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Flashcards in Infectious Disease Deck (46)
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1

IgM

First immunoglobulin to appear in the blood after initial exposure to an antigen (primary antibody response)

2

IgA

Secretory antibody response

3

IgG

Major antibody to protein antigens

4

What antibodies are transferred from mother to baby?
And how long will they protect baby?

IgG can be transferred across placenta and will protect from birth to 6 mo

IgA transferred via breast milk

5

Type I hyper sensitivity rxn

IgE, mast cells, hay fever and anaphylaxis

6

Type II hyper sensitivity rxn

IgM, IgG, cytotoxic, goodpastures Syndrome

7

Type III hyper sensitivity rxn

IgM, IgG, AG-AB complex, serum sickness

8

Type IV hyper sensitivity rxn

T cell infiltrate, Posion ivy dermatitis, PPD positivity

9

Epi pen jr

33 to 66 lbs

10

Urticaria rash

Migratory, waxing and waning, IgE mediated

11

Serum sickness

Type III hypersensitivity rxn does not require prior sensitization

Onset 1-3 wks after initial exposure, fever, lymphadenopathy, rash

12

Food allergy

IgE mediated
Start within minutes

13

What is the MC cause of neonatal bacteremia and sepsis?

Group B strep

14

Define occult bacteremia

Fever without obvious source of infection in a well appearing child with a positive blood culture for bacterial pathogen

15

MC etiology of occult bacteremia in neonates?
In children?

Neonates- GBS
Children- strep pneumo

16

SE of rifabutin

can color body secretions like urine, sweat and tears bright orange

can also dec serum levels of clarithromycin and will be less effective if used with fluconazole

17

Atypical Mycobacterial Infections tx and pphx

Two drug regimen

Either clarithrymycin OR azithromycin

PLUS ethambutol, rifabutin, rifampin, ciprofloxacin OR amikacin

Pphx for CD4 <50: Azithromycin qweek

18

Tx for mumps

MMR vaccine, supportive tx

19

Mumps presentation

Rare viral prodrome

Swelling and tenderness in one or both parotid glands, difficulty opening mouth

20

Mumps etiology

Paramyxovirua (RNA virus)

Spread via respiratory secretions w/ incubation period of 14-24 days

21

Measles (rubeola) presentation

High fever, conjunctivitis with yellow exudate, croup like cough, stuffy/runny nose

Maculopapular rash that starts on face and spreads to trunk, Koplik's spots

22

Measles (rubeola) tx

Supportive + vitamin A

Live attenuated vaccine given at 12-15 mo with booster at 4-6 yrs

23

Flu tx

Symptomatic tx- fluids, rest acetaminophen or ibuprofen

At rist pts: Type A >1 amantadine, >12 rimantadine
Type A and B >18 peramivir, >7 zanamivir, >2 ws oseltamivir

If pregnant→ 5 day course of aniviral tx (oseltamivir)

IM Vaccine for all childrren >6 mo

24

HSV cutaneous vs encephalitic vs disseminated

Cutaneous- involves skin, mouth and eyes w/ vesicular eruptions around 7-10 days of life usually on presenting part

Encephalitic- occurs at 3rd wk of life presents with lethargy, irritability, poor suck and seizures

Disseminated- sepsis like clinical picture (apnea, irritability, hypotonia, hypotension)

25

Tx for occult bacteremia by age:
<60 days
61-90 days
3-36 mo

<60 days- hospitalize and abx, ampicillin and gentamicin for newborns, ampicillin + cefotaxime 2nd mo of life

61-90 days- output web or w/o 1 dose of ceftriaxone

3-36 mo- ceftriaxone optional if Non-septic, if fever > 102 get blood and urine cx

26

What is a good first line tx for UTI in pediatrics?

Cephalosporins

27

Erythema infectioum presentation

fifth disease

1 wk of low grade fever, HA, malaise, myalgia and mild URI sx

"Slapped cheeks"

Lacy maculopapular rash spreads to trunk and extremities

28

Erythema infectiosum tx

Supportive (antipyretics, ↑ fluid intake)

IVIG if immunocomp

29

Pertussis presentation

Cough on expiration and whoop on inspiration

Post-tussive emesis

Catarrhal: congestion, rhinorrhea, mild persistent cough

Paroxysmal: cough and posttussive emesis

Convalescent: plateaus

Duration: 6 wks

30

Pertussis tx

Abx do not help in paroxysmal stage which is toxin mediated

Macrolide abx for pt and household contacts

Isolation until 5 days of therapy

DTap