Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*CPS Statements TD > ID > Flashcards

ID Flashcards

1
Q

Who is at increased risk for invasive meningococcemia disease?

A

Risk increased because of underlying medical conditions:

  • Asplenia or functional asplenia, including those with sickle cell anemia
  • Properdin, factor D or complement deficiency (including those with acquired complement deficiency from eculizumab (Soliris); primary antibody deficiency
  • HIV

Risk increased because of the potential for exposure

  • Laboratory workers who work with meningococcus
  • Military personnel living in close quarters
  • Travellers to endemic areas (currently, travellers to sub-Saharan Africa and Hajj pilgrims)
  • Close contacts of a case of IMD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What vaccine schedule for meningococcal disease in health children?

A

Conjugated MenC at 12 months old

Quadrivalent conj MenC in adolescent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment for head lice w ages?

When to try something else?

A

first line:

  • Pyrethrins (> 2mo)
  • Permethrins (>2mo)
  • for both - 2 applications 7-10 days apart

other:

  • Isopropyl myristate/ ST-cyclomethicone solution (Resultz - >4yo)
  • Dimeticome (>2 yo)

If two permethrin applications 7 days apart do not eradicate live lice, consider administering a full treatment course using a medication from another class.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Should you exclude children from school w head lice?

A

No

  • avoid head to head contact
  • should clean hats, pillow cases, etc w warm water (not FULL environment)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rate of HIV transmission in pregnancy without treatment

A

With no intervention, transmission rates up to 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk factors for HIV infection

A

Late or no prenatal care,
injection drug use,
recent illness suggestive of HIV seroconversion,
regular unprotected sex with a partner known to be living with HIV (or with significant risk for HIV infection),
diagnosis of sexually transmitted infections during pregnancy,
emigration from an HIV-endemic area or
recent incarceration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Time frame of antiretroviral therapy in newborn period

A

If test results are positive for mother or infant, infant antiretroviral prophylaxis should be initiated immediately and no later than 72 hours post-delivery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What viruses are of concern w a needle-stick injury

- which is most likely?

A

HBV, HCV, and HIV

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mgmt if get a needle stick injury

A

Clean wound thoroughly w soap+water, do not squeeze to induce bleeding
Assess child’s immunization status for tetanus, Hep B
Obtain blood for HBV, HIV, and HCV status +/- LFT, CBC, RF if considering ART

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should person with varicella be excluded from camp?

A

When the camp includes persons with immunocompromising conditions, campers or staff with active VZV disease (varicella or zoster), or who have had an exposure to VZV in the past 21 days and are non-immune, should be excluded.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common reasons for children not getting immunized

A
  • parents simply forgetting that their child is due for an immunization,
  • having difficulty getting to a clinic during regular hours,
  • being unconvinced that vaccine-preventable diseases pose a real threat,
  • believing that children are ‘too young’ for certain vaccines (or that they are receiving too many vaccines or that they should develop ‘natural immunity’), and, finally,
  • having concerns about the trustworthiness of health care workers or the safety and efficacy of vaccines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common Bacteria causing AO?

Most common in infants

A

Staphylococcus aureus,
Kingella kingae,
Streptococcus pneumoniae
Streptococcus pyogenes

Kingella kingae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What to consider with S aureus bacteremia with no apparent source?

A

AO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Gold Standard for osteoarticular infection dx?

A

Gold standard: bone biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most sensitive and specific test for osteoarticular infection dx?

A

MRI with gadolinium enhancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mgmt of OA

A 
Consult surgery (SA)
Blood cultures
Aspirate joint
first gen cephalosporin: cefazolin 100-150 mg/kg/day div q6h/q8h
\+ Vanco if concern MRSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When can you transition to oral Abx for OA

A

when neg BCx
clinical improvement
decrease in CRP
compliance and followup is ensured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Quadrivalent HPV vaccine

- which types of HPV

A

6, 11, 16, 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why HPV strains are maliganant

A

HPV 16 and 18 - most malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is schedule for HPV vaccine

A

9-14 yo get 2 dose
>14yo get 3 dose
Immunocompromised and HIV+ should get 3 dose
All 6 months apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Meningococcemia - serotypes

  • most common
  • highest fatality
A 
Five serogroups (A, B, C, Y and W - based on the polysaccharide capsule)
Serogroups B and C predominate 
(B>C in <5yo, C is more in outbreaks of adolescents)

C has highest fatality rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does invasive meningococcemia disease present?

A

septic shock, meningitis or both

can present as sepsis, pneumonia, septic arthritis, pericarditis or occult bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vaccine for invasive meningococcemia- when?

A

Men-C-C (conj) offered at 12 mo

Men-C-ACYW for adol booster (Quadrivalent conj)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who is at increased risk of invasive meningococcemia

A

Risk increased because of underlying medical conditions

  • Asplenia or functional asplenia, including those with sickle cell anemia
  • Properdin, factor D or complement deficiency (including those with acquired complement deficiency from eculizumab (Soliris); primary antibody deficiency
  • HIV

Risk increased because of the potential for exposure

  • Laboratory workers who work with meningococcus
  • Military personnel living in close quarters
  • Travellers to endemic areas (currently, travellers to sub-Saharan Africa and Hajj pilgrims)
  • Close contacts of a case of IMD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how often should high risk its receive meningococcemia vaccine?

A

should receive booster every 3-5 years until 7 yo, and q5y thereafter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

rotavirus transmission

A

Greatest incidence in children < 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

RF for severe rotavirus infection

A

Premature
Not breastfed
Immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Schedule for rotavirus vaccine?

A

2 or 3 doses (dep on vaccine)
First: 6 weeks (latest 20 weeks)
4 weeks between doses
Last dose < 8 months (due to risk of intussusception with later dosing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Contraindications to Rota vaccine

A
  • Hx of intussusception or greater susceptibility to intussusception (ex Meckel’s)
  • Hypersensitivity to any vaccine ingredients
  • Known or suspected SCID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When do preterm infants get rota vaccine

A

Preterm infants can get vaccine
At or following D/C from NICU
Same schedule as term infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Risk factors for AOM

A

Young age
Frequent contact with other children
Orofacial abnormalities (such as cleft palate)
Household crowding
Exposure to cigarette smoke
Pacifier use
Shorter duration of breastfeeding
Prolonged bottle-feeding while lying down
FHx of otitis media
Children of First Nations or Inuit ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

AOM

bug

A

Virus and bacteria

Streptococcus pneumoniae
Moraxella catarrhalis
Haemophilus influenzae
Less common: Streptococcus pyogenes (group A streptococci [GAS])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How to diagnose AOM

A

1) Acute onset of sx (otalgia)
2) MEE (Decreased TM mobility; Loss of bony landmarks; Air fluid level)
3) Significant inflammation of middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Complications of AOM

- most common

A 
Mastoiditis (most common)
Acute facial nerve palsy
6th cranial nerve palsy
Failure of ipsilateral eye abduction
Due to petrous bone inflammation or infection
Gradenigo’s syndrome
Labrynthitis
Venous sinus thrombosis
Meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

AOM

- when should you treat w abx

A

bulging TM,
T ≥39°C,
moderately to severely systemically ill
children who have severe otalgia or have been significantly ill for 48 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

AOM - abx

  • first line
  • next step
  • if allergy
A

Amoxicillin 45-60 mg/kg/day div TID (or 75-90 mg/kg/day div BID)
5 days if >2ys, 10 days if <2ys

Amox Clav If purulent conjunctivitis, If recent AOM (<30d) tx w amox; if no improve in 2-3/7

Allergy to amox or penicillin: 2nd or 3rd gen cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

RSV prevention

A

RSV prevention

  • Young infants should not be in contact w individuals with a RTI
  • Hand hygiene
  • Breastfeeding + avoidance of cigarette smoke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

RSV vaccine name

A

Palivizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Who gets palivizumab

A
  • Hemodynamically signif CHD/CLD on diuretics, bronchodilators, steroids or O2 if <12mo at start of season
  • Prem w/o CLD born <30wga if <6mo at start of season
  • Infants <36wga and <6mo at start of season in remote communities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

N gonorrhoeae Ophthalmia Neonatorum complications

A

corneal ulceration
perforation of the globe
permanent visual impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What percent of Ophthalmia Neonatorum is caused by N gonorrhoeae

A

<1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What to do if mom had untreated N gonorrhoeae infection at delivery

A
  • test & tx immediately w/o waiting for results.
  • If well: a conjunctival culture and a single dose of ceftriaxone IV or IM
  • If unwell also do Blood and CSF cultures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What to do if mom had untreated Chlamydia infection at delivery

A

closely monitor for sx

don’t prophylactically treat or screen unless sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Who to give prophylactic Abx for UTI?
How long?
Which Abx?

A
  • Grade IV or V VUR, or a significant urological anomaly.
  • 3-6 months
  • Trimethoprim/sulfamethoxazole or nitrofurantoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Common bugs for UTI

A 
Escherichia coli
Klebsiella pneumoniae
Enterobacter species
Citrobacter species
Serratia species
adolescent females only:  Staphylococcus saprophyticus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Empiric Abx for UTI

A 
PO 
Amoxicillin
Amox Clav
Co-trimoxazole
Cefixime
Cefprozil
Cephalexin
Ciprofloxacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Imaging for UTI?

A

children <2 years of age with a first febrile UTI: RBUS
- VCUG if abnormal

VCUG indicated for children <2 years of age with a second well-documented UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Most common cause of sepsis in Asplenia/hyposplenia

A 
Encapsulated bacteria
Strept pneumo = 50%
H flu
Neisseria
Salmonella
EColi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is better for Asplenia - conj or polysaccharide vacccines

A

conjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Abx prophylaxis in Asplenia:
<3mo
3mo-5yo
>5yo

A

<3mo: amox clan
3mo-5yo: pen VK or amox
>5yo: pen VK or amox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How long is newborn at risk for vertical HSV transmission

A

Initial symptoms within 4 weeks of life, up to 6 weeks in some

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Treatment of neonatal HSV

- med, duration, associations

A 
IV Acyclovir 60mg/kg/day div TID
Duration:
- SEM = 14 days
- Disseminated and CNS = 21 days
Associated neutropenia and renal damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How to dx neonatal HSV

A

HSV PCR
do CSF and swabs of any vesicular lesions and mucous membranes (conjunctivae, mouth and nasopharynx)

Consider blood PCR if suspected disseminated
Consider NPA for PCR if pneumonia

In exposed asymptomatic infant, do swabs of mouth, nasopharynx, conjunctiva at least 24 hours after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How to manage ASx infant of mom w active HSV lesions at delivery
if
First episode primary or first episode non-primary

A

First episode primary or first episode non-primary:

  • C/S before ROM = MM & NP swabs and discharge if well, if positive then manage as NHSV case
  • SVD or C/S w ROM = MM swab and start acyclovir and check mom’s serology
    • if baby has neg swabs and mom has recurrent HSV, can stop acyclovir
    • If mom primary (or serology not available) continue acyclovir for 10 days even if swabs negative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How to manage ASx infant of mom w active HSV lesions at delivery
if
Recurrent HSV

A

Recurrent HSV at delivery by C/S
- MM & NP swabs and discharge if well, if positive then manage as NHSV case

Recurrent HSV at delivery SVD

  • MM swabs at 24 hours and discharge if well pending results.
  • Some recommend blood PCR too.
  • Acyclovir only if swabs positive or lesions develop
56
Q

Who to consider for neonatal HSV

A

Consider in all sick infants < 6 weeks

If on IV Abx for suspected sepsis, especially with seizures or abnormal CSF but negative bacterial blood culture and not improving

Pneumonia of uncertain etiology, not improving on 24h of IV Abx with viral picture on CXR

Unexplained bleeding at IV sites

Unexplained hepatitis in infant with suspected sepsis

57
Q

Contraindications to LP

A

coagulopathy,
cutaneous lesions on site,
signs of herniation,
unstable clinical status (shock)

If papilledema, focal neuro signs, decreased LOC, do imaging before LP to r/o herniation

58
Q

Mgmt for bacterial meningitis (meds)

A

Abx first choice 3rd gen ceph - ceftriaxone and cefotax

  • Add vanco usually to cover for ceph resistant S pnuemo
  • 3rd gen ceph should cover N mening and H flu

Hib and S pneumo: Give corticosteroids just before or within 2h of abx to reduce severe hearing loss

Close contacts should be treated with rifampin

59
Q

C Diff presentation
mild, moderate, severe
complication?

A

Mild: Watery diarrhea < 4/d, no systemic toxicicty

Mod: >/=4 watery stools/d, no systemic toxicity (may have low grade fever or mild abdo pain)

Severe: Systemic toxicity (high grade fevers, rigor), hypotension shock, peritonitis ileus, megacolon

Pseuomembranous colitis: severe diarrhea, abdominal pain, fever, leukocytosis, systemic toxicity, and stool containing blood, mucous and leukocytes
Toxic megacolon - can lead to perforation

60
Q

how to dx c diff

A

toxin in stool

not culture

61
Q

How to prevent C Diff spread

A

1) Meticulous hand hygiene
2) ID and remove environmental sources of C​diff & use chlorine-containing or other sporicidal cleaning agents to eliminate environmental contamination in areas associated with increased rates or outbreaks of CDI
(Alcohol-based hand hygiene products do not kill C​difficile spores)
3) Contact precautions until 48 h with no diarrhea
4) Use of private rooms or cohorting

62
Q

How to treat CDiff infection

- mild, moderate, severe, severe complicated

A

Mild illness: No Abx

  • If precipitated by abx, these should be stopped, if possible
  • Should seek help if sx worsen or if a child has not improved within 48 h

Moderate illness: PO metronidazole
- Discontinue the offending Abx, if possible

Severe, uncomplicated illness: PO vancomycin
- Discontinue the offending Abx, if possible

Severe, complicated (ileus, megacolon, shock, peritonitis or hypotension) : PO or PR Vanco
AND IV metronidazole

63
Q

How to treat CDiff infection recurrence

A

First recurrence
Same as first episode of Cdiff

Second or later recurrences
Vanco, using a tapered and/or pulsed regimen.

64
Q

Higher Risk for Hep C

A

IVDU major risk factor
○ Being the sexual partner of an IVDU
○ Blood transfusion prior to 1990 (when Canada began HCV screening)
○ Patients/HCW exposed to contaminated blood/body fluids
○ Sexual transmission (consider a minor mode of transmission)
○ Infant female sex
○ ? Prolonged ROM
○ ? Intrapartum fetal scalp monitoring
○ ? Amniocentesis

65
Q

Can Hep C + mom breastfeed?

A

yes

66
Q

Polio - most serious complication

A

acute flaccid paralysis

67
Q

Measles - presentation

A

3 C’s: cough, coryza and conjunctivitis, followed by a descending maculopapular rash; Koplik’s spots

68
Q

What vaccine preventable disease will never be eradicated

A

tetanus

69
Q

What vaccine preventable disease has common vaccine failure

A

Mumps

70
Q

When is TB most infectious

A

Cavitary disease

71
Q

Types of TB disease

A

Latent

Active:

  • Pulmonary
  • Extra pulmonary
  • Disseminated
72
Q

TB Testing

A

Culture = definitive Dx

sputum or AM gastric aspirates

73
Q

Positive TST?

A

> 5mm if immunocompromised or known contact

>10mm for most others

74
Q

Age limit for IGRA?

A

> 2yo

75
Q

TST: what type of reaction

A

Type IV hypersensitivity reaction

76
Q

TST - false positive

A

Cross-reactive with non-TB MB or BCG vaccine

77
Q

TB tests - more specific and more sensitive

A

Specific IGRA

Sensitive: TST

78
Q

Workup for child w TB contact

A

Hx, PE, CXR, TST

79
Q

Meds for tx of TB

A

RIPE

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

80
Q

Indications for TB screening

A
  • contacts of known active TB
  • children w suspected active TB
  • children w known RF for progression of infection to disease
  • children traveling/residing >3mo in area w high incidence of TB
  • children who arrive in Canada from countries w high TB incidence
81
Q

Antibiotics for salmonella infection

A

Azithro mycin

Ceftriaxone

82
Q

Who to treat with antivirals for influenza

A

Mild

  • only consider if 1-5 yo and <48h illness
  • or if risk factors present

Moderate, Severe, Progressive or Complicated
- start therapy

83
Q

Key points for vaccine hesitant parents

A

1) Understand the key role that vaccine advice can play in parent decision-making, and do not dismiss vaccine refusers from your practice
2) Use presumptive and motivational interviewing techniques to understand vaccine concerns
3) Use simple clear language to present evidence of disease risks and vaccine benefits
Risks of VPDs > risks of vaccines
4) Address pain
5) Community protection (herd immunity) does not guarantee personal protection

84
Q

What additional vaccines should be given for immunocompromised children?

A

● Pneumovax 23
● Hib
● additional boosters, ex. Hep B.

85
Q

How soon after immunosuppression can live vaccines be given?

  • high dose steroids
  • immunosuppressive chemo
  • anti-B cell antibodies (Rituximab)
A

● one month after high-dose steroid therapy
● 3 months or more after completion of immunosuppressive chemotherapy
● 6 months after treatment with anti-B cell antibodies (Rituximab)

86
Q

Planned immunosuppression (ex solid organ transplant) - how early before to give vaccines?

A

inactivated: 2 weeks
live: 4 weeks

87
Q

Transplant, how long after do you wait to vaccinate?

A

HSCT:
3-12 mo for inactivated vaccines,
24 mo for live

Solid organ:
3-6 mo for inactivated vaccines,
live are C/I

88
Q

Congenital zika virus features

A

CNS: severe microcephaly, cerebral atrophy, abnormal cortical development, callosal hypoplasia and diffuse subcortical calcifications

Ortho: Abnormal fetal tone can result in clubfoot or fetal akinesia deformation sequence (arthrogryposis)

Eyes: Microphthalmia, cataracts, and retinal abnormalities

SNHL

IUGR

89
Q

How to diagnose congenital zika syndrome

A

Either Serology or ZIKV RNA by PCR
- blood and urine
If features of CZS: test mom and baby
If mom just had exposure: test mom first

90
Q

Exposure to Zika: what time frame of sexual contact with male who traveled to endemic area is a potential exposure

A

If male traveled in the 6 months preceding sexual contact

91
Q

What time frame does it take for mom’s negative serology to confirm no Zika

A

Negative maternal ZIKV serology > 4 weeks after exposure rules out ZIKV infection and congenital ZIKV infection.

92
Q

Most common aetiologies of uncomplicated pneumonia

A

Viral most common
RSV, Influenza, Parainfluenza, HMPV

Bacteria
Strep pneumoniae > GAS > Staph aureus
Mycoplasma and Chlamydia – school age children

93
Q

When to use Vanco in pneumonia

A

rapid progression or pneumatoceles

94
Q

How long to treat pneumonia?

A

7-10 days in hospitalized patient;

5 days for outpatient

95
Q

How best to protect infant. < 6mo against influenza

A

Immunizing pregnant women

During 2nd or 3rd trimester with inactivated flu vaccine

96
Q

Risk Factors for STI

A
  • Inconsistent or no condom use
  • Contact with someone known to have STI
  • New partner
  • > 2 partners in past year
  • Serial monogamy
  • No contraception or only non-barrier contraception (e.g. oral contraceptive, intrauterine device, or Depo-Provera)
  • Injection drug use
    Any drug use (e.g. alcohol, marijuana, others – especially if associated with sex)
  • Previous STI
  • Any unsafe sexual practices (e.g. involving exchange of blood or sharing sex toys)
  • Sex workers and their clients
  • Survival sex (e.g. exchange of sex for food, shelter, or drugs)
  • Street involvement/precarious housing
  • Anonymous sex (sex with a stranger after meeting online or elsewhere)
  • Experience of sexual assault or abuse
97
Q

Treatment of Gonorrhea

A

Ceftriaxone/Cefixime
+
Azithromycin

98
Q

Bacteria in Lyme disease

A

Borrelia burgdorferi

99
Q

window of opportunity to prevent lyme disease if tick on you (how soon to remove tick)

A

<36h

100
Q

Lyme disease clinical manifestations

A

Early localized disease
Erythema migrans 7-14 days after bite; resolves spontaneously within 4 weeks
May also get fever, HA, malaise, neck stiffness, arthralgia

Early disseminated disease
Multiple EM rashes
Acute neuro signs (facial nerve palsy, lymphocytic meningitis, papilledema), lyme carditis with heart block rare in kids.

Late Disease
Arthritis most common (oligoarticular, large joints – knees) about 4 months post-bite
Peripheral neuropathy and CNS manifestations rare in children

101
Q

Jarisch-Herxheimer reaction

A

fever, headache, myalgia after starting tx for Lyme dz

102
Q

What are two main infections aimed at preventing with mosquito and tick bites?

A

West Nile

Lyme

103
Q

Ingredients in insect repellants

A

DEET

Icaridin

104
Q

Best way to prevent mosquito/tick bites

A

Protective clothing (if treated with permethrin even better) + Icaridin/DEET on exposed skin as repellent

105
Q

What vaccines are C/I post solid organ transplant?

A 
Live vaccines
MMR
Varicella
Rotavirus
Live influenza
106
Q

What viruses to screen for pre transplant

A 
HIV
HTLA
Hep A, B, C, D
CMV
EBV
Herpes
Varicella
Toxiplasmosis
MMR - if vaccinated
TB
Strongyloides
107
Q

Most common bugs in acute otitis externa

A

Pseudomonas aeruginosa and Staphylococcus aureus

108
Q

What are some transfusions related adverse events

A

Transfusion associated circulatory overload = 50% of serious adverse events;
severe anaphylaxis = 15%;
hypotension = 12%;
transfusion related acute lung injury = 8%

109
Q

What viruses are at risk for transmission during transfusion

A 
HIV 1/12 million; 
HCV 1/7 million; 
HBV 1/2 million; 
Bacterial 1/50,000 in platelets, 
syphilis < 1/100 million
110
Q

What virus is not tested for in blood products

A

ParvoB19 1/5000

111
Q

CA-MRSA risk factors for spread

A 
close ​skin-to-skin contact
openings in the skin such as cuts or abrasions
contaminated items and surfaces
crowded living conditions
poor hygiene
112
Q

Complications of MRSA

A 
Osteomyelitis
Septic arthritis
Necrotizing fasciitis
Sepsis
Pneumonia (esp following influenza)
113
Q

Abx options for MRSA

when to tx

A
  • TMP/SMX (good coverage except not penetration)
  • Doxycycline (>8yo)
  • Clindamycin (incr resistance)
  • Fluoroquinolones (cipro) (incr resistance)
  • Linezolid

If <3mo or if no improvement after drainage or systemic illness

114
Q

Treatment of candida

A

Fluconazole

115
Q

Treatment for invasive Aspergillosis

A

Voriconazole

Caspofungin

116
Q

Oropharyngeal Candidiasis

tx

A

Nystatin 200,000 units QID after feeds

117
Q

Candida diaper dermatitis

A

Topical antifungal = miconazole or zinc oxide

118
Q

Pityriasis versicolor (Tinea versicolor)

A

Topical Clotrimazole; shampoo antifungals as a lotion

119
Q

Tinea corporis

A

TOPICAL
clotrimazole, ketoconazole, or miconazole BID for 14-21 days

no steroids

120
Q

Seborrheic dermatitis

A

use soap and water, or selenium shampoo if more severe

121
Q

Tinea capitis

A

Terbinafine PO

needs to be oral cause can cause hair loss

122
Q

Invasive GAS infection presentations

A

Necrotizing fasciitis or myositis
Bacteremia
Pneumonia
Toxic shock syndrome

123
Q

Risk factor for invasive GAS infection

A

Varicella

124
Q

Toxic shock syndrome

A

TSS = hypotension and 2+ of:

renal impairment, transaminitis, coagulopathy (Plt < 100 or DIC), ARDS, generalized macular red rash (may peel)

125
Q

Chemoprophylaxis for invasive GAS

  • who
  • abx
  • duration
A

For close contacts of confirmed case of severe GAS from 7 days pre illness to 24 hours post antibiotic initiation

First Gen Cephalosporin preferred (Cephalexin)
(Alternative is 2nd and 3rd Gen = Cefuroxime, Cefixime
Macrolide if Penicillin allergy (Azithromycin))

10 days

126
Q

Treatment of invasive GAS infection

A 
Penicillin = best treatment
Clindamycin added (inhibits protein synthesis)
127
Q

Who should get prophylaxis for infective endocarditis for dental procedures

A
  • Prosthetic cardiac valve or prosthetic material used for valve repair
  • Previous IE
  • Congenital heart disease:
  • -Unrepaired cyanotic CHD, including palliative shunts and conduits
  • -Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
  • -Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit endothelialization)
  • Cardiac transplant recipients who develop cardiac valvulopathy
128
Q

What abc to prophylaxis with for IE?

A

Amoxil

129
Q

What are “Routine practices” in Canada?

A

assume blood, body fluids, excretions and secretions of any patient could contain pathogens.

130
Q

What is airborne precautions for

A

Varicella, measles, TB, smallpox

131
Q

Who should get the influenza vaccine

A

ALL high risk patients + anyone in contact with them

  • Any child < 5 years of age and anyone with Chronic conditions
  • Also: Indigenous peoples, All pregnant women (any trim)
  • Household contacts of high risk conditions; household w babies <6mo; childcare to <5yo
132
Q

What vaccine to give

A

Quadrivalent preferred
LAIV or IM
LAIV can only be given to >2yo and not to pregnant

If first time getting influenza vaccine <9yo: have to give 2 DOSES 1 month apart

133
Q

When is the influenza vaccine contraindicated

A
  • Hx of anaphylaxis to vaccine
  • Hx of GBS within 6 weeks of previous vaccine
  • LAIV in immunocompromised people or those with severe asthma (current wheeze/medical attention for wheeze in past 7 days or high dose steroid use)
  • LAIV in pregnancy is contraindicated
  • Do not give LAIV within 48 hours of completing antiviral therapy (Tamiflu)
134
Q

Congenital syphilis: clinical features

A

SAB, hydrops
Necrotizing funisitis (barbershop pole)
Rhinitis and/or snuffles

Rash: in first 8 weeks - 50% of cases
HSM at first 8 weeks
LAN- 5%
Neurosyphilis: at birth or can be delayed
MSK: first week with permanent bony changes
Osteochondritis or perichondritis
Frontal bossing, poorly developed maxillas, saddle nose, winged scapulas, sabre shins
Recurrent arthropathy and painless knee effusions (Clutton`s joints)
Hematological: present at birth or can be delayed
Anemia, TCP
Interstitial keratitis 2-20 yrs
Hutchinson teeth: when permanent dentition erupts
Mulberry molars
13-19 mo
Sensory neural deafness (eighth nerve)

135
Q

Treatment for congenital syphilis

A
  • 10 days of IV penicillin G q12 if less than 1 week of age
  • -Q8h if 1-4 weeks every 6 h if older than 4 weeks of age

If neurosyphilis need to repeat LP CSF q6months

*CPS Statements TD (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions