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3a Child Health > Infectious Disease > Flashcards

Infectious Disease Flashcards

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1
Q

What is Kawasaki Disease?

A

Self-limiting systemic medium sized vasculitis particularly affecting coronary arteries (inflammation of blood vessels)

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2
Q

What are the symptoms of Kawasaki Disease?

A

Cojunctivitis, erythema, oedema, irritability, mucositis, strawberry tongue, fever, cervical lymphadenopathy

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3
Q

What investigation needs to be done in Kawasaki Disease?

A

ECHO - coronary artery aneurysms, valvular disease, pericarditis

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4
Q

Why is aspirin normally contraindicated in children?

A

Due to the risk of Reye’s Syndrome - rare encephalopathy associated with liver failure

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5
Q

What is the treatment for Kawasaki Disease?

A

Oral aspirin, IV Ig

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6
Q

When is the MMR vaccine given?

A

1 year, 3 years 4 months

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7
Q

Describe measles and its spread

A

It is a highly contagious respiratory viral infection caused by morbillivirus spread by droplet spread

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8
Q

What is the presentation of measles?

A

Koplik spots, erythematous, maculopapular rash, cough, coryza, diarrhoea, fever

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9
Q

What is an antiviral that can be used in measles for those immunocompromised?

A

Ribavirin

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10
Q

What causes chicken pox?

A

Varicella Zoster Virus

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11
Q

Describe the rash of chicken pox

A

Begins as small erythematous macules on scalp, face, trunk and proximal limbs
Develops into papules, vesicles and pustules in itchy crops
Crusting usually after 5 days

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12
Q

Why should NSAIDs be avoided in chicken pox?

A

Increase the risk of necrotising soft tissue infections

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13
Q

What can high risk groups be given for chicken pox?

A

Aciclovir and IV IgG

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14
Q

What can be a long-term effect of chicken pox?

A

VZV remains dormant in the sensory nerve ganglia of the dorsal root and can reactivate as herpes zoster (Shingles) years later

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15
Q

What is rubella?

A

German measles caused by maternal infection with rubella virus in the first 20 weeks of pregnancy

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16
Q

Who is a rubella rash itchy in?

A

Adults only

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17
Q

What causes scalded skin syndrome?

A

Staph aureus - produces epidermolytic toxins which break down proteins holding skin cells together

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18
Q

What is the presentation of scalded skin syndrome?

A

Generalised erythema progressing to bullae (fluid filled blisters) which burst, fever, irritability, lethargy and dehydration

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19
Q

What is Nikolsky sign?

A

In SSS - gentle rubbing of the skin causes it to peel away

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20
Q

What is polio?

A

Highly infectious disease caused by virus transmitted via faecal-oral route and can invade the nervous system and cause paralysis

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21
Q

What is the presentation of polio?

A

Fever, fatigue, headache, vomiting, neck stiffness, limb pain

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22
Q

When is the polio vaccine given?

A

8, 12, 16 weeks, 3 years 4 months, 14 years

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23
Q

What is TB?

A

Infectious disease caused by mycobacteritum tuberculosis (small rod-shaped bacillus) spread by droplet infection

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24
Q

How do you test for TB?

A

Acid fast so stained using Zehil-Neelsen stain turning red

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25
What is the initial presentation of TB (4-8 weeks)?
Febrile illness, fever, night sweats, SOB, malaise, chest pain
26
What is the presentation of TB at 6-9 months?
Progressive healing of primary complex, effusion, cavitation, coin lesion on CXR, miliary spread
27
What is the diagnosis for TB?
Sputum sample x 3 Mantoux skin test CXR - gohn focus and bilateral hilar lymphadenopathy
28
What is the treatment for TB?
RIPE = Rifampicin, Isonazid, Pyrazinamide and Ethambutol
29
What is given with treatment for TB after puberty?
Pyridoxine (B6) because isonazid depletes B6 causing peripheral neuropathy
30
How long are RIPE drugs given for TB?
R and I for 6 months and P and E for 2 months
31
What are the side effects of RIPE drugs?
R - red body fluids I - peripheral neuropathy P - hepatitis and gout E - optic neuritis
32
What vaccine can be used for TB?
BCG - recommended at birth for high risk groups such as Asian or African origin
33
What is HIV?
RNA retrovirus which destroys CD4 T-helper cells and leads to AIDS when levels are below 200 cells/ mm3
34
35
What is given to babies if mothers HIV copies are above 10,000?
IV Zidovudine
36
What are some later clinical features of HIV in children?
Cough, hypoxaemia, delayed development, cerebral palsy, splenomegaly, failure to thrive, chronic diarrhoea, recurrent infections
37
Name 2 AIDS defining illnesses in children
PCP and Candida oesophagitis
38
When is a c-section used for HIV mothers?
Copies over 50
39
What is meningitis?
Inflammation of the meninges
40
What are the viral causes of meningitis?
Viral is most common overall VZV, HSV and mumps
41
What is a bacterial cause of meningitis in newborns?
Group B strep and listeria monocytogenes
42
What is the most common cause of bacterial meningitis?
Strep pneumoniae
43
What is the presentation of meningitis in children?
Fever, vomiting, headache, neck stiffness, photophobia, altered consciousness, seizures
44
What are the symptoms of meningitis in babies?
Very non-specific such as hypotonia, poor feeding, lethargy, hypothermia and bulging fontanelle
45
What is a sign of meningococcal septicaemia?
Non-blanching purpuric rash
46
What is kernigs sign?
Flex the hip, extend the knee and positive if there is a hamstring spasm
47
What is brudzinskis sign?
Passively flex neck and if there is hip/ knee flexion = positive
48
What is the diagnosis of meningitis?
LP at L4 within an hour CT head Blood cultures Throat swab Blood glucose
49
What does LP show for viral meningitis?
Lymphocytes Normal protein Normal glucose
50
What does LP show for bacterial meningitis?
Neutrophil polymorphs Low glucose High protein
51
What is the treatment for meningitis?
IM Ben pen in community if septicaemia Under 3 months - Amoxicillin and Cefotaxime After 3 months - Ceftriaxone Steroids - Dexamethasone Viral - Aciclovir
52
What can be used for post exposure prophylaxis in meningitis?
Ciprofloxacin or Rifampicin - single dose within 24 hours for those with close contact within 7 days
53
List some complications of meningitis
Hearing loss, epilepsy, seizures, cerebral palsy, memory loss, vasculitis, cognitive impairment
54
When is meningitis vaccination given?
MenB - 8, 16 weeks and 1 year 6-in-1 given at 8, 12 and 16 weeks (Hib) Pneumococcal - 12 weeks, 1 year Hib/ Men C given at 1 year MMR MenACWY - 14 years
55
What is encephalitis?
Inflammation of brain parenchyma
56
What is the most common cause of encephalitis?
HSV-1 from cold sores
57
Name some non-infective causes of encephalitis
TB, malaria, vaccination, previous infection, autoimmune disease
58
What is the presentation of encephalitis?
Altered consciousness and cognition, unusual behaviour, acute onset of focal neurological symptoms, focal seizures, fever
59
What is the LP for encephalitis?
Elevated lymphocytes Normal glucose Raised protein
60
Give some contraindications for a lumbar puncture
Focal neurology Infection at LP site Increased intracranial pressure Active seizures GCS below 9
61
What is the treatment for encephalitis?
Aciclovir for HSV and VZV Ganciclovir for CMV
62
What can be given for high ICP?
Dexamethasone
63
Give some other causes of encephalitis
VZV, CMV, ebstein-barr
64
What is parvovirus?
Slapped cheek syndrome - parvovirus b19 induces immune complex formations that deposit in joints and the skin
65
What is the presentation of Parvovirus?
Low grade fever, headache, macules on face which spreads to limbs but spares palms and soles
66
What is impetigo?
Staph or strep skin infection
67
What is the characteristic of a staph skin infection?
Golden crust
68
Describe non-bullous impetigo
Typically around nose or mouth, forms a golden crust Topical fusidic acid can be used for treatment
69
Describe bullous impetigo
Always caused by staph aureus Causes fluid filled vesicles which can form a golden crust Systemic symptoms are more common Treatment with flucloxacillin
70
Give some complications of Impetigo
Cellulitis, sepsis, scarring, post strep glomerulonephritis, scarlet fever
71
What is Candida?
A yeast infection causing no harm found on skin, vaginal area and digestive system but it can sometimes overgrow and cause a rash and itching
72
What are the causes of Candida becoming problematic?
Damaged skin, warm, humid, weak immune system, antibiotics, too long between nappy changes
73
What are the symptoms of Candida?
Rash, patches that ooze clear fluid, pimples, itching or burning, white or yellow vaginal discharge, white patches on tongue, swelling, pain, pus
74
What is the treatment for Candida?
Fungal creams - Clotrimazole Thrush- medicated mouthwash or lozenges Oral anti-fungals - Fluconazole
75
What is toxic shock syndrome?
Acute multi-system inflammatory response to exotoxin mediated bacterial infection which can progress to septic shock
76
What are the risk factors for toxic shock syndrome?
Small surface area burn, children 1-4 years 2 days after a small burn
77
What are the causes of toxic shock syndrome?
Staph aureus and strep pyogenes
78
What is the presentation of toxic shock syndrome?
Fever over 39, macular rash, diarrhoea, headache, muscle aches, vomiting, confusion, weakness, fatigue
79
What is the treatment for toxic shock syndrome?
Add IV Clindamycin to: - Staph aureus - IV Fluclox MRSA - IV Vancomycin Strep - IV ben pen
80
What is scarlet fever?
Group A strep infection usually tonsilitis Caused by an exotoxin produced by strep pyogenes
81
What is the presentation of scarlet fever?
red-pink, blotchy macular rash with sandpaper skin starting on trunk and spreading outwards Red cheeks Fever Lethargy Sore throat Strawberry tongue
82
What is the treatment for scarlet fever?
Penicillin V for 10 days
83
What is Coxsackie Disease?
Hand, foot and mouth caused by Coxsackie A virus
84
What is the presentation of Coxsackie A virus?
URT symptoms - dry mouth, sore throat, fatigue, fever Small mouth ulcers Blistering red spots
85
How do you treat threadworm?
Oral Mebendazole
86
What is the tetrad of HSP?
Rash, abdominal pain, arthralgia and glomerulonephritis

3a Child Health (14 decks)

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