W12_09 pediatric infectious diseases 2 Flashcards Preview

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Flashcards in W12_09 pediatric infectious diseases 2 Deck (19):
1

what's the most common etiology of meningitis in children > 90 days

strep pneumo;
n.meningitidis

2

note: you can't do nuchal rigidity testing in really young children because they're often all over the place

ok;
if they "look" sick, consider LP

3

what's the first line therapy for meningitis in neonates?

ampicillin + cefotaxime

4

what's the first line therapy for meningitis in 1-3 mo children?

ampicillin + cefotaxime + vancomycin

5

what's the first line therapy for meningitis in >3 mo children?

ceftriaxone + vancomycin (for strep pneumo resistance)

6

recall botulism

toxin inhibits acetylcholine release by binding to the presynaptic membrane

7

what are the three manifestations and etiologies of botulism?

food-borne, where the toxin is preformed;
wound botulism, where a wound gets spores;
infant botulism, where the baby ingests spores

8

note: the presentation of infant botulism is nonspecific.

floppy child is the most common. Diagnosis can be easily missed

9

can you use antibiotics for botulism in babies?

no, not helpful, and aminoglycosides will make it worse

10

what's the pathogenesis of streptococcal toxic shock?

superantigen-mediated disease where there's nonspecific activation of T cells, then cytokine storm

11

what's the management for streptococcal toxic shock?

antibiotics (penicillin, clindamycin);
IVIg

12

what's the most common congenital infection?

CMV infection (0.5-1%)

13

what does congenital CMV infection cause?

hearing loss;
microcephaly, CNS calcifications, mental retardation;
chorioretinitis;
hepatosplenomegaly, thrombocytopenia

14

how does congenital CMV typically occur?

mothers have two kids, one in daycare is infected with no symptoms. Passes it to mother, who also has no symptoms. Then mother passes it to the newborn

15

what's the treatment for congenital CMV infection?

ganciclovir

16

blueberry muffin rash is indicative of what?

rubella

17

what kind of antiretroviral therapy is given for prevention of perinatal HIV transmission?

triple ART starting in second trimester;
intravenous zidovudine during labour;
six weeks of zidovudine to infant

18

when to do C-section for prevention of perinatal HIV transmission?

if VL > 1000 copies/mL

19

can you breast feed when the mother is HIV positive?

Canada recommends against it - use formula

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