 weeks
61
forms of extrapulmonary TB
meningitis, adenitis, pleuritis, disseminated
62
petting zoos, swimming pools, child care centers
cryptosporidium non bloody lasts long time
63
toxicity of aminoglycosides
assoc with high trough (30 min before dose) | ototoxicity
64
Latin America/Africa/Asia, contaminated food/water, crampy abd pain, liquid stools x 1-2 weeks
E histolytica | can cause invasive disease with liver/brain abscesses, lung disease
65
dx E histolytica
definitive: enzyme immunoassay in stool can also see cysts in stool, stool culture usually pos can get abd US for liver cysts
66
tx entamoeba histolytica
flagyl/tinidazole --> iodoquinol (if asymptomatic, only iodoquinol) screen household contacts
67
toxo effects with timing of infection during preg
early: low risk of transmission, severe neonatal disease late: high risk of transmission, less severe disease
68
microcephaly, hydrocephaly, chorioretinitis, diffuse calcifications
toxo
69
late manifestations of toxo
deafness, vision issues, seizures, ID, learning disabilities
70
VCA test
IgG to EBV viral capsid antigen - positive early and for life
71
EBNA test
antibodies to EBV nuclear antigen | positive weeks to month after onset of infection
72
periventricular calcifications, HSM, hypotonia, weak suck
CMV
73
most common nongenetic cause of SNHL
congenital CMV
74
dx congenital CMV
urine culture/PCR
75
3-5 days of fever followed by rash
roseola | can have febrile seizure
76
cataracts, PDA
congenital rubella
77
acquired rubella presentation
mild viral illness, maculopapular rash, lymphadenopathy
78
confluent rash, conjunctivitis, fever, cough
measles | AIRBORNE
79
incubation period of measles:
8-12 days
80
measles PEP
pregnant, <12 mos, immunocompromised --> give IG if <6 days since exposure incompletely immunized --> give vaccine
81
how long after measles IG to give vaccine
minimum 5 months
82
measles vaccine timing and PEP
if <=3 days since exposure, give vaccine as may prevent disease if > 3d, should give IG then vaccine later
83
mumps outbreak in school - who can go back
fully immunized - OK due for booster/vaccine - get imm then OK vaccine refusal - wait 26 days after last person had sx has mumps - 9 days after onset of sx
84
dx of HSV
CSF PCR | DFA of vesicle scrapings
85
dx of neonatal HIV
HIV DNA and RNA PCR
86
dx of HIV in non-neonates
enzyme immunoassays --> Western blot
87
timing of HIV testing post exposure
0, 6 wks, 12 wks, 6 months | use antiretrovirals only if very strong likelihood of transmission
88
precautions for varicella
airborne and contact until all lesions are crusted | or for neonates of mothers w/ VZV - until 21-28 days of age
89
superinfection with VZV
staph aureus
90
immunocompromised VZV PEP
VZIG | needs to be given within 96 hours of exposure
91
when are people with VZV contagious
several days before rash until all lesions crusted
92
VZV PEP for neonate
mother with VZV 5 days before until 2 days after | give VZIG
93
dx of RSV
definitive: immunofluorescence
94
who gets synagis
CLD, preterm, congenital heart disease
95
dx flu
rapid antigen screen
96
dx rotavirus
antigen testing of stool
97
rabies PEP
HRIG inflitrate, 4 dose rabies vaccine
98
traveler with abd pain and sx of GI obstruction
Ascaris lumbricoides ingestion of eggs from contaminated soil tx: albendazole or ivermectin
99
eating undercooked pork, horse meat
trichinella | can get eye pain
100
stinging/burning, pruritus, papulovesicular rash --> microcytic anemia, growth delay, cognitive defects, developmental delay
hookworm = necator americanus
101
hepatomegaly and wheezing, eosinophilia
Toxocara canis | exposure to dogs/cats, eating dirt
102
manifestations of toxocariasis
visceral larva migrans - hepatomegaly, fever, wheeze ocular larva migrans - visual disturbances covert - GI, pruritus, rash
103
dx toxocara
ELISA | stool cultures to rule out other infx
104
tx toxocara
albendazole, thiabendazole
105
prianal or perivulvar itching
pinworms = enterobius | fecal oral, direct or via fomites
106
tx enterobius
pyrantel pamoate, albendazole
107
tx cryptococcus
amphotericin + fluconazole/flucytosine
108
travel to CA, AZ, TX with flu like symptoms
coccidiomycosis
109
tx coccidio
amphotericin, fluconazole, ketoconazole
110
dx aspergillus
galactomannan
111
tx aspergillus
voriconazole | ampho in neonates
112
OH, MO, MI with flu like symptoms, HSM
histoplasmosis | bird droppings
113
tx histo
healthy - supportive | disseminated or immcompro - amphotericin, fluconazole
114
pulmonary disease, meningitis, pigeons
cryptococcus

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