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MCN 552- Infectious Disease Questions With Complete Solutions
When is Zika virus testing recommended for infants ?......Correct Answers.... ..When born with microcephaly or intracranial calcifications to women who traveled to or resided in an area with Zika transmission while pregnant OR when born to a mother with positive or inconclusive test results for Zika virus
Because Zika is an arboviral disease, how does that affect notification?......Correct Answers......It must be nationally notified
Zika is a mosquito-borne illness but has also been shown to be transmitted how?......Correct Answers......Intrauterine and intrapartum
What are the symptoms of the Zika virus?......Correct Answers ......Acute onset fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis
Who should health care providers contact in order to facilitate Zika virus testing?......Correct Answers......Their state or territorial health department
For Zika virus evaluation purposes, microcephaly is defined as what?......Correct Answers...... Occipito-frontal circumference less than the third percentile not explained by other etiologies
What repeat testing should be performed on all infants with positive or inconclusive Zika virus results?......Correct Answers ......Hearing and ophthalmologic evaluation
How should Zika virus be treated or prevented?......Correct Answers ......No specific antiviral treatment available only supportive, no vaccine available, only prevention is avoiding areas where Zika virus transmission is ongoing or strictly following steps to avoid mosquito bites
What are some forms of mosquito bite prevention?......Correct Answers.... ..Using air conditioning or window and door screens when indoors, wearing long sleeves and pants, using Permethrin treated clothing and gear, using insect repellents
Who is at particularly high risk of contracting HIV?......Correct Answers.... ..Adolescents 15-19, nontreated infants delivered vaginally or breast fed by infected mothers, needle sharing drug users, unprotected sexual contacts
How is an HIV+ pregnant woman treated in the US?......Correct Answers.... ..Combination antiretroviral therapy
When do HIV symptoms usually begin in an infant?......Correct Answers.... ..12-18 months
How long does the latency period typically last in children with HIV?......Correct Answers......Longer than 5 years
What are the HIV clinical categories based upon?......Correct Answers.... ..CD4 count and viral load
What is usually the first and second symptom of HIV in children?......Correct Answers......Lymphadenopathy and hepatosplenomegaly
What is the most common reason for a child to be taken to the doctor for a sick visit ?......Correct Answers......Infections
Why are dangerous viruses rare?......Correct Answers.. ....The inability to inflict serious harm, go unrecognized by the immune system, and efficiently spread all at once
Bacteria are generally ____________ and may be ______________.......Correct Answers......Harmless, beneficial
Staph aureus is usually found where?......Correct Answers......Skin, hair, naso-oropharynx, lower GI, cerumen
What will produce reliable results of colonization of staph aureus in other areas (axilla, groin, perineum)?......Correct Answers ......Culture of the nose
Which gram positive bacteria have the potential for being a pathogen?......Correct Answers......Staph aureus, strep mutans, strep pneumoniae, strep pyogenes, enterococcus faecalis
Which gram negative bacterial have the potential for being a pathogen?......Correct Answers......Enterobacter, E. Coli, haemophilus Influenzae, kingella kingae, neisseria meningitidis, pseudomonas aeruginosa
Which anaerobic bacteria have the potential for being a pathogen?......Correct Answers......Bacteroides, clostridium
Where is staph epidermidis usually found?......Correct Answers ......Skin, hair, naso-oropharynx, adult vagina, urethra, conjunctiva, ear, lower GI
What is another name for strep saprophyticus?......Correct Answers ......Group B strep
Where is group B strep not commonly found?......Correct Answers ......Oropharynx and postpubertal vagina
Where is strep mutans usually found?......Correct Answers...... Mouth
Where is strep pneumo usually found?......Correct Answers...... Mouth
What is another name for strep pyogenes?......Correct Answers ......Group A strep
Where is group A strep usually found?......Correct Answers...... Mouth, pharynx
Where is enterococcus faecalis usually found?......Correct Answers ......Lower GI, postpubertal vagina, mouth, urethra
Where is enterobacter usually found?......Correct Answers......Lower GI, prepubertal vagina, mouth, axilla
Where is E. Coli usually found?......Correct Answers... ...Lower GI, vagina, mouth, urethra
Disease caused by microbial pathogens results from what? ......Correct Answers......Destruction of infected cells and tissues or from disruption of normal cell functions
What are the crucial aspects of history taking in regards to infectious diseases?......Correct Answers......History of present illness, comprehensive past medical history, current and recent medications, immunizations, family history, social history, exposure history, complete review of symptoms, and diet history
What symptoms raise concern for meningitis particularly in infants and younger children?......Correct Answers......Lethargy, stiff or painful neck, refusal to walk
What does a bacterial infection do to the WBC?......Correct Answers.... ..Elevates WBC, increases neutrophils and bands. If overwhelming sepsis, decreases WBC
What does a viral infection do to the WBC?......Correct Answers ......Decreases the WBC
What type of medication can increase the WBC?......Correct Answers.... ..Steroids
During acute infection, what changes occur in the CBC?......Correct Answers.... ..Either increased or decreased WBC depending on origin and increased platelets
How does a chronic inflammatory disease affect the CBC? ......Correct Answers......Decreased red blood cells
What does a CRP show?......Correct Answers.... ..Acute inflammation
What does a bacterial infection do to a CRP?......Correct Answers ......Increases the CRP
What does a viral infection do to a CRP?......Correct Answers.... ..It is uncommon for it to increase the CRP above 10mg/dL in young children
What inflammatory processes other than infection may elevate the CRP?......Correct Answers......Trauma, rheumatologic diseases, oncologic diseases, and adiposity
What is procalcitonin and what causes it to rise?......Correct Answers.... ..A protein produced by several cell types and many organs in response to proinflammatory stimuli, particularly due to bacteria
What marker has been proven in some cases to be a better marker of sepsis than ESR, WBC, CRP, and IL-6?......Correct Answers.... ..Procalcitonin
What is the difference between CRP and Pro-CT?......Correct Answers.... ..Pro-CT levels tend to rise and fall more quickly than CRP
What does ESR show?......Correct Answers...... Measure of inflammation and reflects the observation that red blood cells settle more rapidly when acute phase proteins such as fibrinogen are present in serum
What type of infections are commonly detected by DNA PCR? ......Correct Answers......Neisseria gonorrhoeae, chlamydia trachomatis, HIV, bordetella pertussis, herpes viruses, and enteroviruses
What type of infectious organisms often rely on serologic diagnosis?......Correct Answers......HIV, West Nile virus, bartonella henselae, and mycoplasma pneumoniae
What do plain radiographs assist in diagnosing?......Correct Answers.... ..Bone, sinus, and lung infections
What do CT scans assist in diagnosing?......Correct Answers...... Deeper infections such as abscesses
What do MRIs assist in diagnosing?......Correct Answers ......Osteomyelitis and encephalitis
What are ultrasounds used to evaluate?......Correct Answers...... Visceral organs, including the liver, spleen, heart, and kidney, for fluid collections suspicious of abscess and anatomy
What type of nuclear medicine remains useful in pediatrics? ......Correct Answers......Bone scan for diagnosis of osteomyelitis
In order to substitute alcohol based hand cleaner for soap and water, what must the alcohol content be ?......Correct Answers.... ..At least 40% but preferably 60% or more
Who develops research protocols around any given vaccination adverse event and helps to understand it?......Correct Answers ......CISA- clinical immunization safety assessment
What has research began showing in regards to acetaminophen prophylaxis after vaccination?......Correct Answers......Significantly lower antibody responses
The response to what type of vaccine is often as protective as the natural infection?......Correct Answers......A live attenuated vaccine
Which vaccines usually confer broader and longer lived immunity than other types?......Correct Answers......Live attenuated vaccines
Which types of vaccines can provide systemic protection (IgG) but may fail to provide local mucosal antibody (IgA)?......Correct Answers.... ..Killed and inactivated
Why are certain vaccines delayed until the child is 1 year old? ......Correct Answers......Maternal antibodies neutralize certain vaccines
What are some general side effects of the attenuated or killed vaccines?......Correct Answers......Fever and local reactions (pain, swelling, erythema), and sterile abscesses
What are some general contraindications to the attenuated or killed vaccines?......Correct Answers... ...Anaphylaxis, pregnancy, allergies to vaccine components or yeast, and moderate to severe acute infections
Which vaccines are inactivated?......Correct Answers... ...DTaP, IPV, Hib, Hep A, Hep B, HPV, PCV, flu, meningococcal
Who should receive the Hep A & Hep B vaccine?......Correct Answers.... ..Children 1-18 years old, those traveling to countries where Hep A & Hep B are endemic, children and adolescents in contact with others from outbreak areas, children in diapers in daycare centers with high rates, men who have sex with men, severe illness, illicit drug users, those with blood clotting disorders, healthy individuals in contact with an international adoptee within the first 60 days
When should a child receive routine booster doses of Hep B? ......Correct Answers......Patients receiving hemodialysis or immunocompromised patients whose anti-HBs level has fallen to less than 10 mIU/mL
When should a preterm infant weighing less than 2000g receive the first Hep B vaccine?......Correct Answers.... ..At 1 month
Who should receive CMV IG?......Correct Answers......Organ transplant recipients with CMV pneumonia
Who should receive Hep B IG?......Correct Answers......Those unvaccinated or incompletely vaccinated who have discrete identifiable exposure to blood or body fluids that contain blood
Why should someone receive IG?......Correct Answers......Hep A prophylaxis, measles prophylaxis, rubella prophylaxis
What is IVIG approved to treat?......Correct Answers... ...Primary immunodeficiencies, chronic lymphocytic leukemia, bone marrow transplants, HIV, ITP, kawasaki disease
Who should receive VariZIG?......Correct Answers ......Immunocompromised contacts, infants whose mother had Varicella 5 days before or 2 days after birth, all preterm infants less than 28 weeks or 1000g, preterm infants more than 28 weeks if mother unimmunized
When should VariZIG be given?......Correct Answers... ...No longer than 96 hours after exposure
Which unique ethnic group should receive the Hep B vaccines? ......Correct Answers......Alaska native or Pacific islander
Which strains of HPV does the Gardasil vaccine protect against? ......Correct Answers......16, 18, 6, and 11
What type of protection is available for HPV oncogenic types acquired prior to vaccination?......Correct Answers......None
Which HPV vaccine is approved for use in males?......Correct Answers.... ..Gardasil
Which strains of HPV does the Cervarix vaccine protect against?......Correct Answers.... ..16 and 18
Who is encouraged to receive the HPV vaccine?......Correct Answers.... ..Preadolescent females as early as 9 years old and all sexually active women through 26 years old
What does the Menactra (MCV4) vaccine cover?......Correct Answers.... ..Meningococcal groups A, C, Y, and W
What does the Menveo vaccine cover?......Correct Answers ......Meningococcal groups A, C, Y, and W135 and oligosaccharide diphtheria CRM
What does the MPSV4 vaccine cover?......Correct Answers ......Meningococcal groups A, C, Y, and W135 made solely of polysaccharides
Who is the meningococcal vaccine recommended for?......Correct Answers.... ..All adolescents, college freshmen living in dormitories, military recruits, those with functional asplenia or persistent deficiencies including infants 9-23 months old, and travelers to hyperendemic or epidemic countries
Which age group receives the Menactra vaccine?......Correct Answers.... ..Infants (9 months) through adults (55 years)
Which age group receives the Menveo vaccine?......Correct Answers.... ..2-55 years old
Which age group receives the MPSV4 vaccine?......Correct Answers ......Older than 55 years but can be given to anyone older than 5 years if MCV4 is unavailable
Who should not receive the MCV4 vaccine?......Correct Answers ......Individuals with prior GBS infection
On what year did the PCV13 vaccine replace the PCV7 vaccine? ......Correct Answers...... 2010
When should a child who has completed the PCV7 series receive a PCV13 vaccination?......Correct Answers......When the child is under 5 years old
Who receives the PPSV23 vaccine?......Correct Answers......Children 2 years and older and adults at high risk or presumed high risk of pneumococcal disease
What will happen if a child is given a live vaccine while on IVIG?......Correct Answers......The virus will be neutralized by the antibodies in the IVIG
Who should not receive a live viral vaccination?......Correct Answers.... ..Children with DiGeorge syndrome, HIV infection, cancers, immunosuppression, or other cellular immune problems
Who should be consulted prior administration of the BCG vaccine?......Correct Answers...... Pediatric TB experts
In the US, who should receive the BCG vaccine?......Correct Answers.... ..Infants and children with a negative TB skin test who lives with someone with infectious TB who is untreated or ineffectually treated or has a drug resistant form of TB and cannot be separated from this person
When should the BCG vaccine be given?......Correct Answers ......Ideally at birth but can be given up to 2 months old without having a TB skin test
Who should not receive the MMR vaccine?......Correct Answers ......Those needing a TB skin test, who are pregnant or plan to become pregnant within the next 28 days, who have had an anaphylactic reaction to gelatin, egg, neomycin, or prior MMR vaccine, or who have febrile illness
How soon after measles exposure must the measles vaccine be given to provide some protection?......Correct Answers...... Within 72 hours
How soon after measles or mumps exposure must IG be given to a susceptible person to provide protection?......Correct Answers ......Within 6 days
In the event of a measles outbreak, how early can vaccination begin?......Correct Answers......6 months old
What type of mild reactions are related to the rubella vaccine? ......Correct Answers......Fever, lymphadenopathy, rash, joint pain, and paresthesias
Who should be the focus for rubella vaccination?......Correct Answers.... ..Females less than 13 years old who have not received the second MMR vaccine
What test is warranted in postpubertal females due to receive the MMR vaccine?......Correct Answers... ...Prenatal screening
What are the side effects related to the Varicella vaccine? ......Correct Answers......Localized pain, erythema, and tenderness,
generalized varicelliform rash within 2 weeks, and fever within 5-12 days
Should immunocompromised household contacts be isolated from someone recently vaccinated for Varicella?......Correct Answers.... ..No
If the patient contracted Varicella after receiving the vaccine, what would the symptoms be?......Correct Answers......Minimal fever, fewer than 50 lesions, and quicker recovery
When should the Varicella vaccine be given after VariZIG? ......Correct Answers......5 months after unless Varicella disease occurred despite VariZIG
What are the contraindications for the Rotavirus vaccine? ......Correct Answers......A history of intussusception or severe combined immunodeficiency disease
When should the smallpox vaccine be administered?......Correct Answers.... ..Only to high risk individuals determined by the CDC during an outbreak, not routinely
What is passive immunization?......Correct Answers......It entails immunizing an individual with a solution of preexisting antibodies to prevent or amend an infectious disease
Who can receive passive immunization?......Correct Answers.... ..It is reserved for patients who suffer from immunodeficiencies in whom a live or attenuated vaccine could be dangerous, who have a problem making antibodies, who are nonimmunized or
