Infections

Question 1

Fever,malaise, muscular pain, earache bilaterally….what is the infection?

Answer 1

Most likely mumps. Parotitis becomes bilateral in 70%

Keep out of school for five days after onset of swollen LN

Question 2

Lethargy, headache, fever, slapped cheek appearance…

Answer 2

Erythema infectiosum, aka fifth disease

Caused by parvovirus B19

Question 3

Hand foot and mouth… Symptoms and causative family

Answer 3

Mild systemic upset: sore throat, fever, anorexia,cough
Oral ulcers
Followed by Vesicles on palms and soles

Most commonly coxsackle A16 and enterovirus 71
Keep off school until Symps and vesicles disappear (?)

Question 4

Most common causes of meningitis in children up to three months

Answer 4

Group B streptococcus (especially in babies with low birth weight)
E. coli and other gram negative organisms
Listeria monocytogenes

Cefotaxime and amoxi (amoxi added due to listeria)

Question 5

Most common causes of meningitis in children from one month to six months

Answer 5

Neil Patrick Harris…

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
Haemophilus influenza 

Treat with IV cefotaxime

Question 6

Most common causes of meningitis older than 6 years

Answer 6

Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)

Question 7

Pertussis management

Answer 7

Oral erythromycin, not likely to change course of illness though (Symps may last for 2 wk)

Question 8

Presentation of pertussis

Answer 8

2-3 days of Coryza followed by
Coughing boughts, esp at night or feeding…vom / central cyanosis
Inspiratory whoop (forced inspiration against glottis)
Symps may last 2 weeks

Immunised at 2, 3, 4 months and 3-5 yr

Question 9

Irritable baby, with fever and conjunctivitis. Rash behind ears that spreads to whole body and becomes blotchy

Answer 9

Measles

Question 10

Mx of Croup

Answer 10

Treatment of mild croup is oral dexamethasone 0.15mg/kg single dose and review

Systemic dexamethasone and nebulised adrenaline 5ml of 1:1000 are used in severe croup, alongside oxygen administration

Question 11

Chicken Pox infectivity

Answer 11

infectivity = 4 days before rash, until 5 days after the rash first appeared

Question 12

Cause of croup

Answer 12

Parainfluenza virus in majority

Question 13

Bronchiolitis description

Answer 13

Low grade fever
Followed by dry cough, fine crackles, wheezing, feeding difficulties
Usually caused by Respiratory syncytial virus…nasopharyngeal secretion antibody test
give humidified oxygen

Question 14

Meningitis symps in children

Answer 14

Fontinelles increase (so less likely to have papilloedeoma)
Headache worse when lying down, or valsavae
Altered conscious
Cranial nerve palsies
Cushing triad is
…Chain stroke breathing (deep ineffective respiration)
…High BP
…Bradycardia

Question 15

Diagnosis of pertussis

Answer 15

Nasal swab showing Bordetella pertussis…but takes weeks to come