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2023 RC Blue's Clues > Infectious Disease > Flashcards

Infectious Disease Flashcards

(156 cards)

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1
Q

How does the tetanus vaccine work?

A
  • inactivated toxin

The tetanus toxoid is an FDA-approved vaccination given alone or in conjunction with other vaccines. It is protective against effects from a gram-positive bacillus, Clostridium tetani.

This bacteria produces a neurotoxin called tetanospasmin, which blocks the release of an inhibitory neurotransmitter and leads to unopposed muscle contractions and spasms.

Vaccinations exert their effect on the human body via priming the active immune system. Following the administration of the tetanus toxoid, the immune system is stimulated and responds to the antigens present in the vaccine.

Preparation of the tetanus toxoid is via inactivation of the toxigenic strains of Clostridium tetani. The toxic strains are grown in liquid media, purified, and then treated with formaldehyde to take away the pathogenic properties.

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2
Q

AOM Diagnostic criteria CPS

A

DIAGNOSTIC CRITERIA:
1.Acute onset symptoms (otalgia or suspected otalgia)
2.Middle ear fluid (loss of mvmt, loss of bony landmarks, air fluid level) and significant inflammation of middle ear
- decrease in TM mobility (as visualized with a pneumatic otoscope) has good sensitivity and specificity for MEE
*Bulging TM esp if yellow or hemorrhagic has high sensitivity for bacterial origin
*Perforation with purulent discharge also indicates bacterial cause

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3
Q

AOM antibiotics

A

AMOXICILLIN
<2y = 10d (or perforated TM)
>2y = 5d
TID: 45-60mg/kg/day
BID:75-100mg/kg/day required
*consider other antibiotics first line:
-Otitis-conjunctivitis syndrome: Hflu/Moraxella more common -> amox clav or second gen cephalosporin
-Recent tx w/ amox in 30d or relapse of current infx -> amox clav

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4
Q

Varicella complications

A
  • varicella pneumonia
  • varicella encephalitis
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5
Q

Lice Management and counselling

A

KIDS WITH LICE CAN GO TO SCHOOL
TREAT LICE WITH PERMETHRIN

Head lice infestations are not associated with disease spread or poor hygiene

Head lice infestations can be asymptomatic for weeks.

Diagnosis requires detection of live head lice. Nits do not indicate active infestation.

Environmental cleaning/ disinfection not warranted. Head lice or nits do not survive for long away from the scalp.

Treatment with topical head lice insecticide (two applications 7 to 10 days apart) is recommended for active infestation

When there is evidence of treatment failure—detection of live lice—using a full course of topical treatment from a different class of medication is recommended.

The scalp may be itchy after applying a topical insecticide but itching does not indicate treatment resistance or a reinfestation.

Topical insecticides can be toxic. Take care to avoid unnecessary exposure and, when indicated, minimize skin contact beyond the scalp.

Excluding children with nits or live lice from school or child care has no rational medical basis and is not recommended.

For children ≥2 months of age, permethrin and pyethrins are acceptable treatments for confirmed cases of head lice. Dimethicone can be used in children ≥2 years of age.
Myristate/ST-cyclomethicone (Resultz) can be used in children ≥4 years of age. Benzoyl alcohol lotion is comparatively expensive but can be used in children ≥6 months of age.

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6
Q

6yoF returned from to to Nova Scotia with family. Has erythematous rash with red centre and concentric ring around it. Also with fever, malaise, arthralgias. What is your management?

A

Start doxy for lyme disease now

Early, cutaneous disease is a clinical diagnosis. Treatment = doxycycline 10d

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7
Q

Dog bite bugs

A

Pasturella, Staph aureus, Strep, Anaerobes

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8
Q

Dog bite management

A
  • tetanus
  • maybe rabies
  • amox clav if:
  • Puncture wound
  • Hands, genitalia, face, joints
  • Wounds requiring closure
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9
Q

Up to how many weeks after birth is a neonate at risk of becoming ill with a perinatally acquired HSV infection?

A

6 weeks

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10
Q

Duration of treatment for neonatal HSV

A

SEM disease 14 days
Disseminated or CNS disease 21 days
–> For infants with CNS disease, CSF should be sampled near the end of a 21-day course of therapy. If the PCR remains positive, treatment should be extended with weekly CSF sampling and ACV stopped when a negative result is obtained.

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11
Q

Criteria staph toxic shock

A

Criteria (all 6 required):
Fever 38.9 or higher
Diffuse macular erythroderma
Desquamation 1-2 weeks after onset, particularly on palms/soles
Hypotension (systolic < 5%ile), orthostatic changes > 15 mmHg, or orthostatic syncope or dizziness
Involvement of 3 or more organ systems: GI, MSK, mucous membrane, renal, hepatic, hematologic, or neurologic
Negative blood, throat, or CSF cultures for alternate pathogens (blood cultures may be positive for staph aureus) and/or negative titres for rocky mountain spotted fever, leptospirosis or measles

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12
Q

Typhoid fever (presentation, w/u ,tx)

A

+/- diarrhea, fever in returning traveller
typically SEA/India
get a blood culture (but only~50% sensitive)
Tx: ceftriaxone (if from Pakistan, there is high ctx resistance so use meropenem)

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13
Q

malaria test

A

thick and thin smears

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14
Q

Severe malaria (clinical manifestations and laboratory measures)

A

Clinical:
- unable to walk
- impaired consciousness
- resp distress
- multiple convulsions
- shock
- DIC
- Jaundice

Labs
5% parasitemia typically
Hb <70
Acidosis
AKI
High lactate

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15
Q

malaria treatment

A

mild: malarone (Atovaquone-Proguanil)
Severe: artesunate

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16
Q

fever of unknown origin definition

A

duration > 2 weeks with uncertain diagnosis despite appropriate initial investigations

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17
Q

baratonella henselae

A

cat scatch disease

Q: unilateral swollen lymph nodes, impsilateral conjunctivitis, enlarged spleen. no atypical lymphocytes on smear

Treatment: azthromycin x 5d

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18
Q

cat scratch treatment

A

azithromycin

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19
Q

chronically draining cervical lymph node in 4year old - most likely pathogen

A

atypical mycobacterium

features
- young age, no fever, unilateral LN, no TB exposure, no cat exposure, chronic

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20
Q

ddx infections acute unilateral lymphadenopathy

A

Acute Bacterial Adenitis: staph aureus or strep pyogenes
Non-TB Mycobacterial Adenitis (Chronic)

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21
Q

chronic infection’s unilateral lymphadenopathy ddx

A

non tuberculous mycobacteria (MAC)
tuberculosis
bartonella
tularemia

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22
Q

chronic infections bilateral lymphadenopathy ddx

A

EBV, CMV, HIV, toxoplasmosis

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23
Q

perineud oculoglandular syndrome

A

bartonella with eye involvement

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24
Q

acute infection EBV lab tests

A

mono spot positive
VCA IgM +
EA IgG +
VCA IgG +

EBNA IgG + is remote past infxn

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25
mono sports avoidance
risk splenic rupture highest risk first 3 weeks for infection return to sport once resolution of symptoms, normal labs and splenomegaly resolved
26
congenital infxn with rash on palms and soles
syphillis
27
congenital syphilis clues
persistent nasal discharge (esp bloody) - snuffles rash on palms and soles desquamating rash pain with movement (pseudoparalysis) suggesting bony involvement
28
congenital syphilis precautions for health care workers
high risk of transmission through touching the skin!! contact precautions when handling baby
29
syphilis testing
treponemal tests (more sensitive and specific) - CMIA, CLIA, TPPA, FTA ABS - typically the screening test Non treponemal tests - RPR (serum), VDRL (CSF) - quantitative titer
30
Syphilis RPR drop for adequate treatment
4 fold drop *divide the RPR number by 4* Ex. 1:64 --> 1:16
31
treatment for baby with congenital syphilis
IV penicillin x 10 days full workup: Long bone XR, CSF, ab titers, labs (LFTs)
32
inadequate maternal treatment of syphilis
- non-penicillin regiment - treated within 30 days of baby's delivery - less than 4 fold trop in titer - no documentation of treatment - mother had relapse or reinfection
33
Managment of baby born of mom with syphilis with adequate treatment
test the baby's RPR and TT at 0,3,6 and 18mo and if negative, no further w/u needed. Baby should have drop in RPR by 3 mo and non reactive by 6 mo if they do not have syphilis. If +RPR at 6 mo -> TREAT
34
CNS syphilis in neonate management
no change in abx (10 days IV penicillin) rpt LP in 6 months
35
approach to possible zika virus exposure
mother with possible zika exposure in pgegnancy - test maternal zika virus serology first - if positive, chehck baby serology and PCR and head US unexplained microcephaly + maternal history of travel or paternal history of travel - zika serology mom then baby
36
Clinical features of congenital CMV
IUGR, microcephaly, rash (petechial), chorioretinitis, HSM, SNHL 10% of asymptomatic infants go onto have symptoms later (hearing loss)
37
Laboratory features of congenital CMV
Low platelets Increased ALT Conjugated hyperbili
38
Risk Factors for cCMV (who to test)
- Fetal US with findings suggestive of CMV (microcephaly, IUGR, periventricular calcifications) - HIV exposure - Primary immunodeficiency - Babies who fail the newborn hearing screen
39
HUS finding in congenital CMV
periventricular calcifications
40
gold standard test for congenital CMV
urine PCR within 3 weeks of age
41
If CMV + newborn, what other investigations do you need to send?
- CBC - Bili - Liver enzymes - HUS if normal neuro exam (MR if abnormal neuro exam) - Hearing eval - Optho eval ** DO NOT NEED TO SEND CSF UNLESS SZ OR SEPTIC
42
treatment for CMV
valganciclovir for 6 mo can use IV ganciclovir if very unwell child
43
indications for CMV treatment
- CNS disease - chorioretinitis (Severe disease) - severe single system - multisystem 3+ systems
44
How frequently do children with cCMV need their hearing checked?
every 1 yr until school age
45
testing options for congenital toxoplasmosis
serum serology PCR on CSF, blood or urine placental pathology
46
findings of toxoplasmosis on CSF
lymphocytic pleocytosis very high protein (can cause obstructive hydrocephalus)
47
toxoplasmosis triad
-hydrocephalus (may have macrocephaly) -Cerebral calcifications (parenchymal) -chorioretinitis
48
congenital varicella syndrome
hypoplastic limbs scarred skin, dermatomal scars micropthalmia typically d/t varicella in 1st or 2nd trimester
49
pregnant woman exposed to chicken pox
if no definitive history of chickenpox, check mom's serology - if IgG postive, no further intervention (she has had infxn previously) - if IgG NEGATIVE, given VZIG within 10 days of exposure and treat with acyclovir if rash revelops
50
congenital cataract most likely cause
rubella
51
classic rash in congenital rubella
blueberry muffin rash due to extramedullary hematopoeisis, often palpable
52
classic rubella triad
cataracts cardiac (PDA) SNHL
53
diagnosis congenital rubella
rubella specific IgM prior to 3 mo of age can also do PCR in NP swab or urine
54
parvo B19 pearls
slapped cheeks can cause aplastic anemia can cause congenital infxn if pregnant woman resulting in hydrops - if exposed, the mom should get serology for parvo (IgM neg, IgG positive is protective)
55
adequate GBS abx prophylais
at least 1 dose 4 hour before delivery amoxicillin or penicillin cefazolin is used for penicillin allergy
56
gram positive cocci in clusters
staph aureus (or cons)
57
antibiotics for sepsis < 28 days
amp + gent
58
workup for HSV in neonate
any signs of HSV - do full wokrup including LP and start acyclovir HSV PCR of vesicle, NP, eyes, urine, stool, blood and csf do LP ieven if clinically well! most common manifestation is skin/eyes/mouth with vesicular lesion SEM = 14 days CNS = 21 days
59
duration treatment for HSV in neonate
IV acyclovir only - isolated SEM: 2 weeks - disseminated or CNS: 3 weeks must repeat the LP before stopping treatment *suppressive oral acyclovir for 6 months if CNS disease *consider suppressive oral acyclovir for other disease - should offer to parents for SEM disease
60
maternal recurrent HSV with lesion at pregnancy
surface swabs for baby at 24hr, no treatment pending results because you know this is recurrent disease for mom
61
management of well appearing, asymptomatic infant possibly exposed to HSV during delivery
moms first episode with membrane rupture (c/s or vaginal delivery) - empiric acyclovir - swabs at 24hr - if negative: 10 days - if positive: 14-21 days of acyclovir moms first episode, no ROM, dry C/S - no empiric acyclovir - swab baby - if swab positive, full work up and treat recurrent episodes - no empiric acyclovir - 24 hr swab, if positive, full work up and treat
62
Treatment of mild C diff (<4 stools per day)
Stop precipitating abx and reassess in 48hr
63
Treatment of moderate C Diff (>4 stools per day, low grade temp)
PO metronidazole x 10-14d
64
Treatment of severe C Diff (systemic toxicity)
Vanco PO x 10-14d If severe and complicated (pseudomembranous colitis) -> Vanco PO and metronidazole IV x 10-14 days
65
First reoccurrence of C diff, how to treat?
Initial regimen repeat, or PO vancox 10-14d
66
Second reoccurance of C diff, how to treat?
Vanco x 4-10 weeks (taper)
67
Initial screening test for C Diff
GDH EIA, if positive -> do toxin EIA
68
Child eats at a picnic and has vomiting and diarrhea 4 hrs later, most likely pathogen?
Staph Aureus
69
Bug associated with raw or undercooked shellfish?
Vibrio Spp
70
Tx of Gonorrhoea
Ceftriaxone 250mg 1g Azithromycin
71
Painless lump or ulcerating lesion to genitals, localized adenopathy, fever, fatigue, myalgia
Lymphogranuloma venereum (chlamydia)
72
Well infant, Mom has untreated gonorrhoea, what to do for baby?
IM CTX + conjunctival swab
73
Well infant, Mom has untreated chlamydia, what to do for baby?
Nothing, swab only if symptomatic
74
Mom with IV drug use and recent incarceration presents in labor with undocumented HIV status, next steps?
Rapid HIV for mom If rapid positive-> with intrapartum and infant postnatal prophylaxis (zidovudine) and send serology If Ab test positive for Mom, send baby HIV PCR If baby HIV PCR +-> start full treatment with 3 drug regimen x 6 weeks
75
Needle stick injury, child is not fully vaccinated for Hep B, next steps?
Test HBsAg and HBsAb If both neg-> give HB vacc and HBIG If HbSAb+ -> complete vaccine series at 1mo and 6 mo If no results available within 48hr, give both HB vacc and HBIG
76
Child fully vaccinated against Hep B with needle stick, next steps?
Test HBsAb If positive -> no further action If negative -> send HBsAg If HBsAg negative-> vaccine and HBIG
77
Baseline and follow up labs for needle stick injury
Baseline: HBV, HIV, HCV (Ab/status) Follow up labs: -1mo-> HIV -3mo-> HIV and HCV -6mo-> HIV, HCV, HBV
78
Hx of MIS-C, when can you give COVID vacc?
3 months post MIS-C
79
When TB is suspected CLINICALLY, what test should you do?
Sputum for culture - send for AFB stain and culture - All patients with TB needs HIV testing
80
TST cut offs for positive test
>5mm for contact cases + immunosuppressed >10mm for everyone else
81
TST is a better test for TB than IGRA/Quantiferon in patients
TST better for <2yrs old
82
Management of close contacts for TB?
ALL GET TST +CXR If <5yrs and TST <5 = WINDOW PROPHYLAXIS (one agent effective for index case +Vit B12) - rpt TST 8-10 weeks after last contact with + case If >5yrs and TST <5 = no treatment - rpt TST 8-10 weeks after last contact with + case If any age and TST >5 = TREAT: Isonazid and Rifampin x 12 weeks
83
Side effects of ethambutol?
Optic neuropathy (requires optho assessment if used in TB treatment regimen)
84
Live vaccines are contraindicated in immunocomprimised patients EXCEPT which conditions:
- IgA deficiency - Complement deficiency - Asplenia - CGD can receive live VIRAL (not bacterial) - HIV if not severely immune comprimised
85
When can you give live vaccines post high dose steroids?
1 month
86
When can you give live vaccines post chemo?
3 months
87
When can you give live vaccines post Ritux?
6mo
88
When can you give live vaccines post stem cell transplant?
2 years post Inactive can be started 3-12 months post
89
When can you give live vaccines post solid organ transplant?
NEVER Inactive 3-6mo post
90
Prophylaxis for close contacts of pt with invasive mennigococcal disease?
Contact within last 10days Give to all household contacts within 24hrs VACCINE + RIFAMPIN (2d)
91
Men-C-C vaccine, when to give for healthy children?
One dose at 12mo
92
HPV vaccine for 9-14 yrs, how many doses, how far apart?
2 doses, 6 mo apart
93
HPV vaccine >15 yrs, how many doses, how far apart?
3 doses at, 0, 1, 6 mo
94
When can you give Rotavirus to hospitalized prems?
On discharge (first dose between 6-15 weeks, all doses complete by 8mo)
95
Complication of rotavirus vacc?
Intuss (highest risk in 1 week after receiving)
96
At what age can you give live flu vaccine?
>2yrs
97
When would you give two doses of the influenza vaccine?
If first time getting it and between 6mo-9yrs Doses 4 weeks apart
98
When to give Tamiflu?
ALL HOSPITALIZED W/ INFLUENZA and basically any underlying comorbidity = start even if >48hrs since symptom onset If <5yrs and mild, start if <48hrs from symptom onset, otherwise supportive care
99
Which vaccines are live?
MMR VZV Live influenza Rotavirus BCG Yellowfever
100
Hep A post exposure prophylaxis
Give to close contacts within the past two weeks If >6mo = Hep A vaccine If <6mo = Hep A immunoglobulin If immunocomprimised = Hep A vaccine + immuniglobulin
101
Mom HepB unknown at delivery, how to manage the baby?
HepBsAg STAT for Mom, if results available within 12 hrs can wait for results to treat baby If Mom HBsAg - = no treatment Mom HBsAg + = Hep B vaccine and immunoglobulin within 12hrs If no results available in 12hrs, give HB vaccine within 12hrs, can wait up to 7d for HBIG
102
When to do Hep B serology in an infant born to Mom with Hep B?
HBsAg and HBsAb at 9-12 mo (at least one month after finishing vaccine series - 3 doses for most, 4 doses if <2kg at birth)
103
Interpret the serology: HBeAg+, HBcAg+, HBsAg+, HBeAb−, HBcAb+, HBsAb−
Acute infection
104
Interpret the serology: HBeAg−, HBcAg−, HBsAg− HBeAb−, HBcAb−, HBsAb+
Immunized
105
Interpret the serology: HBeAg−, HBcAg−, HBsAg− HBeAb+/−, HBcAb+, HBsAb+
Past infection
106
Testing of infant of HCV + mom?
Best method: serology at 12-18mo If cannot ensure f/u: HCV PCR at >2mo, still need to rpt serology at 12-18 mo if neg to ensure Ab clearance If serology negative at >6mo, NO REPEAT TESTING If serology positive anytime earlier than 12-18mo, REPEAT AT 12-18 mo If positive serology at 12-18mo, do HCV PCR to determine if spontaneously cleared or active infection
107
When to give VZIG to baby of Mom with varicella?
If moms rash was ONSET 5 days prior to delivery or 2 days after
108
Partially immunized child, has a clean cut, tetanus proph?
DTaP if <3 doses
109
Fully immunized child has a clean cut, tetanus proph?
Nothing! (even if dirty wound, no need to give vaccine unless it has been >5yrs since last dose)
110
Rabies prophylaxis
Vaccine (4-5 dose series within two weeks) + Immunoglobulin directly into wound Give if: wild animal bite, bat bite or scratch, dog/cat/ferret if seems rabid
111
When can a kid with chickenpox go to school/daycare?
A child with mild illness should be allowed to return to school or child care as soon as she or he is well enough to participate normally in all activities, regardless of their state of rash (contagious 2d before rash onset until all crusted over) JK NOW ITS NOT UNTIL THE RASH IS IMPROVED
112
Who qualifies for RSV prophylaxis?
- <30wks and <6mo - <36wks, <6mo, +rural - CHD <1yr - CLD on O2 <1yr (consider <2yrs if on O2)
113
Infectious contraindications to breastfeeding?
HIV HTLV Active HSV lesion on breast Cracked and bleeding nipples with HCV TB (until Mom has had 2 weeks of tx)
114
Treatment of pinworm?
Treat all family members with mebendazole now and again at 14days
115
Child with unilateral facial weakness, and vesicles in ear canal. Best management?
Ramsay Hunt Treat with acyclovir and steroids
116
Previously healthy 6-year-old male with right sided parotitis and upper respiratory symptoms suggestive of viral illnesss. Two prior similar episodes. Salivary swab growing viridans group streptococci. Cause?
Juvenile recurrent parotitis (non-obstructive, most common in prepubertal males, conservative management)
117
Previously well 6-year-old boy with new onset flaccid paralysis of left leg 5 days after brief febrile illness associated with upper respiratory tract symptoms. Immunizations UTD. No travel. Reflexes intact. CSF normal. Likely diagnosis?
Acute Flaccid Myelitis - Can be secondary to polio or enteroviruses (if immunized)
118
Endocarditis Prophylaxis Indications (who gets it?)
- Previous infectious endocarditis - Unrepaired cyanotic CHD - Completely repaired CHD with prosthetic material during first 6 months after procedure - Repaired CHD with residual defects adjacent to prosthetic material - Heart transplant with valvular defects
119
age cut off for watchful waiting for AOM
> 6 months old
120
treatment for chlamydia pneumonia
azithro or erythro
121
neonate with pneumonia and high eosinophilia - pathogen?
chlamydia
122
empiric treatment for meningitis over 1 mo old
ctx + vanco +/- ampicillin (listeria coverage for if close to 1 mo old)
123
empiric meningitis treatment under 1 mo old
amp + cefotax
124
steroids for meningitis
dex 0.6 mg/kg/day start within 4 hr of antimicrobials helps reduce hearing loss for h flu (gram neg coccobacilli) and strep pneumo (gram positive diplococci) continue x 4 days discontinue if organism not identified within 48 hr (culture negative)
125
repeat LP for meningitis
strep pneumo if resistant strain or if received dex gram negative repeat 24-48hr some people do rpt LP for GBS meningitis
126
prophylaxis for h. flu meningitis | -when to tx household contacts - what to treat with
rifampin x4days preferred treat the household members if: - at least one child < 4 years old who is un/partially immunized - child < 12 months not completed primary series - any immunocomp child in the home
127
prophylaxis for neisseria meningitis
all household contacts get rifampin x 2d +/- meningococcal vaccine depending on the strain
128
abscess management
I&D no antibiotics unless systemic features or young < 3mo if cellulitis, cephalexin for MSSA and septra for MRSA
129
centor score for pharyngitis
one point each for: -exudate or swollen tonsils -tender or swollen anterior cervical LNs -fever -no cough if score 3 or 4, swab for age 3-14 years
130
rheumatic fever antibiotic prophylaxis
no carditis: 5 years or until 21, whichever is longer carditis but no residual heart disease: 10 years or until 21, whichever is longer residual carditis: 10 years or until 40 or lifelong
131
osteo/septic arthritis empiric treatment
IV cefazolin kingella < 4yo staph aureus most common
132
chicken pox leading to severe lesions, erythema with some blackened areas
chickpox leading to necrotizing fascitis
133
6 yo with varicella presents with progressive, localized erythema - red with blue hue and exquisitely painful with temperature 39. what is pathogen and abx?
most likely GAS post chicken pox nec fasc penicillin + clindamycin (need anti toxin)
133
antibiotics for UTI prophylaxis
Do not do it without talking to nephro/uro!! Consider TMP SMX or nitrofurantoin if Grade 4-5 VUR if resistant to both, then don't prophylax
134
chemoprophylaxis for invasive GAS
For close contacts of confirmed severe disease use keflex x 10d close: - household >4 hr/day or 20 hr total during the previous 7 days - non-household: shared bed, sex, direct contact with mucousmembranes/secretions/open skin severe: - TSS - nec fasc - meningitis - pna - other life threatening GAS infxn
134
indications for UTI proph
grade IV - V VUR
135
strep toxic shock definition
hypotension or shock PLUS two or more of: - renal impairment - DIC - hepatic abnormalities - ARDS - scarlet fever rash - soft tissue necrosis need to isolate strep pyogenes (GAS) from normally sterile body site
135
most common neurologic symptom of lyme disease
facial nerve palsy
136
purpura fulminans most likely pathogen
meningococcus
136
classic rash in lyme disease
erythema migrans (large target)
137
eczema flare with punched out lesions
eczema herpeticum tx acyclovir if near the eye, swab, call optho and start IV acyclovir
137
how to diagnose lyme in first mo since bite?
clinical serology can be negative for first 2-4 weeks
138
antibiotic prophylaxis for asplenia
Amox 10mg/kg/day BID 2 yrs post splenectomy SCD 2mo - 5 yr
138
antibiotics for lyme disease
doxycycline regardless of age 10 days if just skin
139
lyme disease prophylaxis
consider for exposed individual in known endemic region with: - Tic attached for > 36, engorged Tic - within 72 hr of tick removal single dose doxy
140
deet percentages depending on age for mosquito prevention
> 12 yrs: 30%
141
c diff mild vs. moderate vs severe definition and treatment
mild: watery diarrhea <4/day - stop precipitating abx, supportive care moderate: watery diarrhea 4+ stools/day, no or minimal systemic toxicity - flagyl or vanco 10-14 days severe: systemic toxicity (fevers, rigors, severe abdo pain) - vanco severe + complicated: colitis - flagyl IV PLUS vanco po recurrence: repeat first regimen or use vanco
142
rapid onset vomiting/diarrhea after soiled food ingestion
staph aeureus (30min-6hr)
143
giardia treatment
flagyl
144
painful vs. painless STI ulcers
painful = HSV painless = syphilis
145
complication of macrolides in neonate
pyloric stenosis
146
hepatitis A post exposure prophylaxis
recommended for those 6+ mo old within 2 weeks exposure
147
hep B positive mom - management neonate
HBIG and HepB vaccine within 12 hr of birth continue vaccine series test HBsAg and HBsAb at 9-12 mo of age to check baby's serology and response to vaccine
148
hep b unknown mom
stat HBsAg If results within 12 hr, wait and give HBIG and vaccine within 12 hr
149
pinworm treatment
mebendazole or albendazole x 2 courses if recurrent, treat full family
150
how do you treat strep throat in a patient with high risk medication non compliance (ex. couch surfing, no health card)
single dose benzathine penicillin IM <27 kg: 600,000 units or ≥27 kg: 1,200,000 units use in any patient you think won't take 10 days po

2023 RC Blue's Clues (20 decks)

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