Infectious Disease I

Question 1

Peak incidence of otitis media

Answer 1

6-36 months

Question 2

Most common bugs of otitis media

Answer 2

s. pneumo, h.flu, m. cat

Question 3

First line therapy for otitis media

Answer 3

amoxicillin

Question 4

Treatment of otitis media if failure of first line

Answer 4

Augmentin

Question 5

Complications of otitis media

Answer 5

mastoiditis, venous sinus thrombosis, brain abscess

Question 6

Key points regarding the effect of abx when treating otitis media

Answer 6

Abx decrease duration of infection but do NOT decrease incidence of complications

Question 7

Main bacteria with otitis externa

Answer 7

pseudomonas, s. aureus, proteus

Question 8

Sx include: Otalgia, Pain at tragus or when auricle is pulled!!!!! Pruritis, Discharge, Hearing loss

Answer 8

otitis externa

Question 9

PE findings include: Edematous and erythematous ear canal. May see yellow, brown, white or grey debris

Answer 9

otitis externa

Question 10

Tx of otitis externa

Answer 10

irrigate gently w/1:1 dilution of 3% hydrogen peroxide AT BODY TEMP.

Question 11

Tx of inflammation associated with otitis externa

Answer 11

Cortisporin, Cipro HC, Tobradex

soln if unsure if TM is intact

Question 12

Most common cause of pharyngitis/tonsillitis in children 2-5 yrs

Answer 12

virus

Question 13

Most common bacterial cause of pharyngitis/tonsillitis

Answer 13

streptococcus pyogenes (GABHS)

Question 14

Sx include: rhinorrhea, cough, mild pharyngitis, fatigue, anorexia, abdominal pain

Answer 14

viral pharyngitis

Question 15

Sx include: beefy red tonsils with exudate, tender anterior cervical lymphadenopathy, fever, HA, abdominal pain

Answer 15

GABHS pharyngitis

Question 16

Diagnostic method of choice for GABHS

Answer 16

throat culture

Question 17

Abx treatment for GABHS pharyngitis

Answer 17

PCN first line. Macrolides as alternative

Question 18

Sx include: malaise, beefy red tonsils/exudate, posterior cervical adenopathy, splenomegaly, afebrile

Answer 18

Epstein-Barr virus

Question 19

Diagnostics for EBV

Answer 19

heterophile antibody test (Monospot). EBV antibodies on CBC (IgG, IgM)

Question 20

How long should a pt with EBV avoid contact sports?

Answer 20

6-8 weeks

Question 21

Caused by enterovirus. High fever and small ulcers on erythematous base on tonsillar pillars, soft palate, and uvula

Answer 21

Herpangina

Question 22

caused by coxsackie virus. Vesicles or red papules found on the tongue, oral mucosa, hands, and feet. Mild fever and malaise

Answer 22

hand, foot, and mouth disease

Question 23

Occurs in unimmunized child (HIB), High fever, sore throat, stridor, Drooling and respiratory distress

Answer 23

epiglottitis

Question 24

one to several small ulcers on the insides of lips or elsewhere in the mouth. Last 1-2 weeks

Answer 24

Aphthous Stomatitis (Canker Sore)

Question 25

Caused by Herpes Simplex. Ulcers in the mouth, Fever, Tender cervical lymphadenopathy. Lasts 7-10 days

Answer 25

Gingivostomatitis

Question 26

Mainly affects infants or older children in debilitated state May occur in patients taking broad spectrum antibiotics or steroids

Answer 26

oral candidiasis (thrush)

Question 27

Sx include: mouth soreness, refusal of feedings. PE reveals white curd-like plaques predominantly on buccal mucosa

Answer 27

oral candidiasis (thrush)

Question 28

Treatment for oral candidiasis (thrush)

Answer 28

Nystatin oral suspension

Question 29

viral URI symptoms persist beyond 10-14 days. patient starts to improve and then becomes worse. Sx include: facial pain, maxillary teeth pain, malodorous breath

Answer 29

sinusitis

Question 30

infectious disease that is rare before age 10 years

Answer 30

sinusitis

Question 31

Infection causing inflammation of the larynx, trachea and bronchi. Most often caused by parainfluenza virus. Presents 6months to 3 yrs of age

Answer 31

Croup (laryngotracheobronchitis)

Question 32

Sx include: URI symptoms with barking cough and stridor. Absent or low grade fever

Answer 32

Croup (laryngotracheobronchitis)

Question 33

Tx of croup

Answer 33

Dexamethasone 0.6mg/kg IM one dose

Question 34

Tx of croup if stridor at rest

Answer 34

Oxygen, nebulized racemic epinephrine. If symptoms resolve in 3 hours can be safely discharged. Otherwise hospitalize

Question 35

Pathogen that most commonly causes epiglottitis

Answer 35

h. flu type B

Question 36

Sx include: fever, dysphagia, drooling, "hot potato" voice, inspiratory retractions, soft stridor

Answer 36

epiglottitis

Question 37

Xray finding for epiglottitis vs croup

Answer 37

epiglottitis = thumbprint sign. croup = steeple sign

Question 38

Sx include: parotid gland swelling common, aseptic meningitis, transient pancreatitis, orchitis or oophoritis, epididymitis

Answer 38

Mumps

Question 39

Vasculitis of unknown etiology affecting medium sized arteries. Occurs almost exclusively in pediatric population

Answer 39

kawasaki disease

Question 40

Typical lab results for kawasaki disease

Answer 40

hypoalbuminemia, thrombocytosis, and elevated ESR

Question 41

Sx include: rash, mucous membrane involvement, unilateral cervical adenopathy, nonpurulent conjunctivitis, swollen hands and feet

Answer 41

kawasaki disease

Question 42

Most serious complications from kawasaki disease

Answer 42

Coronary vasculitis and aneurysm formation

Question 43

Leading cause of acquired heart disease in children in the US and Japan

Answer 43

Kawasaki disease

Question 44

Tx of Kawasaki disease

Answer 44

High-dose Aspirin and 2 days of IV immunoglobulin

Question 45

tiny white dots on a red base appearing on buccal mucosa 1 or 2 days prior to onset of rash

Answer 45

Koplik spots (pathognomic for rubeola-measles)

Question 46

Most important reason we vaccinate for rubella (German measles)

Answer 46

prevent spread to pregnant women to avoid congenital rubella syndrome

Question 47

Most common complications of rubella (German measles)

Answer 47

arthritis and arthralgia

Question 48

Results from HHV-6. Abrupt onset of high fever which lasts for 3-7 days. Resolution of fever is followed by development of erythematous maculopapular rash

Answer 48

Roseola

Question 49

Caused by Parvovirus B19. Rash is flat, lacy, reticular, often pruritic, located on cheeks, trunk, and extremities. Children are NOT contagious once the rash appears

Answer 49

5th disease

Question 50

Generalized pruritic vesicular rash beginning on face, neck, or upper trunk and spreads outward with lesions at different stages (dew drop on rose petal)

Answer 50

varicella (chickenpox)

Question 51

How long is chickenpox contagious?

Answer 51

from 1-2 days prior to onset until the lesions have crusted

Question 52

First sign is "herald patch." Followed by lesions that are oval with "christmas tree" appearance.

Answer 52

Pityriasis Rosea

Question 53

Inflammatory process of the smaller lower airways, usually caused by RSV. Can progress to respiratory failure and is potentially fatal

Answer 53

Bronchiolitis

Question 54

Sx include: fever, URI sx, tachypnea, wheezing

Answer 54

Bronchiolitis

Question 55

URI symptoms with cough and malaise. Coarse bronchial sounds. WBC normal, CXR clear. Most of the time it is viral

Answer 55

bronchitis

Question 56

Tx of pneumonia in kids

Answer 56

abx, fluids, O2

Question 57

Dangerous component of pertussis (whooping cough)

Answer 57

small infant can die from respiratory distress

Question 58

starts as URI symptoms and slight fever may be present, cough is initially. After about 2 weeks, coughs become paroxysmal with classic “whoop”

Answer 58

pertussis (whooping cough)

Question 59

Characterized by abnormal dilation and distortion of the bronchial tree, resulting in chronic obstructive lung disease

Answer 59

bronchiectasis

Question 60

Most common cause of bronchiectasis in developed nations

Answer 60

cystic fibrosis

Question 61

Abx treatment for pertussis

Answer 61

Erythromycin for 14 days | Azithromycin for 5 to 7 days