Childhood illness

Question 1

SCID treatment

Answer 1

haematopoietic stem cell transplant, preferably sibling

Question 2

live vaccines

Answer 2

IMPORT

influenza
MMR
polio
oral ^^
rotavirus
TB

Question 3

how to diagnose HIV in babies

Answer 3

x2 +ve HIV Ab tests after >18m if mother +ve

x1 +ve HIV Ab test anytime if mother -ve

Question 4

school exclusion for measles

Answer 4

4 days from rash starting

Question 5

school exclusion for mumps

Answer 5

5 days after swelling starts

Question 6

school exclusion for rubella

Answer 6

5 days after rash starts

Question 7

school exclusion for pertussis

Answer 7

2 days from abx starting

Question 8

school exclusion for scarlet fever

Answer 8

1 day from abx starting

Question 9

school exclusion for impetigo

Answer 9

2 days from abx starting or once all crusted over

Question 10

HIV immunoglobulin levels

Answer 10

high IgG
low IgM and IgA

Question 11

erythema migrans

Answer 11

lyme disease
bulls eye

Question 12

erythema multiforme

Answer 12

target with palmar and mucosal involvement
viral or mycoplasma or drug
itchy and raised

Question 13

erythema marginatum

Answer 13

ring
not itchy
Rheumatic fever

Question 14

erythema nodosum

Answer 14

red nodules
IBD, sarcoid, drug, malignancy

Question 15

lyme disease abx

Answer 15

1) doxycycline for 21 days (if 9yo +)
2) amoxicillin
3) azithromycin

if CNS involvement,
IV ceftriaxone

Question 16

IgA deficiency

Answer 16

recurrent URTI/LRTI/otitis media
atopy/autoimmune

Question 17

Wiskott Aldrich syndrome

Answer 17

seems like IgA deficiency (recurrent URTI/LRTI/otitis media + atopy/autoimmune) but with low platelets and high IgA/IgG

Question 18

when is slapped cheek no longer infectious

Answer 18

once the rash appears

Question 19

chronic bilateral parotitis

Answer 19

HIV

Question 20

C diff treatments

Answer 20

1) PO vanc
2) PO fidaxomicin
3) PO vanc + IV metro

relapse <12/52 = fidaxomicin

Question 21

testing for IgE allergy

Answer 21

skin prick
IgE serum specific

repeat 1-4 yearly

if diagnostic uncertainty, food challenge

Question 22

testing for non IgE allergy

Answer 22

trial elimination diet with dieticians for 2-6 weeks then reintroduce

Question 23

pertussis rx

Answer 23

erythromycin

Question 24

fever and bradycardia

Answer 24

typhoid (salmonella)

Question 25

testing HIV in neonates

Answer 25

PCR at 24-48h, 6 weeks and 3-4 months

Question 26

HIV testing for older children

Answer 26

HIV Ab

Question 27

who gets which pneumococcal vaccine?

Answer 27

13 PCV = childhood imms PPV 23 = adult imms, splenic disorder, immunocompromise

Question 28

who gets the pneumococcal vaccine?

Answer 28

hyposplenism inc coeliac COPD congenital heart disease CKD/CLD diabetes immunosuppression (if severe, PCV + PPV) cochlear implant CSF leak

Question 29

congenital rubella presentation and mneumonic

Answer 29

cataracts, deaf and PDA two LLs so eyes and ears

Question 30

congenital CMV presentation and mneumonic

Answer 30

venticles/calcifications, hepatomegaly, deaf C looks like an ear

Question 31

congenital toxoplasmosis presentation and mneumonic

Answer 31

b/l chorioretinitis, calcifications, hydrocephalus tOxO - looks like 2 eyes

Question 32

congenital syphilis presentation

Answer 32

rash on palms and soles

Question 33

age for codeine

Answer 33

12y

Question 34

otitis media + penicillin allergy

Answer 34

clarithromycin

Question 35

tinea capitas treatment

Answer 35

PO griseofulvin add topical imidazole if <5yo

Question 36

lacy rash

Answer 36

parvovirus