Peds Infectious Disease 3

1.

1 point

Hyperpyrexia is described as a fever higher than?

105.8 F

40 C

102.2 F

37 C

2.

1 point

A tonic-clonic seizure lasting more than 15 minutes suggests?

infection

injury/trauma

febrile seizure

epilepsy

3.

1 point

If a culture for bacteremia shows an additional pathogen than the original cause the child should be reevaluated for what?

meningitis

chicken pox

shigella

HSP

4.

1 point

If there is increased intracranial pressure with meningitis then Lasix and Mannitol may be used. When are these medications contraindicated? (There are 2 correct answers)

Bulging fontanel

seizure disorder

Isolated coma

kidney failure

5.

1 point

The Fontanel typically closes at what age in children? If not closed by this age may indicate increased ICP

6.

1 point

41 C= ?? F

7.

1 point

A mother presents her child to the clinic. The child has had a high fever, rash and has been crying with nuchal rigidity. You immediately want to rule out what?

pneumococcal disorder

meningococcemia

multiple organ dysfunction syndrome

reaction to medication

8.

1 point

38.0 C = ? Farenheit?

9.

1 point

What is the drug of choice for fevers in children?

acetaminophen

motrin

aspirin

ibuprofen

10.

1 point

Bacterial meningitis can be caused by what pathogen that is normal in a mother but can be lethal for the baby?

Listeria monocytogenes

group B streptococcus

E. Coli

staphylococcus

11.

1 point

If a child comes into contact with someone with meningitis they should be treated with antibiotics and immunized, if not already?

True

False

12.

1 point

A mother calls your clinic to schedule an appointment for her 2 month old baby. Mother states the patient has had a fever for the last few days and she wants to bring him in this afternoon. You tell the mother what?

schedule the appointment, don't give the child tylenol before the visit

ask the mother if she had herpes at the time of the baby's birth; this is a medical emergency

Schedule; don't give child motrin before visit

no need to schedule; treat the child empirically at home

13.

1 point

What lab study should always be obtained in a patient you suspect has sepsis, with or without lesions, exudates, abscesses, etc?

CBC

CXR

urine culture

blood culture

14.

1 point

A 2 yo child presents to your clinic mildly ill-appearing with a fever of 101.5 for the past 5 days. Your first line treatment for this child is?

obtain a blood culture

begin empiric treatment of vancomycin with ceftriaxone

Immunize this child if they are not already

Observe only

15.

1 point

A patient with an IV catheter would likely have sepsis caused by _____; wherease a patient that is neutropenic would likely have sepsis caused by ______?

pseudomonas; coagulase-negative staphylococci

strep pneumonia; klebsiella

staph aureus; klebsiella

klebsiella; staph aureus

16.

1 point

Immunizations are the best way to prevent sepsis. If a child is exposed to H. influenzae or meningococcal disease they should receive what medication to prevent sepsis?

Isoniazid

Ampicillin

Rifampin

Streptomycin

17.

1 point

The younger the child, the more reliable the symptoms of meningitis are?

True

False

18.

1 point

A cause of sepsis can be rickettsiae, also called spotted typhus, and is a what?

protozoa

virus

bacteria

fungus

19.

1 point

Sepsis in an infant may present with which of the following symptoms?
(there are 5 correct answers)

hypotension

oliguria

high fever

tachycardia

hypothermia

cutaneous lesions

hypertension

bradycardia

polyuria

20.

1 point

If a fungal infection is suspected as the cause of sepsis what additional medication should be added to the general treatments?

amphotericin B

vancomycin

metronidazole

clindamycin

21.

1 point

The highest mortality rates associated with meningitis are caused by pneumococcal meningitis?

True

False

22.

1 point

Teething in a child may create a high-grade fever that will shortly subside

True

False

23.

1 point

CSF of a child diagnosed with sepsis will show what?

bacteria and leukocytes

neutrophils and bacteria

nothing, sepsis cannot cross the BBB

macrophages and positive bacterial culture

24.

1 point

In an infant what organ is reacting to infection, malignancy, drugs, etc and produces fever?

kidneys

liver

brain

hypothalamus

25.

1 point

A 3 yo child is admitted to the ER for high fever and dehydration. Mother reports the child is up to date on his immunizations until the age of 1, but she did not get any immunizations after that time. A WBC is drawn and the count is 20,000. Your next step in treatment will be what?

CXR and IV vancomycin

CXR and Ceftriaxone IM

urine culture and observation

Blood culture and Ceftriaxone IM

26.

1 point

Hydrocephalus from meningitis is most likely to occur in the neonatal period?

True

False

27.

1 point

Hearing loss from meningitis is associated with what disease?

28.

1 point

Meningitis may be viral, bacteria or fungal. Viral meningitis is more common in what season(s)?

29.

1 point

Neisseria meningitidis can cause sepsis in a patient. When this is the cause of sepsis you should carefully monitor for what complication?

30.

1 point

Treatment for sepsis depends on the organism. In general, however, what treatment is recommended?

clindamycin plus treatment for MRCA

vancomycin plus macrolide

Metronidazole plus ceftriaxone

vancomycin plus cefotoxime or ceftriaxone

31.

1 point

39 C = ?? Farenheit

32.

1 point

A child 3 months to 3 years with Bacteremia. Under what circumstances will you hospitalize the child?

complete immunizations

toxic appearing without a source

child with incomplete immunizations

non-toxic appearing with fever less than 39

33.

1 point

In sepsis lab results may show light blue-gray, oval, basophilic, leukocyte inclusions located in neutrophils. These are called what?

34.

1 point

A mother presents her child to your clinic. He is 8 months old, up to date on immunizations and uncircumcised. He has a fever of 103 for the past two days. Your next step in his treatment/diagnosis is?

obtain a UA and observe

take blood cultures

observe only, no immediate concern

CXR

35.

1 point

Empiric treatment for meningitis is Vancomycin plus Cefotaxime or Ceftriaxone. If the child has meningitis during the summer what medication should be added to this regime?

vancomycin

acyclovir

metronidazole

clarithromycin

36.

1 point

Reye's disease in children is caused by what medication?

IV antibiotics

macrolides

salicylates

37.

1 point

Even though an infant may have a fever they may present with what symptom?

38.

1 point

Match lab values for the various types of meningitis (3 correct answers)

Bacterial: elevated WBC, decreased glucose, elevated serum protein

Bacterial: normal WBC, decreased protein, decreased glucose

Viral: decreased WBC, normal glucose, slightly elevated protein

Fungal: WBC varies; glucose decreased; protein elevated

Fungal: WBC varies: glucose increased; decreased protein

Viral: elevated WBC, increased glucose, decreased protein

39.

1 point

What's the first-line therapy for a seizure lasting more than 5 minutes?

Antiemetics

Ativan

lumbar puncture to determine cause

no therapy; these are not recommended no matter how long the seizure lasts

40.

1 point

The most common cause of bacteremia:

H. influenza type B

N. Meningitidis

S. pneumonia

Salmonella