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Flashcards in Fever Deck (22):
1

What is the highest risk age group for infection?

Under 3 months old

2

How long does it take for the body's immune system to develop?

2 years. Hence, children under 2 years old are most susceptible to serious bacterial infection

3

What are the investigations done in children presenting with acute fever?

FBC - Leucocytosis will suggest bacterial infection

Throat swab - Group A Streptococcus infection in tonsillitis

Blood Culture - If positive, can suggest septicaemia. Treatment (Ceftriaxone) have to begin before results are shown

Urine analysis - TRO UTI. Pure growth of a single organism with significant leucocytosis is suggestive of bacterial infection. Protein and red cells may be present.

CXR - May reveal cause of fever in infants as chest signs are not always apparant

Lumbar puncture - TRO Meningitis and Encephalitis. Should be performed in seriously ill children where no infection is found, especially in infants <1 year old

4

Which medication cannot be given to children below 12 years? Why?

Aspirin.
Aspirin can cause severe liver failure such as Reye's syndrome.

5

White exudate on the tonsils can be suggestive of which condition?

Tonsillitis
Glandular Fever, aka Infectious mononucleosis
Diphtheria (rare)

6

What are the commonest causes of acute otitis media?

Streptococcus Pneumoniae
Haemophilus infleunza
viruses

7

Which virus is the cause of Infectious Mononucleosis?

Epstein Barr Virus

8

How much fluids are given to children suspected of septic shock?

20 - 40mL per KG

9

Fever progressing for how many days will be worrying?

Fever progressing more than 5 days

10

What should be done if the child appears drowsy?
Why?

A blood glucose test: BM stix to check the blood glucose level.
Hypoglycaemia can occur in sepsis

11

What medication is contraindicated if infected with EBV? Why?

Amoxicillin. AMoxicillin will lead to a maculopapular rash in EBV infection.

12

What condition is caused by EBV?

Glandular fever/Infectious Mononucleosis

13

What are the complications of otitis media?

Secretory otitis media - Glue ear
Conductive deafness
Mastoiditis

14

What are the most common causes of acute otitis media?

Streptococcus pneumoniae
Haemophilus Influenza
Viruses

15

What are the indications for lumbar puncture?

If meningitis is suspected or if the child is under 1 year old

16

What are the signs of dehydration?

Prolonged capillary refill time
Abnormal skin turgor
Abnormal respiratory pattern
Weak pulse
Cool extremities

17

What is the respiratory rate in tachypnoeic children:
a) <5months old
b) 6 - 12 months old
c) >12 months old

a) >60 breaths/min
b) >50 breaths/min
c) >40 breaths/min

18

What are the signs of urinary tract infection in children?

Vomiting
Poor feeding
Lethargy
Irritability
Changes in urinary frequency
Abdominal pain and tenderness
Fever

19

What are the signs of pneumonia?

Tachypnoea
Subcostal recession, etc
Fever
Nasal flaring
Crackles in chest
Cyanosis
Oxygen saturations <95%

20

What are the signs and symptoms in Kawasaki's disease?

Fever persisting for more than 5 days
Any 4 of the following:
- Polymorphous exanthem initially, which may progress to be desquamations.
- Strawberry tongue or red, fissuring lips
- Conjunctivitis (non-purulent, bilateral)
- Cervical lymphadenopathy
- Extremity changes: Swollen fingers or toes, Erythema of palms and soles of feet, Desquamation of fingertips or toes in later stages after rash fades

21

What anti-viral medication is given to children suspected of infleunza infection?

Oseltamivir (Tamiflu)
Zanamivir (Relenza)

22

How is the weight of a child calculated in terms of the age?

Weight = (age+4)x2