Micro

Question 1

Neonatal gonococcal conjunctivitis.
When?
Tx?
Prevention?

Answer 1

• 2-5 days.
• IV Cephtriaxone or Cephotaxime
• Erythromycin ophthalmic ointment to prevent. Silver nitrate is more effective but not used here b/c chemical conjunctivitis

Question 2

Neonatal chlamydial conjunctvitis

When?

Answer 2

5-14dz

Question 3

Bacteremia in Sickle Cell kids (commonest cause and how to prevent)

Answer 3

• Almost always Strep pneuma!!!!
• SS kids should be on penicillin prophylaxis for this until age 5.
• Also get the 23-valent pneumococcal vaccine but what if the strep serotype isn’t covered by the vaccine? That’s why they need penicillin prophylaxis.

Question 4

Chagas Dz

Answer 4

• Trypanosoma cruzi

- Megacolon, megaesophagus, cardiac disease

Question 5

Psittacosis

Answer 5

• Transmitted from birds to humans.

- presents w/ fever, dry cough and headache. Pulm findings are most prominent on physical

Question 6

Blastomycosis

• what makes it different?
• where is it found?
• tx?

Answer 6

• what distinguishes this is the possible characteristic skin lesions (well-circumscribed, verrucous, crusted lesions) and lytic bone lesions
• main sx are months of low-grade fevers, night sweats, productive cough and weight loss (kinda like TB or Histoplasmosis)
• found around the great lakes (Wisconsin is worst state), and Ohio-Mississippi river valley
• TX: Itraconazole or Amphoteracin B

Question 7

Chikungunya fever

Answer 7

• in Caribbean, central/south America, Tropical regions of Africa, and South Asia
• vector is Aedes mosquito (same as Dengue)
• high fevers, POLYARTHRALGIAS, maculopapular rash, headache, myalgia, conjunctivitis, LYMPHOPENIA, thrombocytopenia, bump in liver enzymes
• tx=supportive

Question 8

Hypoparathyroidism causes

Answer 8

1) post-surgical (commmonest
2) autoimmune
3) DiGeorge
4) Defective Ca2+ sensing receptor on parathyroid glan
5) Destruction by something like hemochromatosis, neck irradiation, or Wilson’s disease

Question 9

Ehrlichiosis

Answer 9

• vector is lone star tick
• found in southeast and south central US
• flu-like illness (high fevers, headaches, myalgia, chills), neurologic sx (confusion), rash is very uncommon (Rocky Mountain Spotted Fever w/out the spots!)
• LEUKOPENIA and THROMBOCYTOPENIA, slightly high transaminases and LDH
• Dx: intracytoplasmic morula in Monocytes or PCR
• TX: Doxycycline. Start this while waiting for confirmatory tests

Question 10

Trichinellosis

Answer 10

• get it from eating undercooked meat (typically pork)
• gastric acid releases larva that invade intestinal mucosa (may or may not get intestinal sx) and develop into worms. Larva released 4 wks later and migrate to striated muscle… then form cysts.
• Muscle stage: muscle pain, fever, subungual splinter hemorrhages, PERIORBITAL EDEMA, EOSINOPHILIA, high CK.