Infectious Diseases — Flashcards

Flashcard 71: The most common cause of unilateral proptosis in children is _____.

Answer: orbital cellulitis

Flashcard 72: In children undergoing elective splenectomy, which pneumococcal vaccines are recommended to be administered at least 2 weeks prior?

Answer: PCV13 and PPSV23

Extra: Patients with anatomic or functional asplenia (e.g., splenectomy, sickle cell disease) require vaccination against encapsulated organisms: *S. pneumoniae*, *N. meningitidis*, and *H. influenzae* type b. **Pneumococcal vaccination protocol:** * **PCV13 (Conjugate):** Part of routine series; should be completed. * **PPSV23 (Polysaccharide):** Administered to high-risk patients ≥ 2 years of age, at least 8 weeks after the last PCV13 dose. * **Timing:** Ideally ≥ 2 weeks before elective splenectomy. If the surgery is emergent, vaccinate 2 weeks after surgery.

Flashcard 73: Vesiculobullous lesions are a feature of _____ syphilis

Answer: early congenital

Flashcard 74: The most common infectious etiology for adrenal insufficiency in children is _____

Answer: meningococcemia

Flashcard 75: Rash of chickenpox is deemed non-contagious after the lesions have _____.

Answer: crusted

Flashcard 76: A patient of dengue hemorrhagic fever can be discharged if the platelet count is >_____/cu.mm

Answer: 50,000

Flashcard 77: A child born to a mother who was diagnosed to have TB in pregnancy should receive INH prophylaxis for _____ months, provided congenital TB has been ruled out.

Answer: 6

Flashcard 78: Infants born to HbsAg-positive mothers should receive _____ immunization at birth

Answer: both active and passive (active/passive)

Flashcard 79: What is the upper limit of CD4 count for starting ART in children?_____

Answer: None (ART is recommended for all children regardless of CD4 count)

Extra: Current guidelines (WHO/NACO) recommend the "Treat All" strategy, where Antiretroviral Therapy (ART) is initiated in all HIV-infected individuals, including children, immediately upon diagnosis regardless of CD4 cell count or clinical stage.

Flashcard 80: For diagnosing congenital CMV infection, _____ examination by PCR is the best method

Answer: urine (or saliva)

Extra: The gold standard for diagnosing congenital CMV is PCR or viral culture of urine or saliva samples collected within the first 3 weeks of life. Saliva PCR is often used for screening, while urine PCR is the traditional confirmatory gold standard due to high viral shedding in urine. Blood PCR has lower sensitivity for diagnosing congenital infection in newborns.