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Paediatrics for Finals > Infection and Immunity > Flashcards

Infection and Immunity Flashcards

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1
Q

What is an allergy?

A

Umbrella term for immune mediated hypersensitivity reaction to an allergen

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2
Q

What is an allergen?

A

Proteins that the immune system sees as foreign and harmful

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3
Q

What is a type 1 hypersensitivity reaction?

A
  • IgE mediated to a specific allergen
  • Immediate
  • There is mast cell degranulation and histamine release
    E.g. food allergy
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4
Q

What is a type 2 hypersensitivity reaction?

A
  • IgG or IgM mediated
  • Activation of the compliment system leading to localised damage
    E.g. haemolytic disease of the new-born
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5
Q

What is a type 3 hypersensitivity reaction?

A
  • Due to deposition of immune complexes causing local tissue damage
    E.g. RA, SLE, HSP
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6
Q

What is a type 4 hypersensitivity reaction?

A
  • Cell mediated
  • T lymphocytes inappropriately activated leading to local tissue damage
    E.g. contact dermatitis
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7
Q

How can allergies/ sensitivities be tested for? Describe these methods

A

Skin prick: drops onto skin and then prick. See if a wheal develops. This is used for allergies

Skin patch: Sticker patches are put on to the skin. This is used for contact dermatitis

R: Looks for IgE in the blood

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8
Q

What is allergic rhinitis and what are the signs and symptoms?

A

Type 1 hypersensitivity reaction

  • Sneezing
  • Nasal congestion, discharge
  • Eye watering and redness
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9
Q

How is allergic rhinitis managed?

A

Cetirizine

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10
Q

When and how does cows milk protein allergy present?

A

Often from 3 months, can be at point of weaning.

  • Regurgitation and vomiting
  • Diarrhoea
  • Urticaria, rash, angioedema
  • colic type pain and distress
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11
Q

How should cows milk protein allergy be managed?

A
  1. hydrolysed formulae
  2. amino acid based formulae

If breastfeeding then a maternal cow milk free diet

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12
Q

What are the features of DiGeorge syndrome?

A 
C - congenital heart defect
A - abnormal face 
T - thymus underdevelopment (= T cell non-functional)
C - cleft lip and palate 
H - hypoparathyroidism = hypocalcaemia 
22 - deletion of chromosome 22
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13
Q

How is Wiskott-Aldrich inherited? What are the features?

A

X-linked recessive

  • Abnormal T cells
  • Thrombocytopenia, neutropenia
  • Eczema, recurrent infection
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14
Q

What is SCID and how does it present?

A

Absent/ dysfunctional T and B cells

  • recurrent opportunistic LRTIs
  • persistent diarrhoea
  • reaction to live vaccines (MMR)
  • FTT
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15
Q

How is SCID managed?

A

sterile environment

haematopoietic stem cell transplant

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16
Q

What is selective IgA deficiency and how does it present?

A

maturation defect in B cells

  • very mild and sometimes not picked up
  • frequent respiratory and sinus infections
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17
Q

What is common variable immunodeficiency? How does it present? What are patients more at risk of?

A

Deficiency in IgA, IgG +/- IgM

  • recurrent respiratory infections
  • risk: RA and NH lymphoma
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18
Q

What are the signs and symptoms of Kawasaki disease?

A 
Very high fever
Strawberry tongue 
Red and cracked lips 
Conjunctival redness 
Red palms and soles
Rash over torso - can be desquamating 
Cervical lymphadenopathy
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19
Q

How is Kawasaki disease managed?

A

IvIG and aspirin

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20
Q

What is a complication of Kawasaki disease?

A

Coronary artery aneurysm

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21
Q

Define neonatal conjunctivitis. What organisms most commonly cause it?

Study These Flashcards
A

Conjunctivitis within the first 28 days

- Neisseria gonorrhoea and chlamydia trachomatis

22
Q

What are the signs of neonatal conjunctivitis?

Study These Flashcards
A 
Lid swelling
Mucopurulent discharge 
Conjunctival oedema (chemosis)
23
Q

What causes glandular fever? What are the signs and symptoms?

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A 
EBV
Sore throat + fever + cervical lymphadenopathy 
\+/- splenomegaly 
\+/- palatal petechiae 
\+/- hepatitis
24
Q

How is glandular fever diagnosed?

Study These Flashcards
A

Monospot test in the 2nd week of illness

25
How does threadworm present and how is it managed?
Itchy bottom and vulva - itching worse at night | Mebendazole for the whole family
26
How is impetigo managed?
1. topical hydrogen peroxide 2. topical fusidic acid Oral flucloxacillin if widespread
27
What organism causes chicken pox? How does it present?
varicella zoster Prodromal fever then rash beginning on the torso and progressing in "crops" as follows: macular to papular to vesicular to crust
28
How is chicken pox managed?
topical calamine lotion trimming the nails VZIg and aciclovir if immunocompromised
29
What are the complications of chicken pox?
- varicella pneumonia - miliary opacities seen on CXR - encephalitis - superimposed infection
30
Describe the rash seen in Measles | State if there are any associated features of prodromes
Beginning behind the ears it then spreads down the torso becoming blotchy and confluent + fever, conjunctivitis prodrome + Koplick spots (white) on buccal mucosa
31
Describe the rash seen in Rubella | State if there are any associated features of prodromes
Pink, maculopapular starts on the face - occipital lymphadenopathy - low grade fever
32
Describe the rash seen in Fifth disease | State if there are any associated features of prodromes
Slapped cheek rash on the face - rash spreads to arms - can have lethargy, fever prodrome
33
Describe the rash seen in Roseola infantum | State if there are any associated features of prodromes
- Extremely high fever +/- febrile convulsions - Sore throat - Rash spares the face
34
Describe the rash seen in Scarlet fever | State if there are any associated features of prodromes
- Sandpaper rash on the torso that spares the palms and soles - Strawberry tongue - Fever, tonsillitis, otitis media
35
Describe the rash seen in Hand, foot and mouth disease | State if there are any associated features of prodromes
- Yellow ulcers with a red halo in the mouth | - Then erythematous macules on palms and soles
36
What virus causes: a) rubella b) 5th disease c) Roseola infantum d) Scarlet fever e) Hand, foot and mouth
rubella: Togovirus 5th: parvovirus B19 Roseola: Herpes virus 6 Scarlet: group A haemolytic strep HFM: Coxsackie A16
37
How is scarlet fever managed?
Penicillin
38
Which childhood rashes/ infections require school exclusion?
Measles Rubella Scarlet fever
39
What is ITP?
type 2 hypersensitivity reaction i.e. autoimmune disorder resulting in reduced platelets
40
What are the signs and symptoms of ITP?
Bleeding and bruising - nose bleeds - menorrhagia - gum bleeds Can get intracranial and GI bleeds
41
When and how is ITP pharmacologically managed?
It is dependant on symptom severity 1. prednisolone 2. IV Ig 3. other immunosuppressing agents
42
What advice should be given to parents whose child has ITP?
- No contact sports - Alert medics if involved in trauma eg crash - Avoid IM injections - Avoid NSAIDs and aspirin
43
Which complication of DKA are children particularly at risk of?
cerebral oedema
44
What can cause congenital hypothyroidism?
Most of the time it is a problem with the thyroid gland. | Can also be thyroid hormone or pituitary or hypothalamus
45
How may congenital hypothyroidism present?
- Prolonged jaundice - Poor feeding - Constipation - Hypotonia - Macroglossia
46
If not treated, what characteristic appearance do children with hypothyroidism develop?
- Wide spaced eyes - Eyelid oedema - Narrow palpebral fissure - Depressed nasal bridge
47
What is the most common cause of childhood hypothyroidism and how is it diagnosed?
Hashimotos | Anti-TPO antibodies
48
What are the signs and symptoms of childhood hypothyroidism?
Poor growth | + same as adults (fatigue, weight gain, brittle hair, constipation)
49
What are the hormone abnormalities of congenital adrenal hyperplasia? Therefore how is it managed?
Low cortisol Low aldosterone High testosterone Managed with hydrocortisone and fludrocortisone
50
How does congenital adrenal hyperplasia present in a) both sexes b) females c) males
a) hyponatraemia, low glucose, hyperkalaemia and pigmented skin b) Ambiguous genitalia if severe. Amenorrhoea, tall, deep voice, facial hair c) Tall, deep voice, large penis, small testis

Paediatrics for Finals (11 decks)

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