Paediatric ID 2

Question 1

What is the infective period for measles?

Answer 1

5 days either side of the rash

Question 2

What are the causes of macular star/neuroretinitis?

Answer 2

• Toxoplasmosis
• Syphillis
• Lyme
• Cat scratch (Bartonella)

Question 3

Which serological finding in patients with hepatitis B

indicates active viral replication?

Answer 3

HbeAg

Question 4

What is the seafood-associated diarrhoea?

Answer 4

Vibrio - supportive management only

Question 5

What organism has intrinsic aminoglycoside resistance?

Answer 5

Salmonella

Question 6

What does the aedes aegypti mosquito transmit?

Answer 6

• Dengue
• Zika
• Chikungunya
• Yellow fever

Question 7

How many rotavirus strains are present in Rotarix?

Answer 7

One

Question 8

In SSSS where is the cleavage plane in the skin?

Answer 8

• superficially in the stratum granulosum layer of the skin

- biopsy will show cleaveage in granular layer with no inflammatory cell infiltrate

Question 9

Which serotype of parechovirus causes the most serious infections?

Answer 9

• parechovirus serotype 3

- hot red angry baby

Question 10

How do macrolides work?

Answer 10

Bind to 50s ribosomal unit to inhibit protein synthesis

Question 11

How do antifungals work?
• Polyenes (e.g. amphotericin B)
•Azoles (e.g. fluconazole, vori)
•Echinocandins (e.g. caspofungin)

Answer 11

• POlyenes POke holes in cell membranes
• AzOLes interfere with cell membrane function by inhibiting sterOL synthesis
• EchINocandins INhibit cell wall synthesis

Question 12

What do we use aztreonam for?

Answer 12

Gram negatives that aren’t ESBL

Question 13

Aminoglycoside efficacy is dependent on…?

Answer 13

C max/Mic

Question 14

B-lactam efficacy is dependent on…?

Answer 14

T>MIC

Question 15

Vancomycin efficacy is dependent on…?

Answer 15

AUC/MIC

Question 16

What does the anopheles mosquito transmit?

Answer 16

Malaria

Question 17

What is leishmaniasis transmitted by?

Answer 17

Sandflies

Question 18

What is Lyme disease transmitted by?

Answer 18

• Ixodes ticks
• USA
• If you tick check and remove within 24hrs, you shouldn’t get Lyme

Question 19

How does HUS happen with STEC?

Answer 19

ENDOtoxin binding to renal vessel epithelium

Question 20

What are exotoxins?

Answer 20

• potent protein toxins secreted by any type of bacteria,

Question 21

The most common clinical manifestation of atypical cat-scratch disease is:

Answer 21

Parinaud Oculoglandular Syndrome (unilateral granulomatous follicular conjunctivitis associated with ipsilateral regional lymphadenopathy)

Question 22

If you have persistent diarrhoea in CVID think…

Answer 22

Giardiasis

Question 23

H. pylori is often resistant to…

Answer 23

• macrolides - clarithromycin

Question 24

Cleaved lymphocytes on a blood film with lymphocytosis may mean:

Answer 24

Pertussis!

Question 25

Which type of influenza exhibits antigenic shift?

Answer 25

A

Question 26

How long does natural immunity to influenza last?

Answer 26

4 years

Question 27

Which subtype of influenza is more likely to cause myalgias?

Answer 27

B

Question 28

Which diseases are associated with cold haemoglobinuria/Donath-Landsteiner antibodies?

Answer 28

- Measles vaccination/MMR (the viruses) - Mycoplasma pneumoniae - Haemophilus influenzae and various other viruses - Syphilis, especially congenital and tertiary syphilis

Question 29

Where does brucellosis come from?

Answer 29

Livestock (goat, cattle, sheep, pig) and dogs, occasionally seals

Question 30

Which antibiotic is most likely to give you lupus?

Answer 30

Minocycline

Question 31

What is the cutpoint for LTBI on a mantoux?

Answer 31

≥10mm if 5-14yo+/-BCG, prev BCG <5yo | ≥5mm if <5yo, immunosuppressed, close contact with Tb

Question 32

What are the pertinent side effects of typical Tb treatment?

Answer 32

- Rifampicin: orange body secretions, hepatitis 1%, leukopenia/thrombocytopenia, rash - Isoniazid: peripheral neuritis, hepatitis - Ethambutol: retrobulbar neuritis - Pyrazinamide: joint pain, itch

Question 33

What are the pertinent side effects of zidovudine?

Answer 33

- Zidovudine is a NRTI - Nausea/vomiting - Myopathy - Anaemia/granulocytopaenias (e.g. neutropaenia, low basophils/eosinophils)

Question 34

Which antibiotics give you fixed drug eruptions?

Answer 34

- Sulfonamides most likely - but can get with others e.g. doxy - round/oval, dusky erythematous macules 6-48 hours after administration. - characteristically recurs at the same site with each subsequent exposure to the same drug - May be bullous - May be painful/itchy/burning and get fevers

Question 35

What antibiotics make you have seizures?

Answer 35

- Imipenem (+other carbapenems) - Neurotoxicity 1st-4th generation cephalosporins e.g encephalopathy to non-convulsive status epilepticus, higher risk if renal impairment. - Non-convulsive status epilepticus has been reported frequently with cefepime, also you die more if you're neutropaenic and on cefepime (no cause found)

Question 36

Which antibiotic has been associated with idiopathic intracranial hypertension?

Answer 36

- Doxycycline

Question 37

What cells are the PRIMARY driver of nodule formation in a positive tuberculin skin test reaction?

Answer 37

- Macrophages

Question 38

What do you treat hydatid disease with?

Answer 38

- echinococcosis - albendazole