CPEN Sepsis and Infectious Disease Emergencies 2

Question 1

A 3-year-old presents with high fever, severe headache, neck stiffness, and a non-blanching petechial rash spreading rapidly. What is the PRIORITY intervention?

Accepted Answer

Administer IV ceftriaxone immediately without waiting for LP

Answer

Perform lumbar puncture before starting antibiotics

Answer

Obtain a head CT scan before any other intervention

Answer

Start IV acyclovir as first-line empiric treatment

Question 2

Which CSF analysis result is MOST consistent with bacterial meningitis?

Accepted Answer

Turbid fluid, elevated protein, decreased glucose, neutrophilic pleocytosis

Answer

Clear fluid, low protein, normal glucose, predominantly lymphocytes

Answer

Xanthochromic fluid with elevated RBCs and normal protein

Answer

Clear fluid with normal protein, glucose, and no white cells

Question 3

A 2-year-old has had fever for 6 days with bilateral non-purulent conjunctival injection, erythematous cracked lips, strawberry tongue, and a diffuse macular rash. Which diagnosis BEST fits this presentation?

Accepted Answer

Kawasaki disease

Answer

Scarlet fever from Group A Streptococcus

Answer

Toxic shock syndrome

Answer

Stevens-Johnson syndrome

Question 4

What is the standard first-line treatment for Kawasaki disease?

Accepted Answer

IV immunoglobulin (IVIG) and high-dose aspirin

Answer

IV methylprednisolone and oral azithromycin

Answer

IV ceftriaxone and low-dose aspirin

Answer

Oral prednisone and ibuprofen

Question 5

A 5-year-old develops fever, sore throat, and a diffuse 'sandpaper-like' rash after a positive rapid strep test. What is the MOST appropriate antibiotic treatment?

Accepted Answer

Amoxicillin for 10 days

Answer

Azithromycin for 5 days

Answer

Cephalexin for 7 days

Answer

Clindamycin for 14 days

Question 6

Which clinical triad BEST distinguishes peritonsillar abscess from severe tonsillitis in a child?

Accepted Answer

Uvular deviation, trismus, and muffled 'hot potato' voice

Answer

High fever, bilateral tonsillar enlargement, and odynophagia

Answer

Unilateral otalgia, drooling, and neck rigidity

Answer

Drooling, stridor, and the sniffing position

Question 7

An 18-month-old presents with 3 days of fever and irritability. Examination reveals a bulging, erythematous tympanic membrane with loss of the light reflex. Which antibiotic is FIRST-LINE per AAP guidelines?

Accepted Answer

Amoxicillin

Answer

Azithromycin

Answer

Trimethoprim-sulfamethoxazole

Answer

Cephalexin