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MC > Infectious Dse in Children > Flashcards

Infectious Dse in Children Flashcards

1
Q

Chickenpox has a complication of only____,

A

1%

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2
Q

Chickenpox is a highly contagious infection
caused by the varicella zoster virus, a DNA virus
within the________________

A

herpes virus family.

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3
Q

Severe neonatal varicella

infection can result from perinatal varicella (especially if___________

A

contracted from 5 days before

the birth to 2 days after

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4
Q

rash of varicella

_________, including oral mucosa

‘_____________: vesicles, papules, crusting
lesions present together

Pruritic

A

Centripetal distribution

Cropping’ phenomenon

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5
Q

Varicella

Death rare except in the _______ and _____

A

immunocompromised and

neonates with congenital varicella

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6
Q

Varicella

Give paracetamol for the fever (avoid ___________in
children due to the possibility of Reye
syndrome).

A

aspirin

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7
Q

Varicella

___________ or similar agents can be life-saving in
the immunocompromised host

A

Aciclovir

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8
Q

Varicella

Exclusion is recommended until the ________

A

blisters have
dried, usually at least 5 days in unimmunised children
but possibly shorter in those immunised

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9
Q

Prevention in contacts who are immunocompromised
or at high risk (e.g. neonates) and in contact with
varicella, is possible with _____

A

zoster immune globulin

ZIG

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10
Q

Measles (rubeola) is a highly contagious disease

caused by an _____

A

RNA paramyxovirus

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11
Q

acute febrile exanthematous illness with characteristic

lesions on the buccal mucosa

A

measles

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12
Q

tiny

white spots like grains of salt, opposite the molars).

A

Koplik spots

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13
Q

If an
acute exanthematous illness is not accompanied by a
______, it is unlikely to be measles

A

dry cough and red eyes

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14
Q

Measles

Laboratory diagnosis is by serology, with IgM rising
_____after the onset of the rash.

A

3–5 days

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15
Q

Transmission of measles

A

Measles is transmitted by patient-to-patient contact
through oropharyngeal and nasopharyngeal droplets
expelled during coughing and sneezing

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16
Q

Measles

The incubation period is 10–14 days and the
patient is infectious until about _____

A

4 days after the onset

of the rash

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17
Q

Stages of meales

A

Prodromal stage
Exanthema (rash) stage
Convalescent stage

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18
Q

What stage of measles

This usually lasts 3–4 days. It is marked by fever, malaise, anorexia, diarrhoea and ‘the three Cs’: cough, coryza and conjunctivitis

Sometimes a non-specific rash appears a day before the Koplik spots

A

Prodromal stage.

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19
Q

Identified by a typically
blotchy, bright red maculopapular eruption; this
stage lasts 4–5 days

A

Exanthema (rash) stage

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20
Q

rash of measles

A

The rash begins behind the ears; on the first day it spreads to the face the next day to the trunk and
later to the limbs.

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21
Q

The rash fades, leaving a
temporary brownish ‘staining’. The patient’s
cough may persist for days, but usually good
health and appetite return quickly

A

Convalescent stage

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22
Q

Cx of measles

A 
otitis media (9%),
pneumonia (6%) and diarrhoea (8%).
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23
Q

cx of measles

________ late complication, occurring on average
7 years after infection in 0.5–1/100 000 cases, and
is manifested by universally fatal progressive brain
damage.

A

Subacute sclerosing panencephalitis

(SSPE) is a

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24
Q

Vaccines for measles

A

Live
attenuated measles virus vaccinations combined with
mumps and rubella (MMR) are recommended at the
age of 12 months and then MMRV (with varicella) at 18
months.

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25
Q

Multiple features of ______are
usually evident, which include intellectual disabilities,
cataracts, deafness, cardiac abnormalities, intrauterine
growth disorders (IUGR) and inflammatory lesions
of the brain, liver, lungs and bone marrow

A

Congenital Rubella syndrome

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26
Q

All women of child-bearing age should have________
and if not their immune status should be assessed
serologically.

A

2

documented doses of rubella-containing vaccines

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27
Q

Rubella-containing vaccinations are contraindicated

________ and ________

A

in pregnant woman and pregnancy should be avoided

for 28 days after vaccination

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28
Q

Only

______ of women of child-bearing age are seronegative, though the risk is higher in women born overseas.

A

2.5%

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29
Q

Rubella

T or F

Approximately one-third of infections are
asymptomatic (subclinical). Infection usually confers
temporary immunity

A

f

lifelong

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30
Q

Rubella

A _______ rash, sometimes pruritic,
may be the only evidence of infection.

Other symptoms are usually mild and short-lived.

There is often a reddened pharynx but sore throats are
unusual. An exudate may be seen as well as______

A

generalised, maculopapular

palatal
exanthem.

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31
Q

Rubella

The patient is infectious for_________

A

a week before and at least 4 days after the onset of the rash

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32
Q

Rash of measles vs rubella

A

A discrete pale pink maculopapular rash (not confluent as

in measles

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33
Q

School exclusion in pts with rubella

A

The child is usually excluded until fully recovered or

for at least 4 days from the onset of the rash

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34
Q

CX of rubella

A 
Encephalitis (rare)
Polyarthritis, especially in adult women (this complication
abates spontaneously)
Thrombocytopenia (rare)
Congenital rubella syndrome
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35
Q

This mild childhood infection may be caused by a
number of viruses, especially the enteroviruses,
and produces a rubella-like rash that may be
misdiagnosed as rubella

A

Viral exanthema (fourth syndrome

36
Q

4th syndrome vs rubella rash

A

In 4th syndrome: The rash, which is usually
non-pruritic and mainly confined to the trunk, does
not desquamate and often fades within 48 hours

37
Q

Parvovirus, also known as ‘slapped cheek’ syndrome,

is a childhood exanthem caused by______

A

parvovirus strain

B19.

38
Q

Rash of Parvovirus

A

The bright macular rash erupts on the face first then, after a day or so, a maculopapular
rash appears on the limbs

39
Q

_________is a mild illness but, if the
parvovirus infection occurs during pregnancy, fetal
complications including miscarriage can occur

A

Erythema infectiosum

40
Q 
Pregnant women should be tested for parvovirus
IgM and IgG if:
1
2
3
A

• in the same room as the infected person for
>15 minutes
• face-to-face contact
• household contact

41
Q

parvovirus IgM and IgG

  • IgG alone detected—______
  • IgM detected—_______
A

immune

false positive or early infection

42
Q

If Parvo infection occurs in the first half of pregnancy,
the fetus may become
1
2

A

anaemic (the virus replicates in erythroid progenitor cells) and hydrops fetalis and miscarriage can occur

43
Q

_______ is a viral infection (human herpes virus 6)
of infancy, affecting children at the age of 6 months
and 2 years;

A

Roseola

44
Q

SSx of Roseola

  1. Sudden ______
  2. Runny nose
  3. Temperature falls after _____
  4. ________ rash appears
A

high fever (up to 40 ° C)

3 days (or so) then

Red macular or maculopapular

45
Q

This is a mild vesicular eruption caused by
enteroviruses, the most common being Coxsackie
A-16, with EV-71 being less common

A

Hand, foot and mouth (HFM) disease

46
Q

Other name for HFM

A

Sometimes referred to as ‘crèche
disease’, it often occurs among groups of children in
child care centres

47
Q

Rash of HFM

A

• Starts as a red macule, then progresses to vesicles
• Vesicles lead to shallow ulcers on buccal mucosa,
gums and tongue
• Greyish vesicle with surrounding erythema

48
Q

Scarlet fever results when a _______ organism produces erythrogenic toxin

A

Group A Streptococcus

pyogenes

49
Q

Rash of scarlet fever

A

• First appears on neck
• Rapidly generalised
• Punctate and red, a ‘boiled lobster’ or sunburnt
appearance

50
Q

Where is the rash of scarlet predominant?

A

Prominent on neck, in axillae, cubital fossa

(Pastia lines), groin, skinfolds

51
Q

Tx of scalet

__________(dose according to age) for
10 days with rapid resolution of symptoms. Children
can return to school 24 hours after taking antibiotics
and feeling well

A

Phenoxymethylpenicillin

52
Q

This is an uncommon but important systemic
vasculitis, usually in children under 5 years of age,
likely caused by an infection, though the presumed
agent remains unknown

A

Kawasaki disease

53
Q

Features of KD

• polymorphous rash
• bilateral (non-purulent) _______
• ___________, e.g. reddened or dry
cracked lips, strawberry tongue, diffuse redness
of oral or pharyngeal mucosa
• __________, e.g. erythema of the palms
or soles, oedema of the hands or feet (and in
convalescence desquamation)
•_________(>15 mm diameter,
usually unilateral, single, non-purulent and
painful)

A

conjunctival infection

mucous membrane changes

peripheral changes

cervical lymphadenopathy

54
Q

Cx of KD

The majorcomplication is vasculitis, which causes _______________ in 15–25% of untreated cases,
and which can lead to ischaemic heart disease and
sudden death either at the time or years later

A

coronary

aneurysms and ectasia

55
Q

Tx of KD

Early treatment with_____ and ____ has been shown to be effective in reducing the prevalence of coronary artery abnormalities

A

immunoglobulin and aspirin

56
Q

_______ is an acute infectious disease caused by a
paramyxovirus with an affinity for the salivary
glands and meninges

A

Mumps

57
Q

Transmission of mumps

A

It is usually transmitted by

respiratory secretions or saliva

58
Q

The ______ occurs
in only two-thirds of clinical cases of mumps and is usually
bilateral

A

classic parotitis

59
Q

Mumps can result in________

if contracted in the first trimester of pregnancy

A

spontaneous abortion

60
Q

How to differentiate parotitis vs CLAD

A

Lymph nodes
are posteroinferior to the ear lobe; the parotid gland
is anterior and, when enlarged, obscures the angle of
the mandible

61
Q

________ is associated with

toxaemia and results in a high leucocyte count

A

Bacterial (suppurative) parotitis

62
Q

Common Cx of mumps

A 
Orchitis
Meningeal symptoms (10%)
Abdominal pain (transient)
63
Q

Rare Cx of mumps

A 
Oophoritis
Encephalitis
Arthritis (one or several joints)
Deafness (usually transient)
Pancreatitis
64
Q

Children with mumps should be excluded until ____

A

9 days

after the onset of the parotitis

65
Q

Pertussis (whooping cough) is a respiratory infection
(a bronchitis) caused by________and occurs
worldwide

A

Bordetella pertussis

66
Q

Other organisms that can cause Pertussis

A

Bordetella parapertussis,

Mycoplasma pneumoniae, Chlamydia pneumoniae

67
Q

The _______ followed by ________ is
less common in older children and adults, or children
who have partial immunity from vaccination

A

classical

paroxysmal cough followed by an inspiratory whoop

68
Q

The fatality rate of pts with pertussis in

unvaccinated infants less than 6 months is______

A

8 per 1000

cases.

69
Q

The most common cause of death is pertussis

_______ sometimes complicated by _____ and ______

A

pneumonia,

seizures and
hypoxic encephalopathy

70
Q

Pertussis is also referred to as the
‘________ This can lead to issues with sleep
disturbance, work performance (especially when
dealing with machinery or driving) and rarely rib
fractures.

A

100 day cough’.

71
Q

Phases of Pertussis

Classic whooping cough is characterised by cough
and coryza for 1 week (_______) followed by paroxysms of a more pronounced cough _____

A

catarrhal

(paroxysmal phase).

72
Q

Cx of pertussis

Complications

  • Neurological:_____
  • Pulmonary: _______
A

asphyxia, hypoxia, seizures, cerebral haemorrhages

atelectasis, pneumonia, pneumothorax, bronchiectasis

73
Q

Abx for Pertussis

A 
• azithromycin
— <6 months: 10 mg/kg daily for 5 days
— >6 months: 10 mg/kg on day 1 (up to
500 mg) then 5 mg/kg (up to 250 mg) for a
further 4 days

• clarithromycin
— >1 month: 7.5 mg/kg (up to 500 mg) bd for
7 days

• erythromycin
— >1 month: 10 mg/kg (up to 250 mg, or
400 mg if ethyl succinate) qid for 7 days

74
Q

T or F

High-risk contacts of a pertussis case (those with
close/household contact and who may be vulnerable
to complications, or transmit to others who are
vulnerable) should be treated with the same
medications

A

T

75
Q

Prevention strategies for pertussis:

a________’ strategy of vaccinating any adults
who are or will be in close contact with an
infant

A

‘cocoon

76
Q

Prevention strategies for pertussis:

mothers should be vaccinated in pre-pregnancy
planning or straight after delivery. Alternatively,
if more than 5 years has elapsed since their last
previous dose, a pertussis vaccine should be
given in their ________

A

third trimester (which will boost
maternal antibodies that are transmitted in utero
to the about-to-be-newborn)

77
Q

HSV

The specific gingivostomatitis occurs in ______of cases and can be severe and acute

A

25–30%

78
Q

Cx of HSV

• encephalitis can develop in otherwise healthy
children 
• \_\_\_\_\_\_\_—children  can
get widespread severe herpetic lesions
• disseminated HSV infection in \_\_\_\_\_ (avoid
contact until recovered)
• HSV can be a serious issue in the
immunocompromised patient
A

eczema herpeticum

neonates

79
Q

Impetigo (school sores) is a contagious superficial
bacterial skin infection caused by______ or ________ or a combination of
these two virulent organisms

A

Streptococcus

pyogenes or Staphylococcus aureus

80
Q

2 forms of impetigo

A

1 vesiculopustular with honey-coloured crusts
(either strep or staph)
2 bullous type, usually S. aureus

81
Q

Abx for impetigo

If extensive and causing systemic symptoms:

A

flucloxacillin/dicloxacillin 12.5 mg/kg up to
500 mg) 6 hourly for 10 days
or
cephalexin 25 mg/kg up to 1 g 12 hourly for
10 days

82
Q

Head lice is an infestation caused by the louse

A

Pediculus

humanus capitis

83
Q

Spread of head lice

A

Head lice spread from person to person by direct
contact, such as sitting and working very close to one
another

84
Q

Insecticides used to treat head lice include:
1
2
3

A
  • malathion
  • permethrin
  • phenothrin
85
Q

Caution for head lice insecticides

A

These applications can be irritating to the scalp,

so use caution in children prone to atopic dermatiti

MC (90 decks)

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