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132 Cards in this Set

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incubation of varicella.
14-16 days. 28 days who receive VZIG
treatment for entamoeba histolytica
metronidazole
flucytosine
adjunct for cryptococcus and candida severe infections. Like rifampin has lots of resistance, must be used with ampho
Rx for invasive pulm aspergillosis
ampho.
Rx for gc/chlamyd
azithromycin, ceftriaxone.
complications of measles
pneumonia. most deaths from measles are from pneumonia. encphalitis is less common but is more common in older kids. Few die from enceph but many have perm damage.
skinned rabbit, think and treat
Yersinia. from flea bites. lymphadenitis regional (near bites), fever. Streptomycin
community acquired celluluits from varicella. treat
nafcillin/oxcillin
highest risk factor for transmitting Hep B
e antigen positive.
complications of mumps
meningeal signs, arthritis, thyroiditis, orchitis, hearing problems. test for mumps in parotitis
most common org in peritonitis from chronic dialysis
Staph epi and Staph aureus.
early signs of Lyme
erythema migrans. 90% of patients ahve rash. 1-2 weeks after tick bite. lasts for 1-2 weeks.
seventh nerve palsy think
early Lyme
timing of arthritis in Lyme
late. wks to months after infection. knees.
giardia Rx
metro
ALL patient with high fever, herpetic lesions, deep seated and umbilicated, palms and soles
varicella. HSV is grouped not generalized.
risk from MMR vax in 1st trimester
risk is congenital rubella syndrome. no cases reported from MMR. theoretical risk 1%. pregnant after 3 months from vax is completely safe.
pertussis duration and complications
6-10wks, sz, pneumonia, encephalopathy, death
treatment of household with pertussis
erythromycin for all household contacts, irrespective of age or vaccination status.
cipro modifies which drugs
theophylline
How many months do you have to wait for HIV Ab to revert to neg in a baby that has HIV+ mom but has no HIV infection
18 months.
Rx for varicella exposed immunocomprimised patient
VZIG withing 96hrs.
chemoprophylaxis for malaria
1 week before travel. chloroquine. Mefloquine if going to sub-saharan africa (chloroquine resistant)
meningococcal vax covers which goups
A, C, Y, W. none for B
at risk groups who need meningococcal vax
>2yrs. asplenia, copmlement def.
Hep A IG can prevent hep A if given within 2 wks of exposure. who gets it?
only direct contacts. If in child care with diapers, give to all kids and all employees.
who gets invasive aspergillus
immunocompromised pt. bone marrow is most likely. allergic bronchopulmonary aspergillosis is noninvasive.
Don't treat salmonella enteritis in
chronic carriers. usually self-limited illness. most cases are <1yr old. Give Abx if <3mo, bacteremia, invasive disease, hemoglobinopathyies.
lab detection of arboviruses
serology. acute and convalescent titers of IgG
ulcerated tick bite, fever, chills, regional adenopathy
tularemia
Tularemia labs
serology for Francisela tularensis.
ticks or rabbit exposure, flu
tularemia
patients who get worse EBV infections
cell-mediated immune system disorders. T-cell disorders
SE of chronic fluconazle
GIsx.. LFTs elevated
penicillin mech of action
disrupts cell wall synthesis. no cross linking of peptidoglycans
how to manage Hep B exposure in a fully immunized pt
check anti-HBs. If positive, do nothing, if neg give another hep B vax
animals in whom to suspect rabies
unknown cat, bats, raccoons, skunk, fox, coyote
management of rabies suspected bite
wash well. HRIG injected around wound within 7 days. vaccine 4 times within first 4 weeks
when to give TD
every 10 yrs. give if wound is complex and no vax within 5. TIG is only for bad wound and incomplete primary series of IZ
2 week old diffuse vesicobullous lesions
congenital syphilis
HS megaly, mildly preterm infant, IUGR, lymphadenopathy, chorioretinitis. intracranial Ca, hydrocephalus
Toxo
TORCH with cataracts
rubella > toxo
TORCH with heart defect
Rubella
TORCH with hydrocephalus
toxo
TORCH with microcephaly and anemia
CMV
TORCH with intracranial Ca
toxi, CMV
TORCh with thrombocytopenia
CMV
7yr old, fever, headache, edema, palpable purpura, early Spring
Rocky Mountain spotted fever
recent transplant, pneumonia
CMV from the transplant
3 yr old fever, abdom pain, wheeze, urticaria, HSmeg, lymphadenopathy, eosinophilia
toxocariasis. round worm from dog or cat.
when to give VZIG
within 72hrs of exposure to immunocprimised. If receiving monthly IVIG, no need.
risk factor for hepC
transfusions, IV drug, hemodialysis. perinatal transmission is low.
late onset GBS sites
meningitis.
conjunctivitis, cervical adenopathy lasting weeks
Bartonella henselae
bad complication of VZ in immunocomprimised
pneumonia
most common complication of mumps in young child
meningitis. orchitis is common only after puberty.
PPD + sib of INH resistant TB, Prophylaxis
Rifampin alone
etiology of atypical pneumonia in teen
Mycoplasma. viral and bacterial causes less likely.
Abx causing fever, morbilliform rash, neutropenia
bactrim
drugs that suppress bone marrow
chloramphenicol, sulfonamides, anticonvulsants.
Initial therapy for fever, neutropenia
gram+ and Gram -. with pseudomonas covered. aminoglycoside + anti-pseudo abx, meropenum
IVIG SE
fever, chills, headaches. rarely hypotension, shock.
reasons to not give further doses of DTaP
anapylactic reaction. encephalopathy within 7 days,
PPD neg with known TB
severe disseminated TB has sufficiently immunesuppressed the response.
6yr old, tick bite, HA, photophobia, myalgia, HSmeg, pancytopenia
ehrilichiosis. A ricketsial infection similar to RMSF but with more leukopenia and pancytopenia. Rash is not as common.
Malaria like illness, anorexia, high fevers, chills, myalgia, arthralgia.
Babesiosis (parasite)
ketoconazole common SE
nausea.. can also increase LFTs
CMV retinitis Rx
gancyclovir, if recurs foscarnet
immunocomprimised. pneumonitis and retinitis
CMV
VZ maternal infection 1st tri, sx
2% risk of congeintal VZ. limp hypoplasia, eye, brain abnormal, skin lesions.cataracts, chorioretinitis
Viruses which can be cultured
CMV, HSV, enterovirses, respiratory viruses
mono rash from Abx, which Abx
ampicillin, less so amox, less augmentin
organism in nephrotic S peritonitis
Strep pneumo
fever, tachycardia, low BP
myocardial vs pericardial disease. pulsus paradoxus favors pericardial.
treatment of RMSF or Ehrlichiosis
Tetracycline for any rickettsiae.
<4yrs old exposed to active TB
PPD, CXR. INH if ppd (-), retest in 12 weeks. INH for at least 9 months
SCC pneumococcus prevention
oral penicillin prior to age 4mo.. Prevnar and later pneumococcal im
when does C3 return to normal after post strep gmn
6-8weeks. if still low at 10weeks work up for something else.
MMR not to be given to
pregnant women. Or planning to be in 4 months. immunocomprimised, not including healthy HIV. OK for breastfeeders. OK for egg allergic.
signs of anaphylaxis in IVIG
IgA deficiency. most common immunodef. often unknown. Presence of IgA provokes anaphylaxis. IVIG has a small amount of IgA. Same problem to blood products.
timeline for maternal varicella
<20wk gestation 2% risk for congenital VZ
>20wk sensitized without problem up to:
5 days prior to delivery to 2 days after (in mother) infant at risk for primary VZ
who gets VZIG
exposure of suseptible household contact or playmates
mother has onset 5 days prior to 2 days after delivery, then give to baby.
potential complication of EES therapy in <6wk old
hypertrophic pyloric stenosis.
who gets pertussis prophylaxis
household and close contacts of known patient
Pertussis prophylaxis in classmates
no Abx, give IZ if not up to date.
At what age do you discontinue pen prophylaxis for sickle cell
5yrs
fever, sweats, weakness, lymphadenopathy, (flu-like) unpasteurized milk
brucellosis. doxycycline
flu-like illness, conjunctivitis, no pus, can have jaundice, rash. Myalgias of calf and back.
Leptospirosis
Treatment of Lepto, complications
Penicillin. jaundice, renal failure, hemorrhagic pneumonitis
Lepto, where do you get it?
animal urine, mucosa or abraded skin, wacontminated water, veterinarians, famers, sewer workers
flu-like illness, painful maculopapular lesion with regional lymph adenitis
Tularemia
tularemia Rx and epi
Streptomycin, rabbits, domestic animlas, tick and mosquito bites from these animals.
fever, leuikocytosis, eosinophilia, hepatomegaly
toxocariasis. roundwroms of dog and cat. get from eating contaminated soil. mebendazole
seizures, pork
cysticcercosis, taeniasis. forms cysts anywehere. . one adult worm in intesine, larbae cause the illness. months to years between ingestion and sx.
school exposure to VZ
if not immunized do so within 72 hrs
meningococcus prophylaxis
household contacts, childcare congacts, including 7 days prior to onset. Rif for kids, cipro for adults
Salmonella return to school crit
24hrs no diarrhea if >5yrs. 3 neg stool cx if <5yrs test all in school
TB in healthcare worker
PPD+, CXR neg, INH alone
PPD+, CXR+, therapy, no work until cough gone and sputum neg x 3
best test for HSV encephalitis
PCR of CSF
best time to measure Gent Peak
1hr after infusion
tests for congenital rubella
IgM or IgG over time
TORCH with calcifications on head CT
diffuse = toxo
periventricular = CMV
PPD>15mm withhx of BCG
+ PPD, if CXR - treat with INH
who is PPD + at 5mm
close contact has active TB, clincal signs of TB, CXR shows signs of TB
PPD + at 10mm
<4yrs, immunocopm, increased exposure to TB
intial treatment of dental abscess
pen VK oral
gentamycin peak and trough
peak 5-12, trough 0.5-1
chloramphenicol SE
rare dose independent aplastic anemia. dose dependent bone marrow suppression. check CBC twice weekly
rifampin drug interactions
OCPs don;t work as well
warfarin, digoxinm, chloramphenicol all affected
meorpenem use and SE
resistant enterobacter. Long time in PICU, suddenly worsened. increased risk of seizures
amantadine, rimantadine, oseltamivir
oseltamivir keds to 1yr flu A or B
Rimantadine amantadine: flu A
ganciclovir SE
anti-CMV for immunocomprimised or congenital. bone marrow suppression is most common.
foscarnet use and SE
acyclovir resistant herpes viruses, nephrotoxic
ampho Se
low K, nephrotoxicity, rigors
ketoconazole, use and SE
GI SE, most dangerous is hepatic failure.
EBV labs
primary infection goes to B cells, lifelong latent infection established.
EBV capsid Ag. IgG rises quickly, IgM + in acute
EBV nuclear Ag takes weeks to months to see.
contagious period for VZ
1-2 days before rash until lesions crusted
measles contagious period
4 days on either side of rash.
incubation for measles
8-12days
neonate, septic, rash: 1-2mm light papules
Listeria
Staph aureus is different than other staph in what way
coagulase +
animal bite bacteria
Pasteurella, penicillin
human bite bacteria
eikenella
treatment of primary Lyme
doxcycline. amoxicillin for kids younger than 8.
Camping trip Colorado, fever, painful unilateral lymphadenitis
Yersinia pestis, bubonic plague
bacterial diarrhea associated with animal contact or uncooked meat
Yersinia. self limited in most
H. pylori Rx
only treat in patients with EGD proven ulcers. amox, metro, bismuth
HUS signs
pallor, oliguria, hematuria
types of acid fast stain
Kinyoun and Ziehl-Neelson
treatment for amebiasis
iodoquinol
treatment for ascaris
vague GI sx, chronic low level infectino. mebendazole
treatment for schistosomiasis
praziquantel