14408083
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 6 years ago
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| Question | Answer |
| 1. Which of the following clinical features makes bacterial tonsillitis LESS likely? A. Temperature >39 B. Cough C. Age 5-10 years D. Tender lymphadenopathy E. Purulent tonsillar exudate | B. Use Centor criteria ie. T >38, no cough, tender anterior cervical nodes, tonsillar swelling or exudate, 3-14yo = 1 score. Score 0-1 = no culture, no Abx. Score 2-3 = culture all, treat if +ve. Score 4+ = culture and treat all. |
| 2. What is the most frequent cause of bacterial meningitis in neonates? A. Streptococcus pneumoniae B. Escherichia coli C. Staphylococcus aureus D. Streptococcus agalactiae E. Streptococcus pyogenes | D. This figure is correct for Australia, however, Gram negative organisms like E. coli may be more frequent in some contexts. |
| 3. Which of the following results has the highest specificity for UTI? A. Urinalysis positive for leukocyte esterase B. Urinalysis positive for blood C. White blood cell count >15 D. Urinalysis positive for nitrites E. Urine microscopy showing >100 x10^9/L WCC | D. See Table 1 American Academy of Pediatrics UTI Clinical Practice Guidelines (Pediatrics 2011; 128: 595-610). |
| 4. Name the organism for these gram stain appearance in bacterial meningitis. A. Gram positive rods | Listeria monocytogenes |
| 4. Name the organism for these gram stain appearance in bacterial meningitis. B. Gram negative rods | E. coli |
| 4. Name the organism for these gram stain appearance in bacterial meningitis. C. Gram positive cocci in chains | Streptococcus agalactiae (S. pneumoniae classically in pairs or diplococci) |
| 4. Name the organism for these gram stain appearance in bacterial meningitis. D. Gram negative cocci | Neisseria meningitidis |
| 4. Name the organism for these gram stain appearance in bacterial meningitis. E. Gram positive cocci in clusters | Would be the gram stain appearance of Staphylococcus aureus, an which is an infrequent cause of CNS infection. |
| 5. Antibiotics – yes or no? a. 12 month old child with fever 38.2, pulling at ears, difficult to visualise tympanic membrane ?red on right. | No, likely viral, safe to watch and wait +/- delayed script. |
| 5. Antibiotics – yes or no? b. 5yo child wakes screaming with pain in ear, bulging tympanic membrane on examination. | Yes, more specific clinical diagnosis hence would be more inclined to treat. |
| 5. Antibiotics – yes or no? c. 18 month old child with fever 37.8, rhinorhoea, red pharynx. | No, likely viral. |
| 5. Antibiotics – yes or no? d. 7yo child with sore throat for 24 hours, fever 38.5, tender cervical nodes. | Yes. Use Centor criteria. Score = 3 (age 3-14, T >38, cervical nodes) ie. culture and treat if positive. |
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