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Flashcards in Infectious Diseases Deck (126)
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Components/type of vaccine for pneumococcal and meningococcal polysaccharide vaccine

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoid

C. polysaccharide capsules

1

Components/type of vaccine for Polio and Hepatitis A

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoids

A. whole inactivated microorganisms

2

Components/type of vaccine for acellular pertussis, HPV, and Hep

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoid

B. parts of the organism

3

Components/type of vaccine for measles, mumps, rubella, varicella, rotavirus, and live-attenuated influenza vaccines

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoid

e. live-attenuated microorganisms

4

Components/type of vaccine for Hib, pneumococcal, and meningococcal conjugate vaccines

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoid

d. polysaccharide capsules conjugated to protein carrier

5

Components/type of vaccine for tetanus and diphtheria

a. whole inactivated microorganisms
b. parts of the organism
c. polysaccharide capsules
d. polysaccharide capsules conjugated to protein carriers
e. live-attenuated microorganisms
f. toxoid

f. toxoid

6

Mechanisms of fever production (3)

pyrogens (endogenous /exogenous )
heat production exceeding loss (salicylate poisoning or malignant hyperthermia)
defective heat loss (ectodermal dysplasia / severe heat exposure)

7

Give examples of drugs known to cause fever (3)

allopurinol
vancomycin
amphotericin B

8

In an infant 1-3 mos old with temperature >38C, with no localizing signs, unremarkable medical history, and normal PE, what laboratory studies should be done to ascertain that the patient may be managed as outpatient and no antibiotics are needed?

Lab Studies should be normal:

Urine: no leukocyte esterase or nitrite,WBC< 1500; or band:total neutrophil ratio <8, negative gram stain

CXR: no infiltrate

If child does not fulfill all low-risk criteria, hospitalize and administer parenteral antibiotics until all cultures are final and definitive diagnosis determined and treated.

9

What are the four subtypes of FUO?

Classic FUO
Health-care associated
Immune-deficient
HIV related

10

What is the definition of Fever of Unknown Origin in children?

1. children with fever documented by a health care provider
2. cause could not be identified after 3 wk of evaluation as an outpatient or after 1 wk of evaluation in the hospital

11

Define classic FUO

fever >38 C
> 3 weeks
> 2 visits or > 1 week in hospital

12

Define healthcare associated FUO

fever > 38 C
> 1 week
Not present or incubating on admission

13

Define neutropenia

ANC < 1000 cells/mm3

- associated with significant risk for developing severe bacterial and fungal disease

14

Most often manifests during the 1st year of life with cellulitis, perirectal abscesses, or stomatitis from Staphylococcus aureus or Pseudomonas aeruginosa

Primary congenital neutropenia

(neutropenia - absolute neutrophil count of <1,000 cells/mm3)

15

Fixed cycles of severe neutropenia between periods of normal granulocyte number. Most often the disease is characterized by recurrent aphthous ulcers and stomatitis during the periods of neutropenia

Cyclic neutropenia

- cycles classically occur every 21 days (range, 14-36 days), with neutropenia lasting 3-6 days
- most neutropenic syndromes respond to colony stimulating factor

16

Children with this defect can have a history of delayed cord separation and recurrent infections of the skin, oral mucosa, and genital tract beginning early in life.

Leukocyte adhesion defects
- caused by defects in the β chain of integrin (CD18), which is required for the normal process of neutrophil aggregation and attachment to endothelial surface
- neutrophil count in the peripheral blood is usually extremely elevated and pus is not found at the site of infection

17

Inherited neutrophil dysfunction syndrome where neutrophils have defects in their NADPH oxidase function, rendering them incapable of generating superoxide and thereby impairing intracellular killing

Chronic granulomatous disease

common pathogens:
S. aureus, Serratia marcescens, Burkholderia cepacia, Nocardia spp, Aspergillus

infections usually affect liver, bone, and lungs

prophylaxis:
trimethoprim-sulfamethoxazole, recombinant human interferon-γ (IFN-γ), and oral antifungal agents

18

Children who have congenital asplenia or splenic dysfunction due to hemoglobinopathies such as sickle cell disease or have undergone splenectomy are at risk for serious infections from these pathogens (2)

encapsulated bacteria
blood-borne protozoa such as Plasmodium and Babesia

- consider prophylaxis with penicillin, esp in children under 5 yo
- most common causative organisms include Streptococcus pneumoniae, Haemophilus influenzae type b, and Salmonella, which can cause sepsis, pneumonia, meningitis, and osteomyelitis

19

Terminal complement defects (C5, C6, C7, C8, and C9) are associated with recurrent infections with this pathogen

Neisseria

- Vaccines for S. pneumoniae, H. influenzae type b, and Neisseria meningitidis should be administered to all children with abnormalities in opsonization or complement pathways.

20

Antibody deficiency that leads to a lack of production of secretory antibody at the mucosal membranes

Selective IgA deficiency
- recurrent sinopulmonary infection and GI disease are the major clinical manifestations

21

Caused by a defect in the CD40 ligand on the T cell and is associated with a deficiency in the production of IgG and IgA antibody. Recurrent neutropenia, hemolytic anemia, or aplastic anemia can be present

Hyper-IgM Syndrome

- at risk for bacterial sinopulmonary infections, Pneumocystis jiroveci pneumonia (PCP), and Cryptosporidium intestinal infection

22

The mainstay of treatment for most of the primary IgG antibody deficiencies

intravenous immunoglobulin (IVIG)

* not advocated for IgA deficiency, because it does not correct the defect

23

X-linked recessive disease associated with eczema, thrombocytopenia, a reduced number of CD3 lymphocytes, moderately suppressed mitogen responses, and impaired antibody response to polysaccharide antigens

Wiskott-Aldrich syndrome

- infections with S. pneumoniae or H. influenzae type b and PCP are common

W- Weeping skin lesions- eczema
A- Absent platelets- thrombocytopenia - leading to petechiae
S- Severe immunodeficiency...... (low IgM and high IgA & IgE levels)

24

Children with this syndrome have markedly elevated levels of IgE and present with recurrent episodes of S. aureus abscesses of the skin, lungs, and musculoskeletal system

hyper IgE syndrome

25

Single most common finding among infants with congenital rubella syndrome

Nerve deafness

26

Most common ocular abnormality in congenital rubella syndrome

salt and pepper retinopathy

- unilateral or bilateral cataracts are the most serious ocular abnormality

27

The most common cause of viral meningitis in mumps-immunized populations, accounting for up to 90% or more of cases in which a cause is identified

Enteroviruses

28

1) Viral infection characterized by sudden onset of fever, sore throat, dysphagia, and lesions in the posterior pharynx.

2) Which virus is most commonly implicated?

Herpangina

Coxsackie A virus

29

1) Viral infection characterized by paroxysmal thoracic pain, due to myositis involving chest and abdominal wall muscles

2) Commonly implicated viral etiology

1) Pleurodynia (Bornholm disease)

2) Coxsackie B and Echovirus