Burning question
Funny bone
Pain in the neck
Heartbreaker
Strep Up
100
Treatment duration for afebrile UTI
Presumed cystitis + no fever: 2-4 days PO Abx
100
Common presentation or symptom of osteomyelitis
Decreased range of motion of the affected limb or refusal to weight-bear on a lower limb
100
Common meningitis pathogens in infants (name 2)
Infants: GBS, E. Coli
(others: Listeria, S. pneumo, N. mengitidis)
100
What is septic shock?
Septic shock: severe infection leading to cardiovascular dysfunction (e.g. impaired perfusion, hypotension, etc.)
Sepsis-associated organ dysfunction: severe infection leading to cardiovascular or non-cardiovascular organ dysfunction
100
List 2 common presentations of invasive group A strep
Toxic shock syndrome (TSS)
Necrotizing fasciitis
Bacteremia
Pneumonia, especially with pleural effusion
Meningitis
200
Name 4 symptoms or signs of UTI
Preverbal: unexplained fever
Dysuria, urinary frequency, hematuria, abdo pain, back pain, new daytime incontinence
200
Part of the bone that is a common location of osteomyelitis
Metaphysis of the long bones (highly vascularized areas)
200
Common meningitis pathogens in:
Older infants + children (2)
Older infants + children:
S. pneumo, N. meningitidis
200
Name 3 high risk populations for developing pediatric sepsis.
Infants <60 d
Immunosuppressed
Immunodeficient
Asplenic
Malignancy
200
Two recent infections that pose an increased risk for invasive group A strep
Pharyngitis
Varicella
Other risk factors: HIV, malignancy, heart disease, diabetes, lung disease, IV drug use
300
Which finding on a urinalysis is most specific (98%) for a UTI?
Positive nitrites
- may be falsely negative if the bladder is frequently emptied or if the organism doesn’t metabolize nitrate (including gram positive organisms)
300
Two most common pathogens of osteomyelitis
Staph aureus
Kingella kingae (most common in infants)
300
5 things that you normally send CSF from a lumbar puncture for
Cell count
Glucose
Protein
Culture
Viral NAT
300
Two pathogens often implicated in toxic shock
Staph aureus
Strep pyogenes
300
Empiric treatment for invasive group A strep includes these 2 agents
Need to cover Staph aureus + group A strep with:
Cloxacillin (a penicillin)
Clindamycin (halts toxin release)
May add vancomycin
400
When should a renal-bladder US be standardly ordered?
Children <2 yo with a first febrile UTI
400
Empiric antibiotics for osteomyelitis
Cefazolin IV 100-150 mg/kg divided q6-8h
Kingella is resistant to vancomycin, clinda, and cloxacillin.
Cefuroxime for unimmunized <4 yo (or any population at higher risk of hemophilus influenza)
400
What instances do we add dexamethasone to antimicrobial therapy for meningitis?
H. influenzae infection (can also consider with S. pneumo meningitis) - decreases risk of severe hearing loss
400
Name at least 3 populations that would be at risk of adrenal insufficiency in sepsis and would likely benefit from hydrocortisone
Chronic steroid use
Pituitary insufficiency
Adrenal abnormalities
Meningococcemia, with purpura fulminans or Waterhouse- Friedrichsen syndrome (bleeding into adrenals)
400
Additional therapy that you can use for severe invasive group A strep or TSS that is not an antibiotic
IVIG - consider this on day 1 of presentation
500
Minimum colony forming units that are indicative of a UTI in:
Clean catch (midstream)
500
Reasons to consider repeat imaging prior to stopping antibiotics in osteomyelitis
Repeat imaging only if growth plate was involved or lytic lesion
Can stop abx when: normal exam, normal CRP, +/- reimaging
500
Which of the following has the longest treatment duration for meningitis(and - which abx?):
GBS
Strep pneumo
H. influenza
Neisseria meningiditis
GBS: Pen G or Ampicillin for 14-21 d
Strep pneumo: Pen G or ampicillin for 10-14 d
H. influenza: Ampicillin for 7-10 d
Neisseria meningitidis: Pen G or ampicillin for 5-7 d
*God Save His Neck*
500
Name 3 vascular or immune complex manifestations of infective endocarditis
500
Fill in the blank:
If you have been in close contact with a person with invasive GAS disease within _____ days of their symptom onset, you require antibiotic treatment with _____.
If you have been in close contact with a person with invasive GAS disease within SEVEN days of their symptom onset, you require antibiotic treatment with 1ST GEN CEPHALOSPORIN (EG KEFLEX) X10 DAYS.