Kaplan Pediatrics: Chapter 11 Infectious Disease

Front 1

_______ may be given to the pt who APPEARS WELL, but has no source for fever & has a WBC COUNT > 15,000

Back 1

Ceftriaxone

Front 2

If meningitis with S. pneumoniae is a possibility, then _____ should be added to the regimen

Back 2

Vancomycin

Front 3

What are the 3 bacteria that MCC Meningitis in patients < 3 months of age?

Back 3

GBS

L. monocytogenes

E. coli

Front 4

What are the 3 MCC of Meningitis in pts > 3 months old?

Back 4

N. meningitides

S. pneumoniae

HiB

Front 5

Patients with CSF shunt infections may have _______ infections

Back 5

S. epidermidis

Front 6

Pts with Sick Cell Disease & CSF leaks are prone to _______ infections

Back 6

Pneumococcal

Front 7

What is the Brudzinksi sign?

Back 7

involuntary flexion of the knees & supine hips after flexion of the neck while supine

Front 8

What is the Kernig Sign?

Back 8

flexion of the hip 90 degrees with subsequent pain on extension of the leg

Front 9

Data suggest that the administration of ________ given to kids > 6 wks w/ acute bacterial meningitis may reduce the incidence of hearing problems, decrease fever, & lower CSF protein & lactate levels

Back 9

IV Dexamethasone

Front 10

When does Aseptic Meningitis usually occur?

Back 10

Summer & Fall

Front 11

When is the only time when Aseptic Mengitis is treated?

Back 11

HSV = acyclovir

Front 12

What drug is given to family contacts of pts with HiB & N. meningitides Meningitis?

Back 12

Rifampin

Front 13

Pts with Sickle Cell disease are predisposed to these 2 pathogens that can cause Osteomyelitis

Back 13

S. auerus

Salmonella

Front 14

________ infections may be associated with puncture wounds of the foot thru a sneaker causing Osteomyelitis

Back 14

P. aeruginosa

Front 15

A 12-month old infant presents to the physician with the CC of refusing to bear weight on his left lower extremity. The mother states that the child had an ear infection 1 wk ago. The patient was prescribed Abx, but the mother states she did not fill the prescription

Back 15

Osteomyelitis

Front 16

What is done to confirm the diagnosis Osteomyelitis?

Back 16

Periosteal Bone Cx

Radiographs turn + after 10-14 days, showing soft tissue swelling & periosteal elevation

If radiographs are negative, but there is still a suspicion, then an MRI should be performed as the next step

Front 17

What are the best ways to determine response to therapy of Osteomyelitis treatment?

Back 17

ESR & C-reactive protein

Front 18

How long is treatment for Osteomyelitis?

Back 18

4-6 wks

Front 19

A 5-yr old presents with fever, knee pain, & a limp. On physical examination the knee is red, warm, & swollen. Full ROM of the knee is not possible on physical exam

Back 19

Septic Arthritis

Front 20

In newborns, what bacteria are important agents of septic arthritis?

Back 20

S. aureus

GBS

Gram-negative bacilli

Front 21

What is the cause of Whooping Cough = forceful inspiratory gasp (whoop) after a paroxysmal cough

Back 21

B. pertussis

Front 22

What are the 3 stages of Pertussis?

Back 22

Catarrhal: lasts 1-2 wks & consists of rhinorhea, conjunctival injection, & cough

Paroxysmal: lasts 2-4 wks & consisting of coughing spasms, insiratory whoop, & facial petechiae

Convalescent: lasts 1-2 wks w/ decreased frequency of symptoms

Front 23

What does a CBC show in Pertussis Whooping Cough?

Back 23

Leukocytosis caused by absolute Lymphocytosis

Front 24

What is the treatment for Pertussis infection?

Back 24

Supportive Care

ERYTHROMYCIN shortens the period of communicability
-family members should recieve for 14 days
-does not affect duration of Paroxysmal stage

Front 25

Lyme disease
1. bacteria
2. vector

Back 25

1. B. burgdorferi
2. Ixodes scapularis = deer tick

Front 26

What is the presentation of Lyme Disease?

Back 26

Early localized disease = Erythema Migrans = red-raised border with central clearing

Early disseminated = Neurologic & Cardiac
-Neurologic = "aseptic meningitis", Bell palsy, neuropathy
-Cardiac = myocarditis, heart block

Late = Arthritis

Front 27

What is the treatment for Early disease Lyme Disease?

What is Rx for Disseminated dx?

Back 27

Doxycycline or Amoxicillin
-kids <8 yo should not receive Doxy

Ceftriaxone or Penicillin G

Front 28

What is the MC complication of Measles infection?

Back 28

Otitis Media

Pneumonia & Encephalitis are other major complications

Front 29

A 15-month-old infant is brought to the physician b/c of a RASH. The mother states that the pt had a FEVER of 104 F for the last 3 DAYS without any source of infection. She explains that the ever has resolved, but now the child has pink, slightly raised lesions on the trunk, upper extremities, face, & neck

Back 29

Roseola = HSV-6

Front 30

Explain the rash in Roseola

Back 30

Before the rash physical findings are minimal but may include mild URI signs such as rhinorrhea & conjunctival redness. Occipital Lymphadenopathy may be found

Rash is rose colored & begins on the trunk & spreads to the neck, face, & proximal extremities

Front 31

A 5 yo kid has low-grade fever, pinpoint rash, postoccipital & retroauricular lymphadenopathy, & rose spots on the soft palate

Back 31

Rubella

Front 32

How does the RMSF rash present?

Back 32

begins on the extremities & spreads to the entire body, including the palms & soles, & which turn into petechiae

Front 33

What is the treatment of choice for RMSF?

Back 33

Tetracycline or Doxycycline
-chloramphenicol for pts able to take tetracycline

Front 34

What are the complications if RMSF is not treated?

Back 34

-Death
-Vasulitis = gangrene of digits, ear lobes, nose, scrotum, or entire limbs
-Meningoencephalitis

Front 35

a 5 year old child is brought to the emergency center b/c he has a temperature of 102 F & is developing a pruritic rash. Rash appears to be in various stages of papules, vesicles, & crusts. It began on his trunk & spread to his extremities

Back 35

Varicella = chicken pox

Front 36

What is the cause of Whooping Cough = forceful inspiratory gasp (whoop) after a paroxysmal cough

Back 36

B. pertussis

Front 37

What are the 3 stages of Pertussis?

Back 37

Catarrhal: lasts 1-2 wks & consists of rhinorhea, conjunctival injection, & cough

Paroxysmal: lasts 2-4 wks & consisting of coughing spasms, insiratory whoop, & facial petechiae

Convalescent: lasts 1-2 wks w/ decreased frequency of symptoms

Front 38

What does a CBC show in Pertussis Whooping Cough?

Back 38

Leukocytosis caused by absolute Lymphocytosis

Front 39

What is the treatment for Pertussis infection?

Back 39

Supportive Care

ERYTHROMYCIN shortens the period of communicability
-family members should recieve for 14 days
-does not affect duration of Paroxysmal stage

Front 40

Lyme disease
1. bacteria
2. vector

Back 40

1. B. burgdorferi
2. Ixodes scapularis = deer tick

Front 41

What is the presentation of Lyme Disease?

Back 41

Early localized disease = Erythema Migrans = red-raised border with central clearing

Early disseminated = Neurologic & Cardiac
-Neurologic = "aseptic meningitis", Bell palsy, neuropathy
-Cardiac = myocarditis, heart block

Late = Arthritis

Front 42

What is the treatment for Early disease Lyme Disease?

What is Rx for Disseminated dx?

Back 42

Doxycycline or Amoxicillin
-kids <8 yo should not receive Doxy

Ceftriaxone or Penicillin G

Front 43

What is the MC complication of Measles infection?

Back 43

Otitis Media

Pneumonia & Encephalitis are other major complications

Front 44

A 15-month-old infant is brought to the physician b/c of a RASH. The mother states that the pt had a FEVER of 104 F for the last 3 DAYS without any source of infection. She explains that the ever has resolved, but now the child has pink, slightly raised lesions on the trunk, upper extremities, face, & neck

Back 44

Roseola = HSV-6

Front 45

Explain the rash in Roseola

Back 45

Before the rash physical findings are minimal but may include mild URI signs such as rhinorrhea & conjunctival redness. Occipital Lymphadenopathy may be found

Rash is rose colored & begins on the trunk & spreads to the neck, face, & proximal extremities

Front 46

A 5 yo kid has low-grade fever, pinpoint rash, postoccipital & retroauricular lymphadenopathy, & rose spots on the soft palate

Back 46

Rubella

Front 47

How does the RMSF rash present?

Back 47

begins on the extremities & spreads to the entire body, including the palms & soles, & which turn into petechiae

Front 48

What is the treatment of choice for RMSF?

Back 48

Tetracycline or Doxycycline
-chloramphenicol for pts able to take tetracycline

Front 49

What are the complications if RMSF is not treated?

Back 49

-Death
-Vasulitis = gangrene of digits, ear lobes, nose, scrotum, or entire limbs
-Meningoencephalitis

Front 50

a 5 year old child is brought to the emergency center b/c he has a temperature of 102 F & is developing a pruritic rash. Rash appears to be in various stages of papules, vesicles, & crusts. It began on his trunk & spread to his extremities

Back 50

Varicella = chicken pox

Front 51

A mother brings her 4 yo child to the physician with hx of Anal itching. The pt attends day care, & you are told that the child's favorite activity is playing in the sandbox

Dx?
Diagnostic tests?
Rx?

Back 51

Enterobiasis = Pinworms
Cellophane tape test
Albendazole, Mebendazole, Pyrantel pamoate

Front 52

A patient is brought to the physicians office b/c the mother found a worm in the diaper

Back 52

Ascariasis

Front 53

A 5 yo presents w/ complaint of anorexia, ab pain, & diarrhea. The pt is noted to have a yellow-green pallor

Back 53

Hookworm = Ancylostoma duodenale, Necator Americanus