Infection

Question 1

what does SIRS stand for?

Answer 1

systemic inflammatory response syndrome

Question 2

state some symptoms of SIRS?

Answer 2

fever
tachycardia
tachypnoea
leucocytosis

Question 3

state some pathogens that cause sepsis in neonates ?

Answer 3

group B strep
E coli
listeria monocytogenes

Question 4

state some pathogens that cause sepsis in children ?

Answer 4

strep pneumonia
meningococci
group A strep
staph aureus

Question 5

state some symptoms of sepsis ?

Answer 5

fever 
cold hands 
prolonged cap refill 
limb pain 
vomiting 
malaise 
reduced urine output 
chills

Question 6

what two things are required for paediatric sepsis?

Answer 6

SIRS and a proven or suspected infection

Question 7

what is ARDS?

Answer 7

acute respiratory distress syndrome

Question 8

what is toxic shock syndrome?

Answer 8

warm shock

- vasodilation due to toxins released by strep or staph

Question 9

what is the presentation of meningitis in children?

Answer 9

Nuchal rigidity, headaches, reduced GCS, seizures, irritability, bulging fontanelle, nappy pain

Question 10

what investigations should be done for sepsis ?

Answer 10

FBC 
CRP
Coagulation factors 
blood gases 
glucose 
CSF 
urine culture 
CT cerebrum (not in acute presentation)

Question 11

what will the FBC show in sepsis ?

Answer 11

leucocytosis

thrombocytopenia

Question 12

will the CRP be elevated or reduced during meningitis?

Answer 12

elevated

Question 13

what will the ABGs show during meningitis ?

Answer 13

metabolic acidosis

Question 14

will glucose be reduced or increased during meningitis?

Answer 14

reduced

Question 15

will CSF have increased or reduced protein during meningitis?

Answer 15

elevated

Question 16

what antibiotics should be used with good CSF penetration for meningitis ?

Answer 16

3rd generation cefalosporins

+ amoxicillin in neonates

Question 17

with what meningitis infections should close family be treated for as well?

Answer 17

meningococcus B and strep group A

Question 18

what are some complications of pneumococcal meningitis ?

Answer 18

brain damage
hearing loss
hydrocephalus

Question 19

what are some complications of meningococcal meningitis ?

Answer 19

amputation and skin scarring

Question 20

are there vaccinations to reduce the incidence of meningitis ?

Answer 20

yes

• meningoccocal
• pneumococcal
• haemophilus influzena B

Question 21

what endotoxin does meningococcal disease release?

Answer 21

lipooligosaccharide

- increased levels increases mortality

Question 22

out of strep and staph what has higher resistance?

Answer 22

staph

Question 23

what is strep treated with?

Answer 23

penicillins

Question 24

what is staph treated with?

Answer 24

flucloxacillin

Question 25

what is the resistant form of staph called?

Answer 25

MRSA

Question 26

is MRSA becoming more or less common?

Answer 26

more common

Question 27

is scarlet fever a strep or staph infection?

Answer 27

strep infection | - usually S pyogenes

Question 28

state some symptoms of scarlet fever?

Answer 28

malaise fever tonsillitis strawberry tongue exanthema (sand paper rash)

Question 29

what is the treatment of scarlet fever?

Answer 29

10 day penicillins

Question 30

what are some complications of scarlet fever?

Answer 30

cellulitis impetigo rheumatic fever GN (glomerulonephritis)

Question 31

what are the two virulence factors of scarlet fever?

Answer 31

M proteins | Exotoxins

Question 32

state two skin infections caused by strep and staph ?

Answer 32

impetigo | SSSS (staphlococcal scalded skin syndrome)

Question 33

out of impetigo and SSSS what one is more mild?

Answer 33

impetigo

Question 34

what is impetigo treated with?

Answer 34

topical Tx

Question 35

what is SSSS treated with?

Answer 35

IV antibiotics

Question 36

is impetigo highly contagious?

Answer 36

yes

Question 37

state three types of vesicular rashes?

Answer 37

herpes simplex varicella zoster enertovirus

Question 38

what are the two types of HSV

Answer 38

1 - oral | 2 - genital

Question 39

what are some symptoms of HSV?

Answer 39

stomatitis recurrent cold sores finger infections

Question 40

what is the Tx for HSV?

Answer 40

self limiting | acyclovir

Question 41

what age range is more at risk of HSV complications?

Answer 41

neonates

Question 42

state some complications of HSV?

Answer 42

sepsis meningoencephalitis hepatitis

Question 43

is varicella zoster virus very prevalent ?

Answer 43

yes - in children and adults - remains latent in nerve roots

Question 44

within what time period after infection should new lesions appear in chicken pox?

Answer 44

5 days

Question 45

what is reactivation of varicella zoster called?

Answer 45

shingles

Question 46

state some compilations of varicella zoster ?

Answer 46

secondary skin infections ( form scratching) meningoencephalitis cerebelitis

Question 47

state some warning signs that the chicken pox may be fatal

Answer 47

high fever new lesions after 10 days inflamed lesions general malaise

Question 48

what are the two risk groups for complications ?

Answer 48

<1yrs | T cell deficiencies

Question 49

give an example of an enterovirus infection?

Answer 49

hand foot and mouth disease

Question 50

what is the management for enterovirus infections?

Answer 50

supportive | - no treatment available

Question 51

what investigations should be done for viral infections?

Answer 51

smear of vesicle (ulcer base) PCR (fluids, CSF, blood) serology

Question 52

what infection does kawasaki disease mimic?

Answer 52

strep A infections

Question 53

give an example of a strep A infection?

Answer 53

scarlet fever

Question 54

what organism causes scarlet fever?

Answer 54

S pyogenes

Question 55

what is a complication of kawasaki disease?

Answer 55

coronary artery disease

Question 56

state some symptoms of kawasaki disease?

Answer 56

``` fever for at least 5 days peripheral oedema and erythema strawberry tongue conjunctivitis cervical lymphadenopathy change in mucous membranes - lips and tongue ```

Question 57

what are the two treatments for kawasaki disease

Answer 57

immunoglobulins - stop inflammation aspirin - stop thrombotic events in inflamed vessels

Question 58

what is the cause of kawasaki disease

Answer 58

unknown

Question 59

what is a DD for kawasaki disease?

Answer 59

strep infections | henoch scholein purpura

Question 60

what are some symptoms of henoch scholein purpura ?

Answer 60

vasculitis non blanching generally well

Question 61

what medication is used to treat staph infections?

Answer 61

flucloxacillin

Question 62

what gram is meningococcal disease?

Answer 62

gram negative