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paediatrics > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

Macules

A

Red/Pink discrete flat areas which blanch on pressure

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2
Q

Papules

A

Solid raised hemispherical lesions, usually tiny, blanch on pressure

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3
Q

Rubella

A

macular rash

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4
Q

Measles

A

Maculopapular rash

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5
Q

Purpuric, petechia

A

non blanching red/purple spots, tested with a glass

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6
Q

some conditions that are purpuric or petechial

A
  • meningococcal
  • HSP
  • Enterovirus
  • Thrombocytopenia
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7
Q

vesicles

A

raised hemispehrical lesions, <0.5cm diameter, contain clear fluid

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8
Q

infections with vesicles

A
  • Chicken pox
  • shingles
  • Hand, foot and mouth disease
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9
Q

Pustules/ bullae

A

raised hemispherical lesions >0.5cm diameter, contain clear or purulent fluid

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10
Q

Infections with pustules/ bullae

A
  • impetigo
  • scalded skin syndrome
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11
Q

Desquamation

A

dry and flaky loss of surface epithelium, often in peripheries

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12
Q

Infections with desquamation

A
  • post- scarlet fever
  • kawasaki
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13
Q

measles is caused by

A

the measles virus

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14
Q

measles

incubation period

A

around 2 weeks

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15
Q

measles

mode of spread

A

droplet spread, highly infectious during viral shedding

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16
Q

measles

pathognomic feature

A

koplik spots

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17
Q

measles

Clinical features

A
  • cough
  • conjunctivitis, coryza
  • koplik spots
  • Maculpapular Rash
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18
Q

measles

Koplik spots

A

white spots on the buccal mucosa seen against a red background

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19
Q

measles

Rash seen

A

maculopapular rash starting from behind the ears to the whole body. May desquamate in the second week

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20
Q

measles

Respi complications

A
  • Pneumonia
  • Secondary bacterial infection and otitis media
  • Tracheitis
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21
Q

measles

Neuro complications

A
  • Febrile convulsions
  • EEG abnormalities
  • Encephalitis
  • SSPE
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22
Q

measles

SSPE

A

late and rare manifestation by around 7 years. loss of neuro function and 100% death rate

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23
Q

measles

complications

A
  • Respi
  • Neuro
  • Diarrhea
  • Hepatitis
  • Appendicitis
  • Corneal ulceration
  • Myocarditis
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24
Q

measles

Mx

A
  • Symptomatic Rx
  • Isolate the child
  • Ribavirin for immunocompromised
  • Vitamin A to boost immunity
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25
Q

measles

Prevention

A

MMR vaccine- given at 9 months and 3 years

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26
Q

Chicken pox

MO

A

Varicella zoster

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27
Q

Chicken pox

Incubation period

A

around 2 weeks

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28
Q

Chicken pox

Spread

A

by respiratory droplets. until the last lesion has crusted, child is infectious

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29
Q

Chicken pox

Clinical features

A

Vesicular rash starting on the head and trunk and progress to peripheries

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30
Q

Chicken pox

Rash

A

starts as papules, vesicles with sorrounding erythema and pustules for upto one week.

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31
Q

Chicken pox

Why do children present with difficulty eating

A

lesions may appear on the palate

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32
Q

Chicken pox

Does it leave scars

A

no unless they are scratched

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33
Q

Chicken pox

lesions appear beyond 10 days

A

suggests defective cellular immunity

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34
Q

Chicken pox

Complications

A
  • bacterial superinfection
  • CNS- cerebellitis, generalised encephalitis, aspetic meningitis
  • Immunocompromised- Penumonitis, hemorrhagic lesions, DIC, progressive and disseminated infections
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35
Q

Chicken pox

Rx

A
  • immunocopromised- IV acyclovir
  • high- risk immunocompromised following contact- HZV Ig vaccine (VZIG)
  • Normal immunity- no Rx
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36
Q

Chicken Pox

Prevention

A

Immunization against chickenpox

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37
Q

Mumps

Incubation period

A

15-24 days

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38
Q

Mumps

MO

A

Measles virus

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39
Q

Mumps

spread by

A

aerosolized droplets

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40
Q

Mumps

clinical features

A
  • Fever, malaise, parotitis
  • Parotitis starts U/L but spreads B/L in the next week
  • Earache, pain on eating and drinking (acidic, salty)
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41
Q

Mumps

Parotitis

A

Usually starts U/L and then spread B/L over the next few days

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42
Q

Mumps

how long does the fever last

A

around 3-4 days

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43
Q

Mumps

pancreatic involvement

A

Serum amylase is high

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44
Q

Mumps

how long does the infectivity last

A

upto a week

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45
Q

Mumps

complications

A
  • transient and U/L hearing loss
  • viral meningitis, encephalitis
  • Orchitis- uncommon
  • Myocarditis
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46
Q

Mumps

risk of subfertility

A

Mumps complicated with B/L orchitis

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47
Q

Mumps

Prevention

A

MMR vaccine
SL remedy- ali hakka

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48
Q

Rubella

MO

A

Rubella virus

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49
Q

Rubella

incubation period

A

15-20 days

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50
Q

Rubella

Spread

A

Respiratory

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51
Q

Rubella

Clinical features

A
  • Prodrome- mild fever
  • maculopapular rash
  • Lymphadenopathy
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52
Q

Rubella

Rash

A

Maculopapular rash starting from the face and spreading centrifugally to the whole body

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53
Q

Rubella

Lymphadenopathy locations

A
  • Suboccipital
  • Postauricular
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54
Q

Rubella

Complications

A
  • Arthritis
  • Encephalitis
  • Thrombocytopenia
  • Myocarditis- rare
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55
Q

Rubella

Prevention

A

MMR vaccine

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56
Q

Impetigo

MO

A

Staphylococcal
Streptococcal

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57
Q

Impetigo

most common in

A

children with pre- existing skin disease

58
Q

Impetigo

lesions location

A
  • Face
  • Neck
  • Hands
59
Q

Impetigo

rash

A
  1. begins as erythematous macules
  2. become vesicles/ pustules/ bullae
  3. rupture
  4. honey- colored crusted lesions
60
Q

Impetigo

Infection spread

A

autoinculation

61
Q

Impetigo

Rx

A
  • Mild cases- topical ABx (Mupirocin)
  • Severe- flucloxa, co-amoxiclav
  • Isolate the child
  • Nasal cream of mupirocin, chlorhexidine
62
Q

SSSS

Pathophysiology

A

exfoliative toxin of staph seperates the epidermal skin from the dermis

63
Q

SSSS

affected age groups

A

Infants, young children

64
Q

SSSS

Clinical features

A
  • fever, malaise
  • purulent, crusting, localized infection around the eyes, nose, mouth
  • widespread erythema and tenderness of skin
  • subtle pressure cause epidermis to peel off, leaving denuded skin
  • denuded areas dry and heal without scarring
65
Q

SSSS

Mx

A
  • iv ABx- flucloxa, vancomycin
  • iv morphine
  • fluid balance- NS
  • Losing protein- high protein diet (NG tube, TPN)
66
Q

HIV

Spread

A
  • mother- to child transmission- during PG, at delivery, through breastfeeding
  • infected blood products- abuse, contaminated needles
67
Q

HIV

Sx of mild HIV

A
  • lymphadenopathy
  • parotitis
68
Q

HIV

Sx of moderate HIV

A
  • Recurrent bacterial infections
  • candidiasis
  • chronic diarrhea
  • lymphocytic interstitial pneumonitis (LIP)
69
Q

HIV

Sx of severe HIV

A
  • opportunistic infections- pneumocystis carinii pneumonia
  • severe failure to thrive
  • encephalopathy
  • malignancy
70
Q

HIV

  • Dx of <18 months
  • > 18 months
A
  • <18 months- HIV DNA PCR
  • > 18 months- HIV Ab
71
Q

HIV

How to know the infant is not infected anymore

A

Two negative PCR within first 3 months of life at least two weeks after the completion of postnatal antiretroviral therapy

71
Q

HIV

confirmatory test that the infant is free of HIV

A

loss of transplacental maternal HIV Ab from the infant’s circulation after 18 months of age

71
Q

HIV

screening Dx

A

all infants born to HIV infected mothers needs to be tested whether they are symptomatic or not

72
Q

HIV

Rx

A
  • ART- combo of 3-4 drugs
  • Prophylaxis against Pneumocystis jiroveci carinii pneumonia- Co- trimoxazole
  • MDT approach
73
Q

HIV

immunization

A
  • no live vaccines- BCG not given
74
Q

HIV

MDT consists of

A
  • Pediatrician
  • venerologist
  • Psychiatrist
  • social workers
75
Q

HIV

prevention

A
  • antenatal ART
  • offer LSCS
  • avoid breastfeeding
76
Q

Malaria

MO

A
  • Plasmodium vivax
  • Plasmodium falciparum
  • Pl ovale
  • Pl malariae
77
Q

Malaria

incubation period

A

7- 10 days

78
Q

Malaria

spread

A

Female anopheles mosquito

79
Q

Malaria

Sx

A
  • high- grade cyclical fever
  • diarrhea, vomiting
  • flu- like Sx
  • Jaundice
  • Anemia, thrombocytopenia
  • Chills, rigors
80
Q

Hepatosplenomegaly
High- grade fever
chills and rigors
Recent travel Hx to Africa

A

Malaria!

81
Q

Malaria

complications

A
  • severe anemia
  • hepatic, liver failure
  • renal failure
  • cerebral malaria
82
Q

Malaria

Dx

A
  • thick film- +/- to malaria
  • thin film- the causative species
83
Q

Malaria

Rx

A
  • Quinine
  • Artemether
  • Artesunate
84
Q

Malaria

Rx for Pl vivax malaria

A
  • Chloroquine
  • Primaquine
85
Q

Malaria

Cerebral edema risk is highest

A

Pl falciparum

86
Q

Malaria

Malaria MO that are mostly seen in SL

A
  • Pl falciparum
  • Pl vivax
87
Q

Malaria

Immediate Dx test

A

RAT

88
Q

Malaria

Prevention

A
  • prophylaxis- primaquien before traveling to high risk areas
  • mosquito nets, repellants
  • cleaning breeding areas
89
Q

Malaria

Best drug for the hepatic form of Pl vivax

A

Primaquine

90
Q

Malaria

ADRS of Quinine

A

hypoglycemia

91
Q

Malaria

ADRS for Primaquine, Chloroquine

A

G6PD deficiency. Not given during PG

92
Q

Typhoid

MO

A

Salmonella typhi
Salmonella paratyphi

93
Q

Typhoid

Incubation period

A

7-14 days

94
Q

Typhoid

spread

A

Feco- oral route

95
Q

Typhoid

Salmonella is G+ or G-?

A

G- flagellated

96
Q

Typhoid

Clinical features

A
  • Worsening fever, headache, cough, abd pain, anorexia, malaise, myalgia
  • GI Sx- Starts with constipation upto diarrhea
  • mild to mod soft splenomegaly, bradycardia, rose- colored spots on the trunk
97
Q

Typhoid

Complications

A
  • GI perforation - Peritonitis
  • Myocarditis
  • Hepatitis
  • Nephritis
  • Meningitis
  • Osteomyelitis
98
Q

Typhoid

Dx

A
  • 1st week- Blood culture
  • 2nd week- urine and stool culture
  • after first week BM culture can be done
  • Standard agglutination test (SAT)- after one week. H Ag and O Ag
99
Q

Typhoid

SAT which antigen is most specific of typhoid

A

O Ag

100
Q

Typhoid

Rx

A

iv 3rd Gen cephalosporin + azithromycin - cefotaxime +clarithromycin (7-10 days)

101
Q

Typhoid

Prevention

A
  • Practicing safe food hygiene methods
  • vaccination against typhoid (3 yearly)
102
Q

Typhoid

Typhoid vaccine is included in the EPI or not

A

not included

103
Q

Constipation, fever turning into abd pain, diarrhea
Hx of food intake from outside
Rose spots
Relative bradycardia

A

Typhoid

104
Q

Typhoid

Carriers

A

MO lodge in the gall bladder and cholecystectomy should be offered

105
Q

Typhoid

Typical Abdomen

A

Doughy abdomen

106
Q

Typhoid

Drug used in the past but not given anymore

A

Chloramphenicol - aplastic anemia

107
Q

Typhoid

Why is ciprofloxacin not given to children

A

cause cartilage, growth problems

108
Q

Typhoid

3rd Gen cephalosporins cover

A

Both G+ and G- but mostly G- coverage

109
Q

Leptospirosis

MO

A

Leptospira

110
Q

Leptospirosis

Incubation period

A

7-14 days

111
Q

Leptospirosis

Spread

A

Via contaminated soil or water mainly muddy water, paddy fields. Bacteria infect domestic and wild animals and are excreted in animal urine to soil or water

112
Q

Leptospirosis

Clinical features during the first week

A
  • fever, chills
  • headache
  • muscle soreness in the calves
  • redness of the eyes- conjunctivitis, conjunctival suffusions
  • Abd pain, nausea, vomiting
  • skin rash over the shins ( pretibial)
113
Q

Leptospirosis

how long does the fever last

A

around a week and it settles for 1-3 days and again returns with additional Sx
* Uveitis, iritis
* Meningitis
* Hepatitis
* Lymphadenitis

114
Q

Leptospirosis

Dx

A
  • IgG, IgM in blood samples
  • Culture of leptospira- body fluids or tissue
  • Dark field microscopy
115
Q

Leptospirosis

Ix

A
  • FBC
  • LFT
  • RFT
  • Coagulation studies
116
Q

Leptospirosis

Complications

A
  • Hepatitis, Jaundice
  • Bleeding
  • Kidney failure
  • Irregular heart rhythm
  • Hemorrhagic pneumonitis
  • Meningitis
117
Q

Leptospirosis

Hepatitis and Jaundice

A

Weil’s disease

118
Q

Leptospirosis

Rx- prophylaxis

A
  • <8 y/o- PO amoxicillin
  • > 8y/o- doxycycline
119
Q

Leptospirosis

Rx

A
  • iv penicillin
120
Q

Leptospirosis

why is doxycycline not given to children <8 years

A

cause teeth abnormalities- teeth staining

121
Q

Leptospirosis

Prevention

A
  • Personal hygiene- protective boots
  • Avoid muddy waters
  • Vaccination of pets
122
Q

Scrub typhus

MO

A

Rickettsia (Orientia tsutsugamishi)

123
Q

Scrub typhus

Incubation period

A

5-20 days

124
Q

Scrub typhus

Spread

A
  • Bite of an infected mite larvae or chigger
  • Transmitted to humans and rodents by the mites
  • Children goes to jungles, tree areas with no shirts
125
Q

Scrub typhus

Sx

A
  • Chigger bites
  • Headache
  • Fever
  • Shaking chills
  • Conjunctivitis
  • Lymphadenopathy
  • Spotted rash on trunk
  • splenomegaly
  • Hepatomegaly
126
Q

Scrub typhus

chigger bite

A

Painless, localized itch, an eschar seen on the groin, axilla, genitalia, neck

127
Q

Scrub typhus

Eschar

A

Resembles cigarette burn marks

128
Q

Scrub typhus

complications

A
  • CNS, pulmonary, cardiac involvement
  • Renal failure
  • Shock
  • DIC
129
Q

Scrub typhus

Dx

A
  • Early lymphopenia
  • Late lymphocytosis
  • Decreased CD4:CD8 ratio
  • Thrombocytopenia
  • Increased AST, ALT
  • Hypoalbuminemia
  • IgM, IgG elevated
130
Q

Scrub typhus

Rx

A
  • > 8y/o- Doxycycline
  • <8y/o- Azithromycin
131
Q

Scrub typhus

Prevention

A
  • Vector control
  • Protective clothing
132
Q

Congenital Rubella

Sx

A
  • LBW
  • Microcephaly
  • Cataracts
  • PDA
  • Pulm Stenosis
  • Hepatosplenomegaly
  • Thrombocytopenia
  • Rash
133
Q

CMV

Sx

A
  • LBW
  • Microcephaly
  • Chorioretinitis
  • Brain calcification
  • Hepatosplenomegaly
134
Q

CMV

Dx

A

Urine sample for CMV

135
Q

CMV

Mx

A
  • Anti- viral
  • Acyclovir
136
Q

Toxoplasmosis

Sx

A
  • Hydrocephalus
  • Diffuse calcification in basal ganglia
  • Eye abnormalities
137
Q

Toxoplasmosis

Vector

A

Domestic pets

138
Q

Toxoplasmosis

Mx

A

Anti- parasitic drugs

139
Q

Congenital infection

Signs

A
  • Baby too small <2.5kg
  • PG mom has fever+ rash
  • SGA baby
  • Microcephaly
  • Abnormal eyes- cataracts
  • PDA
  • Bleeding manifestations
  • Hepatosplenomegaly
140
Q

Congenital infections

TORCH

A
  • toxoplasmosis
  • Rubella
  • CMV
  • Hepatitis, HIV, Herpes

paediatrics (15 decks)

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