pediatric infectious disease

Question 1

t cell independent responses are weak until

Answer 1

2 years of age - poor response to encapsulated bacteria with polysacharides

Question 2

maternal igG starts at

Answer 2

28 weeks gestation

Question 3

fever in children < 3 yrs of age

Answer 3

minor self-resolving viral

Question 4

2 day old infant with fever

Answer 4

FULL WORK UP

Question 5

0-3 month old toxic infant

Answer 5

full septic work up, empiric abx

Question 6

Common infections (Bacteria) perinatally

Answer 6

• GroupB strep
• Ecoli, gram negative enteric (1)
• Listeria

Question 7

Common infections (viral) perinatally

Answer 7

HSV

Entero/parechovirus

Question 8

If infant is toxic, NO meningitis

Answer 8

• give Ampicillin + gentamicin Or cefotaxime

Question 9

If infant is toxic, YES meningitis

Answer 9

• Ampicillin (for listeria) + cefotaxime

Question 10

group B strep can cause (early onset) < 7 days

Answer 10

• Pneumonia
• septicemia
• meningitis

Question 11

group B strep can cause (LATE onset) > 7 days

Answer 11

• vertical or horizontal transmission
• Meningitis
• osteomyelitis
• soft tissue infection
• sepsis

Question 12

managing group B strep Abx?

Answer 12

amp +/- gentamicin IV 2-3 weeks

Question 13

maternal Abx for GBS

Answer 13

• Penicillin G q 4hrs until delivery

or Amp

Question 14

sufficient prophylaxis is

Answer 14

4 hours or more prior to delivery

Question 15

clinical manifestations of HSV -

Answer 15

• skin eye mouth (45%) (day 10)

- neurological (2nd week days 16 -19)/disseminated disease - may not have skin manifestation

Question 16

Tx duration for isolated mucocutaneous HSV

Answer 16

• 2 weeks

- 3 weeks disseminates or CNS

Question 17

3 week infant fever x 12 hours

Answer 17

Full septic work up and empiric therapy

Question 18

risk of serious bacterial infection in neonates with no risk factors is

Answer 18

3-6%

Question 19

2 month old with fever and irritability 24 hours

Answer 19

outpatient management if low risk -

discharge - close follow up

Question 20

Common bacterial infections 1-3 month old

Answer 20

• group B strep
• E coli
• Listeria
  INCLUDE environmental
• strep pneum
• N. meningitidis
• Staph aureus
• GAS

Question 21

Low risk criteria for serious infection in 1-3 month old

Answer 21

• previously healthy/term infant
• Non-toxic
• No focal infection
• peripheral leukocytes 5- 15
  urine < 10 WBCper high field
  Stool < 5 WBC per high field

Question 22

3-36 month old infants - infections

Answer 22

occult bacteria - strep pneump, N. meningitidis

HIB and Pneumococ - vaccines - less seen

Question 23

Fever in 3 - 36 month olds non-toxic

Answer 23

1) - acetaminophen monitor 2 days

2) higher UTI risk in males - consider cbc AND BLOOD CULTURES if not immunized

Question 24

empiric Abx for 0-28 days old

Answer 24

No meningitis - Amp+ gentamicin

Yes meningitis - Amp + cefotaxime

Question 25

29-90 days empiric Abx

Answer 25

No meningitis - Amp + cefotaxime | Yes meningitis - Amp + cefo +/- VANCO

Question 26

3- 36 months

Answer 26

No meningitis - Cefuroxime/Cefotaxime | YES meningitis - Cefotaxime + VANCO

Question 27

Vancomycin mostly for

Answer 27

resistant strep pneumo

Question 28

4 year old boy fever, headache, lethargy x24 hrs, nuchal rigidity, UTIs in classs

Answer 28

strep pneumo infection > 3 months

Question 29

normal WBC count

Answer 29

5-15

Question 30

3 month old with poor suck, constipation, afebrile but lethargic and FLOPPY

Answer 30

- Full septic work up! and empiric Abx -

Question 31

what do you do for Botulinim toxin in infants?

Answer 31

- supportive care | Abx NOT helpful, aminoglycosides can exacerbate Sx

Question 32

15 year old, fever cough, lethargic, hypotensive, elevated ddimer, elevated Serum creatinine and liver enzymes

Answer 32

- Group A strep | Toxic shock syndrome

Question 33

managing toxic shock

Answer 33

- iv fluids - Inotropes - Penicillin and CLINDAMYCIN IVIG

Question 34

strawberry tongue or tonsils

Answer 34

strep pyogenes

Question 35

newborn infant - hepatosplenomegaly and petechial rash and thromboytopenia

Answer 35

- CMV common cause of acquired hearling loss Majority ASYmptomatic at birth

Question 36

congenital CMV can cause

Answer 36

- chorioretinitis | - periventricular calcification/brain atrophy

Question 37

Osteomyelitis/periostitis can be due to

Answer 37

Syphilis infection

Question 38

Cicatrical scars, and limb hypoplasia can be due to

Answer 38

Varicella zoster

Question 39

Cataracts, blueberry muffin rash

Answer 39

Rubella

Question 40

Hepatosplenomegaly Chorioretinitis CNS calcifications can be due to

Answer 40

Toxoplasmosis

Question 41

4 month old - dry cough - tachypneic hypoxemic inspiratory crackles

Answer 41

positive for pneumocystis and CMV