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Flashcards in Infectious diseases Deck (39):
1

Neonate with poor feeding and lethargy, suspect....

neonatal sepsis
JACL PT
-jaundice, abnormal WBC count (high or low), CNS (lethargy, irritable, apnea), left shift (bandemia), poor feeding, temp instability (fever or hypothermia)

2

neonate with hypothermia, lethargy, poor feeding. What is the order of treatment/diagnostic steps

1. take blood, urine, CSF cultures first
2. empiric antibiotics: ampicillin (listeria), gentamycin (Gm -), enterococci until cultures return

-if neonate is acutely ill, admin antibiotics first

3

Encapsulated bacteria

Please-pseudomonas
SHINE-strep pneumo, h flu, influenza, neisseria, e.coli
my
SKiS-salmonella, klebsiella, strep group b

4

sickle cell pt with fever, chills.
-diagnosis
-what is the likely bug
-RX

sepsis
Encapsulated: esp strep pneumo (even when vaccinated)
RX: penicillin+always take penicillin prophylaxis

5

Kid develops a maculopapular rash a week after receiving the MMR vaccine

live attenuated vaccine type measles=does not equal wild type measles
-milder form, still contagious so avoid contact with immunocomp people
-RX: self-limited, reassurance

6

papular lesion+ipsilateral lymphadenopathy+cat exposure

Bartonella
rx: macrolide (azithromycin)

7

LAD in the RLQ+abdominal pain

Mesenteric adenitis
-salmonella-contact with turtles
-yersenia
-

8

bacterial sinusitis #1 predisposing risk factor

viral URI

9

kid with rhinorrhea, cough, congestion for 10 days followed by prurulent discharge...

viral infection that led to bacterial sinusitis
-viral illness causes mucosal inflamm preventing ciliary clearance
-Rx: amoxicillin+clavulonate

10

swelling anterior to the ears that obscures the angle of the mandible.....

parotitis
-Mumps
--parortitis, orchitis, aseptic meningitis, otalgia (ear pain)

11

complications of otitis media

facial n. palsy
mastoiditis

12

Cat bites vs Cat scratches
-organism
-rx

cat bite-pasteurella, treat with amoxicillin clavulonate

cat scratch-bartonella, treat with macrolide (azithromycin)

13

meningitis+petechial rash

Neisseria meningitides

14

acute otitis media vs serous otitis media

acute otitis media
-acute inflamm signs: fever, bulging tympanic membrane

serous otitis media
-no acute inflamm signs (no bulging TM), no fever
-effusions

15

tetracyclines should be avoided in kids under age

under age 8 and pregnant women

16

peds drug of choice for lyme disease

amoxicillin or cefuroxime

-avoid tetracyclines under 8 yrs of age bc of risk of teeth discoloration

17

4 yo girl with vaginal and anal pruritis at night

Entomeba vermicularis
-Dx: tape test on anus
-RX: albendazole or pyrantel pamoate

18

girl with vaginal and anal pruritis throughout the day and night, bleeding, ecchymosis

lichen sclerosis
-thinning skin
-

19

baby with hypoplastic nails and digits

fetal hydantoin syndrome-phenytoin teratogen

20

kid with history of neglect, abuse now in adopted and doesn't respond emotionally to them

reactive attachment disorder
-kid with hx of neglect, institutionalization, many foster homes
-seldom seek comfort and don't respond when caregivers give comfort to them

21

when are arterial lines used

arterial lines
-BP monitoring
-Drawing for labs
-NOT FOR: fluid resuscitation

22

discuss the types of IV lines that can be used for emergency fluid resuscitation

#1 peripheral IV line
#2 interosseus (IO) line
- big bones i.e. tibia-->advantage, it's away from the sternum (in case of cv resusc)
-contraindications: cellulitis over the area, fracture, bone fragility (osteogenesis imperfecta)

23

primary amenorrhea causes
-no uterus:
-yes have a uterus

no uterus: do a karyotype
-mullerian agenesis: normal female testosterone levels,
46 XX
-androgen insensitivity syndrome:male testost levels,
46XY

yes have uterus: do pelvic ultrasound to rule out GU anatomy issues
-turners syndrome

24

teenage girl who is anemic loses her period. why

calorie restriction=functional hypothalamic amenorrhea-->(-) hpo axis-->dec LH, FSH,

25

girl taking corticosteroids develops cushings and experiences amenorrhea. why

steroids (-) GnRH-->dec LH, FSH

26

tourette syndrome
-characteristics
-RX

-both motor and vocal tics (don't have to occur concurrently)
RX
-habit reversal training (behavioral0
-antidopaminergic (best pharm therapy): tetrabenazine (dopamine deleter), antispychotic (DA receptor blocker)
-alpha adrenergic:guanfacine, clonidine (don't work as well)

27

Teenage girl with tender breast lump right before menses
-what is it
-Dx

Fibroadenoma: single, solitary, mobile mass inc pain/size before menses

Dx: re-examine @ menses to see if the mass decreases in size/tenderness. If yes-->re-assure

28

criteria for primary amenorrhea

>13 yo, no secondary sex charact.
>15 yo, yes secondary sex charact.

29

another name for Plan B

levonorgestral=Plan B
-can give to teen girls to prevent pregnancy (this is not abortion)
-most states allow Plan B for teens

30

most states allow confidential care for teens for what...

STIs, pregnancy, prevention of pregnancy (plan B, contraception)

31

brick dust/pink stain in a neonae's diaper

Uric acid crystals-uric acid levels are higher at birth. NORMAL

32

at what age does imaginative play occur

-ages 3-6 yrs, but throughout elementary school is normal
-consists of:imaginary friends, storytelling, play dress up
-does NOT interfere with making friends

33

Teen girl with abnormally heavy periods that only occur every few months.

immature HPA axis ca.uses inadequate hormone secretion causing no ovulation-->no CL so no progesterone, only estrogen-->inc proliferation leading to breakthrough bleeding

34

Teen girl with abnormally heavy periods that only occur every few months
-DX
-RX

estrogen injections or combo estrogen/progesterone pills-estrogen will stop bleeding and maintain the endometrium

35

Characteristics of Rett Syndrome

-X linked MEP2 gene, in girls
-developmental regression at 1 yr
-stereotypic hand movements
-gait issues
-head growth deceleration

36

Tourette syndrome highest assoc comorbidities

Tourettes, OCD, ADHD

37

Mullerian agenesis (Mayer Rokitansky syndrome)

-failure of the mullerian duct to develop->no uterus, blind ended vagina (no upper vagina), present ovaries (so normal FSH)
-

38

what followup should be done in androgen insensitivity syndrome

Gonadectomy-remove the testes to prevent malignancy
Gender identity counseling

39

mild cramping during ovulation

Mittelschmerz-ovarian rupture causing follicular fluid to release and irritate the peritoneum