Infectious disease Flashcards by Aneesa Sheikh

What are inactivated vaccines

Killed versions of pathogens

Safe for immunocompromised patients

Polio, flu, hep A, rabies

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What are subunit and conjugate vaccines

Contain part of organism

Safe for immunocompromised patients

Pneumococcus, meningitis, hep B, whooping cough, haemophilus influenza B, HPV, shingles

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What are live attenuated vaccines

Weakened version of pathogen

Can cause infection

MMR, BCG, chickenpox, nasal influenza, rotavirus

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What are toxin vaccines

Cause immunity to toxins, not pathogen itself

Diphtheria, tetanus

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What vaccines are included in the vaccine schedule

8 weeks: 6 in 1 (diphtheria, tetanus, pertussis, polio, haemophilus influenza B, hep B), meningococcal B, rotavirus (oral)

12 weeks: 6 in 1 (again), pneumococcal, rotavirus (again)

16 weeks: 6 in 1 (again), meningococcal B (again)

1 year: 2 in 1 (haemophilus influenza B, meningococcal C), pneumococcal (again), MMR, meningococcal B (again)

Yearly from 2-8: influenza (nasal)

3 year 4 months: 4 in 1 (diphtheria, tetanus, pertussis, polio), MMR (again)

12-13 years: HPV

14 years: 3 in 1 (tetanus, diphtheria, polio), meningococcal ACWY

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What strains does the HPV vaccine protect against

6 and 11: genital warts

16 and 18: cervical cancer

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What are the signs of paediatric sepsis

Deranged physical observations

Prolonged capillary refill time

Fever or hypothermia

Deranged behaviour

Poor feeding

Inconsolable or high pitched crying

Weak cry

Reduced consciousness

Reduced body tone

Cyanosed, mottled, pale, ashen skin

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What are the 4 categories that make up the traffic light system for paediatric sepsis

Colour

Activity

Respiration

Circulation and hydration

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How should babies under 3 months with a temperature be managed

Urgently treat for sepsis until proven otherwise

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What is the immediate management for paediatric sepsis

Call for senior help early

Oxygen

IV access

Bloods (normal, clotting, blood gas)

Urine dip

Antibiotics (within 1 hour)

IV fluids (20ml/kg bolus, repeat as needed)

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What are the further management steps for paediatric sepsis

Chest X-ray

Abdominal and pelvic ultrasound

Lumbar puncture

Meningococcal PCR

Serum cortisol

Continue antibiotics for 5-7 days

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What are the common causes of meningitis in children and neonates

Children: neisseria meningitidis, streptococcus pneumoniae

Neonates: group B strep

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How might a patient with meningitis present

Fever

Neck stiffness

Vomiting

Headache

Photophobia

Altered consciousness

Seizures

Non-blanching rash

Neonates and babies: hypothermia, poor feeding, lethargy, hypotonia, bulging fontanelles

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What are the investigations for meningitis

Lumbar puncture if: < 1 month with fever, 1-3 months with fever and unwell, < 1 year with fever and other features of serious infection

Kernig’s test

Brudzinski’s test

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What is the management for meningitis in the community

Urgent stat IV/IM benzylpenicillin

Urgent transfer to hospital

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What is the management for meningitis in hospital

Blood cultures

Lumbar puncture

Steroids (dexamethasone)

Notifiable disease

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What is involved in post-exposure prophylaxis for meningitis

Close contacts for past 7 days

Single dose antibiotic (ciprofoxacin)

Within 24 hours of diagnosis

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What is viral meningitis

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Caused by herpes simplex or enterovirus varicella zoster

Usually milder than bacterial meningitis

Often only need supportive care

Give aciclovir

What would a lumbar puncture show in bacterial meningitis

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Cloudy

High protein

Low glucose

High neutrophils (WCC)

Bacteria in culture

What would a lumbar puncture show in viral meningitis

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Clear

Slightly raised or normal protein

Normal glucose

High lymphocytes (WCC)

Negative culture

What are the complications of meningitis

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Hearing loss

Seizures and epilepsy

Cognitive impairment

Learning disability

Memory loss

Cerebral palsy

What is encephalitis

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Inflammation of the brain

Usually viral: herpes simplex, varicella zoster, cytomegalovirus, Epstein-Barr

How might a patient with encephalitis present

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Altered consciousness

Altered cognition

Unusual behaviour

Acute onset focal neurological symptoms

Acute onset focal seizures

Fever

What are the investigations for encephalitis

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Lumbar puncture

CT head

MRI brain

EEG

Swab of area (look for causative organism)

HIV test

What is the management for encephalitis

IV antivirals: aciclovir for herpes simplex/varicella zoster, ganciclovir for cytomegalovirus Repeat lumbar puncture (ensure successful treatment before stopping antivirals) Follow up support and rehabilitation

What are the complications of encephalitis

Lasting fatigue Prolonged recovery Changes in personality Changes in memory and cognition Learning disability Headaches Chronic pain Movement disorders Sensory disturbance Seizures Hormonal imbalance

What is infectious mononucleosis

Infection with Epstein-Barr virus Aka mono, glandular fever Transmitted through infected saliva

How might a patient with infectious mononucleosis present

Fever Sore throat Fatigue Lymphadenopathy Tonsillar enlargement Splenomegaly

What are the investigations for infectious mononucleosis

Specific antibody tests (IgG, IgM) Heterophile antibodies: not specific to EBV, take 6 weeks to be produced, aka monospot test

What is the management for infectious mononucleosis

Usually self limiting Acute illness lasts 2-3 weeks Advise to avoid alcohol and contact sports

What are the complications of infectious mononucleosis

Splenic rupture Glomerulonephritis Haemolytic anaemia Thrombocytopenia Chronic fatigue Lymphoma

What is mumps

A viral infection Droplet spread 14-25 day incubation Usually self limiting Lasts around 1 week A notifiable disease

How might a patient with mumps present

Initial flu-like symptoms Parotid swelling (painful) Fever Muscle aches Lethargy Reduced appetite Headaches Dry mouth Symptoms of complications (abdominal pain for pancreatitis, testicular pain for orchitis)

What are the investigations for mumps

Saliva swab for PCR and antibody testing

What is the management for mumps

Supportive care (rest, fluids, simple analgesia)

What are the complications of mumps

Pancreatitis Orchitis Meningitis Sensorineural hearing loss

What is HIV

RNA retrovirus Destroys CD4+ T helper cells Initial seroconversion flu-like illness Asymptomatic phase Symptoms due to being immunocompromised

How is HIV transmitted

Unprotected anal, vaginal, or oral sex Vertical transmission Exposure to bodily fluids

What are the investigations for babies of HIV positive parents

HIV viral load test at 3 months HIV antibody test at 24 months

What is the management for HIV

Antiretroviral therapy Normal childhood vaccines Prophylactic co-trimoxazole Treat opportunistic infections

What is hepatitis B

DNA virus Transmitted through contact with bodily fluids Most neonates fully recover in 2 months (some have chronic infection)

Which children should be screened for hep B

Have hep B positive mother (screen at 12 months) Migrants from endemic areas Close hep B contact

What is the management for hep B

Babies of hep B positive mothers: hep B vaccine and hep B immunoglobulin infusion at birth Safe to breastfeed as long as baby is vaccinated

What is the management for hep C

Test babies of positive mothers at 18 months Able to breastfeed (stop if nipples crack) Usually resolves spontaneously Regular monitoring (liver function, hep C viral load) Children over 3: pegylated interferon, ribavirin Treatment delayed until adulthood if possible

Infectious disease Flashcards

(44 cards)