infectious dz

Question 1

bronchiolitis

Answer 1

inflammation of the bronchioles/small airways
bronchioles obstreucted w/ mucus and edema–> air trapped–> wheezing

Question 2

average age of bronchiolitis vs bronchitis

Answer 2

bronchiolitis is typically less than 2 years old

Question 3

most common cause of bronchiolitis

Answer 3

respiratory syncytial virus (RSV)

late fall & winter; can be afebrile

Question 4

common cause of croup

Answer 4

parainfluenzae

Question 5

• lower resp tract in young kids
• only URI sx most times followed in 1-3 days w/ wheezing, worse cough, dyspnea

Answer 5

RSV bronchiolitis

Question 6

diagnostic testing for RSV bronchilitis

Answer 6

nucleic acid testing

Question 7

treatment of bronchiolitis

Answer 7

supplemental oxygen PRN
saline nose drops & suctioning PRN

Question 8

6 indications for hospitalization for CAP

Answer 8

• Hypoxemic – O2< 90%
• Age < 6 months
• Toxic appearance
• Respiratory distress
• Known pathogen with increased virulence
• uncertain of adherence to tx at home

Question 9

tachypnea in under 2 mo vs 1 yr vs 5 yrs

Answer 9

• under 2 mo: over 60
• under 1 yo: over 50
• under 5 yo: over 40
• over 5yo: over 20

Question 10

most common cause of pneumonia in under 3 months vs under 4 yrs vs over 5 yrs

Answer 10

• under 3 months: chlamydia trachomatis, RSV, HMPV, B pertusis
• under 4 yo: RSV, HMPV, flu, mycoplasma
• over 5: mycoplasma, chlamydophilia pneumo.

s. pneumo in all age groups

Question 11

4 signs of meningitis in infants

Answer 11

• constant or weak crying
• increased sleeping/lethargic
• vomiting
• bulging fontanelle- but not always

Question 12

which age group is bacterial vs viral pneumonai more common

Answer 12

• bacterial is more in under 3mo
• preschool is most likely viral

Question 13

expected CBC finding with bacterial meningitis

Answer 13

WBC over 15k w/ bandemia

Question 14

CSF findings for bacterial meningitis (3)

Answer 14

• glucose under 40
• protein over 50
• polymorphonuclear cells

Question 15

3 most common bacterial meningitis etiologies in under 1 month

Answer 15

• ecoli
• GBS
• listeria mono.

Question 16

two most common bacterial etiologies in 1 mo. to 10 y.o

Answer 16

s. pneumo
n. meningitidis

Question 17

most common bacterial etiology for bacterial meningitits

Answer 17

N. meningitidis

Question 18

empiric tx for bacterial meningitis in onver 1 month old

Answer 18

vancomycin and ceftriaxone

Question 19

tx of bacterial meningitis d/t N. meningitidis

Answer 19

ceftriaxone for 5-7days

Question 20

2 things recommended after meningitis resolves

Answer 20

hearing test
neurodevelopmental f/u

Question 21

most common cause of viral meningitis

Answer 21

enterovirus

Question 22

how is viral meningitis diagnosed

Answer 22

NAT of CSF-multiplex PCR

Question 23

• altered mental status
• seizures
• behavioral or personal changes
• focal neurologic signs

Answer 23

encephalitis

Question 24

most common cause of encephalitis

Answer 24

viral (HSV, enterovirus, arbovirus)

Question 25

other than viral etiologies, other treatable cause of encephalitis

Answer 25

rickettsia-- Rocky Mountain SF, Anaplasma phagocytophilum, Coxiella burnetti, Ehrlichia chaffeensis | doxycycline

Question 26

gram negative coccobacillus blood culture with meningitis

Answer 26

Neisseria meningitidis

Question 27

Vasculitis with N. meningitidis

Answer 27

inflammation and damage of small blood vessels that progresses very fast | seen less d/t meningococcal vaccines that tend to target N. meningitidis

Question 28

diff between SIRS and sepsis

Answer 28

* SIRS-- dysregulation of the immune response * Sepsis is SIRS in presence of known or suspected infection all septic patients have SIRS but not all SIRS patients have sepsis | definition is different in adults

Question 29

criteria for peds SIRS

Answer 29

* core temp over 38.5 or under 36 * tachycardia or brady in under 1 month old * tachypnea * elevated or depressed WBC | also could have delayed refill, cool extremities, ARDS

Question 30

when do you typically see hypotension in children

Answer 30

late