infection Flashcards Preview

Paeds > infection > Flashcards

Flashcards in infection Deck (92):
1

what organisms are likely in neonate- 3m meningitis

group B strep, E coli, listeria

2

what is added to cef antibiotics in neonatal meningitis

ampicillin

3

what organisms likely in 3m-6y meningitis

Neisseria meningitides, strep pneum, H influenza

4

what organisms likely in >6y

Neisseria meningitides, strep pneum

5

signs meningococcal infection

purpuric rash, non blanching. give IM benzlypenicillin straight away

6

contraindications to LP

cardiorespiratory instability, coagulopathy, signs incr ICP, local infection, thrombocytopenia, focal neuro signs

7

if CI to LP in meningitis what can be done

PCR, rapid antigen test

8

LP results bacterial

turbid, incr polymorphs, incr protein, low glucose

9

LP results viral

clear, incr lymphocytes, normal or incr protein, normal or low glucose

10

LP results TB

clear, turbid or viscous, incr lymphocytes, very high protein, very high glucose

11

treatment meningitis

cefotaxime or ceftriaxone. dexamethasone

12

complications meningitis

hearing loss, hydrocephalus, local vasculitis, local cerebral infarction, subdural effusion, cerebral abscess

13

what organisms can cause viral meningitis

enteroviruses, adeno, EBV, mumps.

14

what organisms may be more likely in the immunocompromised

mycoplasma and borelia (lyme)

15

commonest cause septicaemia in children

meningococcus

16

signs of septicaemia

fever, tachycardia, tachypnoea, purpuric rash, shock.

17

treatment septicaemia

antibiotics, fluids, circulatory support (inotropes), FFP and platelets for DIC

18

what can cause impetigo

staph/strep

19

signs impetigo

lesions on face, hands, neck. erythematous macules which can become vesicular and pustular, can rupture and leak. honey coloured cruster lesions

20

when can go to school with impetigo

when the lesions are dry

21

treatment impetigo

topical mupirocin, flucloxacillin, co amoxiclav

22

how to eradicate carriage impetigo

need to eradicate nasal carriage. nasal cream- mupirocin or neomycin

23

signs periorbital cellulitis

fever, erythema, tender, oedema eyelid. unilateral.

24

how can periorbital cellulitis occur

may follow local trauma. spread from paranasal sinus infection or dental abscess. treat promptly with IV antibiotics to prevent progression to orbital

25

signs orbital cellulitis

proptosis, painful eye movements, decr visual acuity. do CT

26

signs infectious mononucleosis

fever, malaise, tonsillopharyngitis, lymphadenopathy, petechiae on soft palate, spleno/hepatomegaly, maculopapular rash, jaundice

27

diagnosis infectious mononucleosis

monospot test. IgM and IgG to EBV antigens

28

what should you not give in EBV infection

amoxicillin or ampicillin as causes maculopapular rash in EBV

29

treatment EBV

symptomatic. corticosteroids if severe airway compromised. penicillin if group A grown

30

features measles

temp, maculopapular rash- starts behind the ears and involves the whole body, conjunctivitis, Kopliks spots, cough, coryza

31

what are pathognomonic in measles

Kopliks spots- white spots on buccal mucosa

32

complications measles

pneumonia, otitis media, febrile convulsions, encephalitis, subacute sclerosing panencephalitis, hepatitis, diarrhoea, appendicitis, croup

33

when does encephalitis come on in measles

8d after initial infection. initially- headache, lethargy, irritable. convulsions and coma.

34

long term complications encephalitis (measles)

hearing problems, hemiplegia, LD

35

when does subacute sclerosing panencephalitis occur

can occur 7-13y after infection. primary infection usually

36

signs subacute sclerosing panencephalitis

loss of neuro function- behaviour changes, myoclonus, choreoatheotosis, dystonia, leading to dementia and death

37

what can you give if patient is immunocompromised in measles and what to give patients in developing world

ribavirin (anti viral drug). vitamin A

38

how is measles spread

droplets

39

incubation measles

7-12 days, infective from prodrome until 5 days after rash starts

40

infectivity rubella

5 days before to 5 days after start of rash.

41

signs rubella

macular rash, suboccipital lymphadenopathy

42

is the rubella vaccine a live virus

yes

43

complications rubella

small joint arthritis, malformations in utero.

44

what malformations in first four weeks if infected rubella in utero

eye anomaly

45

malformation 4-8 weeks infection rubella in utero

cardiac abnormalities

46

malformation 8-12 weeks rubella infection in utero

deafness

47

spread of mumps

droplets, saliva

48

immunity mumps

lifelong once infected

49

infectivity mumps

7 days before and 9 days after parotid swelling

50

signs mumps

prodromal malaise, incr temp, painful parotid swelling, bilateral in 70%.

51

complications mumps

usually none. orchitis (+- infertility), arthritis, meningitis, pancreatitis, deafness

52

features hand foot and mouth disease

mildly unwell child, vesicles on palms soles and mouth, may cause discomfort until they heal without crusting

53

cause hand foot and mouth

coxsackie virus a16 or enterovirus 71

54

signs erythrovirus (parvovirus 19)

mild acute infection wth malar erythema (slapped cheek) and rash mainly on the limbs ( glove and socks syndrome)

55

complications erythrovirus

aplastic crisis. fetal death in pregnancy- hydrops fetalis.

56

what is roseola infantum

mild self limiting. incr temp, maculopapular rash, ulcers.

57

what causes roseola infantum

herpes virus 6

58

what is Kawasaki disease

systemic vasculitis. 6m-4y

59

features Kawasaki disease

prolonged fever >5 days. conjunctiva, mucous membranes, cervical lymphadenopathy, rash, extremities (red, peeling)

60

treatment Kawasaki disease

IvIg. aspirin- 6 weeks. persistent inflammation- infliximab, steroids

61

what can be affected in 1/3 Kawasaki patients

coronary arteries- aneurysms (give warfarin),MI

62

what is chicken pox

primary varicella zoster infection. spread by resp droplets

63

features chicken pox

vesicular rash- papules vesicles and pustules. starts on head and trunk then spreads to peripheries. temperature.

64

complications chicken pox

bacterial superinfection, staph, strep, toxic shock syndrome, nec fasciitis, encephalitis, meningitis, pneumonitis, DIC, purpura fulminans

65

treatment chicken pox

in immunocompromised- IV acyclovir. then switch to oral valaciclovir. varicella zoster IG to immunocompromised

66

can chicken pox be caught from someone with shingles

yes

67

treatment bacterial superinfection in chickenpox

flucloxacillin

68

what is shingles

herpes zoster. reactivation of latent varicella zoster

69

features shingles

vesicular eruption in dermatomal distribution. unlikely to get neuralgic pain in childhood. common in the thoracic region. if recurrent- immunocompromised

70

treatment shingles

oral analgesia. acyclovir in immuno.

71

what can be given as prophylaxis in pregnancy

varicella zoster globulin

72

what happens if pregnant lady gets infected with varicella zoster

aciclovir

73

what does HSV1 cause

lip and skin

74

what does HSV2 cause

genital lesions

75

what is the most common presentation of herpes simplex in children

gingivostomatitis

76

features gingivostomatitis

vesicles on lips, gum, tongue, palate can ulcerate and bleed. 10m-3y. fever and miserable child

77

what is a herpetic whitlow

painful white pustules on site of broken skin. fingers and thumbs

78

eye complications herpes simplex

blepharitis, conjunctivitis, cornea- scarring, loss vision

79

investigations in osteomyelitis

MRI shows infection with pus and debris, radionuclide bone scan

80

when is the mother at risk of passing on HIV

during pregnancy, during delivery, breastfeeding

81

when is HIV vertical transmission more likely

high viral load or symptomatic

82

diagnosing vertically acquired HIV

HIV DNA PCR- to be clear need 2 negative in first 3m of life 2 weeks after postnatal antiretrovirals

83

how long do children have placentally transferred IgG antibodies HIV

18 months so don't use standard tests

84

when should you consider HIV in children

PUO, lymphadenopathy, hepatosplenomegaly, persistent diarrhoea, parotid enlargement, shingles decr platelets, failure to thrive, clubbing, CMV

85

decreasing vertical transmission HIV

antiretrovirals to mother, avoid breastfeeding, pre labour C section, avoid prolonged rupture of membranes

86

treatment vertically transmitted HIV

highly active antiretroviral therapy PENTA regimen- start at once if AIDs defining conditions or CD4

87

features diphtheria

nasal discharge, bull neck, sore throat, airway obstruction, cardiac and neuro toxins

88

opportunistic infections in HIV

aspergillus, candida, Cryptococcus, cryptosporidium, pneumocystitis, HH8 (Kaposi sarcoma), pseudomonas, CMV encephalitis, TB encephalitis, lymphoma, toxoplasmosis

89

what does cryptosporidium cause (HIV)

chronic diarrhoea

90

what does Cryptococcus cause (HIV)

meningo encephalitis

91

treatment PCP

co trimoxazole

92

what is Kaposi sarcoma

cause HHV-8. 4 types. skin not always involved. can get purple macules papules nodules and plaques affecting limbs, face +- periorbital purpura/raccoon eyes