Bacterial Infections: Diagnosis & Symptoms
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Questions and Answers

Which set of symptoms would LEAST likely point towards a bacterial infection?

  • Absence of rash, petechiae, and lymph node enlargement (LNE).
  • Presence of rash, petechiae, and elevated CRP. (correct)
  • High PMN count, toxicity, and absence of LNE.
  • High WBC count, elevated CRP, and toxicity.

A child presents with a limp, point bone tenderness, and limited range of motion. Which is the MOST appropriate term to use?

  • Musculoskeletal (correct)
  • Hemoatological
  • Central nervous system
  • Gastrointestinal

A patient has a fever, pallor, and a bleeding profile. On examination, they have petechiae, ecchymosis, hepatomegaly and splenomegaly. Which system is MOST likely involved?

  • Hemoatological (correct)
  • Central nervous system
  • Gastrointestinal
  • Musculoskeletal

Which finding is LEAST associated with cardiovascular involvement in a bacterial infection?

<p>Light stools (A)</p> Signup and view all the answers

A patient presents with dysuria, frequency, and suprapubic pain. Examination reveals suprapubic tenderness. Which system is MOST likely to be involved?

<p>Genitourinary (A)</p> Signup and view all the answers

Which of the following is the MOST likely finding in a patient with gastrointestinal involvement of a bacterial infection?

<p>Hematochezia (A)</p> Signup and view all the answers

A patient showing jaundice, dark urine, and anorexia is MOST likely experiencing issues primarily within which system?

<p>Liver (B)</p> Signup and view all the answers

Why does initiating empirical antibiotics complicate relying on cultures for microbiologic diagnosis?

<p>Antibiotics may suppress or eliminate the bacteria, resulting in false negatives. (D)</p> Signup and view all the answers

A child presents with a sandpaper-like rash, circumoral pallor, and a white strawberry tongue which later turns red. High-grade fever and sore throat are also noted. Which condition is most likely?

<p>Scarlet Fever (B)</p> Signup and view all the answers

Pastia's lines are associated with which of the following conditions?

<p>Scarlet fever. (D)</p> Signup and view all the answers

A patient is suspected of having toxic shock syndrome. Which of the following antibiotics would be the MOST appropriate initial treatment?

<p>Intravenous Vancomycin (C)</p> Signup and view all the answers

A patient is experiencing skin rash, facial swelling, and difficulty breathing after being stung by a bee. Which of the following is the MOST appropriate initial treatment?

<p>Intramuscular Epinephrine (B)</p> Signup and view all the answers

A child presents with arthritis, a rash on the extensor surfaces of their limbs, and abdominal pain. Which of the following conditions is MOST likely?

<p>Henoch-Schönlein Purpura (HSP) (B)</p> Signup and view all the answers

Leakage of serum from blood vessels into the skin causes which type of rash?

<p>Urticarial rash (A)</p> Signup and view all the answers

Which of the following conditions is LEAST likely to cause a purpuric rash?

<p>Anaphylaxis (D)</p> Signup and view all the answers

A patient presents with a sudden high fever, vomiting, diarrhea, and skin peeling. Hypotension is also noted. Which condition should be suspected?

<p>Toxic Shock Syndrome (C)</p> Signup and view all the answers

A patient presents with a fever and a diffuse macular rash. Which of the following viruses is LEAST likely to be the cause?

<p>Mumps (B)</p> Signup and view all the answers

A child is diagnosed with bronchiolitis. While several viruses can cause this condition, which of the following is the MOST common etiological agent?

<p>Respiratory Syncytial Virus (RSV) (A)</p> Signup and view all the answers

A patient exhibits a fever accompanied by a rash characterized by small, pinpoint hemorrhages. Which type of rash is MOST consistent with this presentation?

<p>Purpuric rash (D)</p> Signup and view all the answers

Which of the following is a pathognomonic enanthema associated with measles (Rubeola)?

<p>Koplik spots on the buccal mucosa (A)</p> Signup and view all the answers

Healthcare providers are investigating a cluster of acute gastroenteritis cases. Which group of viruses should be considered as potential causative agents?

<p>Rotaviruses, noroviruses, and adenoviruses (D)</p> Signup and view all the answers

A patient presents with cough, coryza, conjunctivitis, and Koplik spots. Which of the following stages of Measles is the patient MOST likely in?

<p>Prodromal stage (C)</p> Signup and view all the answers

Which of the following viruses is primarily associated with causing croup?

<p>Respiratory Syncytial Virus (B)</p> Signup and view all the answers

A public health agency is tracing the source of a measles outbreak. During which period is an individual infected with measles MOST contagious?

<p>5 days before and after the appearance of the rash (D)</p> Signup and view all the answers

A child presents with a macular rash, otitis media, and mouth ulcers. Which of the following complications is most directly associated with the described presentation, necessitating specific monitoring?

<p>Aseptic meningitis (A)</p> Signup and view all the answers

A 10-month-old infant is diagnosed with measles. Which preventive measure should be prioritized for their unvaccinated younger sibling?

<p>Administering the measles vaccine immediately if not contraindicated due to age (C)</p> Signup and view all the answers

A child exhibits a 'slapped cheek' appearance and a lacy rash on their limbs. Which of the following activities should be limited to prevent recurrence of the rash?

<p>Exposure to direct sunlight (A)</p> Signup and view all the answers

An infant presents with a high fever that resolves abruptly as a rash appears. What is the most likely causative agent of this condition?

<p>Human herpesvirus 6 (A)</p> Signup and view all the answers

A teenager is diagnosed with infectious mononucleosis and presents with splenomegaly. Which activity should they avoid for the next few weeks?

<p>Participating in contact sports (B)</p> Signup and view all the answers

After being diagnosed with measles, a child develops secondary bacterial bronchopneumonia. Which therapeutic intervention is most appropriate at this stage?

<p>Providing supportive care and initiating antibiotics (D)</p> Signup and view all the answers

A pregnant woman is exposed to a child with a confirmed case of Rubella. What is the primary concern regarding this exposure?

<p>Development of congenital rubella syndrome in the fetus (C)</p> Signup and view all the answers

A child who has been diagnosed with infectious mononucleosis starts experiencing difficulty in breathing. What immediate intervention should be considered?

<p>Administering steroids (A)</p> Signup and view all the answers

A 6-year-old child presents with joint pain following a recent bout of Erythema infectiosum. What management approach is the most appropriate?

<p>Providing symptomatic treatment for pain (C)</p> Signup and view all the answers

Following a measles infection, a child experiences prolonged diarrhea leading to secondary malnutrition. What is the most important intervention to address the malnutrition?

<p>Providing nutritional support (A)</p> Signup and view all the answers

Which of the following diseases is NOT typically associated with causing pharyngitis?

<p>Tuberculosis (C)</p> Signup and view all the answers

If a patient is suspected of having an airborne disease requiring specific precautions, which set of diseases would be of primary concern based on the provided information?

<p>Measles, Tuberculosis, Varicella (D)</p> Signup and view all the answers

A patient presents with symptoms of impetigo and suspected scabies. Which type of precaution is MOST appropriate to implement?

<p>Contact precautions (C)</p> Signup and view all the answers

In managing a patient with a multidrug-resistant organism (MDRO) and a wound infection, what type of precautions should be strictly followed to prevent the spread of infection to other patients and healthcare workers?

<p>Contact precautions (B)</p> Signup and view all the answers

A patient is diagnosed with malaria after traveling to Yemen. Which of the following signs and symptoms would MOST likely be associated with the acute phase of the disease?

<p>Fever, rigor, and jaundice (B)</p> Signup and view all the answers

If a patient with malaria develops cerebral malaria, which stage of malaria progression is indicated?

<p>Severe or complicated malaria (A)</p> Signup and view all the answers

A researcher is investigating the life cycle of the malaria parasite. In which phase does schizogony occur?

<p>In the human during the asexual phase (D)</p> Signup and view all the answers

Which of the following control measures would be MOST effective in preventing the transmission of malaria in an endemic area?

<p>Eradicating the Anopheles mosquito population (B)</p> Signup and view all the answers

A patient with Leishmaniasis presents with anemia, fever, and bleeding tendencies. What is the MOST appropriate initial management strategy?

<p>Initiating supportive care, including blood transfusions and platelet transfusions, before specific treatment. (D)</p> Signup and view all the answers

Following treatment for Leishmaniasis, when is the OPTIMAL time to repeat a bone marrow aspiration (BMA) to assess treatment efficacy?

<p>After completing the full course of antileishmanial treatment to confirm complete cure. (D)</p> Signup and view all the answers

In Dengue Hemorrhagic Fever (DHF), what is the PRIMARY mechanism contributing to hypovolemia?

<p>Capillary damage causing leakage of fluid and electrolytes into extravascular spaces. (D)</p> Signup and view all the answers

A patient presents with fever, headache, rash and muscle pain, and is suspected of having Dengue Fever. Which of the following is the MOST appropriate initial diagnostic investigation?

<p>Complete blood count (CBC), PT, and PTT to evaluate for hemorrhagic manifestations. (D)</p> Signup and view all the answers

A patient with Dengue Hemorrhagic Fever (DHF) develops hypotension and altered level of consciousness. According to the WHO classification, which stage of illness is the patient MOST likely experiencing?

<p>Dengue Shock Syndrome (DSS). (D)</p> Signup and view all the answers

Which of the following scenarios BEST describes the synergistic effect contributing to bleeding in Dengue Hemorrhagic Fever (DHF)?

<p>Disseminated intravascular coagulopathy (DIC) is worsened by concurrent liver damage and thrombocytopenia. (D)</p> Signup and view all the answers

What is the MOST likely cause of metabolic acidosis in a patient with severe Dengue Hemorrhagic Fever?

<p>Increased cardiac work and tissue hypoxia leading to lactic acid production. (D)</p> Signup and view all the answers

Which mosquito species is the PRIMARY vector responsible for transmitting the Dengue virus?

<p>Aedes aegypti. (A)</p> Signup and view all the answers

Flashcards

Bacterial Infection Symptoms

Common signs include fever, pallor, and bleeding tendencies.

Tachycardia

An abnormally fast heart rate, often over 100 bpm.

Hepatomegaly

Enlargement of the liver, often seen in infections.

Petechiae

Small red or purple spots caused by bleeding under the skin.

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Empirical Antibiotics

Antibiotics given before a specific diagnosis is made.

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Blood Cultures

Tests to detect bacteria in the blood, sensitive for bacteremia.

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Kernig Sign

A clinical sign of meningitis involving leg pain when lifting the leg.

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Nuchal Rigidity

Stiffness in the neck, a common sign of meningitis.

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Viruses that cause croup

Croup is primarily caused by the parainfluenza virus and respiratory syncytial virus.

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Viruses causing bronchiolitis

Respiratory syncytial virus is the leading cause of bronchiolitis, followed by human metapneumovirus.

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Viruses causing pneumonia

Pneumonia can be caused by RSV, parainfluenza virus, influenza virus, and adenoviruses.

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SARS virus

Severe acute respiratory syndrome is caused by SARS-associated coronavirus (SARS-CoV).

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Viruses causing gastroenteritis

Acute gastroenteritis is caused by rotaviruses, caliciviruses, noroviruses, and others.

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Viruses causing hepatitis

Hepatitis is caused by several viruses including HAV, HBV, HCV, and others.

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Macular rash

A macular rash appears as a change in skin color and is seen in various infections.

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Measles characteristic

Measles presents with a high fever, cough, conjunctivitis, and Koplik spots as diagnostic signs.

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Pharyngitis

Inflammation of the pharynx, causing sore throat.

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Transmission: Airborne

Diseases spread through the air, like Measles and Tuberculosis.

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Contact Precautions

Infection control measures for direct contact-related diseases.

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Malaria Epidemiology

Malaria causes 1,000,000 deaths yearly; common in Yemen.

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Malaria Causative Organisms

Key species include P. falciparum, P. ovale, and others.

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Malaria Symptoms (Acute)

Fever, rigors, anemia, jaundice, and more.

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Severe Malaria Complications

Includes heart and renal failure, and cerebral malaria.

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Malaria Life Cycle

Malaria parasite alternates between mosquitoes and humans.

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Macular rash progression

Macular rash spreads over 3 days and disappears in 3 days with desquamation lasting for 3 months.

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Complications of viral infections

Potential complications include otitis media, keratitis, CNS complications, and secondary infections.

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CNS complications

Includes viral encephalitis, aseptic meningitis, and GBS following some infections.

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Immune amnesia

Destruction of humoral and cellular immunity leading to loss of past immunity.

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Rubella transmission

Rubella spreads via droplets and is infectious 7 days before and after rash appears.

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Roseola infantum clinical picture

Characterized by high fever followed by a rash that appears on the third day without desquamation.

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Infectious mononucleosis symptoms

Symptoms include mild fever, sore throat, lymphadenopathy, and potential splenomegaly.

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Management of viral infections

Management is generally supportive with no specific treatment.

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Vaccine preventable diseases

Vaccination at 9, 18, and 36 months prevents many viral infections.

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Erythema infectiosum features

Caused by parvovirus 19; characterized by slapped cheek appearance and reticular rash.

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Scarlet Fever Symptoms

Characterized by a rash, high fever, sore throat, and 'strawberry tongue'.

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Pastia’s Lines

Skin folds in antecubital and axillary areas observed in scarlet fever.

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Strawberry Tongue Stages

Starts as white strawberry, progressing to red strawberry appearance in scarlet fever.

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Toxic Shock Syndrome Causes

Caused by toxins from Staph. aureus, Group B strept, and chemotherapy.

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Clinical Signs of Toxic Shock

Includes high fever, skin peeling, hypotension, vomiting, and diarrhea.

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Urticarial Rash Cause

Caused by serum leakage from blood vessels, often due to anaphylaxis.

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Purpuric Rash Definition

Leakage of red blood cells from vessels, causing petechiae and purpura.

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Management of Anaphylactic Shock

Immediate treatment includes epinephrine IM and hydrocortisone IV/IM.

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Electrolytes

Minerals in the body that carry an electric charge, essential for various bodily functions.

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Dengue Fever Symptoms

Common symptoms include high fever, headache, and muscle pain.

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Dengue Hemorrhagic Fever (DHF)

A severe form of dengue fever characterized by bleeding and fluid leakage.

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Dengue Shock Syndrome (DSS)

A critical condition of dengue fever with hypotension and reduced consciousness.

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Capillary Damage Mechanism

Damage that allows fluid and cells to leak into areas outside blood vessels.

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Fluid Redistribution

The internal movement of fluid to different body compartments, often due to illness.

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Pancytopenia

A reduction of red blood cells, white blood cells, and platelets in the blood.

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Stibogluconate

A medication used to treat leishmaniasis, administered for 28 days.

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Study Notes

Classification of Infections

  • Infections are classified by the involved system (e.g., respiratory system, gastrointestinal tract, central nervous system, or musculoskeletal system)
  • Infections can also be classified according to the type of microbe causing them (e.g., bacterial, viral, parasitic, or fungal)

Causes of Fever in Children

  • Autoimmune diseases
  • Malignant diseases
  • Infectious diseases

Advantages of Fever

  • Protective role in the immune system
  • Inhibits the growth and replication of microbes
  • Aids in the body's acute-phase reaction
  • Enhances the function of white blood cells (WBCs)
    • Lymphocytes
    • Interferon production
    • Bactericidal activity of neutrophils
    • Monocyte maturation into macrophages
    • Promotion of lymphocyte antibody production
  • Decreases the availability of free iron for bacterial replication

Normal Temperature

  • The normal temperature range is 36.5-37.2°C.

Sites of Temperature Measurement

  • Oral
  • Rectal
  • Axillary
  • Tympanic

Fever Classification

  • Normal: 36.5-37.2°C
  • Hypothermia: <35°C
  • Low grade: 37.3-37.8°C
  • Moderate: 37.9-39.4°C
  • High grade: 39.5-40.5°C
  • Hyperpyrexia: >40.5°C

Important Definitions

  • Bacteremia: Presence of bacteria in the bloodstream.
  • Sepsis: Systemic response to infection.
  • Septicemia: Severe sepsis affecting the central nervous system, circulatory system, and disseminated intravascular coagulation (DIC).
  • Fever of unknown origin: Fever lasting more than 14 days, despite a history, physical examination, and investigations failing to identify a cause.

Bacterial Infections in Infants (<3 months)

  • Urinary tract infection (UTI): Escherichia coli (E. coli)
  • Pneumonia: Group B Streptococcus (GBS), Streptococcus pneumoniae, Staphylococcus aureus
  • Meningitis: Streptococcus pneumoniae, Haemophilus influenzae, GBS
  • Septic arthritis: Staphylococcus aureus, GBS
  • Bacteremia: GBS, E. coli, Listeria monocytogenes

Evaluation of Fever Causes

  • Upper respiratory tract issues (e.g., rhinorrhea, sore throat, cough, drooling, stridor, trismus, sinus pain, tooth pain, hoarse voice, ear pain)
  • Lower respiratory tract issues (e.g., cough, chest pain, dyspnea, sputum)
  • Cardiovascular problems (e.g., tachycardia, hypotension, cardiomegaly)

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Test your knowledge of bacterial infections with this quiz. Questions cover symptoms, affected systems (cardiovascular, gastrointestinal, etc.), and the impact of empirical antibiotic use on diagnosis. Improve your understanding of diagnostic approaches.

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