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Paediatrics > Infection, Inflammation and Fever > Flashcards

Infection, Inflammation and Fever Flashcards

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1
Q

What are the vascular causes for fever in children?

A

Kawasacki Syndrome, Systemic Erythematous Lupus and Juvenile Idiopathic Arthritis

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2
Q

What are the inflammatory/infection causes for fever in children?

A

Everything! Chest infections, meningitis/encephalitis, skin infections (cellutitis and impetigo), gastroenteritis, UTIs

Inflammatory Bowel Disease, Coeliac Disease

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3
Q

What are the autoimmune causes for fever in children?

A

Systemic Erythematous Lupus and Juvenile Idiopathic Arthritis

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4
Q

What are the iatrogenic or idiopathic causes for fever in children?

A

Drug reactions

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5
Q

Questions to ask to localise a fever for Central Nervous System disease?

A

Any visual changes?

Any bright lights, or not being able to handle the light?

Do any positions make head pain worse?

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6
Q

Questions to ask to localise a fever for ENT?

A

Is the child pulling their ear?

Is the ear looking inflamed?

Have they experienced difficulty swallowing or denying food?

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7
Q

Questions to ask to localise a fever for respiratory disease

A

Cough? Productive?

Stridor?

Breathlessness?

Recession and increased work of breathing?

Cyanosis?

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8
Q

Questions to ask to localise a fever for abdominal disease?

A

Change in bowel habits (diarrhoea)?

Vomiting?

Abdominal pain?

Jaundice or icterus?

Distension?

Changes to stool colour, consistency etc?

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9
Q

Questions to ask to localise a fever urinary disease?

A

Dysuria, frequency, urgency?

Changes to colour of urine?

Changes to smell of urine?

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10
Q

Questions to ask to localise a fever to joint disease?

A

Swellings in the joints?

Red, painful joints?

Struggling to move in that region?

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11
Q

Physical signs of dehydration in children?

A

Sunken fontanelle, tachycardia, dry mucous membranes, reduced skin turgor

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12
Q

What is Kernig’s Sign?

A

Signs of meningitis

An inability to straighten the leg when the hip s flexed at 90oC

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13
Q

What does IO stand for paediatric management?

A

Interosseous

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14
Q

What do the lumbar puncture results for normal children look like?

A

Low neutrophils

Low Lymphocytes

<1.0 Protein

> 0.6 Glucose

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15
Q

What do the lumbar puncture results for bacterial meningitis in children look like?

A

High neutrophils (but may be normal)

Low lymphocytes

High Protein (>1.0)

<0.4 Glucose

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16
Q

What do the lumbar puncture results for viral meningitis in children look like?

A

Low neutrophils

High lymphocytes (but may be normal)

Low to normal Protein (0.4-1.0)

Normal glucose

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17
Q

What do the lumbar puncture results for TB meningitis in children look like?

A

Low Neutrophils

High lymphocytes

High protein

Low to normal Glucose

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18
Q

Common causes of bacterial meningitis ages 0-3 months?

A

Group b Streptococcus

E.coli

Listeria monocytogenes

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19
Q

Common causes of bacterial meningitis ages 3 months - 5 years?

A

Niesseria Meningitides

Streptococcus penumoniae

Haemophilus Influenza B (same thing that causes epiglottitis)

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20
Q

Common causes of bacterial meningitis ages over 5 years?

A

Niesseria Meningitides

Streptococcus penumoniae

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21
Q

What are the common causes for viral meningitis?

A

Enteroviruses

But it can be caused by many other viruses

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22
Q

Which steroid is used in bacterial meningitis for some serious cases?

A

Dexamethasone

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23
Q

What are the indications for the use of dexamethasone in bacterial meningitis?

A

Frank purulent pus

CSF white cell count >1000/mcL (very high)

Above result, with >1g Protein

Bacteria on gram stain

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24
Q

What are some reasons not to do a lumbar puncture?

Study These Flashcards
A

Evidence of raised intracranial pressure

Child is too unstable

Extensive or spreading purpuric rash

Bleeding disorder

Infection at site of proposed LP

25
What is the go to antibiotic for bacterial meningitis over 3 months old?
Ceftriaxone
26
What is Kawasaki's Disease?
Vasculitis of unknown aetiology. It causes multi-system involvement and inflammation of the small to medium sized arteries which results in aneurysms.
27
Which ages does Kawasaki's Disease mainly affect?
Less than 5 years old (Peak incidence between 2 and 3 years old)
28
How many phases are there for Kawasaki's Disease and what are these phases called?
**3** Acute Subacute Convalescent
29
How long does the acute phase of Kawasaki last?
1 - 2 weeks
30
What happens during the acute phase of Kawasaki Disease?
Hectic fever - really bad, unresolvable fever Conjunctival erythema Dry, cracked lips Strawberry Tongue
31
What happens during the subacute phase of Kawasaki Disease?
Fever resolves Desquamation of the skin (fingers and toes) Platelet count increases Coronary artery aneurysms
32
Hwo long is the **subacute** phase of Kawasaki?
2 weeks
33
What marks the beginning of the Convalescent phase of Kawasaki?
The disappearance of the symptoms seen in the first two phases
34
What are the main treatments for Kawasaki Disease?
Intravenous immunoglobulins (IVIG) Aspirin
35
What are the clinical features of Toxic Shock Syndrome?
Fever, coryzal symptoms, including headache, exhaustion, aching body
36
How is Toxic Shock Syndrome (TSS) managed?
IV fluids IV antibitoics
37
What bacteria is Scarlet Fever caused by?
Group B streptococcus
38
What are the symptoms of Scarlet Fever?
Fever Sore throat Strawberry tongue Sandpaper rash (*malaise, headache, nausea and vomiting*)
39
How is Scarlet Fever managed?
Penicillin [or Azithromycin is penicillin-allergic]
40
What is Henoch-Schonlein Purpura?
IgA Vasculitis Inflammation of the small blood vessels that causes a petechial/purpuric rash
41
What is a common complication of Iga Vasculitis (Henoch-Schonlein Purpura)?
Kidney disease (glomerulonephritis) - IgA Nephritis
42
What are the clinical features of henoch-schonlein purpura?
Petechial/Purpuric rash Swollen joints (Arthralgia) Kidney problems Abdominal/GI involvement
43
What is the most common preceeding illness to Henoch-Schonlein Purpura?
Upper respiratory infection (possibly triggering abnormal IgA activation)
44
How is HSP (henoch-schonlein purpura) managed?
Steroids [namely Prednisolone] Azathioprine (5-ASA)
45
What is the organism that causes Measles?
Single stranded RNA Paromyxovirus
46
What happens in Measles
The organism infects the upper airway and the surrounding lymph nodes
47
What are the clinical features of Measles?
Fever, conjunctivitis, coryza, cough and **Koplik Spots** (on the back of the throat)
48
How many phases of Measles are there AND What are they called?
**4** Incubation Prodromal Exanthematous Recovery
49
How is Measles managed?
Routine support care Fluids and antipyretics
50
What is in a full paediatric SEPSIS screen?
FBC CRP (LP if this is greater than 10) Blood cultures ECG Throat swab
51
What does a skin biopsy of Henoch-Schonlein Vasculitis show?
Leukocytoclastic vasculitis with IgA deposition
52
What is Immune Thrombocytopenic Purpura?
Purpura that is caused by destruction of criculating platelets in the body, by the body's own immune system, leading to bleeding.
53
What are the clinical features of Immune Thrombocytopenic Purpura?
Purpuric rash Epistaxis or other mucosal bleeding *(Intracranial bleeding, however this is not common)*
54
What is the organism that causes Lyme Disease?
Borrelia burgdorferi (bacteria)
55
What is the classical sign of Lyme Disease?
Erythema Chronicum Migrans
56
What disease does Parvovirus characteristically cause?
Slapped Cheek Syndrome
57
What is the distinct Newborn test done of their 5th day of life?
**Guthrie Heel Prick Test** This tests for many different conditions such as Cystic Fibrosis, PKU, SCID, Sickle Cell and Congential hypothroidism. some other disease are identified as well.
58
Which antibiotic is given to a child with bacterial tonsilitis?
Phenoxymethylpenicilin (if they aren't allergic to penicillin) Clarithyromycin (if they are allergic to penicillin)
59
What does a ToRCHS Screen look for?
Toxopalsmosis Rubella Cytomegalovirus Herpes Simplex Virus Syphillis

Paediatrics (10 decks)

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