Infection and Immunity Flashcards

Question

What is the management of hand, foot and mouth disease?

Answer 1

Nothing lol

Answer 2

Begins with: • Fever • Coryza • Conjunctivitis Then: • Koplik spots = White spots on buccal mucosa (Pathognomonic) Then rash: • Begins behind the ears • Spreads to rest of body • Initially maculopapular, before becoming blotchy Investigations • IgM antibodies can be detected within a few days of rash onset

Answer 3

Investigations: • IgM antibodies detected within a few days of rash onset Treatment: • Notify authorities • Self limiting • Symptom relief (paracetamol/ibuprofen) • Stay away from school for 4 days from the onset of rash Complications: • Otitis media is most common • Pneumonia most common cause of death • Encephalitis starts 1-2 weeks after onset of illness

Answer 4

Maculopapular rash is typically the first sign of infection • Begins on the face • Spreads to the rest of the body • Fades after 5 days Lymphadenopathy • Particularly postauricular and occipital May have low grade fever

Answer 5

Investigations: • IgM antibodies serology from oral fluid sample Treatment: • Notify authorities • Self limiting • Symptom relief (paracetamol/ibuprofen) • Stay away from school for 4 days from the onset of rash

Answer 6

``` Begins with • Fever • Malaise • Parotitis ○ Initially unilateral ○ Proceeds to bilateral ○ Children complain of earaches and pain when eating/drinking ```

Answer 7

Investigations: • Oral swab serology Treatment: • Notify authorities • Self limiting • Symptom relief (paracetamol/ibuprofen) • Adequate fluids • Stay away from school for 5 days from the onset of parotitis Complication: • Orchitis

Answer 8

``` Conjunctivitis Rash - Maculopapular rash that desquamates Adenopathy - Typically cervical Strawberry tongue Hands - Swelling of hands/feet and Burn - High fever lasting >5 days ``` In scarlet fever, the rash is sheet like with fine, tiny papillae Kawasaki typically presents in <5s Scarlet fever typically presents in 5-15 year olds

Answer 9

Investigation - Clinical IVIG High dose aspirin Complication: Coronary artery aneurysm - Hence you do an echocardiogram (Not a angiogram due to radiation)

Answer 10

Investigation: • Throat swab (Start Abx immediately however) Treatment: • Oral penicillin V for 10 days • Patients who have a penicillin allergy should be given azithromycin • Children can return to school 24 hours after commencing antibiotics • Scarlet fever is a notifiable disease Complications: Otitis media Rheumatic fever Acute glomerulonephritis

Answer 11

``` In children they are NON-SPECIFIC Prolonged fever Malaise Anorexia Weight loss Focal signs of infection (e.g. lymph node swelling) ``` Diagnosed via gastric washings followed by Ziehl-Neelsen stains

Answer 12

Rifampicin + Isoniazid = 6 months Pyrazinamide + Ethambutol = 2 months Pyridoxine in adolescents to prevent peripheral neuropathy Prevention: • BCG vaccine from birth to high risk groups • If a child <2 years is in contact with someone with TB, they should receive prophylactic isoniazid. If after 6 weeks they are negative for TB, stop meds and give vaccine

Answer 13

Child >18 months = HIV antibodies Child <18 months = HIV RNA PCR This is because children to HIV positive mothers will have transplacental HIV antibodies from mother. Hence, it is not a reliable indicator of infection in the child. After 18 months these antibodies will be gone if the child is negative for HIV

Answer 14

``` Erythematous macule at the sight of the bite, that looks like a target shaped rash (erythema migrans) Headache Fever Myalgia Lymphadenopathy ``` Late features: Neurological - meningoencephalitis Cardiac - myocarditis, heart block Joint - Episodes of arthritis

Answer 15

Investigation: • Clinical (Presence of erythema migrans) • If no erythema migrans, ELISA, then immunoblot test Management: 1st line = Doxycycline 2nd line = Amoxicillin 3rd line = Azithromycin

Answer 16

At presentation, affected children often have a fever. The rash is the most obvious feature, but HSP affects four systems: • Skin: Palpable purpuric rash on buttocks and extensors of lower limbs - "gravity-depending areas". • Gastro-intestinal system: Non-specific abdominal pain which can be acute and severe. • Joints: Arthralgia, particularly of the knees and ankles. Long-term damage of the joints does not occur ○ ±Oedema • Kidneys: Renal involvement is common but is rarely the first symptom. ○ Glomerulonephritis: Over 80% have microscopic or macroscopic haematuria or mild proteinuria.

Answer 17

Children present with intense perianal itching, which is typically worse at night when the worms come out of the anus. Nocturnal itching may lead to disturbed sleep and irritability. Some people may be asymptomatic, and only notice worms on stool or on the perianal skin. Girls may also experience itching around the vulva.

Answer 18

Based on clinical features. If uncertain can perform adhesive tape test: Transparent tape is applied to the perianal area first thing in the morning and then examined under a microscope to detect threadworm eggs. Stool examination is not recommended.

Answer 19

Generally recommended that all household members are treated at the same time, with an anthelmintic (mebendazole). Improve hygiene

Infection and Immunity Flashcards

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