Infectious Flashcards
1
Q
- What are key principles of antibiotic stewardship in pediatric practice?
A
Stewardship: Use narrowest-spectrum drug, avoid unnecessary antibiotics (e.g., viral infections), dose appropriately, reassess regularly
2
Q
- What are common antibiotic side effects in pediatrics?
A
Side effects: Diarrhea (e.g., amoxicillin), rash (e.g., penicillin), nephrotoxicity (aminoglycosides), teeth staining (tetracyclines)
3
Q
- What is MIS-C and how is it related to COVID-19?
A
MIS-C: Multisystem inflammatory syndrome in children post-COVID-19
- Features: Persistent fever, inflammation, shock, organ dysfunction
4
Q
- What are the complications of untreated Kawasaki disease?
A
Complications: Coronary artery aneurysms, myocarditis, arrhythmias, MI, sudden death
5
Q
- What is the treatment protocol for Kawasaki disease?
A
IVIG 2 g/kg single dose + high-dose aspirin (30–50 mg/kg/day)
- Low-dose aspirin continued 6–8 weeks
6
Q
- What are the diagnostic features and treatment of MIS-C?
A
Diagnosis: Elevated CRP, ESR, D-dimer, ferritin; echo abnormalities
- Treatment: IVIG, steroids, anticoagulation
7
Q
- What are the TORCH infections and their common features?
A
TORCH: Toxoplasmosis, Others (syphilis, VZV, parvovirus), Rubella, CMV, HSV
- Features: IUGR, hepatosplenomegaly, rash, microcephaly
8
Q
- What is the approach to occupational HIV exposure in adolescents?
A
HIV occupational exposure (e.g., needlestick in adolescent trainee): Begin 3-drug antiretroviral PEP within 72 hours, continue for 28 days
- Baseline and follow-up HIV testing at 6 weeks, 3 and 6 months
9
Q
- How is congenital syphilis diagnosed and treated?
A
Diagnosis: Serology (RPR/VDRL), dark field microscopy, PCR
- Treatment: IV penicillin G for 10 days
10
Q
- What are the typical features of congenital syphilis?
A
Features: Snuffles, rash, hepatosplenomegaly, pseudoparalysis, anemia, saddle nose, Hutchinson teeth (late)
11
Q
- What is the approach to an infant born to an HIV-positive mother?
A
- Antiretroviral Prophylaxis
Initiation: Start as soon as possible, ideally within 6 hours of birth.
Regimen Selection:
Low-risk infants (maternal viral load <50 copies/mL with good ART adherence): Give Zidovudine for 4 weeks.
High-risk infants (maternal viral load ≥50 copies/mL, poor adherence, or unknown status): Start triple therapy (Zidovudine + Lamivudine + Nevirapine) for 6 weeks. - Feeding Recommendations
High-resource settings: Recommend exclusive formula feeding.
Low-resource settings: Recommend exclusive breastfeeding with maternal ART, if formula is not safe/available. - HIV Testing Schedule for the Infant
14–21 days: HIV PCR.
1–2 months: Repeat HIV PCR.
4–6 months: Third HIV PCR.
12–18 months: Final antibody test to confirm HIV-negative status. - Cotrimoxazole Prophylaxis
Start at 6 weeks of age and continue until HIV infection is definitively excluded. - Ongoing Monitoring and Follow-Up
Regular monitoring of growth and development.
Laboratory tests: CBC, LFTs if on ART. Ensure complete vaccination based on HIV status.
Summary
Early ART prophylaxis, appropriate feeding choice, scheduled HIV testing, cotrimoxazole prophylaxis, and close clinical follow-up are essential to prevent vertical HIV transmission and ensure infant well-being.
12
Q
- What are the manifestations of congenital CMV infection?
A
Congenital CMV: Sensorineural hearing loss, petechiae, hepatosplenomegaly, intracranial calcifications (periventricular)
13
Q
- What are the features and risks of congenital Zika virus infection?
A
Congenital Zika: Microcephaly, intracranial calcifications, seizures, arthrogryposis, eye defects
- Caused by maternal infection in pregnancy
14
Q
- What is the first-line treatment for acute bacterial sinusitis?
A
Treatment: Amoxicillin-clavulanate for 10–14 days
15
Q
- What are the most common causes of otitis media in children?
A
Most common: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
16
Q
- What are the clinical features and complications of otitis media?
A
Features: Fever, ear pain, bulging tympanic membrane
- Complications: Hearing loss, mastoiditis, perforation, meningitis
17
Q
- What is the treatment of acute otitis media in children?
A
First-line: Amoxicillin (80–90 mg/kg/day)
- Treat if <2 years or severe symptoms; observe if mild and >2 years
18
Q
- What are the signs and management of scarlet fever?
A
Scarlet fever: Sandpaper rash, strawberry tongue, fever, exudative pharyngitis
- Treat with penicillin for 10 days
19
Q
- What is the treatment of streptococcal pharyngitis in children?
A
Treatment: Oral penicillin V or amoxicillin for 10 days
- Alternatives: Cephalexin, azithromycin (if allergic)
20
Q
- What is the role of penicillin in rheumatic fever prophylaxis?
A
Penicillin G benzathine every 3–4 weeks
- Duration depends on presence of carditis and valve disease
21
Q
- What are the common causes and signs of sinusitis in children?
A
Causes: S. pneumoniae, H. influenzae, M. catarrhalis
- Signs: Nasal discharge >10 days, facial pain, fever, cough
22
Q
- What are the common fungal infections in immunocompromised children?
A
Common: Candida, Aspergillus, Cryptococcus
- Present with persistent fever, pulmonary or CNS involvement
23
Q
- What is the diagnosis and treatment of giardiasis in children?
A
Diagnosis: Stool microscopy or antigen test
- Treatment: Metronidazole or tinidazole
24
Q
- What are the common intestinal parasites in children and their presentations?
A
Common parasites: Ascaris (obstruction), hookworm (anemia), Enterobius (perianal itch), Giardia (diarrhea)
25
114. What are the key features of pediatric giardiasis?
Giardiasis: Chronic diarrhea, abdominal cramps, bloating, FTT, often from contaminated water
26
61. What are the common causes and signs of viral gastroenteritis in children?
Causes: Rotavirus, norovirus, adenovirus, astrovirus
- Signs: Watery diarrhea, vomiting, fever, dehydration
27
56. What are the clinical features and diagnosis of enteric (typhoid) fever in children?
Typhoid: Prolonged fever, abdominal pain, rose spots, hepatosplenomegaly, constipation or diarrhea
28
57. What are the complications of typhoid fever?
Complications: Intestinal perforation, hemorrhage, encephalopathy, hepatitis, myocarditis
29
58. What is the treatment of typhoid fever in pediatric patients?
Treatment: Azithromycin or ceftriaxone (based on resistance pattern)
- Ciprofloxacin used in older children/adults
30
59. What are the common causes of acute bloody diarrhea in children?
Causes: Shigella, Salmonella, EHEC, Campylobacter, Entamoeba histolytica
31
62. How is viral gastroenteritis managed in pediatric patients?
Management: Oral rehydration therapy (ORS), continued feeding, zinc supplementation
- Avoid antibiotics/antidiarrheals
32
77. What are the complications of infectious mononucleosis?
Complications: Splenic rupture, airway obstruction, hepatitis, rash if given ampicillin
33
99. What is the management of human and animal bite wounds in children?
Bite wounds: Wash thoroughly, tetanus prophylaxis, amoxicillin-clavulanate
- Assess for rabies exposure
34
101. What are the risk factors and signs of infective endocarditis in children?
Risk: Congenital heart disease, indwelling catheters, prosthetic valves
- Signs: Fever, murmur, splenomegaly, petechiae, emboli
35
102. What is the treatment of infective endocarditis in pediatrics?
Treatment: High-dose IV antibiotics for 4–6 weeks (e.g., vancomycin + gentamicin), surgery if complications
36
64. What is Clostridioides difficile infection (CDI) and how is it treated in children?
C. difficile: Diarrhea after antibiotics
- Diagnosis: Stool toxin or PCR
- Treatment: Oral vancomycin or metronidazole (mild cases)
37
55. What are the signs and management of neonatal herpes simplex virus infection?
Neonatal HSV: Localized (skin/eye/mouth), CNS (encephalitis), disseminated
- Treat with IV acyclovir 14–21 days
38
79. How is parvovirus B19 infection diagnosed and what are its complications?
Parvovirus B19: Slapped cheek rash, arthropathy
- Complications: Aplastic crisis in hemolytic anemia, fetal hydrops
39
60. How is shigellosis diagnosed and treated in children?
Shigellosis: High fever, bloody diarrhea, seizures (neurotoxin effect)
- Diagnosis: Stool culture
- Treat with azithromycin or ceftriaxone
40
78. What are the signs of cytomegalovirus (CMV) infection in immunocompetent vs immunocompromised children?
CMV: Mild or asymptomatic in healthy child
- Immunocompromised: Pneumonitis, colitis, retinitis
- Treat with ganciclovir
41
105. What is the presentation and treatment of pediatric brucellosis?
Brucellosis: Fever, joint pain, hepatosplenomegaly, fatigue
- Treat with rifampicin + doxycycline or TMP-SMX (age-based)
42
63. What is rotavirus and how can it be prevented?
Rotavirus: Leading cause of severe diarrhea in infants
- Prevent with live oral rotavirus vaccine (given at 6 & 10 weeks)
43
45. What are the causes and signs of neonatal conjunctivitis?
Causes: Chemical (1st day), gonococcal (2–5 days), chlamydia (5–14 days), HSV
- Signs: Discharge, conjunctival swelling
44
46. How is gonococcal conjunctivitis in neonates treated?
Treatment: IV or IM ceftriaxone + saline irrigation
- Prevent with prophylactic eye ointment at birth
45
43. What are the classic features of pertussis (whooping cough)?
Pertussis: Catarrhal → paroxysmal cough with whoop → convalescence
- Post-tussive vomiting common
46
90. What is the role of prophylaxis in immunosuppressed children (e.g., post-transplant)?
Prophylaxis: TMP-SMX (Pneumocystis), acyclovir (HSV), fluconazole (fungal), vaccines pre-transplant
47
89. What are the signs and management of invasive candidiasis?
Candidiasis: Fever, sepsis, hepatosplenic abscess
- Treat with amphotericin B or fluconazole
48
5. What are the clinical signs of serious bacterial infection in neonates?
Signs: Lethargy, poor feeding, temperature instability, apnea, irritability, hypotonia, bulging fontanelle
49
87. What is the presentation of epiglottitis and its urgent management?
Epiglottitis: Sudden fever, drooling, tripod position, muffled voice
- Secure airway + IV ceftriaxone
50
13. What is the management of suspected HSV encephalitis in children?
Management: IV acyclovir (10–20 mg/kg q8h), supportive care, MRI and CSF PCR for HSV
51
132. What is Whipple disease in children and how does it present?
Whipple disease: Rare chronic infection (Tropheryma whipplei)
- Pediatric features: Chronic diarrhea, arthralgia, weight loss, lymphadenopathy, neurologic signs
- Diagnosis: PAS-positive macrophages in small intestine biopsy
- Treat with long-term antibiotics (ceftriaxone then TMP-SMX)
52
44. What is the recommended treatment for pertussis in children?
Treatment: Azithromycin or clarithromycin (macrolides)
- Treat close contacts as well
53
129. What is the link between EBV and pediatric malignancies?
EBV: Linked to Burkitt lymphoma, Hodgkin lymphoma, post-transplant lymphoproliferative disorder (PTLD)
54
128. What are the features and transmission of Hepatitis A and E in children?
Hep A & E: Fecal-oral spread, usually self-limited hepatitis with jaundice, fever
- Hep E more severe in pregnancy
55
18. What are the side effects of isoniazid and rifampicin?
INH: Hepatitis, peripheral neuropathy
- RIF: Hepatitis, orange secretions, drug interactions
56
131. What is Lemierre’s syndrome and how does it present in adolescents?
Lemierre’s: Septic thrombophlebitis of internal jugular vein post-pharyngitis (usually Fusobacterium necrophorum)
- Features: Fever, neck pain, swelling, septic emboli to lungs
- Treat with IV antibiotics ± anticoagulation
57
80. What is the presentation and treatment of tetanus in children?
Tetanus: Trismus, opisthotonus, spasms
- Treat with TIG + metronidazole + supportive care
- Prevent with DTaP vaccine
58
42. What are the clinical features of diphtheria and how is it treated?
Diphtheria: Gray pseudomembrane in throat, cervical LAD, myocarditis
- Treatment: Antitoxin + penicillin or erythromycin
59
36. What is hand-foot-and-mouth disease and its clinical features?
HFMD: Fever, painful oral ulcers, vesicles on hands/feet/buttocks
- Caused by coxsackievirus A16
60
32. What are the features of erythema infectiosum (fifth disease)?
Fifth disease: Caused by parvovirus B19
- Slapped cheek rash followed by lacy body rash; may cause fetal hydrops in pregnancy
61
86. What are the key features of Haemophilus influenzae type B (Hib) infection?
Hib: Causes epiglottitis, meningitis, pneumonia, septic arthritis
- Preventable with conjugate vaccine
62
76. What are the signs and management of Epstein-Barr virus (EBV) infection?
EBV: Fever, pharyngitis, lymphadenopathy, fatigue, hepatosplenomegaly
- Treat supportively; avoid contact sports
63
124. What is hyperinfection syndrome in strongyloidiasis?
Hyperinfection: Disseminated strongyloides in immunosuppressed (e.g., steroids, transplant)
- Causes sepsis, ARDS, high mortality
- Treat with ivermectin
64
28. What are Koplik spots and when do they appear?
Koplik spots: Bluish-white lesions on buccal mucosa, appear 1–2 days before rash
65
126. What is the approach to prolonged fever or fatigue post-COVID in children?
Post-COVID: Fatigue, headache, palpitations, joint pain, sleep issues lasting >4 weeks
- Management: Supportive, screen for MIS-C if red flags
66
123. What is strongyloidiasis and how does it present in children?
Strongyloidiasis: GI symptoms (abdominal pain, diarrhea), urticaria, eosinophilia
- Acquired from contaminated soil (larvae penetrate skin)
67
104. What is the difference between bacterial and atypical mycobacterial lymphadenitis?
Bacterial: Acute, tender, red, responsive to antibiotics
- Atypical: Subacute, non-tender, violaceous, surgical excision often needed
68
109. What are the signs of possible primary immunodeficiency in children?
Red flags: ≥8 ear infections/year, ≥2 pneumonias/year, poor wound healing, FTT, need for IV antibiotics, family history
69
125. What are the signs of disseminated BCG disease and its significance?
Signs: Generalized lymphadenopathy, hepatosplenomegaly, osteomyelitis post-BCG vaccine
- Suggests severe combined immunodeficiency (SCID)
70
103. How does cervical lymphadenitis present and what are its common causes?
Presentation: Unilateral tender neck swelling, fever
- Causes: Staph aureus, Strep pyogenes, atypical mycobacteria
71
12. What are the common pathogens causing viral meningitis in children?
Common pathogens: Enteroviruses (coxsackie, echovirus), HSV-2, mumps, arboviruses
72
11. What are the typical CSF findings in bacterial vs viral meningitis?
Bacterial: ↑WBC (neutrophils), ↓glucose, ↑protein, positive Gram stain
- Viral: ↑WBC (lymphocytes), normal glucose, mildly ↑protein
73
10. What are the complications of bacterial meningitis in children?
Complications: Hearing loss, hydrocephalus, cerebral abscess, seizures, developmental delay
74
9. What is the empirical antibiotic therapy for pediatric meningitis (1 month–5 years)?
Empiric therapy: Ceftriaxone + vancomycin
- Add dexamethasone if Hib suspected
75
8. How is bacterial meningitis diagnosed in children?
Diagnosis: Lumbar puncture—CSF analysis (WBC, glucose, protein), Gram stain, culture
- Blood cultures also important
76
7. What is the most common cause of meningitis in infants under 3 months?
Common cause: Group B Streptococcus, E. coli, Listeria monocytogenes
77
140. What are the PEP options for influenza exposure in high-risk pediatric contacts?
Influenza PEP: Oseltamivir (3 mg/kg BID for 10 days) for high-risk exposed children <48 hours post-exposure
- Especially if immunocompromised, <5 yrs, or chronic conditions
78
108. What is post-exposure prophylaxis for hepatitis B in newborns?
Newborn: If mother HBsAg-positive → HBIG + HBV vaccine within 12 hours of birth
79
134. What is the post-exposure prophylaxis protocol for meningococcal exposure in pediatrics?
Meningococcal PEP: Rifampin (10 mg/kg q12h x 2 days), ciprofloxacin (age ≥1 month), or ceftriaxone IM (125 mg <15 yrs, 250 mg ≥15 yrs)
- Indicated for close contacts, household, daycare
80
136. What is the post-exposure prophylaxis for hepatitis A in children?
Hepatitis A PEP: Give single dose of HAV vaccine within 2 weeks if child ≥1 year
- For <12 months or immunocompromised: Hepatitis A immunoglobulin (IG)
81
137. What is the PEP protocol for pertussis exposure in pediatric contacts?
Pertussis PEP: Give macrolide (azithromycin x 5 days) to all close contacts regardless of age/vaccine status
- Most effective if within 21 days of cough onset in index case
82
138. What is the rabies PEP protocol for partially vaccinated or unvaccinated children?
Rabies PEP: Immediate wound cleaning + 4-dose vaccine (days 0, 3, 7, 14)
- Plus RIG (rabies immunoglobulin) infiltrated at wound site if not previously vaccinated
83
91. What are the WHO classifications of pneumonia in children?
WHO: No pneumonia (cough/cold), pneumonia (fast breathing), severe pneumonia (chest indrawing), very severe (danger signs)
84
20. What is the first-line antibiotic for community-acquired pneumonia in children over 3 months?
First-line: Amoxicillin
- If atypical suspected: Add azithromycin
85
93. What are danger signs in a child with pneumonia requiring urgent referral?
Danger signs: Inability to drink, convulsions, lethargy, stridor in calm child, severe malnutrition
86
19. What are the clinical signs of pneumonia in children?
Signs: Cough, fever, tachypnea, chest retractions, decreased breath sounds, crackles, hypoxia
87
92. What is the management of fast-breathing pneumonia per WHO guidelines?
Fast-breathing pneumonia: Oral amoxicillin for 5 days, follow-up in 2 days
- Ensure feeding and oxygen saturation
88
97. What are the criteria for toxic shock syndrome (TSS) in pediatrics?
TSS: Fever, hypotension, rash, multi-organ involvement (GI, renal, hepatic, CNS), desquamation later
89
96. What is the management of septic shock in children?
Management: Fluid bolus (10–20 mL/kg), broad-spectrum antibiotics, vasopressors (if fluid refractory), oxygen, ICU
90
95. What are the diagnostic criteria for pediatric sepsis and septic shock?
Sepsis: Suspected infection + systemic signs (tachycardia, fever, leukocytosis)
- Shock: Hypotension + perfusion failure despite fluids
91
94. What are the causes and signs of sepsis in older infants and children?
Causes: Bacterial (meningococcus, pneumococcus), viral, fungal, malaria
- Signs: Fever, tachycardia, altered sensorium, poor perfusion
92
98. What is the treatment of toxic shock syndrome in children?
Treatment: Fluids, clindamycin + vancomycin (± IVIG), ICU support
93
1. What are the common causes of fever without focus in infants under 3 months?
Common causes: Group B Streptococcus, E. coli, Listeria monocytogenes, enteroviruses, HSV
94
70. What are the causes and approach to fever of unknown origin (FUO) in children?
FUO: >38.3°C for >8 days without diagnosis
- Causes: Infections (TB, EBV), autoimmune, malignancy, Kawasaki
- Workup: CBC, cultures, ESR, imaging
95
49. How is congenital toxoplasmosis diagnosed and treated?
Diagnosis: IgM + PCR from CSF/urine
- Treatment: Pyrimethamine + sulfadiazine + leucovorin for 1 year
96
6. What is the empirical antibiotic therapy for neonatal sepsis?
Empirical therapy: Ampicillin + gentamicin or cefotaxime (avoid ceftriaxone in neonates)
97
71. What are the diagnostic criteria for Kawasaki disease?
Fever ≥5 days + 4 of: bilateral conjunctivitis, oral changes, rash, extremity changes, cervical lymphadenopathy
98
38. What are the diagnostic criteria for rheumatic fever?
Jones criteria: 2 major or 1 major + 2 minor + evidence of strep infection
- Major: Carditis, polyarthritis, chorea, rash, nodules
99
3. What is the approach to fever without source in infants 1–3 months?
Infants 1–3 months: Stratify by risk (Rochester/Boston criteria), consider labs, urine/csf studies; admit if toxic or <1 month
100
2. What is the approach to fever without source in neonates (0–28 days)?
Neonates: Full sepsis workup (CBC, CRP, blood/urine/csf cultures), hospital admission, IV antibiotics
101
4. What is the most common cause of sepsis in neonates?
Most common: Group B Streptococcus, followed by E. coli, Listeria
102
100. What is the management of pediatric patients exposed to rabies?
Rabies PEP: Immediate wound cleaning, rabies vaccine (days 0, 3, 7, 14), rabies immunoglobulin (category III exposure)
103
113. What is the treatment of uncomplicated and severe malaria in children?
Treatment: Uncomplicated: Artemisinin combination therapy (ACT)
- Severe: IV artesunate or quinine, supportive care
104
122. How is Zika virus diagnosed and managed in neonates?
Diagnosis: Zika PCR or IgM from serum/CSF, maternal travel history
- No specific treatment; supportive care and neurodevelopmental follow-up
105
106. What are the clinical features and management of leishmaniasis in children?
Leishmaniasis: Visceral form (kala-azar) with fever, anemia, hepatosplenomegaly
- Treat with amphotericin B or miltefosine
106
107. What is cat scratch disease and how is it managed?
Cat scratch: Bartonella henselae
- Local lymphadenopathy, mild fever
- Usually self-limited; treat severe cases with azithromycin
107
111. What is the approach to suspected malaria in a febrile child returning from an endemic area?
Approach: Check thick/thin smear or rapid diagnostic test
- Symptoms: Fever, chills, hepatosplenomegaly, anemia
- Always rule out malaria in febrile child from endemic area
108
112. What are the common signs and complications of severe pediatric malaria?
Severe malaria: Altered consciousness, seizures, severe anemia, acidosis, hypoglycemia, respiratory distress
109
14. What are the clinical features of tuberculosis in children?
TB: Chronic cough, weight loss, fever, night sweats, lymphadenopathy, hilar nodes on CXR
110
15. How is latent tuberculosis infection diagnosed in pediatrics?
Diagnosis: Tuberculin skin test (TST) or interferon gamma release assay (IGRA), no symptoms, normal CXR
111
16. What is the treatment of latent TB in children?
Latent TB: Isoniazid daily for 6–9 months
- Alternatively, rifampin for 4 months
112
17. What is the standard treatment for active TB in children?
Active TB: Isoniazid + rifampicin + pyrazinamide ± ethambutol for 2 months, then INH + RIF for 4 months
113
120. What is the difference between droplet, airborne, and contact precautions in pediatric infection control?
Droplet: >5 µm, mask needed (e.g., flu)
- Airborne: <5 µm, N95 + negative room (e.g., TB, measles)
- Contact: Gloves/gown (e.g., MRSA, RSV)
114
119. What infection control precautions are necessary for hospitalized children with infectious diseases?
Precautions: Hand hygiene, cohorting, PPE use, isolation for airborne (e.g., TB, measles), droplet (e.g., flu), contact (e.g., RSV)
115
84. What vaccines are live attenuated and given in routine pediatric schedule?
Live attenuated: MMR, varicella, oral polio (OPV), rotavirus, intranasal influenza, yellow fever (non-routine)
116
65. What are the causes of recurrent UTI in children?
Causes: Vesicoureteral reflux, constipation, neurogenic bladder, poor hygiene, dysfunctional voiding
117
69. What is the role of renal ultrasound and VCUG after pediatric UTI?
Renal US: Detects anomalies (hydronephrosis)
- VCUG: Identifies vesicoureteral reflux
- DMSA: Detects scarring
118
68. What are the signs and management of pyelonephritis in children?
Pyelonephritis: Fever, flank pain, vomiting, leukocytosis
- Treat with IV antibiotics (ceftriaxone, cefotaxime) then oral
119
67. What is the treatment of uncomplicated UTI in pediatric patients?
Uncomplicated UTI: Oral cephalexin, amoxicillin-clavulanate, or TMP-SMX for 7–10 days
120
66. What investigations are done after a febrile UTI in a young child?
Investigations: Renal US (all <2 years), VCUG if abnormal US or recurrent infections, DMSA for renal scarring
121
83. What are the contraindications to live vaccines in children?
Contraindications: Severe immunosuppression, pregnancy (for some), allergy to vaccine components
122
82. What are the components of the pentavalent vaccine used in infancy?
Pentavalent: DTP + Hib + Hepatitis B
- Given at 6, 10, 14 weeks
123
81. What is diphtheria-tetanus-pertussis (DTaP) vaccine schedule in children?
DTaP: Given at 6, 10, 14 weeks; booster at 15–18 months and 4–6 years
- Part of EPI schedule
124
130. What are the challenges of vaccination in refugee or displaced pediatric populations?
Challenges: Incomplete vaccination, lack of records, cold chain issues, missed boosters
- Use catch-up schedule per WHO/EPI guidelines
125
117. What is the vaccine schedule for immunocompromised children?
Schedule: Inactivated vaccines given on time
- Live vaccines delayed or contraindicated depending on immune status
126
118. What live vaccines are contraindicated in immunocompromised children?
Contraindicated: MMR, varicella, oral polio, intranasal influenza (if severely immunocompromised)
127
27. What is the clinical presentation of measles?
Measles: Cough, coryza, conjunctivitis, Koplik spots, followed by maculopapular rash spreading cephalocaudally
128
26. What are the common viral exanthems in children and their distinguishing features?
Exanthems: Measles (Koplik spots, 3 Cs), Rubella (mild, postauricular nodes), Roseola (high fever, then rash), Erythema infectiosum (slapped cheek)
129
35. What is the treatment of varicella in immunocompetent vs immunocompromised children?
Immunocompetent: Supportive ± acyclovir if early or >12 years
- Immunocompromised: IV acyclovir
130
30. How is rubella differentiated from measles?
Rubella: Milder rash, posterior auricular lymphadenopathy, shorter duration, no Koplik spots
131
31. What are the clinical features and diagnosis of roseola infantum?
Roseola: Sudden high fever for 3–5 days, followed by a pink maculopapular rash as fever resolves
- Caused by HHV-6
132
54. What is the role of rubella vaccination in pregnancy planning?
Women of childbearing age should be vaccinated before pregnancy (live vaccine contraindicated in pregnancy)
133
33. What is the presentation of varicella (chickenpox) in children?
Varicella: Fever, malaise, vesicular rash in various stages (macule → papule → vesicle → crust)
- Starts on trunk, spreads outward
134
133. What is the post-exposure prophylaxis (PEP) for varicella in susceptible children?
Varicella PEP: Give varicella vaccine within 3–5 days if ≥12 months and immunocompetent
- If immunocompromised or <1 year: Varicella-zoster immunoglobulin (VZIG) within 10 days
135
53. What is the clinical presentation of congenital rubella syndrome?
Rubella: Congenital cataracts, sensorineural hearing loss, PDA, blueberry muffin rash, IUGR
136
135. What is the PEP recommendation for measles exposure in children?
Measles PEP: MMR vaccine within 72 hours for eligible contacts
- Immunoglobulin within 6 days for immunocompromised, pregnant women, or infants <6 months
137
41. What are the signs and complications of mumps in children?
Mumps: Parotitis, fever, malaise
- Complications: Orchitis, meningitis, pancreatitis, deafness
138
85. What are the adverse effects of MMR vaccine?
MMR: Fever, rash, febrile seizures (rare), transient thrombocytopenia, lymphadenopathy
139
29. What are the complications of measles infection?
Complications: Otitis media, pneumonia, encephalitis, subacute sclerosing panencephalitis (SSPE)
140
34. What are complications of varicella infection?
Complications: Bacterial superinfection, pneumonia, cerebellitis, hepatitis, thrombocytopenia, congenital varicella
