Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paeds > Infection > Flashcards

Infection Flashcards

1
Q

What is TORCH?

A

Congenital and neonatal infections:

  • Toxoplasmosis
  • Other (syphilis, parvovirus, VZV, HIV, HBV)
  • Rubella
  • CMV
  • HSV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the management of toxoplasmosis?

A
  • Pyrimethamine
  • Sulfadiazine
  • Calcium folinate
  • +Consider prednisolone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the management of Syphilis?

A

IM benzathine penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management of parvovirus?

A

Intrauterine = blood transfusion if foetal hydrops
Infant = self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the management of VZV?

A

Mild:

  • Supportive care (e.g. hydration, paracetamol, skin emollients, antihistamines)

Moderate:

  • Oral acyclovir
  • +Supportive care

Severe:

  • IV acyclovir
  • +Supportive care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the management of HBV?

A
  • Complete course of HBV vaccination (for all infants of mothers who are HBsAg +ve)
  • Blood test at 12m for HBV infection
  • Mother = tenofovir disoproxil OR lamivudine (no risk of transference through breastfeeding)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the management of Rubella?

A
  • Refer to foetal medicine unit and notify HPU
  • Rest, adequate fluids, analgesia
  • Infant = cardiac scans, hearing tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of CMV?

A

IV ganciclovir or oral valganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the management of HSV?

A

Acyclovir
if neonate exposed on delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the management of GBS?

A

Baby:

  • Benzylpenicillin or ampicillin PLUS gentamicin
  • Supportive therapy

Mother (during labour):

  • IV benzylpenicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the cause and consequence of listeria monocytogenes?

A
  • Mother has mild influenza-like illness and passes to child in placenta
  • Can cause spontaneous abortion, PTL, neonatal sepsis
  • Mortality = 30%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the S/S of listeria monocytogenes?

A
  • Meconium stained liquor (MSL) in preterm infant
  • Widespread rash

Can cause:

  • Sepsis
  • Pneumonia
  • Meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of listeria monocytogenes?

A
  • IV ampicillin
  • +Gentamicin (if severe infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Kawasaki Disease?

A

Systemic vasculitis disease
characteristically affecting young children (<5yrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who does Kawasaki Disease affect?

A
  • Children 6m-4yrs (peak 1yr)
  • Japanese, Black-Caribbean ethnicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the S/S of Kawasaki Disease?

A

(CRASH + Burn)

  • C = conjunctivitis (bilateral)
  • R = rash (polymorphous, begins hands/feet)
  • A = adenopathy (cervical lymphadenopathy)
  • S = strawberry tongue
  • H = hands + feet swollen / red (and desquamate/peel)
  • Burn = fever >5d (not responsive to antipyretics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the investigations for Kawasaki Disease?

A

Clinical diagnosis

  • FBC (inc. platelets), CRP, ESR
  • Echo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the management of Kawasaki Disease?

A

>ADMISSION

1st line: (if within 10d / ongoing inflammation)

  • IVIG
  • Plus high-dose aspirin
  • Consider corticosteroids

2nd line:

  • Infliximab, ciclosporin, plasmapheresis

If > 10 days / no ongoing inflammation:

  • Low-dose aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the main complication of Kawasaki Disease?

A

Coronary aneurysms

Early dx key to stop coronary artery aneurysms forming > ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes malaria?

A

Protozoa Plasmodium, spread by female Anopheles mosquito

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the types of malaria?

A
  • Falciparum (most fatal)
  • Ovale
  • Malariae
  • Vivax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the S/S of malaria?

A
  • Onset 7-10d after inoculation (<1yr)
  • Fever (cyclical / continuous with spikes)
  • D&V
  • Flu-like sx > shaking, chills, night sweats, headache, myalgia
  • Jaundice
  • Anaemia
  • Thrombocytopaenia
  • Particularly susceptible to cerebral malaria, severe anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the investigations for malaria?

A
  • 3 thick and thin blood films (detects parasites inside erythrocytes)
  • Malaria rapid diagnostic tests (RDTs) (detection of parasite antigen or enzymes)
  • Bloods: FBC, Clotting profile, U&Es, LFTs, BM, ABG
  • Urinalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the management of malaria?

A

General:

  • Bite-prevention (repellent and nets)
  • Prophylaxis - mefloquine
  • Arrange immediate admission (medical emergency)
  • Notify PHE

Non-falciparum:

  • 1st line = Chloroquine + primaquine / ACT

Falciparum:

  • Severe / complicated = IV artesunate (doe minimum 24hrs, then switch to ACT)
  • Uncomplicated = Artemisinin-based combination therapies (ACT)
  • +Supportive care (careful fluid management, renal support, airway protection, control of seizures, transfusion of blood products)
  • +/-ICU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes Typhoid Fever?

A

Salmonella typhi or paratyphoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is typhoid fever transmitted?

A

Faeco-oral transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the complications of typhoid fever?

A
  • GI perforation
  • Myocarditis
  • Hepatitis
  • Nephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where have people with typhoid fever commonly travelled to?

A

Pakistan, India, Bangladesh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the S/S of typhoid fever?

A
  • Persistent high temperature that gradually increases each day
  • Relative bradycardia
  • Abdominal pain and distension
  • Constipation
  • Headache
  • Anorexia (WL+++)
  • Rose-spots on trunk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the investigations for typhoid fever?

A
  • Blood culture (diagnostic)
  • FBC, LFTs
  • Stool culture, urine culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the management for typhoid fever?

A
  • 1st line = IV ceftriaxone + supportive care (antipyretics, fluids)
  • 2nd line (if resistant) = PO azithromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What causes Dengue fever?

A

Caused by dengue arbovirus transmitted by Aedes Aegyptii mosquito

33
Q

Where is dengue fever usually imported from?

A

SE Asia or South Africa

34
Q

What are the S/S of dengue fever?

A

Primary infection:

  • Headache (retro-orbital)
  • Fine erythematous sunburn-like rash
  • High fever and myalgia

Other:

  • Hepatomegaly, abdominal distension

Severe:

  • Low WCC, low platelets, haemorrhage

Dengue haemorrhagic fever (secondary infection):

  • Previously infected child > subsequent infection (different strain) > severe capillary leak, hypotension, haemorrhagic manifestations > fluid resus usually helps a lot
  • Due to partially effected host immune response augmenting the severity of the infection
35
Q

What are the investigations for dengue fever?

A
  • PCR viral antigen
  • Serology (positive IgM and IgG)
  • FBC, LFTs, serum albumin (low)
36
Q

What is the management of dengue fever?

A
  • Supportive (fluids and monitoring)
  • ITU (if increased deterioration / severe disease)
37
Q

What causes mumps?

A

Mumps orthorubulavirus

38
Q

How is mumps transmitted?

A

Respiratory secretions

39
Q

What is the timeline of mumps?

A
  • Long incubation period (15-24d)
  • Infectious 5d before and 5d after the parotid swelling (should pass totally in 1-2wks)

> Can still get infected if they had vaccine but likely to be reduced sx

40
Q

What are the S/S of mumps?

A
  • Asx (30%)
  • Headache, fever
  • Parotid swelling
  • Other > pancreatitis, neuritis, arthritis, mastitis, nephritis, thyroiditis, pericarditis
41
Q

What are the investigations for mumps?

A
  • Salivary mumps IgM
42
Q

What is the management of mumps?

A

General:

  • Notify HPU
  • Isolate for 5d from time of parotid swelling

Advise and educate:

  • Self-limiting condition
  • Supportive care (rest, analgesia, fluids)

Safety net for complications:

  • Mumps orchitis > infertility (very rare)
  • Viral meningitis > encephalitis (very rare)
  • Deafness (unilateral and transient)
43
Q

What causes measles?

A

Paramyxovirus

44
Q

How is measles transmitted?

A

Respiratory secretions

One of the most highly communicable diseases (>15m in direct contact is enough to transmit)

45
Q

What is the timeline of measles?

A

Incubation = 7-18d
Infective period = 4d before and 4d after rash

46
Q

What are the S/S of measles?

A
  • Prodrome = high fever, irritability, conjunctivitis, coryza, febrile convulsions
  • Maculopapular rash (face/neck > hands/feet)
  • Koplik spots (small white spots surrounded by red ring in mouth)
  • Cough
47
Q

What are the investigations for measles?

A
  • Measles specific IgG and IgM serology (ELISA)
  • 2nd line = PCR of blood or saliva
48
Q

What is the management for measles?

A

General:

  • Notify HPU
  • Advise it’s self-limiting but likely to cause unpleasant symptoms e.g. rash, fever, cough, conjunctivitis
  • Immunise close contacts and encourage vaccination after acute episode
  • Isolate for 4d after development of rash

Supportive tx

  • Fluids, antipyretics, rest
  • Children isolated in hospital
  • Vitamin A supplements if severe

Safety net for complications

  • Seek urgent medical advice if they develop complications such as: SOB, uncontrolled fever, convulsions / altered consciousness
49
Q

What are the complications of measles?

A
  • Otitis media (most common)
  • Encephalitis (after 102wks) > headache, lethargy, irritability, seizures, coma
  • Sub-acute sclerosing panencephalitis (SSPE) (after 7yrs) > measles dormant in CNS, dementia, death
  • Pneumonia
  • Keratoconjunctivitis
50
Q

What causes Rubella?

A

‘German Measles’ caused by Togavirus

51
Q

How is Rubella transmitted?

A

Spread through coughing and sneezing

52
Q

What is the timeline of rubella?

A
  • Incubation period = 6-21d
  • Infective period = 1wk before to 5d after rash onset
  • Illness period = 7-10d
53
Q

What are the S/S of rubella?

A
  • Prodrome = mild fever / asx
  • Pink maculopapular rash (face > whole body), fades in 3-5d
  • 20% > Forchheimer spots (red spots on soft palate)
  • Lymphadenopathy (suboccipital, postauricular)
  • > No Koplik spots or conjunctivitis
54
Q

What are the investigations for rubella?

A
  • Rubella serology (IgG and IgM) from oral fluid test
  • RT-PCR (2nd line)
55
Q

What is the management for rubella?

A
  • Notify HPU
  • Isolate for 4d after development of rash
  • Advise that it is a self-limiting disease
  • Supportive (fluids, analgesia, rest)
  • Safety net the complications (haemorrhagic complications due to thrombocytopenia)
56
Q

What does Parvovirus B19 cause?

A

“Fifth’s disease / erythema infectiosum / Slapped Cheek”

57
Q

How is parvovirus B19 transmitted?

A
  • Respiratory secretions
  • Vertical transmission
58
Q

When is a patient with Parvovirus B19 infectious?

A

10d before to 1d after rash develops

59
Q

What is parvovirus B19 in pregnancy associated with?

A

Hydrops fetalis

60
Q

What are the RFs for parvovirus B19?

A
  • HIV
  • Sickle cell
61
Q

What are the S/S of parvovirus B19?

A

1st:

  • Asx, or
  • Coryzal illness for 2-3d > latent for 7-10d

2nd:

  • Erythema infectiosum (most common)
  • Red ‘slapped cheek’ rash on face (viraemic phase of fever, malaise, headache, myalgia)
  • Progresses 1w later to maculopapular (lace) like rash in trunk and limbs

Aplastic crisis:

  • Occurs in children with chronic haemolytic anaemia (sickle cell) or immunodeficient

Foetal disease:

  • Maternal transmission
  • Leads to foetal hydrops, death due to severe anaemia
62
Q

What are the investigations for parvovirus B19?

A
  • B19 serology (IgM and IgG)
  • RT-PCR (2nd line)
63
Q

What is the management for parvovirus B19?

A
  • Supportive (fluids, analgesia, rest) > will clear in 3wks
  • Secondary arthritis may be treated with ibuprofen
  • No need to stay off school or avoid pregnant women (not infectious once rash develops)
  • Safety net complications (anaemia, lethargy, pregnancy)
64
Q

What causes chickenpox?

A

Varicella zoster virus (HHv-3)

> Reactivation of dormant virus after chickenpox leads to herpes zoster (shingles)

65
Q

What is the timeline of chickenpox?

A
  • Incubation period = 10-21d
  • Infectious period = 48hrs before rash to last crusted over lesion (5-7d after rash appears)
66
Q

What are the S/S of chickenpox?

A
  • Pyrexia, headache, abdominal pain, malaise
  • Crops of vesicles appear over 3-5d
  • Head, neck, trunk (less on limbs) > itchy
  • Papule > vesicle > crust > several stages at once
67
Q

What is the management of chickenpox?

A

Supportive:

  • Fluids, analgesia (no ibuprofen), rest
  • Advice > nail short, loose clothing, adequate fluid,
  • Isolate from > immunocompromised, pregnant women, neonates, keep off school

Admit if serious complications:

  • Secondary bacterial superinfection > sudden high fever, toxic shock, necrotising fasciitis
  • Encephalitis
  • Purpura fulminans > purpuric skin rash
  • Dehydration (severe)
  • Immunocompetent = oral acyclovir (if <24hrs of rash)
  • Immunocompromised = IV acyclovir > oral acyclovir

Prophylactic prevention:

  • Human VZV IVIG
68
Q

What causes hand, foot, and mouth disease?

A

Most commonly due to Coxsackie A16 virus

Severe = enterovirus 71
Atypical = Coxsackie A6

69
Q

What are the S/S of hand, foot, and mouth disease?

A
  • Painful, itchy, vesicular lesions (hand, foot, mouth, tongue, buttocks)
  • Mild systemic features > fever, sore throat, spots in mouth > develop into ulcers
70
Q

What is the management of hand, foot, and mouth disease?

A
  • Supportive > fluids, analgesia, rest (will clear in 7-10d)
  • Safety net > dehydration, if doesn’t clear up in 2wks, pregnancy
  • Don’t need to be kept off school but HPA recommend they do until better
71
Q

What causes Roseola Infantum?

A

HHV6
(Sixth disease / exanthum subitem)

72
Q

When are children infected with Roseola Infantum?

A
  • Most children infected by 2yrs (6m-2yrs)
  • Highly infectious during whole period of disease
  • > Infected VERY young compared to other infections
73
Q

What are the S/S of roseola infantum?

A

Fever followed later by rash

  • High fever and malaise (3-4d) > generalised macular (small pink spots) rash appears as fever wanes
  • Rash starts on neck/body and spread to arms, lasts 1-2d, non-itchy, blanching
  • Many have febrile illness and never develop a rash, commonly misdiagnosed as measles/rubella
  • Febrile convulsions in 10-15%
  • Sore throat, lymphadenopathy, coryzal sx, D&V
  • Nagayama spots (spots on the uvula and soft palate)
    >Lack of Koplik spots (white spots on buccal mucosa)
74
Q

What are the investigations of roseola infantum?

A
  • HHV6/7 serology (IgG and IgM)
  • Measles & rubella serology (similar presentation)
75
Q

What is the management of roseola infantum?

A
  • Supportive > fluids, rest, analgesia > will clear in ~1w
  • No need to stay off school
  • Safety net the complications > high fever, febrile convulsions
76
Q

What are the investigations for HIV in children?

A
  • > 18m = antibody detection (ELISA)
  • <18m (still have transplacental anti-HIV IgG from mother) = PCR of virus
  • > Measured at birth, on discharge, 6wks, 12wks, 18m
77
Q

What is the management of HIV in children?

A

Reducing Vertical Transmission:

  • C-section will be recommended
  • Cord clamped as soon as possible and baby bathed immediately after birth
  • Zidovudine monotherapy for 2-4wks (low/med risk) or PEP combination (high risk)
  • Women not to breastfeed
  • Give all immunisations including BCG (unless mod-high risk of transmission)

PCR HIV virons at 6 and 12w (at least 2 and 8w after stopping prophylaxis)

  • Baby will have passive IgG from mother up until at least 6m

Decision to start is based on a combination of clinical status, HIV viral load and CD4 count
IMPORTANT: infants should start ART shortly after diagnosis because they are at higher risk of disease progression

  • PCP prophylaxis with co-trimoxazole is given to infants who are HIV-infected, and for older patients with low CD4 counts

Other aspects of management:

  • Immunisation (except BCG)
  • MDT approach
  • Regular follow-up with particular attention to weight and developmental progress
78
Q

What is the management if an immunocompromised patient comes into contact with chicken pox?

A

Immunocompromised patients and newborns with peripartum exposure should receive varicella zoster immunoglobulin (VZIG).

If chickenpox develops then IV aciclovir should be considered

Paeds (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions