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51 Cards in this Set
- Front
- Back
Name the organisms detected by the following methods
1) Ziehl-Neelsen Stain 2) Silver stain 3) Fluorescent Ab-Ag staining 4) Dark field microscopy |
1) Acid fast bacilli
2) Fungal elements 3) Viruses - HSV, WZV, RSV 4) T. palladium |
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Which of the following patients should be admitted for a sepsis work-up?
1) 22-day old with fever of 100.5? 2) 5-year old with fever of 99.5 3) 8 month old with fever of 102.2? |
1 and 3
ALL neonates (<28 days) with fever must be admitted Children 3-36 months with fever >39 (102.2) |
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23-day old presents with poor feeding, irritability, and lethargy. Suspecting meningitis, you check for Kerning's and Brudzinski's sign - both are negative. Are you home free?>
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Nuchal rigidity is often NOT present in the neonate - must do a LP
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What's the most likely cause of meningitis in the following age groups?
1) 0-1 month 2) 1-3 months 3) 3 months - 3 years |
1) GBS, E. coli, Listeria - tx with amp and gent
2) GBS, S. pneumo, Listeria - tx with amp and cefotaxime 3) S. pneumo, Hib, N. meningitidis - tx with cefotaxime + vanc (resistant S. pneumo) |
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Brain imaging on a child with meningitis shows BASILAR ENHANCEMENT. What type of meningitis does he have?
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TB meningitis
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Is treatment for viral meningitis needed?
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No - most cases are self-limited
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In which order do the sinuses develop?
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1) Ethmoid/maxillary - present at birth
2) Sphenoid - develop btw 3-5 yrs 3) Frontal - develop btw 7-10 |
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2-year old child presents with a fever, painful vesicles on the POSTERIOR pharynx, and blisters on the hand and foot. What's the most likely dx?
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Hand-foot-mouth disease 2/2 coxsackie
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7-year old child presents with a fever ans sore throat without other URI symptoms. PE shows exudate on the tonsils, petechiae on the soft palate, strawberry tongue, and enlarged anterior LN. What's the most likely dx?
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GABHS pharyngitis - oral penicillin or macrolide if penicillin allergy
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5-year old child presents with a sore throat. On PE, you note a gray, adherent tonsillar membrane. What's the most likely dx?
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Diptheria - tx with oral erythromycin
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What bacterial pathogens cause an acute otitis media?
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S. pneumo
Non-typable H. influenzae M. catarahalis Tx with amoxicillin |
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6-year old presents with pain, itching, and draining from the ear. He says he's been going swimming a lot in the past week. On PE, you note ERYTHEMA and EDEMA of the EAC. What's the most likely dx?
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Acute otitis externa - PSa, S. auerus, C. albicans
Tx - acetic acid (mild) or topical Abx (severe cases) |
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Child presents with mobile, tender, and warm cervical LN. You decide it's probably a localized bacterial infection. What are the most likely pathogens?
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S. aureus - most common
S. pyogenes Mycobacterial infections B. henselae (cat scratch disease) |
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Child presents with swelling above the angle of the jaw with a fever. You decide it's probably a parotitis. What are the most likely pathogens?
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Viral - mumps, CMV, EBV - usually b/l --> supportive tx
Bacterial - S. auerus, S. pyogenes, M. Tb - usually unilateral --> abx |
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Child presents with HONEY-CRUSTED lesions around the nares. What's the most likely diagnosis?
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Impetigo (skin infection involving upper dermis) - usually S. aureus
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Child presents with tender, erythematous skin with a DISTINCT border on the face. What's the most likely diagnosis?
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Erysipelas - skin infection involving dermal lymphatics
Caused by GABHS |
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Name the skin infection:
A child presents with tender, erythematous skin with an INDISTINCT syndrome |
Cellulitis - skin infections that occurs within dermis
Caused by GABHS/S. aureus |
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Name the skin infection:
A child presents with a unilateral bluish discoloration on the cheek. |
Buccal cellulitis - caused by Hib
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Name the skin infection:
A child presents with fever, TENDER skin, and bullae. On PE, a positive Nikolski sign is present. |
Staph scalded skin syndrome - caused by toxin-producing S. aureus species
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A child has had a sore throat and fever for 3 days. Today, he presents with a rash. On PE, you note an erythematous, papular rash that has the texture of SANDPAPER. You note that his hands are peeling (DESQUAMATION) What's the most likely diagnosis?
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Scarlet fever 2/2 GABHS
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Name the sequelae of GABHS infection
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1) Post-strep GN
2) Rheumatic fever 3) Post-strep arthritis 4) PANDAS |
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A child presents to your clinic in WINTER with vomiting and diarrhea for 4-7 days. What's the most likely dx?
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Viral gastroenteritis 2/2 rotavirus
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A child presents to your clinic with vomiting for the past 48 hrs. His mom says that the rest of his daycare is also sick. What's the most likely dx?
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Norwalk virus - vomiting is prominent; shorter duration
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You have a child with suspected HUS. Are Abx an appropriate next step?
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NO - HUS may worsen with abx
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Name the diarrhea
1) Major cause of traveler's diarrhea; no stool WBC 2) Responsible for HUS; stool WBC present 3) Bloody diarrhea predominates; stool WBC present 4) Associated with exposure to poultry, milk, eggs, lizards/turtles 5) Most common cause of bloody diarrhea in USA 6) May cause mesenteric adenitis (mimics acute appendicitis) |
1) Enterotoxigenic E. coli
2)O157:H7 E. coli 3) Shigella 4) Salmonella 5) Campylobacter 6) Yersinia |
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You run a BMP on a child with 2 days of diarrhea. What you expect to find?
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Non-gap hyperchloremic metabolic acidosis
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A child presents with FTT, lymphadenopathy, difficult to treat thrush, and severe varicella infection. What are you most worried about?
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HIV Infection
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For an HIV-negative infant born to an HIV-positive mother, what do you expect the results from the following tests to be at 4 months?
1) ELISA 2) HIV PCR |
1) ELISA - positive for 18-24 months (have transplacentally acquired maternal Ab)
2) HIV PCR - negative |
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How should infants born to HIV-infected mothers be manged?
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1) Zidovudine for 6 weeks
2) Bactrim for PCP ppx until HIV PCR is negative 3) No breastfeeding |
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An HIV-positive child presents with fever, hypoxia, and interstial pulmonary infiltrates. What's the most likely dx?
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PCP - tx with bactrim
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An HIV-positive child presents with constitutional symptoms and elevated ALT/AST. What's the most likely dx?
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MAC
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11-year old presents with a fever and a sore throat. On PE, you note posterior cervical lymphadenopathy with HMS. On CBC, you note ATYPICAL LYMPHOCYTES. You correctly suspect mono. What's the best diagnostic test in children < 4 yrs and > 4 yrs?
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< 4 yrs: EBV Ab titers
1) Acute infection: elevated IgM-VCA (viral capsid) 2) Ab against Epstein-Barr nuclear Ag > 4 yrs + anti-heterophile Ab |
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What is the classic clinical course of measles?
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1) Prodrome: cough, conjunctivitis, coryza
2) Enanthem with koplik spots - small, gray papules on erythematous base on buccal mucosa 3) Exanthem - erythematous maculopapular rash that begins on face and spreads to chest/upper extremities |
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What is the treatment of measles and what are the complications?
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Treatment
1) Supportive 2) Vitamin A Complications 1) Bacterial pna is most common complication 2) Otitis media 3) Encephalomyelitis 4) Subacute sclerosing pancephilitis |
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What is congenital rubella syndrome?
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Fetal anomalies that occur after primary maternal infection during first trimester
1) Blueberry muffin baby 2) Congenital cataracts and PDA 3) Sensorineural hearing loss |
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A child with CF presents with wheezing. CXR shows pulmonary infiltrates and a CBC shows eosinophilia. What's the most likely dx?
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ABPA - elevated aspergillus-specific IgE
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Child from SOUTHWESTERN USA presents with a mild pna. You suspect a fungal infection. What's the most likely cause?
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Coccidiodomycosis
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A child travels to MEXICO and eats from a street vendor. 4 days later, he develops cramping abd pain, tenesmeus, and diarrhea. What's the most likely dx?
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Entamoeba histolytica - can also form ANCHOVY PASTE abscess in liver
1) Dx - trophozite/cysts in stool or serum Ab assay 2) Tx - metronidazole |
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Child presents with voluminous, watery, and foul-smelling diarrhea. His mom says that they went camping one week ago and he drank CONTAMINATED MOUNTAIN WATER. What's the most likely dx?
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Giardia
1) Dx - cysts/trophozites in stool or stool ELISA 2) Tx - metronidazole |
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A child who's been traveling in India presents with fevers every 48-72 hrs. A CBC shows a hemolytic anemia. What's the most likely dx?
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Malaria - Plasmodium (P. falciparum - most severe dz) - transmitted by anopheles mosquito
1) Clinical features - cyclic fevers correlate with RBC rupture and subsequent parasitemia 2) Dx - thick and thin Giemsa-stained peripheral blood smear |
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A child who enjoys playing in CAT FECES presents with a mono-like illness. What's the most likely dx?
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T. gondii - usually don't need treatment
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What congenital infection is associated with following classic triad
1) Hydrocephalus 2) Intracranial calcifications 3) Chorioretinitis |
T. gondii
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How are parasitic infections diagnosed?
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3 stool examinations for ova and parasites
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Name the helminth infection
1) Most common helminthic infection 2) Anal pruritis |
Pinworm
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A child from MEXICO presents with seizures. A head CT/MRI shows solitary parenchymal cyst in FOURTH VENTRICLE. What's the most likely dx?
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Cysticerocosis - caused by T. solium --> encysts in muscle, subcu tissue, brain
1) Dx - ova and parasite stool eval 2) Tx - anti-convulsants |
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A child who recently traveled to SE AMERICA presents with a fever, HMS with jaundice, hypotension, and a petechial rash that began on the extremities (hands/soles included) and moved toward his trunk. His labs are significant for THROMBOCYTOPENIA and HYPONATREMIA. What's the most likely dx and tx?
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Rocky mountain spotted fever (rickettsia rickettsii) - tx with doxycycline
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A child presents with all the features of RMSF but without the rash. What's the most likely dx?
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Ehrlichiosis - caused by ehrlichia chaffeensis - Tx with doxycycline
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A 5-year old child with a new kitten presents with regional lymphadenopathy. His mom can't remember if the kitten every scratched him but says it's possible. What's the most likely dx?
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Cat scratch disease 2/2 Bartonella henselae - develop regional lymphadenopathy distal to and after a cat scratch
Only need supportive treatment |
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Tb disease is called what in the following areas:
1) Cervical lymphadenitis 2) Skeletal disease |
1) Scrofula
2) Pott's disease |
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What is the treatment for latent Tb?
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9 months of INH
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What is the treatment for active Tb?
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2 months of INH, rifampin, pyrazinamide followed by 4 months of INH and rifampin
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