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Pediatrics PLE > Infectious > Flashcards

Flashcards in Infectious Deck (89):
1

Organism produces exotoxin and inhibits protein synthesis and causes gray-brown adherent pseudomembrane to bleeding edematous submucosa

Corynebacterium diphtheria

2

Bull neck appearance, leather like adherent membrane (pseudomembrane)

Corynebacterium diphtheria

3

Difference of diphtheria from strep throat

Relative lack of fever
Non-exudative throat

4

Period of communicability of pertussis

7 days after exposure to 4 weeks after onset of paroxysms

Catarrhal stage

5

Conjunctival suffusion, petechiae on upper anterior chest, clear breath sound, whooping cough

In between paroxysms child is well looking

Pertussis

6

Abrupt onset of fever, chills, headache, vomiting

Rapid worsening of symptoms within hours

Initially morbiliform rash becoming petechial then purpuric within hours

Meningococcemia

7

Drug of choice for Meningococcemia

Penicillin G 250000 - 300000 U/kg/day

8

CSF FINDINGS in Meningitis:

Pressure: 100-300mmHg
WBC: 100-10,000
CHON: 100-500
Glucose: <50%

Acute Bacterial Meningitis

9

CSF FINDINGS in Meningitis:

Pressure: 80-150 mmHg
WBC: >1,000
CHON: 50-200
Glucose: usually normal; may be low

Viral Meningitis

10

CSF FINDINGS in Meningitis:

Pressure: elevated
WBC: 10-500
CHON: 100-3,000
Glucose: <50

TB Meningitis

11

CSF FINDINGS in Meningitis:

Pressure: elevated
WBC: 5-500
CHON: 25-500
Glucose: <50

Fungal Meningitis

12

High grade fever, malaise, myalgia, cough, abdominal pain, hepatosplenomegaly, anorexia, diarrhea/constipation

Rose spots

Caused by S. Typhi

Enteric fever

13

Most commonly involved extraintestinal sites for complications of enteric fever

Cns and hepatobiliary

14

Mainstay of diagnosis of Enteric Fever

Blood culture, positive

15

Treatment for Uncomplicated Typhoid Fever

Fully sensitive: Chloramphenicol (14-21days) or Amoxicillin (14days)

Multidrug-resistant: Fluoroquinolone (5-7 days) or Cefixime (7-14 days)

Quinolone resistant: azithromycin (7days) or Ceftriaxone (10-14days)

16

Treatment for Severe Typhoid Fever

Fully sensitive: Azithromycin (14days) or Ceftriaxone (10-14 days)

Multidrug-resistant: Fluoroquinolone (10-14days)

Quinolone resistant: Ceftriaxone (10-14days)

17

Organism crosses the colonic epithelium through M Cells overlying the peyer patches

Shigella

18

Painful defecation, severe abdominal pain, high fever with significant dehydration

Watery voluminous diarrhea initially then into frequent small volume bloody mucoid stools

Shigellosis

19

Most common extraintestinal manifestation of Shigellosis

Neurologic manifestation

20

Definitive diagnosis of Shigellosis

Culture of stool and rectal swab

21

Infantile explosive diarrhea with dehydration

>1y/o; Common in travellers

Responds to TMP-SMX

ETEC

22

Prolonged Nonbloody diarrhea with low grade fever

At risk for are <2y/o especially <6mos

EPEC

23

Shiga-toxin-producing E. Coli

Bloodr diarrhea, afebrile

6mos - 10 y/o; elderly

EHEC

24

Prolonged watery diarrhea that causes significant dehydration

<1y/o; Common in travellers

EAEC

25

Acute onset of profuse, painless, watery diarrhea with rice-water consistency and fishy odor

With vomiting; without abdominal cramps or fever

Cholera

26

Treatment for cholera

Fluid and electrolytes
Tetracycline for 3 days (not for <9y/o); Doxycycline single dose

27

Headache, restlessness, irritability followed by stiffness, trismus, sardonic smile, boardlike rigidity

Tetanus

28

Manifests within 3-12days of birth as progressive difficulty in feeding with associated hunger and crying; paralysis or diminished movement, stiffness to the touch, spasms with or without opisthotonus

Neonatal Tetanus

29

Treatment for Tetanus

Give Tetanus Ig 500 U single dose
Penicillin G (DOC) 100,000 U/kg/day in 4-6hr intervals for 10-14 days

Alternative:
Metronidazole
Erythromycin
Tetracycline

30

Painless papule appears at the site of inoculation 2-6wks after inoculation with regional lymphadenitis

Clean painless ulcer with raised border that heals spontaneously w/in 4-6wks

Primary Syphilis

31

Clean painless ulcer with raised border that heals spontaneously w/in 4-6wks

Chancre

32

Untreated patients: develops a non-pruritic maculopapular rash involving the palms and soles

Becomes latent within 1-2months after the onset id the rash

Secondary syphilis

33

Development of nonsuppuratjve granulomas of the skin and musculoskeletal system due to host's hypersensitivity reaction (gummatous lesions)

Tertiary Syphilis

34

Acute systemic febrile reaction with exacerbation of lesions in 15-20% of all patients with acquired or congenital syphilis who are treated with penicillin

Jarisch-herxheimer reaction

35

Treatment for Syphilis

Benzathine Penicillin G

36

2 phases of Anicteric leptospirosis

Initial or Septicemic Phase
Secondary or Immune Phase

37

This phase is abrupt, with fever, chills, severe headache, severe muscular pain and tenderness

Truncal red maculopapular rash

Conjunctival suffusion with photophobia and ocular pain WITHOUT chemosis and purulent exudate

Initial or Septicemic Phase

38

This phase follows a brief asymptomatic interlude with biphasic fever

Some with aseptic meningitis

Secondary or Immune Phase

39

Severe form of leptospirosis

Right upper quadrant pain, hepatomegaly, increased liver enzymes, hyperbilirubinemia

Azotemia -> oliguria -> anuria

Icteric / Weil's Syndrome

40

Presumptive diagnosis of leptospirosis

Fourfold rise in Ab titer in soecimens obtained 2 or more weeks apart

41

Most useful screening test for Leptospirosis

Microscopic slide-agglutination test using killed Ags

42

Treatment for Leptospirosis

Penicillin G

Alternative: Tetracycline

43

High grade fever with conjunctivitis and colds then appearance of rash

When the rash fades, branny desquamation and disappears within 7-10 days

Measles

44

Grayish white spots with red border opposite the lower molars appear before the prodrome period

Koplik Spots

45

Timing of appearance of rash in Measles

At the height of the fever

46

Period of communicability of Measles

4 days before and 4 days after the onset of rash

47

Post exposure prophylaxis of Measles

1) Measles Ig for prevention and attenuation within 6 days of exposure
2) measles active vaccine can be given for susceptible children >1 y/o within 72 hours

48

Chronic complication of measles with a delayed onset due to persistent infection with an altered virus that is harbored intracellularly in the CNS

Subacute Sclerosing Panencephalitis

49

CSF analysis in SSPE

Normal cells but high IgM and IgG Ab titers in >1:8

50

Period of communicability of Rubella

5 days before and 6 days after the onset of rash

51

Most characteristic sign of Rubella

Retroauricular, posterior cervical and postoccipital lymphadenopathy

52

Discrete rose spots on the soft palate in Rubella

Forchheimer Spots

53

How is Rubella different from Measles?

Low grade fever for 1-3 days, polyarthritis and No photophobia

54

Diagnostic of Rubella

(+) IgM antibody and (+) IgG with fourfold increase in titer is diagnostic

55

Congenital profound SNHL
Salt and pepper retinopathy
IUGR
Congenital Cataracts
microcephaly
Blueberry muffin skin lesions

Congenital Rubella Syndrome

56

Period of communicability of Mumps

1-2 days before the onset of parotid swelling until 5 days after the onset of swelling

57

Pain and swelling in one or both parotid glands

Swollen glands push the ear lobe upper, outward and the angle of mandible is no longer visible

Mumps

58

Most frequent complication if Mumps

Meningoencephalitis

59

Causative agent of Roseola Infantum

HHV 6

60

Fever for 3-5 days with fussiness, rash appears within 12-24 hours of fever resolution

Ulcers in the uvulopalatoglossal junction

Roseola

61

Ulcers in the uvulopalatoglossal junction in Roseola

Nagayama Spots

62

Lifelong latent infection of sensory ganglion neuron

Chickenpox / varicella

63

Period of communicability of Varicella

1-2 days before the onset of rash until 3-7 days after onset of rash and all the lesions have crusted

64

Rash often appear first on the scalp, face, or trunk then spread to other parts of the body

Intensely pruritic macule -> papule -> vesicle

All stages are present simultaneously

Varicella

65

Tender vesicular lesions in the hands and feet

Ulcerative intraoral lesions

Most frequent etiology: Coxsackievirus A16

Hand Foot And Mouth Disease

66

Sudden onset of fever, vomiting, abdominal pain, dysphagia

Small vesicles and ulcers with a red ring found mainly in the tonsillar pillars

Herpangina

67

Also known as Fifth Disease

Due to parvovirus B19, with a primary target - erythroid cell lines

Erythema Infectiosum

68

Low grade fever, headache, URTI, slapped cheek appearance that spreads rapidly to the trunk and proximal extremities as a diffuse macular erythema

Erythema Infectiosum

69

Skin vesicles and shallow ulcers that resolves in 7-14 days

Most commonly affected: 6mos - 5y/o

Pain in mouth, drooling, refusal to drink or eat, fever up to 40C

Herpetic Gingivistomatitis

70

Gold standard in diagnosing HSV infection

Viral Culture

71

Test of choice in examining CSF of HSV

PCR

72

Parts of the brain affected by HSV

Frontal lobe
Temporal lobe
Limbic System

73

First virus to be associated with malignancy

Epstein Barr Virus

74

Severe pharyngitis with marked tonsillar enlargement with petechiae at the junction of the hard and soft palate

Infectious mononucleosis

75

Primary infection in adolescents and adults in Infectious Mononucleosis

Classic triad: fatigue, pharyngitis, generalized lymphadenopathy

76

Most feared complication id Infectious Mononucleosis

Splenic rupture

77

Most common congenital infection which causes the syndrome cytomegalic inclusion disease (hepatosplenomegaly, jaundice, petechiae, purpura, microcephaly)

CMV

78

Pathognomonic of CMV

Strikingly enlarged epithelial or mesenchymal cells with large intranuclear inclusions

79

Hearing loss or learning disability, IUGR, jaundice, purpura intracerebral calcifications, chorioretinitis

Congenital CMV

80

Virus causes lytic infection of the respiratory epithelium that permits secondary bacterial invasion

Orthomyxoviridae

81

Onset of symptoms is abrupt

Coryza, conjunctivitis, pharyngitis, dry cough, high grade fever, myalgia

Diagnosis is confirmed by hemagglutination inhibition

Influenza

82

Dengue fever's characteristic rash

Transient macular generalized rash that blanches under pressure seen during the 1st 24-48 hours of fever

1-2 days after defervescence: generalized maculopapular rash appears which spares the palms and soles (Hermann's rash)

83

Isles of white in a sea of red

Hermann's Rash

84

Most common route of transmission of Viral Pneumonia

Airborne droplets

85

Punched out ulcers in the posterior palate

Herpangina/Coxsackie A

86

Diagnosis of Typhoid fever is best made by

Isolation of S. Typhi from blood, urine or stool

87

Most common etiologic agent for early onset neonatal sepsis in the newborn in the LOCAL SETTING

E. coli

88

Most common etiologic agent for early onset neonatal sepsis in the newborn

GBS

89

DOc for neonatal sepsis

Ampicillin + Gentamicin