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Paediatrics > Child with a fever > Flashcards

Child with a fever Flashcards

1
Q

presentation of bacterial meningitis symptoms in <3 months

A
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2
Q

presentation of bacterial meningitis symptoms in 3months - 3years

A
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3
Q

presentation of meningitis symptoms in >3 years

A
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4
Q

microscopy and culture of CSF should be performed in all cases except

A

coma or decerebrate/decorticate posturing
absent or non purposeful responses to pain
focal neurological signs or seizures
abnormal pupil size or reactions
irregular breathing
papilloedema
cardiovascular instability, bradycardia, hypertension

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5
Q

treatment of bacterial meningitis

A

antibiotics and supportive care
- 3rd gen cephalosporin
- vancomycin if pneumococcal disease is likely
- penicillin/amoxicillin (<1m or immunosuppressed)
corticosteroids - give early if at all
cautious use of IV fluids
observation and treatment of complications - convulsions, haemodynamic compromise, cerebral oedema

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6
Q

signs of bactrial meningitis <3 months

A
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7
Q

signs of bacterial meningitis 3months - 3 years

A
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8
Q

signs of bacterial meningitis >3 years

A
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9
Q

pathogens causing bacterial meningitis <3 months

A
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10
Q

pathogens causing bacteral meningitis 3months - 3 years

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11
Q

pathogens causing bacterial meningitis >3 years

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12
Q

complications of bacterial meningitis

A

death 2-5%
intellectual disability, spasticity, seizures, hydrocephalus, deafness 10-15%
learning and behavioural disorder 25-45%

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13
Q

important investigations for pneumonia

A

plasma glucose
blood cultures
CXR
NP swabs/aspirate for respiratory virus
others that may be useful: sodium, creatinine, bicarbonate, WCC, neutrophils, CRP and/or procalcitonin

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14
Q

bacteria causing lower resp tract infection

A
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15
Q

viruses causing lower resp tract infection

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16
Q

other agents causing lower resp tract infection

A
17
Q

broncholitis

A

most common viral LRTI in infants - a clinical diagnosis
pathophysiology is characterised by airway oedema, mucous production
usually secondary to RSV and hMPV
self resolving after 7-10 days
preterm and babies with underlying lung disease at greatest risk

18
Q

broncholitis severrity

A
19
Q

pneumonia presents with

A

cough and tachypnoea
can be due to viral or bacterial infection, viral is most common
clinical features and diagnostic tests are unreliable at distinguishing viral from bacterial
amoxycillin is appropriate treatment

20
Q

bacterial pneumonia is most frequently due to

A

S. pneumoniae in young children
M. pneumoniae in older children

21
Q

empyema

A

defined as the presence of pus in the pleural space (compared with parapneumonic effusion)
drainage is both diagnostic and therapeutic

22
Q

suggestive features of empyema

A

pneumonia wth pleural effusion
failure of pneumonia to improve within 48 hours with Rx

US or CT may be helpful to identify effusion

23
Q

empyema is most frequently due to

A

S. pneumoniae (or staphylococcus aureus)

24
Q

kawasaki’s disease

A

fever and 4 of 5 clinical features:
- bilateral non-purulent conjunctivitis
- oral mucosa changes: erythema, pharyngitis, strawberry tongue, dry cracked lips
- cervical lymphadenopathy (unilateral > bilateral)
- changes in extremitis: swelling of hands/feet, erythema of palms/soles, desquamation
- a generalised variable rash

25
Q

incomplete presentation of kawasaki disease

A

15-20% of children have an incomplete presentation - this is more common at the extremes of age

26
Q

community acquired sepsis pathogens

A
27
Q

hospital acquired sepsis pathogens

A
28
Q

other clinical features that may present with kawasaki’s disease

A

inflammation and crusting of BCG site
sterile pyuria
aseptic meningitis
hydrops of the gall bladder

29
Q

kawasakis disease prognosis

A

without treatment, fever lasts median of 11 days (may be weeks)

30
Q

what investigations are needed for kawasakis

A

WCC and platelet count
CRP and ESR
sodium, creatinine, albumin

echcardiography is required as complications include coronary aneurysms

31
Q

what is kawasakis disease

A

uncommon but important non-infectious condition in young children
most common between ages 1-4
more common in children of asain descent
aneurysms develop in 20% if not treated

32
Q

treatment for kawasakis disease

A

anti-inflammatory therapy: IV immunoglobulin +/- low-dose aspirin
10-20% will require a second dose
follow up: echocardiographic follow up
- low dose aspirin until echocardiogram normal

33
Q

simple febrile convulsion

A

temp >38° C
no evidence of CNS infection
no evidence of metabolic derangement
no history of afebrile seizures or neurological problem

Paediatrics (31 decks)

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