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paediatrics > infection > Flashcards

infection Flashcards

1
Q

kawasakis disease presentation (My HEART)

A

mucosal involvement - dry lips, strawberry swollen tongue
hand and feet with oedmea
eyes - non purulunt bilateral conjunctivitis
andenopathy - cervical, unilateral
rash - truncal and pleomorphic (maculopapular)
temperature - non remittting fever at least 5 days

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2
Q

kawasakis disease what is it

A

idiopathic systemic vasculitis

causes coronary aneurysms - echocardiogram

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3
Q

kawasakis disease management

A 
aspirin (beware reyes syndrome)
IV immunoglobulin (reduces fever and myocardial inflammation)
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4
Q

measles (notifiable disease) presentation (4cs) and rash

A

prodrome - cough, coryza, conjunctivitis, cranky
rash - first behind ears, forehead, spreads to involve trunk and limbs
also grey/white spots in mouth

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5
Q

measles (notifiable disease) complications

A

otitis media - most common
pneumonia - most common cause of death
subacute sclerosing panencephalitis - chronic complication, develops 7-13yrs after measles with changes in behaviour, dementia, death

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6
Q

measles (notifiable disease) management

A

nutrition

vitamin A in developing world

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7
Q

scarlet fever (notifiable disease) presentation

A

sore throat and fever
rash on chest, axilla or behind ears
red ‘pin prick’ blanching rash, facial flushing and strawberry tongue

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8
Q

scarlet fever (notifiable disease) management

A

penicillin or clarithromycin

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9
Q

scarlet fever (notifiable disease) complications

A

sydenhams chorea (involuntary jerking movements)

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10
Q

scarlet fever (notifiable disease) cause

A

endotoxin from strep pyognes (group A haemolytic)

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11
Q

rubella (notifiable disease) presentation

A

macular rash

suboccipital lymphadenopathy

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12
Q

rubella (notifiable disease) complications

A 
small joint arthritis
infection during fetal development causes:
week 1-4 eye anomaly 
week 4-8 cardiac abnormality
week 8-12 deafness
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13
Q

rubella (notifiable disease) managment

A

RNA virus - vaccine

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14
Q

chicken pox cause and presentation

A

varicella zoster virus

itchy vesicles

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15
Q

chicken pox management

A

calamine lotion

flucloxacillin if bacterial superinfection

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16
Q

chicken pox DD

A

shingles

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17
Q

shingles presentation

A

reactivation of vzv in posterior root ganglia

confined to one dermatone

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18
Q

diphtheria presentation

A

tonsilits
may cause polyneuritis
dysphagia, muffled voice, upper airway obstruction

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19
Q

diphtheria treatment

A

anti-toxin and erythromycin

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20
Q

pertussis (whooping cough) (notifiable disease)

A

bordetella pertussis (gram -ve coccobacillus)

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21
Q

diphetheria cause

A

toxin from corynebacterium diphtheriae

22
Q

pertussis signs

A

apnoea

barking cough - worse at night

23
Q

pertussis management

A

macrolides - azithromycin/clarithromycin

24
Q

TB signs and symptoms

A 
suspect with overseas travel
weight loss
low fever
malaise
cough
25
Q

TB diagnosis

A

tuberculin hypersensitivity (mantoux test)
culture and ziehl neelson acid fast stain
CXR - consolidation, miliary spots

26
Q

TB management RIPE +SE

A

rifampicin - 6 months Nausea; thrombocytopenia; vomiting
isoniazid - 6 months hepatitis
pyrazinamide - 2 months hepatitis
ethambutol - 2 months Hyperuricaemia; nerve disorders; visual impairment

27
Q

HIV diagnosis

A

CD4 count <200 = AIDS (CD4 count useful for staging)
HIV viral PCR
p24 antigen

28
Q

HIV considerations

A 
children should always be bottle fed if mother +ve (risk of vertical transmission)
consider in children with:
pyrexia of unknown origin
hepatosplenomegaly
persistant diarrhoea
29
Q

HIV management

A 
highly active antiretroviral therapy
ccr5 antagonists
nucleotide and non nucleotide reverse transcriptase inhibitors
integrase strand transfer inhibitors
protease inhibitors
30
Q

meningitis aetiology 3 children 3 neonates

A

children: neisseria meningitis, haemophilus influenza, strep pneumoniae
neonates: group B haemolytic step (via mothers vagina), e.coli, listeria

31
Q

meningitis presentation (septic and meningeal signs)

A 
septic signs:
increased temp, pulse and RR
decreased BP
abnormal cry / skin colour
cold extremities

meningeal signs:
neck stiffness
kernings sign
photophobia

32
Q 
bacterial meningitis diagnosis
opening pressure
WBCs
appearence
glucose
protein
A 
elevated
polymorphs - neutrophils
turbid
low
elevated
33
Q 
viral meningitis diagnosis
opening pressure
WBCs
appearence
glucose
protein
A 
normal
lymphocytes
clear
normal
elevated
34
Q

meningitis management

A

IV cefotaxime STAT, then cultures/CSF
in community - benzylpenicilin
contact tracing - close contacts have Ciprofloxacin one dose or Rifampicin BD 2 days
if viral - acyclovir

35
Q

encephalitis signs

A

flu like prodrome
behaviour changes
vomiting
fits

36
Q

encephalitis causes

A

Herpes simplex virus also mumps, varicella zoster

37
Q

encephalitis management

A

HSV - aciclovir

38
Q

slapped cheek syndrome (erythrovirus) cause

A

parovirus B19 (respiratory droplets spread)

39
Q

slapped cheek syndrome (erythrovirus) presentation

A 
malar erythema (slapped cheek rash), spreads to limbs (mainly extensor surfaces)
may cause aplastic crisis
40
Q

slapped cheek syndrome (erythrovirus) diagnosis

A

B19 IgM - current / recent infection

B19 IgG - immunity

41
Q

slapped cheek syndrome (erythrovirus) complications

A

growth restriction
hydrops
fetal death in pregnancy

42
Q

impetigo cause

A

staph aureus +/- strep pyogenes

43
Q

impetigo management

A

fusidic acid and oral flucloxacilin

44
Q

toxic shock syndrome cause

A

s.aureus + group a step (rare)

45
Q

toxic shock syndrome signs

A

fever, hypotension, malar rash

46
Q

toxic shock syndrome management

A

ITU

ceftriaxone + clindamycin

47
Q

coxsackies disease presentation

A

mildly unwell

vesicles on palms, soles and mouth

48
Q 
red flags for serious illness
colour
activity
respiratory
circualtion
other
A 
pale
no response
grunting, RR>60
reduced turgor
non blanching rash, bludging fontanelle, seizures, neck stiff <3months old
49
Q 
orange flags for serious illness
colour
activity
respiratory
circulation and hydration
other
A 
pallor
not responding normally to social ques
nasal flaring RR>50
tachycardia, CRT>3, dry mucus membranes
prolonged fever, 3-6 months, rigors
50
Q

TORCH infections - teratogenic

A

most common perinatal infections
toxoplasmosis
other - syphilis (can cause miscarriage. benzylpenicilin), varicella zoster, parovirus B19
rubella
CMV - most common, growth retardation (IUGR) may develop hearing, visual and mental impairment
herpes simplex - blindness, low IQ

paediatrics (13 decks)

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