Nelson - Ch. 182 S. pneumoniae

Question 1

Hemolysis pattern of S. pneumoniae

Answer 1

Alpha

Question 2

T/F S. pneumoniae: Bile soluble

Answer 2

T

Question 3

T/F S. pneumoniae: Optochin sensitive

Answer 3

T

Question 4

Reaction that demonstrates the capsule of S. pneumoniae

Answer 4

Quellung

Question 5

T/F Conjugated PCV protect against pneumococcal colonization

Answer 5

T

Question 6

T/F Pneumococcal polysaccharide vaccine protects against pneumococcal colonization

Answer 6

F

Question 7

Rates of pneumococcal carriage peak when

Answer 7

1st and 2nd year of life

Question 8

MC cause of bacteremia, bacterial pneumoniae, otitis media, and bacterial meningitis in children

Answer 8

S. pneumoniae

Question 9

Children at increased risk of pneumococcal infections

Answer 9

1) Sickle cell disease 2) Asplenia 3) Humoral (B cell) and complement-mediated immunodeficiency 4) HIV infection 5) Certain malignancies 6) Chronic heart, lung, or renal disease 7) CSF leak 8) Cochlear implants

Question 10

T/F Males are at increased risk for invasive pneumococcal infections than females

Answer 10

T

Question 11

An important cause of secondary bacterial pneumonia in patients with influenza

Answer 11

S. pneumoniae

Question 12

Invasive pneumococcal infection is highest in what age group

Answer 12

Less than 2, antibody production to most pneumococcal serotypes is poor

Question 13

Increased frequency of pneumococcal disease in asplenic persons is related to

Answer 13

1) Deficient opsonization 2) Absence of clearance by the spleen of circulating bacteria

Question 14

Children with sickle cell disease have increased frequency of pneumococcal disease because

Answer 14

1) Deficit in antibody-INDEPENDENT properdin (alternative) pathway of complement activation 2) Functional asplenia

Question 15

T/F With advancing age, children with sickle cell disease produce anti capsular antibody, augmenting antibody-dependent opsonophagocytosis and greatly reducing the risk of severe pneumococcal disease

Answer 15

T

Question 16

Immunodeficiency associated with recurrent pyogenic infection

Answer 16

Complement

Question 17

T/F Cultures of nose and throat is helpful for diagnosis of pneumococcal infection in cases of otitis media, pneumonia, and septicemia or meningitis

Answer 17

F

Question 18

Average time to isolation of pneumococcal organisms

Answer 18

14-15hrs

Question 19

Children 1 month of age or older with suspected pneumococcal meningitis should be treated with

Answer 19

Vancomycin (60mkday q6) and high-dose Cefotaxime (300mkday q8) or Ceftriaxone (100mkday q12)

Question 20

Penicillin-susceptible pneumococcal meningitis can be treated with

Answer 20

1) Penicillin or 2) Cefotaxime or Ceftriaxone

Question 21

Penicillin-, cefotaxime- and ceftriaxone-resistant pneumococcal meningitis should be treated with

Answer 21

Vanco + Ceftri or Cefotax, consider adding Rifampin

Question 22

First-line therapy for PCAP in previously healthy, appropriately immunized infants and preschool children with mild to moderate uncomplicated PCAP

Answer 22

Amoxicillin (outpatient), Ampicillin or Pen G (if admitted)

Question 23

First-line therapy for PCAP in not fully immunized infants and preschool children with mild to moderate uncomplicated PCAP

Answer 23

3rd gen Cephalosporin

Question 24

First-line therapy for PCAP in not fully immunized infants and preschool children with life-threatening pneumococcal infection

Answer 24

3rd gen Cephalosporin

Question 25

Alternatives to penicillin in patients with pneumococcal infection with penicillin allergy

Answer 25

1) Clindamycin 2) Erythromycin 3) Cephalosporins 4) TMP-SMX

Question 26

Treatment for otitis media caused by penicillin-resistant strep

Answer 26

Amoxicillin, high dose (80-100mkday)

Question 27

The mortality rate for pneumococcal meningitis is approximately

Answer 27

10%

Question 28

T/F Pneumococcal meningitis results in sensorineural hearing loss

Answer 28

T

Question 29

T/F Pneumococcal meningitis can cause serious neurologic sequelae such as paralysis, epilepsy, blindness, and intellectual deificits

Answer 29

T

Question 30

Pneumococcal prophylaxis in sickle cell disease has been safely discontinued after ___ birthday in children who have received all recommended pneumococcal vaccine doses and who had not experienced invasive pneumococcal disease

Answer 30

5th

Question 31

When is pneumococcal prophylaxis given for children who have undergone splenectomy

Answer 31

2 years after splenectomy up to 5 years of age