Infectious Diseases

Question 1

Most common causes of Acute Otitis Media?

Answer 1

SMH
- Strep. Pneumo
- Moraxella
- H. Influenza

Question 2

What will you see with Acute Otitis Media?

Answer 2

Bulging, red TMs
– May be an effusion or retraction of TM
– May see decreased TM mobility with insufflator bulb

Question 3

What is the treatment for Acute Otitis Media?

Answer 3

Amoxicillin +/- Clavulanic Acid for 10 days

Question 4

If a child has Chronic Otitis Media, what may be necessary?

Answer 4

Tympanostomy tubes

Question 5

Most common cause of Bronchiolitis?

Answer 5

RSV
– Other viruses can cause it too

Question 6

What symptoms will the child have with Bronchiolitis?

Answer 6

Respiratory distress
Fever
Cough
Rhinorrhea

Question 7

What examination findings will you see with Broncohiolitis?

Answer 7

Tachypnea
Hypoxia
Retractions
Crackles/Coarse/Wheezes with auscultation

Question 8

What is the treatment for Bronchiolitis?

Answer 8

O2
Suction
Hydration
Time

Question 9

When might you use a Bronchodilator with Bronchiolitis?

Answer 9

If the patient has a family history/or has asthma and it helps their symptoms

Question 10

If a patient has an underlying disease or is immunocompromised what drug can be given for Bronchiolitis? What prophylaxis can be given?

Answer 10

Ribavirin
- Prophylaxis = Palivizumab

Question 11

Most common cause of Croup?

Answer 11

Parainfluenza
– Other viruses can cause it too

Question 12

If you get a bacterial superinfection on top of Croup, what can that cause?

Answer 12

Tracheitis

Question 13

What are the main signs of Croup?

Answer 13

URI symptoms
Inspiratory stridor
Barking cough
Hoarse voice

Question 14

What are the main signs of Croup?

Answer 14

URI symptoms
Inspiratory stridor
Barking cough
Hoarse voice

Question 15

What can be seen on XR with Croup? Why?

Answer 15

Steeple sign due to narrowing of the subglottic space

Question 16

What are the treatment options with Croup?

Answer 16

Oxygen
Corticosteroids
Nebulized Racemic Epinephrine

Question 17

Most common causes of Epiglottitis?

Answer 17

H. Influenzae
Streptococcus species

Question 18

What are the signs of Epiglottitis?

Answer 18

Drooling
Muffled voice
Inspiratory stridor
Respiratory distress

Question 19

What are the signs of Epiglottitis?

Answer 19

Drooling
Muffled voice
Inspiratory stridor
Respiratory distress

Question 20

How may a child with Epiglottitis sit?

Answer 20

Tripod position with neck like they are a dog sniffing something

Question 21

What are 2 things you should NOT do with suspected Epiglottitis?

Answer 21

Do NOT examine the throat
Do NOT order an XR

Question 22

Why should you not examine the throat with Epiglottitis?

Answer 22

Risk of laryngospasm and airway compromise

Question 23

How is Epiglottitis confirmed?

Answer 23

Direct fiber optic visualization = cherry red and swollen epiglottis

Question 24

What can be seen on lateral XR with Epiglottitis?

Answer 24

Thumbprint sign

Question 25

What are the 2 treatments for Epiglottitis?

Answer 25

Secure the airway - intubation/tracheostomy IV Ceftriaxone

Question 26

What causes the Whooping cough?

Answer 26

Bordetella Pertussis (gram neg. rod)

Question 27

How is Pertussis spread?

Answer 27

Aerosol droplets

Question 28

What are the signs of Pertussis?

Answer 28

URI symptoms Whooping cough Posttussive emesis

Question 29

Posttussive emesis is concerning for?

Answer 29

Pertussis (whooping cough)

Question 30

What is the treatment for Pertussis and what is unique about it?

Answer 30

Azithromycin -- GIVE IT TO CLOSE CONTACTS TOO

Question 31

What is the treatment for Pertussis?

Answer 31

Azithromycin for patient and close contacts

Question 32

What bacteria usually causes Retropharyngeal and Peritonsilar abscesses and which one presents earlier in life?

Answer 32

Group A Streptococcus -- Retropharyngeal abscesses occur earlier!

Question 33

What are the shared symptoms between Retropharyngeal and Peritonsilar abscesses?

Answer 33

Muffled "hot potato" voice Drooling Trismus (stiff jaw)

Question 34

What are the shared symptoms between Retropharyngeal and Peritonsilar abscesses?

Answer 34

Muffled "hot potato" voice Drooling Trismus

Question 35

What will be present with a Peritonsilar abscess that is not present with a Retropharyngeal?

Answer 35

Uvula deviation to the opposite side

Question 36

Most common causative organisms for neonates with meningitis?

Answer 36

GEL - GBS - E. Coli - Listeria

Question 37

Most common causative organisms for infants/children with meningitis?

Answer 37

SNH - Strep. Pneumo - Neisseria - H. Influenza

Question 38

Most common causative organisms for adolescents with meningitis?

Answer 38

SN - Strep. Pneumo - Neisseria

Question 39

What type of viruses are the most common viral cause of meningitis?

Answer 39

Enteroviruses

Question 40

Kernig sign with meningitis

Answer 40

Flex the patient's hip and attempt to straighten knee and they do not want that

Question 41

Brudzinski sign with meningitis

Answer 41

Flex the patient's head and they immediately flex their hips

Question 42

If you see signs of elevated ICP with meningitis, what test should be obtained?

Answer 42

CT of the head

Question 43

For meningitis, what test should be done and what are you looking for?

Answer 43

LP - Gram stain/culture - Protein and Glucose - Cell count - Respiratory PCR

Question 44

What is the treatment of meningitis in neonates?

Answer 44

Ampicillin + Gentamicin/Cefotaxime

Question 45

What can be added to the treatment of meningitis in neonates if you suspect the mother has HSV?

Answer 45

Acyclovir

Question 46

What is the treatment for meningitis in children?

Answer 46

Vancomycin + Ceftriaxone

Question 47

Why should you not use Ceftriaxone in neonates?

Answer 47

Elevates bilirubin

Question 48

What 3 pathogens cause ocular infections in neonates?

Answer 48

HSV Chlamydia Trachomatis Neisseria Gonorrhoeae

Question 49

Signs of an ocular infection due to Chlamydia Trachomatis?

Answer 49

Late onset eyelid swelling and watery discharge

Question 50

Treatment of an ocular infection caused by Chlamydia Trachomatis?

Answer 50

Topical and oral erythromycin

Question 51

Signs of an ocular infection due to Neisseria Gonorrhoeae?

Answer 51

Early onset eyelid swelling and purulent discharge

Question 52

Treatment of an ocular infection caused by Neisseria Gonorrhoeae?

Answer 52

3rd/4th gen Cephalosporin

Question 53

Signs of an ocular infection due to HSV?

Answer 53

Vesicular eruptions + watery discharge

Question 54

Treatment of an ocular infection caused by HSV?

Answer 54

Acyclovir and topical Vidarabine

Question 55

What tests are used to diagnose HSV and Chlamydia/Neisseria ocular infectionos?

Answer 55

HSV -- PCR Chlamydia/Neisseria -- Gram stain/culture