Immun/Infectious 2 Flashcards Preview

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Flashcards in Immun/Infectious 2 Deck (49)
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1

Oral Candidiasis

  • another name for this?
  • Type of infection / etiology?
  • 3 sxs / presentation

  • "thrush"
  • yeast infection of oral mucosa - Candida albicans
  1. adherent white plaques (r/o milk residue)
  2. Underlying mucosa reddened & friable
  3. Decreased feeding (due to pain)

2

Treatment for Oral Candidiasis (Thrush)

  • Nystatin suspension (0.5mL into each cheek 4x/day)
  • Tx mom PRN (esp if breastfeeding)

3

Diagnosis?

Oral Candidiasis (Thrush)

  • adherent white plaques
  • underlying mucosa is red/friable
  • pt w/ decreased POs due to pain
  • Tx w/ Nystatin / Mom PRN

4

Enterobiasis (Enterobus vermicularis)

  • Another name for this?
  • Presentation?
  • How is it transmitted?
  • PE findings?

  • "Pinworms"
  • Usually asymptomatic
  • Anal itching (esp at night)
  • Eggs under fingernails --> transmission
  • PE: excoriations in perianal area

5

 Pinworms / Enterobiasis

  • Diagnosed how? (2)
  • Treatment? (3)
  • Prevention? (3)

  • Sxs / "scotch tape test"
  • Mebendazole (Vermox) - one 100mg tab, repeat in 2 weeks
    • Treat ENTIRE family
    • Wash bedding in hot water, careful bc eggs can go airborne, so fold linens inward
  • Prevention
    • hand washing
    • clip nails short
    • avoid scratching anus

6

Diagnosis?

  • Causes flesh colored, dome shaped papules w/ central umbilication
  • Common in childhood
  • Can be transmitted in adults through skin contact (sex / sports / sharing towels)
  • Etiology?

Molluscum Contagiosum

  • Poxvirus**

7

Tx for Molluscum Contagiosum (6) 

 

  • Curettage
  • Cryotherapy
  • Cantharidin
  • Podophyllotoxin (Condylox)
  • Retinoids
  • Salicylic acid
  • Lasers

(CCC Sally Recked her Podo stick)

(no great data for any)

8

Bacterial Meningitis

  • Bacterial infection of meninges of what 2 structures?
  • Suspected bacterial meningitis is an emergency
  • Untreated mortality reaches almost ___%

  • Brain & spinal cord
  • 100%

9

Bacterial Meningitis

  • ***Pathogen for 1 month - 3 month olds***

(ON EXAM)

  • Group B Streptococcus

10

Bacterial Meningitis

  • Pathogen for 3 months - 3 yrs

  • S. pneumoniae

11

Bacterial Meningitis

  • Pathogen for 3 yrs - 10 yrs

S. pneumoniae

12

Bacterial Meningitis

  • Pathogen for 10 yrs - 19 yrs

N. meningitidis

13

Bacterial Meningitis

  • 8 Sxs in pediatric pts? (which is most important?)

  1. Fever
  2. N/V
  3. Irritability**
  4. HA
  5. Confusion
  6. Photophobia
  7. Back pain
  8. Nuchal rigidity

14

4 possible signs of bacterial meningitis?

  • seizure
  • increased ICP
  • papilledema
  • altered LOC

(ISA party....) (;

15

  • Which pathogen of bacterial meningitis causes a rash?
  • Blanching or non-blanching?

N. meningitidis (10-19 yrs)

  • non-blanching

16

Viral meningitis

  • Sxs / presentation?
  • How do you differentiate it from bacterial?
  • What is the BOTTOM LINE?

  • similar to bacterial
  • lab studies (CBC , LP)
  • it is bacterial until proven otherwise

17

What are the 6 Primary Immunodeficiencies on this test?

  1. Selective IgA Deficiency
  2. Common Variable Immunodeficiency
  3. Severe Combined Immunodeficiency (SCID)
  4. DiGeorge Syndrome
  5. Wiskott-Aldrich Syndrome
  6. Ataxia-Telangiectasia

18

Primary Immunodeficiency

  • Disorders resulting from ___ defects of the immune system (both isolated & combined)
  • Defect may be present in which parts of the immune system?
  • Impaired antibody (Ig) production is called what?

  • inherited
  • any part (or multiple parts) including the humoral immune system
  • Humoral immunodeficiency

19

Pediatric presentation of Primary Immunodeficiency

  • Recurrent, severe URI / LRTI including what 3 infections?
  • What type of bacteria?

  • OM
  • Sinusitis
  • PNA
  • Encapsulated Bacteria***

20

4 signs/sxs of Primary Immunodeficiency in peds patients

  • Poor growth
  • Failure to Thrive (FTT)
  • Unexplained splenomegaly
  • Chronic diarrhea

(Poor FUCking kid)

21

6 encapsulated bacteria of Primary Immunodeficiency

  • Hib
  • S pneumo
  • N menigitidis
  • Group B strep
  • Klebsiella pneumoniae
  • Salmonella typhi

22

  • What is the most common immunodeficiency?
  • This immunodeficiency is less common in what race?

  • Selective IgA Deficiency
  • Asian

23

Selective IgA Deficiency

  • What 2 levels are normal in the serum?
  • Child over what age? (kids under this age don't always have optimized levels of Ig's)
  • IgA is __% of normal circulating Ig's

  • IgG and IgM are both normal
  • 4 yrs
  • 70%

24

Selective IgA Deficiency signs / sxs

  • Typical presentation?
  • Recurrent infections of what type?
  • What disorders? (3)
  • What type of reaction?
  •  

  • Most are asymptomatic (<1/3 are actually diagnosed)
  • sinopulmonary infections
  • Autoimmune / GI / Allergic
  • Anaphylactic transfusion rxns

25

What are the 5 indications for a workup of Selective IgA Deficiency?

  • Recurrent OM
  • Recurrent Sinusitis
  • Recurrent PNA
  • Giardiasis
  • Family hx of any primary immunodeficiency

Family POGS

26

  • How is Selective IgA Deficiency diagnosed?
  • Treatment/Management?

  • Dx: Serum levels of IgA, IgG, IgM
  • Tx: refer to immunology

27

Common Variable Immunodeficiency (CVID)

  • Impaired production of what 3 cells?
  • This leads to impaired production of what?

  • B-cell
  • T-cell
  • Dendritic cell
  • --> impaired Ig production**

28

Common Variable Immunodeficiency

  • Common or uncommon?
  • Pts usually present at what age?
  • Peaks around what age?
  • NOT a single disease
  • What are the clinical manifestations?

  • Common
  • around puberty
  • 8 yrs
  • "variable" manifestations

29

4 criteria for Common Variable Immunodeficiency

  • Reduced serum IgA, IgG, IgM***
  • Poor response/ no response to vaccines***
  • Presence of B cells
  • Absense of other immunodefiency

30

What are the 4 signs/sxs of Common Variable Immunodeficiency?

  • Chronic or recurrent URI/LRTI  
    • May develop bronchiectasis (even in peds!), watch for abnormal CXRs
  • GI infections
  • Diarrhea, malabsorption, weight loss --> FTT
  • Atopic triad (asthma, allergies, eczema)

(GUFA)