high yield- viral/ bacterial infections

Question 1

how does meningitis present in general + in neonates?

Answer 1

SPECIFIC TO NEONATES:

• bulging fontanelle
• hypothermia
• poor feeding
• hypotonia

GENERAL:

• NON BLANCHING RASH
• neck stiffness
• photophobia
• fever
• vomiting
• loss of consciousness + seizures

Question 2

tests for suspected meningitis?

Answer 2

Kernigs Test: (Kernigs= Knee)
+ve test= pain
-bend knee 90 degrees, slowly stretch

Brudkinskis Test
+ve test= involuntary flexion of hip + knee
-patient lies down and brings chin to chest

LUMBAR PUNCTURE!! (between L3-L4)

Question 3

Appearance of bacteria, viral and TB cause of meningitis on lumbar puncture?

Answer 3

Bacteria= cloudy
Viral= clear
TB= cloudy

Question 4

protein in sample from lumbar puncture of bacteria, viral and TB cause of meningitis?

Answer 4

bacteria= low
viral= normal
TB= low

Question 5

glucose in sample of lumbar puncture in patient with bacterial, viral or TB meningitis?

Answer 5

bacterial= low
viral= normal
TB=low

Question 6

WCC in sample from lumbar puncture of someone with bacterial, viral or TB meningitis?

Answer 6

bacterial= High (neutrophils)
Viral= high (15-1000 lymphocytes)
TB= high (30-300 lymphocytes)

Question 7

bacteria culture of lumbar puncture for bacterial, viral or TB meningitis

Answer 7

bacteria= bacteria in culture
viral= no bacteria
TB= bacteria in culture

Question 8

cause of meningitis 0-3 months?

Answer 8

GEL

Group B strep (specific <3 months)
E.coli (specific <3 months)
L. monocytogens (also found >60 years and immunocompromised)

Question 9

cause of meningitis 3months- 6 years?

Answer 9

H. influenza (only found in 3 months- 6 years)

N. meningitidis
Strep. pneumoniae

Question 10

cause of meningitis 6-60 years?

Answer 10

N. meningitis

Strep. pneumoniae

Question 11

cause of meningitis >60 years?

Answer 11

N. meningitidis
Strep. pneumoniae

L. monocytogenes (only found in <3 months, >60 years and immunocompromised)

Question 12

meningitis treatment community GP?

Answer 12

call 999
administer IM or IV benzylpenicillin

POST EXPOSURE:
-rifampicin + ciprofloxacin (ciprofloxacin is preferred)

(we cam Really Close to catching meningitis)

Question 13

meningitis treatment hospital?

Answer 13

• Lumbar puncture
• Bloods for culture

<3 months amoxicillin + cefotaxime
>3 months cefTRIaxone + dexamethasome

(only give dexamethasome if bacteria)

Question 14

causes of UTI?

Answer 14

E.coli (80%):
-gram neg rod shaped anaerobe, coliform bacterium

Vesicoureteric reflux (35%)

Question 15

treatment for lower UTI?

Answer 15

<3 months= amoxicillin + genatmycin

>3 months= trimethoprim + notrofurentoin

Question 16

cause of measles?

Answer 16

RNA virus

-paramyxovirus

Question 17

presenation of measles?

Answer 17

• Kolpik spots (white spots on buccal mucosa)
• Rash starts behind ears and spreads across body

mEARsles

Question 18

treatment for measles?

Answer 18

• tell public health

- supportive

Question 19

most common complication from measles?

Answer 19

otitis media

Question 20

most common cause of death from measles?

Answer 20

pneumonia

Question 21

what may occur 1-2 week after exposure to measles?

Answer 21

encelopathy

Question 22

cause of rubella?

Answer 22

togavirus

Question 23

presentation of rubella?

Answer 23

• fever
• pink/ red maculopapular rash on face + body
• lymphadenopathy

Question 24

when is fetus at highest risk of rubella and why?

Answer 24

first 8-10 weeks of pregnancy

Rubella is a TRCH organism and so can cause cerebral palsy

Question 25

cause of scarlet fever?

Answer 25

group A strep pyogenes

Question 26

scarlet fever presentation?

Answer 26

- strawberry tongue - fine punctuate erythema (rash) that starts on trunk and spares to soles, palms and around the mouth - sore throat Scarlet fevere, Sore throat, Strawberry tongue

Question 27

treatment for scarlet fever?

Answer 27

- oral penicillin (10 days) - notify public health - can return to school 24 hours after antibiotics start

Question 28

cause of chickenpox?

Answer 28

varicella zoster

Question 29

presentation of chicken pox?

Answer 29

- brief fever - very itchy rash macular> papular> vesicles > scabs

Question 30

treatment to stop chicken pox itch?

Answer 30

-Calamine lotion 'calmine calms the itch'

Question 31

cause of mumps?

Answer 31

paramyxovirus

Question 32

presentation mumps?

Answer 32

- fever, fatigue | - parotitis (earache/ pain on eating)

Question 33

treatment for mumps?

Answer 33

-rest + paracetamol

Question 34

complication post pubertal males with mumps?

Answer 34

Orchiditis (inflammation of testes)

Question 35

cause of erythema infectiosum (slapped cheeks)?

Answer 35

Parvovirus B19

Question 36

presentation erythema infectiosum?

Answer 36

- red cheeks | - erythema on face, proximal + extensor surfaces

Question 37

complications of erythema infectiosum?

Answer 37

- sickle cell anaemia (sickle cell crisis) - aplastic anaemia - spontaneous abortions in pregnancy <20wks

Question 38

cause of hand, foot and mout?

Answer 38

Coxsackie virus A16

Question 39

treatment for hand, foot and mouth?

Answer 39

self limiting | goes away after about 1 week