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Infections + immunity Flashcards

(55 cards)

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1
Q

Meningitis pathology

A

Usually in first 5 years of life
Inflammation of leptomeninges surrounding brain tissue

Release of inflammatory mediators + activated leucocytes
Endothelial damage = causes cerebral oedema, raised ICP + decreased cerebral blood flow
Inflammatory response causes vasculopathy - causes cerebral cortical infarction
Fibrin deposits block reabsorption of CSF
Causes hydrocephalus

75% occur before age of 15

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2
Q

Incubation period for bacterial meningitis

A

2-10 days

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3
Q

Bacteria causing meningitis

A

Neonates = group B strep, E coli, Listeria
Infants + kids = Neisseria, strep pneumonia, Haemophilus influenza B
Adolescents = neisseria, strep pneumonia

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4
Q

S+S meningitis (+ for ages)

A 
Shock = tachycardia, tachypnoea, prolonged cap refill
General = fever, headache, photophobia, irritability, hypotonia, purpuric rash 
Infants = poor feeding, respiratory distress, coma 
Infants = lethargy, unsettled, refusing food 
Adolescents = muscle aches + pains, neck stiffness, N+V
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5
Q

Kernigs + Brudzinskis sign

A

Kernig = child lies supine, hips + knees flexed, back pain on extension of knee

Brudzinski’s = flexion of neck causes flexion of knees + hips

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6
Q

Complications of menigitis

A 
Hearing loss 
Vasculitis 
Cerebral infarction = seizures 
Subdural effusion = especially H influenza 
Hydrocephalus 
Cerebral abscess
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7
Q

Investigations for meningitis

A 
Lumber puncture 
Septic screen
Bloods + glucose, lactate, cultures + gas 
Urine for M,C +S 
Nasal + throat swabs 
Viral/ bacterial PCRs
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8
Q

Management of bacterial meningitis

A 
<3 months cefotaxime + amoxicillin 
Ceftrixone >3 months
IM benpen in community 
Dexamethasone 
Rifampicin to family
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9
Q

S+S neonatal meningitis

A

Bulging fontanelle

Hyperextension of neck (opisthotonus)

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10
Q

Sepsis vs severe sepsis vs septic shock

A 
Sepsis = infection + systemic inflammatory response 
Severe = sepsis + CV dysfunction/ acute respiratory distress
Shock = Severe sepsis + CV dysfunction
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11
Q

Boundaries for tachycardia in children

A

<12 months = >160
12-24 months = >150
2-5 years = >140

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12
Q

Chicken pox incubation period + S+S

A

10-21 days (average 14)
Fever + itchy vesicular rash - mainly on trunk
Lasts 7 days

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13
Q

Complications of chicken pox

A

Secondary infection
Necrotising fasciitis
Encephalitis
VZV associated cerebellitis = ataxia + cerebellar signs = resolves within a month

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14
Q

Management of chicken pox

A

Fluids, paracetamol, calamine lotion

IV acyclovir if immunocompromised

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15
Q

Conjunctivitis organisms

A

Neonates = chemical (<24hrs), Neisseria gonorrhoea (<1 week), chlamydia (1-2 weeks)
Infants = H influenza, strep pneumoniae
School age = VZV, HSV, viral, allergic

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16
Q

S+S conjunctivitis

A 
Purulent discharge (chlamydia + gonorrhoea)
Blepharitis + dendritic ulcers (HSV) 
Red eye, discharge
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17
Q

Allergic vs chemical vs viral vs bacterial conjunctivitis symptoms

A 
Allergic = itchy, swelling, watery discharge
Chemical = neonatal 
Viral = sudden onset, pre-auricular lymphadenopathy, watery discharge 
Bacterial = purulent discharge
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18
Q

Management of conjunctivitis

A

Clean with saline
Neomycin
Gonococcal = cephalosporin
Chlamydia = erythromycin

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19
Q

Food allergy cause

A

IgE mediated
Infants = milk, egg, peanut
Older kids = peanuts, fish

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20
Q

S+S food allergies (IgE mediated vs not)

A

IgE mediated: facial swelling, anaphylaxis

Non IgE = D+V, abdo pain

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21
Q

Pathology of anaphylaxis

A

Maldistribution of fluid
Allergen reacts with IgE ab on mast cells + basophils (type 1 hypersensitivity reaction)
Causes capillary leakage, mucosal oedema + shock

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22
Q

Management of anaphylaxis

A

> 12 years = 500mcg IM adrenaline
6-12 = 300mcg
<6 = 150mcg

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23
Q

S+S infectious mononucleosis

Study These Flashcards
A 
Malaise
Anorexia 
Low grade fever 
Tonsillitis/ pharyngitis 
Lymphadenopathy 
Spleno + hepatomegaly 
Maculopapular rash
24
Q

Blood test results for infectious mononucleosis

Study These Flashcards
A

Increased mononuclear cells
Atypical lymphocytes
Thrombocytopenia
Heterophile antibodies

25
Management of infectious mononucleosis
Supportive | DO NOT GIVE AMOXICILLIN
26
Pathology of Kawasaki's disease
Systemic vasculitis
27
S+S of Kawasakis
``` Fever >5 days Non-purulent bilateral conjunctivitis Red mucous membranes Inflamed mouth, cracked lips Cervical lymphadenopathy Polymorphous rash Red palms + soles + peeling ```
28
Complications of Kawasakis
Coronary artery aneurysm leading to myocardial ischaemia
29
Management of Kawasakis
IV Immunoglobulin | Aspirin to reduce risk of thrombosis - continue until echo at 6 weeks shows no aneurysm
30
Measles incubation period + organism causing
7-12 days | Rubeola virus
31
S+S measles
Fever, cough, runny nose Koplik spots, maculopapular rash Rash starts behind ears on day 4 then spreads to face + trunk
32
Complications of measles + long term effects of this
Encephalitis - occurs about 8 days after onset S+S = headache, convulsions Long term effects: deafness, hemiplegia, learning difficulties Pneumonia Otitis media
33
Why is periorbital cellulitis a concern in children?
May be secondary to underlying bacterial sinusitis or due to spread from primary infection
34
What are complications of periorbital cellulitis?
Sub-periosteal abscess, cavernous sinus thrombosis, intracranial abscess
35
How to diagnose HIV in infants?
<18 mths = HIV DNA PCR | Over 18mths = detecting ab to virus
36
Incubation period for rubella
15-21 days
37
Pathology of rubella
RNA Rubella virus spread by droplet infection | Also called German measles
38
What are the complications of congenital rubella?
Malformations in cardiac, ocular, CNS + skeletal system
39
S+S of rubella
Headache, conjunctivitis, runny nose, maculopapular rash on face then spreading Lymphadenopathy
40
Contraindications for LP
raised ICP, thrombocytopaenia, local infection at site of LP, extensive purpura shock - stabilise first after convulsions - stabilise first respiratory insufficiency - stabilise first
41
CSF results for bacterial meningitis
Cloudy/ turbid High protein (>1) Low glucose Neutrophils present
42
CSF results for viral meningitis
Clear fluid Normal/ high protein Normal glucose Lymphocytes present
43
CSF results for TB meningitis
Clear/ slightly cloudy High protein >1.5 Low glucose Lymphocytes + acid-fast bacilli present
44
What infection is caused by herpes 4?
EBV
45
What antibodies are involved in HSP?
IgA + IgG interact + deposit in organs
46
What complication is associated with men B?
Febrile convulsions
47
Which vaccines are live?
MMR + BCG – avoid in immunocompromised kids
48
Describe the course of viral meningitis
starts with infection in mucus membrane, then lymph nodes, then causes initial viraemia then secondary viraemia (CNS infection)
49
What pathogens commonly cause viral meningitis?
entero, parechovirus, herpes (worst) | begin acyclovir for herpes one
50
What are the complications of meningitis + what measures are in place to detect these?
Septic shock, DIC, cerebral oedema, seizures Long term: hearing loss, seizure, focal paralysis, cerebral palsy All kids to have hearing test after 6 weeks from discharge
51
Which organism causing meningitis has the highest mortality?
Pneumococcal
52
What is the most common cause of meningococcal sepsis?
gram negative diplococci = Neisseria meningitis
53
What are the early S+S of sepsis?
leg pain, skin mottling, cold peripheries, breathing difficulties Haemorrhagic rash = >12 hrs into illness
54
Late S+S of sepsis
Leaky vessels leads to poor perfusion so confusion, poor peripheral perfusion
55
Complications of sepsis (early + late)
Complications = DIC, AKI, adrenal haemorrhage, circulatory collapse Late complications = deafness, renal failure, scarring, amputations

Paediatrics (19 decks)

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