Infectious Disease in kid Flashcards
(114 cards)
1
Q
Congenital syphilis early manifestations
A
Jaundice: anemia maculopapular rash (palms of soles) lymphadenopathy rhinitis chorioretinitis hepatosplenomegaly Osteochondritis congenital nephrosis
2
Q
Late manifestations of congenital syphilis
A
saber skins keratitis Hutchinson teeth saddle nose deafness
3
Q
mc predisposing factor for acute bacterial sinusitis
A
Viral URI
4
Q
Complications of sinusitis
A
orbital cellulitis w/ intracranial extension
5
Q
First line Rx for acute bacterial sinusitis
A
amoxicillin plus Clavulanic acid
6
Q
Herpangina is what
A
Coxsackie A virus
7
Q
typical age of herpangina and what season
A
3-10 yrs
Summer/early fall
8
Q
C/F of herpangina
A
Fever, pharyngitis
gray vesicles/ulcers on posterior oropharynx
9
Q
Rx of herpangina
A
supportive management
10
Q
Herpetic gingivostomatitis is what? age?
A
HSV1
6 months to 5 yrs
11
Q
HSV1 C/F
A
fever, pharyngitis
Erythematous gingiva
clusters of small vesicles on anterior oropharynx/lips
12
Q
Rx herpetic ging….
A
acyclovir
13
Q
Stept pyogenes c/f in pharyngitis
A
fever, pharyngitis
tender anterior cervical LAD
tonsillar exudates!
14
Q
2 year old kid has comes in with respiratory distress, hypotensive, 37.7C, coughing, 98% saturation RX with o2. DX is laryngotracheobronchitis, he begins to decline and 92% sat with 40RPM….
whats the next step?
A
Give racemic epinephrine in cases of croup before intubation
Epi: acts by a adrenergic(reduce bronchial secretions/ mucosal edema) and beta adrenergic (relax smooth muscle)
15
Q
Immunizations in kids should be given according to
A
chronological age
16
Q
Standard Inactivated (killed) Pediatric vaccine (2)
A
Polio
Hep A
17
Q
Standard Toxoid (inactivated toxin) Ped vaccine (2)
A
Diptheria
tetanus
18
Q
Standard Subunit/conjugate Peds Vaccine (7)
A
Hep B Pertussis Haemophilus Influenzae type b Pneumococcal Meningococcal HPV Influenza (injection)
19
Q
Live attenuated standard ped immunization (4)
A
Rotavirus
MMR
Varicella
Influenza (nasal)
20
Q
Preterm newborn is good to receive vaccines according to (1) but one exception (2)
A
- chronologic age
2. weight should be above 2 kg before 1st hep b vaccine
21
Q
Neonatal tetanus general onset
A
Onset w/in first 2 weeks
22
Q
Neonatal tetatnus signs and symptoms
A
poor suckling and fatigue
followed by rigidity, spasms and opisthotonus
23
Q
Mortality in tetanus is due to
A
1st week: apnea
2nd week: septicemia
24
Q
Child with painful non-itchy pustules and honey crusted lesions
A
Non-bullous Impetigo
25
Child with Rapidly enlarging flaccid bullae with yellow fluid; "collarette" of scale at the periphery of ruptured lesions
Bullous Impetigo
26
Treatment of Impetigo
Non-bullous: topical antibiotic: mupirocin
| Bullous: oral anti: cephalexin, dicloxacillin, or clindamycin
27
Impetigo cause
S. Aureus (both)
| S. pyogenes(non- bullous)
28
Epiglottitis classic presentation
High grade fever
sudden-onset resperiratory distress
dysphagia and drooling
Stridor (tripoding- leaning forward)
29
Rx of acute epiglottitis
OR- endotracheal intubation
| unsucceful- Emergency tracheotomy
30
Differentiate btw periorbital and orbital cellulitis
Periorbital is before the orbital Septum; Orbital cellulitis:
- Opthalmoplegia,
- Pain w/ mvt
- Proptosis
- vision impairments
31
Anterior uveitis c/f
Red eye, pain and blurry vision
| also Pupil defects, corneal precipitates and leukocytes
32
Causes of anterior uveitis
trauma
infection
AI disease
33
rx orbital cellulitis
IV antibiotics to cover s. aureus
| may require drainage
34
Conjunctivits C/f
inflammation of conjunctiva: erythema, exudate
| No proptosis, pain w/ mvt, or vision loss
35
Congenital Toxoplasmosis (7)
```
Hydrocephalus, microcephaly
chorioretinitis
Intracranial calcifications
hepatomegaly
diffuse LAD
jaundice
diffuse petechiae
```
36
risk of transmission during pregnancy increase as pregnancy progresses but severity of...
neonatal disease decreases
37
Congenital syphilis C/F (6)
```
intermittent fever
osteitis osteochondritis
mucocutaneous lesions
LAD
hepatomegaly
persistent rhinitis
```
38
Congenital rubella (3ish)
```
Oko, ucho i serducho
Congenital glaucoma
sensorineural deafness
cardiac anomalies(PDA, ASD)
microcephaly, microphthalmia, meningoencephalitis
```
39
Congenital Herpes (3)
encephalitis
chorioretinits
disseminated disease
40
Neonatal conjunctivitis: first 24 hrs
Chemical prob from Silver nitrate
| Rx: supportive management
41
Neonatal conjunctivits day 2-5
Gonococcal
42
Gonoccocal conjunctivitis findings
Marked eyelid swelling/exudates
| Profuse purulent discharge
43
Gonococcal conjunctivitis Rx
IV or IM ceftriaxone or cefotaxime
44
Nenatal conjunctivitis day 5-15
Chlamydial infection
45
Chlamydial conjunctivitis C/F
Mild to moderate swelling of eyelids
thickened, injected conjunctivae (chemosis)
Watery or mucopurulent eye discharge
Blood stained eye discharge is highly characteristic
Conjunctival pseudomembrane
46
Rx chlamydial conjunctivitis
oral erythromycin
| only macrolide used for chlamydial conjunctivitis
47
Risk of infant who recieves oral erythromycin
infantile hypertrophic pyloric stenosis
48
three stages of Pertussis
| and what are the C/F in them?
```
Catarrhal : 1-2 wks
-mild cough, rhinitis
Paraxysmal: 2-6 wks
- coughing paraxyms w/ inspiratory "whoop"
-posttussive emesis
- apnea, cyanosis (infant)
Convalescent (wks-months)
-symptoms resolve gradually
```
49
Rx pertussis
Macrolides
| vaccine
50
Complications of Pertussis
```
Pneumonia
weight loss
subconjunctival hemorrhages
pneumothorax
RF
death (infants)
```
51
Tinea Corporis or ringworm in kids Rx
Topical Antifungals
52
Ringworm C/f
erythematous, scaly, pruritic lesion
| Red ring w/ central clearing
53
Ringworm exposure
infected animals, people, and public places
54
Cellulitis C/F
painful, erythematous, and indurated
| Not scaly or itchy
55
Cellulitis Rx
IV antistaphylococcal antibioitic
| Nafcillin
56
Erysipelas
Begins small erythematous patch
then red, indurated, tense and shiny plaqes
Presence of a raised, sharply demarcated margin is classic
may have LAD indicating lymphatic involvement
57
Mom right before birth is Dx with Hep B; kid delivered what do you do?
Give Hep B IG and Hep B vaccine
58
If mom has HBeAG negative or positive? risk for kids to develop chronic hepatitis
negative 20%
| positive: 90%
59
Cystic fibrosis related pneumonia gram-negative rod
Pseudomonas Aeruginosa
burkholderia cepacia complex
stenotrophomonas maltophilia
60
Cystic fibrosis pneumo gram neg coccobacilli
nontypeable H.influenzae
61
CF pneumonia gram positive cocci in chains
Strept pneumoniae
62
CF pneumonia gram+ cocci in clusters
Staphylococcus aureus
63
Rabies clinical features
```
Encephalitic:
Hydrophobia
Aerophobia
Pharyngeal spasm, spastic paralysis
Agitation
Paralytic: ascending flaccid paralysis
```
64
Rx of Rabies
Rabies immune globulin and rabies vaccine
65
Enterobius vermicularis
| pinworm Rx
Albendazole or pyrantel pamoate
| for patient and all household contacts (highly contagious)
66
Chagas disease Rx
| trypanosoma cruzi
Benznidazole or nifurtimox
67
Stronygloidiasis: uritacaria, abd pain, resp problems
| Rx?
Ivermectin
68
Scarlet fever C/F
Initial: Fever, chills, toxicity, abd pain, pharyngitis
| 12-48 hrs: rash neck, axillae, groin and generalizes w/in 24 hrs
69
Rash in scarlet fever
punctate or finely papular texture: Sandpaper like
70
Pharynx in scarlet fever
erythematous, swollen, possibly gray-white exudates
| mouth:circumoral pallor
71
Rx: of Scarlet fever
DOC: Penicillin V
allergy: erythromycin, clindamycin, 1st gen cephalosporin
72
Viral symptoms in pharyngitis
Cough, rhinorrhea, conjunctivitis, oral ulcers
73
MC organisms for acute bacterial rhinosinusitis (3)
S. pneumoniae 30%
H. influenzae 30%
Moraxella Catarrhalis 10%
74
dacryostenosis
nasolacrimal duct obstruction
newborn: chronic tearing often unilateral
rx: massage gently
75
Lyme Disease rx in kid
Oral amoxicillin or cefuroxime
| kids
76
MC organism for osteomyelitis in infants and children
Both: S. Aureus MC
Infants: GBS + E.coli
Children: S.pyogenes
77
cat bite kid, Rx w/?
Amoxicillin/clavulanate
| worried about pasteurella multocida: cellulitis
78
Waterhouse-friderichsen syndrom is characterized by
sudden vasomotor collapse
Skin rash: purpura + petechiae
Due to adrenal hemorrhage
79
Viral meningitis in kids, organisms
90% enteroviruses: echovirus, coxsackievirus
80
Pertussis prophylaxis in family with child sick
Prescirbe a macrolide antibiotic for household contacts
| age1 month: azitho 5 days; clarithryo 7xdays; erythro 14xdays
81
erythromycin in neonate is assoc with
pyloric stenosis
82
Pertussis sick child should be on antibiotics therapy for (1) days and what else
5 days
respiratory isolation for first 5 days with antibioitics
kept at home
infants
83
Lymph node becomes tender, erythematous and becomes enlarged (3-6 cm in size); Dx?
lymphadenitis
84
Mc pathogen for lymphadenitis
1. S. aureus
| 2. GAS
85
Unilateral subacute-chronic LADl kid
Nontuberculous mycobateria lymphadenitis
86
acute unilateral lymphadenitis; older child with periodontal disease; dx?
peptostreptococcus lymphadenitis
| anaerobic bacteria
87
mcc of neonatal jaundice are (4)
breastfeeding jaundice
breast milk jaundice
hematologic conditions
sepsis
88
Acute Otitis media pathogens
S. Pneumo
Nontypeable H.influenzae
Moraxella catarrhalis
89
AOM c/f
Acute onset
middle ear effusion
bulging tympanic membrane
90
AOM rx:
Initial: Amoxicillin- 10 days
2nd: Amox + clavulanic acid
Amox allergy: azithryomycin
91
Complications of AOM
Conductive hearing loss
mastoiditis
meningitis
92
Recurrnet AOM despite appropraite anitbiotic rx; do what next
Tympanocentesis and culture during myringotmy w/ tympanostomy tube placement
93
Laryngeal inflammation that results in hoarseness, barkin cough, varing degrees of respiratory distress over time; lateral xray subglottic narrowing, Dx?
Croup
| Parainfluenza virus
94
Long term sequelae assoc w/ bacterial meningitis (5)
```
Hearing loss
Loss of cognitive function(neuronal loss in dentate gyrus of hippocampus)
Seizures
Mental Retardation
Spasticity or paresis
```
95
Edema, erythema and thick otorrhea, significan pain of outer ear, conductive hearing loss
preauricular nodes; Dx?
Otitis externa
96
Rx Otitis externa
topical otic preparations+/- steroids
97
Otitis externa pathogens
mc: P.aeruginosa
| 2nd mc: S.aureus
98
Rx of acute mastoiditis
Myringotomy and IV antibiotics
99
cyst like growth w/in middle ear r temporal bone; lined by keratinized stratified squamous epithelium; malodorous discharge
Acquired cholesteatoma
100
Rx cholesteatoma
Tympanomastoid surgery
101
Dx sinusitis (3)
Nonspecific complaints: nasal congestion, discharge, fever, cough
Persistent URI symptoms w/ou improvement for at least 10 days
Purulent discharge and fever (at least 102) for 3 consecutive days
102
Asymptomatic, scattered erythematous macules, papules and pustules throughout the body (spares palms/soles)
Erythema toxicum neonatorum
| Rx: none
103
low grade Fever, postauricular adenopathy, conjunctivitis, LAD, fine truncal rash starts at forehead and moves down, patchy erythema on soft palate; Dx?
Togavirus: Rubella
104
High fevers up to 40C (104), coryza, malaise, rash spread gradually includes hand and feet, reddishbrown, conjunctivitis; Dx?
paramyxovirus: Measles
105
Follicular conjunctivitis and pannus (neovascularization) formation in the cornea, inflamed eye; Dx?
Trachoma; Chlamydia trachomatis infection
106
HSV keratitis c/f
Pain, photophobia, decreased vision
Dendritic ulcer MC presentation
minute clear vesicles in corneal epithelium
107
C/I for DTaP vaccine
Immediate anaphylaxis
unstable neuro disorders
encephalopathy w/in a wk of administration
108
post-antibiotic rash is
typically polymorphous and maculopapular
109
Inability to extend the neck and widened prevertebral space suggest a dx of
Retropharyngeal abscess
110
RPA organisms
polymicrobial:
S.pyogenes
S.aureus
anaerobes
111
RPA antimicrobial rx
Ampicillin-sulbactam and clindamycin
If not working: Vanco and Linezolid
Also surgical drainage of course
112
Congenital CMV
```
IUGR
Periventricular calcification
Chorioretinitis
Microcephaly
Hepatosplenomegaly, jaundice
Thrombocytopenia- petechiae
```
113
which antibiotic is used to prevent vertical transmission of toxoplasmos from mother to fetus?
spiramycin
| macrolide concentrates in placenta
114
Congenital VZV
```
zig zag skin lesions
microphthalmia: small eyes
extremity hypoplasia
cataracts
chorioretinits
```
