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81 Cards in this Set
- Front
- Back
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An infant that is febrile and irritable..what should be in the DDx?
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Meningitis
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What organisms are cause meningitis in 0-1 months olds?
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Group B Strep
E. coli Listeria Monocytogenes |
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What is the treatment?
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Ampicillin and gentamicin or cefotaxime
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What organisms are cause meningitis in 1-3 months olds?
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Group B Strep
Strep. pneumo Listeria mono |
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What is the treatment?
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Ampicillin and cefotaxime
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What organisms are cause meningitis in 3 years old to adult?
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Strep pneumo
Neisseria Meningitis |
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What is the treatment?
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Cefotaxime (vancomycin if bacterial meningitis)
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Aseptic Meningitis
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inflammation of the meninges with a CSF lymphocytic pleocytosis..normal CSF glucse and minimal elevated protien
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Organisms that cause the commmon cold?
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rhinovirus
parainfluenza coronavirus RSV |
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Color of nasal discharge does predict the presence of concurrent sinusitis infection?
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FALSE
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What is the tx for the common cold?
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Adequate hydration is most important...
NO antibiotics needed |
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What organism are common cause of sinusitis?
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S. pneumoniae
H influ M. catarrhalis |
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What are the symptoms of sinusitis?
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Nasal discharge and cough for > 10 days
Headache, malodorous breath, facial pain and low grade fever > 90 day is chronic thing of underlying conditons: CF, immunodef with S. aureus |
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What is the treatment of sinusitis?
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Amoxicillin and clavulanate
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What are the viral and bacterial causes of pharyngitis?
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Viral: Coxsackie, EBV, CMV
Bacterial: Strep pyogenes (group A B hemolytic strep), Coryne diptheriae |
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EBV pharyngitis
- SS |
Tonsilar exudates
enlarged poster cervical lymph nodes hepatosplenomegaly |
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Coxsachievirus pharyngitis
-SS |
painful vesicules or ulcers on the post. pharynx soft palate (herpangina)
- blisters on hand and feet (hand foot and mouth) |
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GABHS pharyngitis
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Exudates on tonsils
petechiae on the soft palate strawberry tongus enlarged tender ant. cervical lymph nodes Fever scarlatiniform rash |
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Dx of GABHS pharyngitis?
Tx: |
Culture (gold standard)
antigen test (rapid strep test) - Tx: penicillin |
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Acute Otitis Media pathogens?
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S. pneumoniae
H. influ Moraxella catarrhalis |
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What is the tx of AOM?
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Amoxicillin
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Pathogen causing OME?
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Pseudomonas
Staph aureus Candida albicnas - see erythema and edma of EAC |
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What is the most successful managment of OME?
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restore the EAC to its natural acidic environment..acetic acid solution
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Cervical lymphadenitis etiology
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Bacteria: S. aureus, S pyogenes, TB, B henselae
Viral: EBV, CMV, HIV (diffuse and persistant) Kawasaki disease T. gondii |
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Parotitis causes
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Bilateral: Mumps, CMV, EBV, HIV
unilateral: S. aures, S pyogenes, TB Tx: is antibiotics |
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What are the pathogen that cause impetigo and what is the treatment?
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S. aureus (most common)
GABHS tx: dicloxacillin, cephalexin or clindamycin |
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What is erysipelas?
Organism clinical features |
skin infection that involves the dermal lypmphatics
- Organism: GABHS -Features: tender, erythematous skin with distinct borders |
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What organism cause cellulitis?
Clinical features Tx |
-Skin infections that occur withing the derms
-cause GABHS and S. aureus - tx: cephalosporins or anti-staph penicillins |
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Staphy Scalded skin syndrome?
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caused Staph aureus
large sheets of skin slough, tender skin (Nikolsky sign is present..extension of bullae when pressure is applied to the skin |
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Scarlet fever
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Exanthem:
- begins on the trunk - feels like sandpaper -skin is erythematous with skin colored papules -patechiae are within skin creases in a linear distribution - Desquamination of skin |
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What is the treatment of scarlet fever
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Penicillin
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What organisms cause TSS
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S. aureus and GABHS
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What is the criteria for TSS?
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Fever > 101
Hypotension Diffuse erythroderma Desquamation occurs 10-14 days multi system involvment negative culture of book , CF and pharynx (except + blood cultures for staph) |
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Cause of bacterial conjunctivitis?
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H. Influ
Strep pneum Moraxella catarrhalis Staph aureus |
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Pharyngoconjunctival fever
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-URT includes pharyngitis, fever and bilateral conjunctivitis
-etiology: adenovirus |
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Epidemic keratoconjunctivitis
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petechial conjunctival hemorrhage, photophobia, keratitis
-management is supportive |
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Primary ocular HSV
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HSV-1
Clinical features: skin eruptions with multiple vesicular lesions Corneal ulcers Tx: systemic or topical acyclovir |
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Blepharitis
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eyelid inflammation
Etiology: Staph aureus -Clinical features: crusting and scales at the eyelash base |
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Infectious Mono
clinical features |
Fever
Malaise and fatigue Pharyngitis Post cervical lymphadenopathy Macular or scarlatiniform rash |
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Infectious Mono
-complications |
- Cranial nerve palsies
-Upper airway obstruction - Amoxicillin ass rash - Splenic rupture - Malignancy |
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Measles
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- very contagious
- 3 C (cough conjunctivitis and coryza) - Koplik Spots (gray papules in mouth) - Exanthem that begins in the neck and them spreads down the chest |
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Rubella
Clincal features |
- prodrome is a mild URT infection
-painful lymphadenopathy - Exanthem: non pruritic maculopapular and confluent |
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Congenital Rubella
Clinical features |
- occurs during the first trimester
Features: thrombocytopenia, hepatosplenomegaly Jaundice purpura (blueberry muffin_ |
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Congenital Rubella
- Structural abnormalities |
congenital cateracts
patent ductus arteriosus sensorineural hearing loss |
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Allergic bronchopulmonary aspergillosis
-Clinical features |
Wheezing
eosinophilia pulmonary infiltrates -mostly in those with chronic lung infections -tx: amphotericin B |
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Coccidiodomycosis
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-found in the southwestern united states
- most are asymptomatic and mild pneumonia |
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Entamoeba histolytica
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- ingestion of cyst from contaminated water and food
- mild colitis to sever dysentery -cramping abd pain, tenesmus and diarrhea (blood and mucous) |
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Entamoeba histolytica
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-Dx: cyst in the stool, serum antibody assay
Tx: metronidazole |
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Giardiasis
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- fecal ingestion of cyst
- drinking contaminated mountain water, day care -ss: localize to small bowel, diarrhea (voluminous, watery, foul smelling) -Dx: cyst and trophozoites in stool and stool ELISA -Tx: metronidazole |
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Toxoplasmosis
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transmission is direct contact with cat feces, placenta
-mono-like illness, malaise, fever, lymphadenopathy, rash -reactive disease: encephalitis, focal brain lesions,seizures Tx: sulfadiazine, pyrimethamine |
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What is the most common cause of infectious chorioretinitis?
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Ocular toxoplasmosis
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Triad of Congenital toxoplasmosis
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1. Hydrocephalus
2. Intracranial calcifications 3. Chorioretinitis |
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Rocky mountain spotted fever
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-caused by rickettsia rickettsii
Clinical features: -Fever -Petechial rash (begins on the extremities) -Myalgias -Hepatosplenomegaly and jaundice LabL thrombocytopenia, hyponatremia |
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Rocky Mountain Spotted Fever
Tx: |
intravenous doxycycline and supportive care
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Cat Scratch Disease
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caused by Bartonella henselae
- Clinical features: regional lymphadenopathy, fever, lymph node is red, warm and tender Dx: serum IgM antibodies |
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IgA Deficiency
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serum IgA con < 7
Clinical features: respiratory infection (sinusitis, pneumonia, OM) atopic disease, rheumatic disease Dx: quantitative measure of serum immunoglobulins **can lead to fatal anaphylactic reaction to blood products and IVIG** contraindicated |
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Common Variable Immunodef
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def: hypogammaglobulinemia with abnormal # of B and T cells
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Severe Combined Immunodef Disease
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group of inherited disorders characterized by defective T and B cells
feature: infection within the first few months of life with opportunistic infection: candida and p carinii persistent lymphopenia absent thymic shadow Dx: decreased serum IgG, IgA and IgM |
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Ataxia Telangiectasia
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AR
combined immunodef cerebellar ataxia oculocutaneous telangiectasias (on the bulbar conjunctiva) High risk malignancy Dx: Quantitative measurement of serum immunoglobulins, |
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Wiskott Aldrich syndrome
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X linked
-combined immunodef -eczema -congenital thromobcytopenia |
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Wiskott Aldrich syndrome
Clinical features |
-susceptablity to infection with encapusulated organisms
-thrombocytopenia with defective platelets -Eczema Dx: decreased IgM and Increased IgA |
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Brutons congenital Agammaglobulinemia
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Def: profound defect in B lympocytes, severe hypogammaglobulinemia, X linked
- abnormal BTK gene -increased infections with encapsulated bacteria Dx: decreased B cell, decrease in ALL immunoglobulin isotypes |
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Chronic Granulomatous Disease
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Def: neutrophil dysfunction, defective neutrophil oxidative metabolism
-inability to kill catalase postitive microorganisms Clinical features: increased infections of skin and lymph nodes (abscess common) pneumonitis Dx: nitroblue tetrazolium Tx: bone marrow transplant |
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Chediak Higashi Syndrome
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-abnormal neutrophil function
characterized by: neutropenia and thrombocytopenia increased infection with Staph Aures -partical oculocutaneous albinism |
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This disease starts on the face and spreads to the trunk and extremities
-the lesions are papular with small clear vesicles on a erythematous base that nave not began to crust lesions are al differnt stages |
Chicken pox
-very contagious -Transmitted by respiratory secretions -may have a prodrome of URT symtoms Dx: multinucleated giant cells on Tzanck preparation Tx: immunoglobulin to exposed infants Vaccine: is a live attenuated given 12-18 months |
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A 3 year old child comes in with high fever, runny nose, dry cough, conjunctivitis, and a rash that starteds as macules on the neck now more maculopapular and then spreads to the face neck arms and chest
Also there are gray white spots in the mouths |
This is Rubeola or Measles
*Think the 4 C+ cough, conjunctivitis, coryza and Koplik spots -has a live attenuated vaccine (egg allergies) |
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A pt comes in with a mild upper respiratory track infection has a lace like rash on face that then spreads to the trunk and extremities
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Fifth Disease (Parvo B19)
Tx: is supportive -cause aplastic crisis in sickle cell, thalassemia and hereditary spherocytosis |
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a 2 year old boy is brought in by this mother for a rash. She is worried because for the last 3 days the body had a fever 0f 102. Today the fever has resolved but he broke out into a diffuse rash. The rash raised lesions on the trunk that spread to the neck, face and extremities.
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Roseola
just think: high fever that has resolve now a rash -it is contagious from 1 week before the rash appears to 1 week after it fades |
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A 6 year is here because of a mild fever for 2 days, a rash that started on the face and spreads to the trunk with lymphadenopathy
What is a complication of this |
Rubella
Progressive panencephalitis: behavior changes, problems with school, dementia Vaccine: is a live attenuated |
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A 10 year old boy who originally presented with a fever and swollen parotid gland presents with 8 days later with a swollen tender testis
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Mumps orchitis
Spread via respiratory secretions Can also have: pancreatitis, thyroiditis, Deafness Vaccine: live attenuated vaccine MMR |
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A 7 year old girl that had a rash that was blanchable macules that are on the ankles, palms and soles that has not spread to the extremitis and face. Now they are deep red papules that are no longer blanchable
The pt does remember playing in woods and getting a tick bite |
Rocky Mountain Spotted Fever
Caused by Rickettsia rickettsii -they adhere to vascular endothelium resulting in vascular necrosis |
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A 5 year old girl come in a has arthritis, carditis and a nerologic problem (bells palsy. A month ago she ahs fever, myalgia, headach and a rash
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Lyme Disease
History of acute onset of fever, chills, myalgia, weakness 7-14 days get a target shaped rash known as erythematous migrans that affects teh trunk, proximal extremitis, axillia and inguinal area Dx:Serologies |
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Urticaria (Hives)
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Type 1 hyerpsensitive reaction causing a Wheals
Etiology: Infections, medication. food, insects SS: Raised pale and pink pruritic rash with annular morphology Rash can be migritory |
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For the past 2 weeks a 6 year old boy has had aggressive edema f various site. Puffy cheeks and eyes on awakening and swelling of the fet and abdomen as the day progresses. His history includes an upper respiratory illness and a sting by a yellow jacket
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serum sickness
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Stevens Johnson Syndrome
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extreme variant of erythema muliforme with systemic toxicity and involvment of the mucous membranes
Drugs: sulonamides and anticonvulsants SS: TraidL conjunctivitis, oral ulcers and urethritis Derm: erythematous blistering rash (target lesions), inflamed bullous lesions |
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A 2 month old infant with congenital heart disease is hospitalized with cough and tachypnea. X-ray films of the chest show diffuse infiltrates and no thymic shadow. Serum calcium is 6.5mg/
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DiGeorge Syndrome
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DiGeorge Syndrome
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Primary disorder T cell function (absent T lymphocyte)
-Congenital heart disease -right sided aortic arch - Hypocalcemic tetany -Esophageal atresia -Hypoparathyroidism -Abnormal facies (short philtrum, hypertelorism, low set ears) |
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Chediak Higashi Syndrome
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Abnormal neutrophil function
SS: -increase susceptibiliy to infection of skin and respiratory tract - mild bleeding diathesis - oculocutaneous albinism -progressive peripheral neuropathy -lymphoma like syndrome -pancytopenia |
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What are the risk of aspenia?
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Increased infection with encapsulated organism leading to sepsis
Tx: need prophylaxis of penicillin |
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Chronic granulomatous disease
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Neutrophil dysfunction
-defective killing -defect in microbial oxygen metabolites SS: sever recurrent infections of skin and lymph nodes hepatosplenomegaly Pneumonitis |
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Job Syndrome
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Neutrophil chemotactic defect
SS: recurrent stap infection resistant to therapy pruritic eczematoid dermatitis coarse facial features |
