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Infectious diseases Flashcards

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1
Q

Macules

A

Red/Pink discrete flat areas which blanch on pressure

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2
Q

Papules

A

Solid raised hemispherical lesions, usually tiny, blanch on pressure

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3
Q

Rubella

A

macular rash

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4
Q

Measles

A

Maculopapular rash

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5
Q

Purpuric, petechia

A

non blanching red/purple spots, tested with a glass

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6
Q

some conditions that are purpuric or petechial

A
  • meningococcal
  • HSP
  • Enterovirus
  • Thrombocytopenia
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7
Q

vesicles

A

raised hemispehrical lesions, <0.5cm diameter, contain clear fluid

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8
Q

infections with vesicles

A
  • Chicken pox
  • shingles
  • Hand, foot and mouth disease
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9
Q

Pustules/ bullae

A

raised hemispherical lesions >0.5cm diameter, contain clear or purulent fluid

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10
Q

Infections with pustules/ bullae

A
  • impetigo
  • scalded skin syndrome
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11
Q

Desquamation

A

dry and flaky loss of surface epithelium, often in peripheries

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12
Q

Infections with desquamation

A
  • post- scarlet fever
  • kawasaki
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13
Q

measles is caused by

A

the measles virus

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14
Q

measles

incubation period

A

around 2 weeks

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15
Q

measles

mode of spread

A

droplet spread, highly infectious during viral shedding

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16
Q

measles

pathognomic feature

A

koplik spots

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17
Q

measles

Clinical features

A
  • cough
  • conjunctivitis, coryza
  • koplik spots
  • Maculpapular Rash
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18
Q

measles

Koplik spots

A

white spots on the buccal mucosa seen against a red background

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19
Q

measles

Rash seen

A

maculopapular rash starting from behind the ears to the whole body. May desquamate in the second week

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20
Q

measles

Respi complications

A
  • Pneumonia
  • Secondary bacterial infection and otitis media
  • Tracheitis
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21
Q

measles

Neuro complications

A
  • Febrile convulsions
  • EEG abnormalities
  • Encephalitis
  • SSPE
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22
Q

measles

SSPE

A

late and rare manifestation by around 7 years. loss of neuro function and 100% death rate

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23
Q

measles

complications

A
  • Respi
  • Neuro
  • Diarrhea
  • Hepatitis
  • Appendicitis
  • Corneal ulceration
  • Myocarditis
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24
Q

measles

Mx

A
  • Symptomatic Rx
  • Isolate the child
  • Ribavirin for immunocompromised
  • Vitamin A to boost immunity
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25
# measles Prevention
MMR vaccine- given at 9 months and 3 years
26
# Chicken pox MO
Varicella zoster
27
# Chicken pox Incubation period
around 2 weeks
28
# Chicken pox Spread
by respiratory droplets. until the last lesion has crusted, child is infectious
29
# Chicken pox Clinical features
Vesicular rash starting on the head and trunk and progress to peripheries
30
# Chicken pox Rash
starts as papules, vesicles with sorrounding erythema and pustules for upto one week.
31
# Chicken pox Why do children present with difficulty eating
lesions may appear on the palate
32
# Chicken pox Does it leave scars
no unless they are scratched
33
# Chicken pox lesions appear beyond 10 days
suggests defective cellular immunity
34
# Chicken pox Complications
* bacterial superinfection * CNS- cerebellitis, generalised encephalitis, aspetic meningitis * Immunocompromised- Penumonitis, hemorrhagic lesions, DIC, progressive and disseminated infections
35
# Chicken pox Rx
* immunocopromised- IV acyclovir * high- risk immunocompromised following contact- HZV Ig vaccine (VZIG) * Normal immunity- no Rx
36
# Chicken Pox Prevention
Immunization against chickenpox
37
# Mumps Incubation period
15-24 days
38
# Mumps MO
Measles virus
39
# Mumps spread by
aerosolized droplets
40
# Mumps clinical features
* Fever, malaise, parotitis * Parotitis starts U/L but spreads B/L in the next week * Earache, pain on eating and drinking (acidic, salty)
41
# Mumps Parotitis
Usually starts U/L and then spread B/L over the next few days
42
# Mumps how long does the fever last
around 3-4 days
43
# Mumps pancreatic involvement
Serum amylase is high
44
# Mumps how long does the infectivity last
upto a week
45
# Mumps complications
* transient and U/L hearing loss * viral meningitis, encephalitis * Orchitis- uncommon * Myocarditis
46
# Mumps risk of subfertility
Mumps complicated with B/L orchitis
47
# Mumps Prevention
MMR vaccine SL remedy- ali hakka
48
# Rubella MO
Rubella virus
49
# Rubella incubation period
15-20 days
50
# Rubella Spread
Respiratory
51
# Rubella Clinical features
* Prodrome- mild fever * maculopapular rash * Lymphadenopathy
52
# Rubella Rash
Maculopapular rash starting from the face and spreading centrifugally to the whole body
53
# Rubella Lymphadenopathy locations
* Suboccipital * Postauricular
54
# Rubella Complications
* Arthritis * Encephalitis * Thrombocytopenia * Myocarditis- rare
55
# Rubella Prevention
MMR vaccine
56
# Impetigo MO
Staphylococcal Streptococcal
57
# Impetigo most common in
children with pre- existing skin disease
58
# Impetigo lesions location
* Face * Neck * Hands
59
# Impetigo rash
1. begins as erythematous macules 2. become vesicles/ pustules/ bullae 3. rupture 4. honey- colored crusted lesions
60
# Impetigo Infection spread
autoinculation
61
# Impetigo Rx
* Mild cases- topical ABx (Mupirocin) * Severe- flucloxa, co-amoxiclav * Isolate the child * Nasal cream of mupirocin, chlorhexidine
62
# SSSS Pathophysiology
exfoliative toxin of staph seperates the epidermal skin from the dermis
63
# SSSS affected age groups
Infants, young children
64
# SSSS Clinical features
* fever, malaise * purulent, crusting, localized infection around the eyes, nose, mouth * widespread erythema and tenderness of skin * subtle pressure cause epidermis to peel off, leaving denuded skin * denuded areas dry and heal without scarring
65
# SSSS Mx
* iv ABx- flucloxa, vancomycin * iv morphine * fluid balance- NS * Losing protein- high protein diet (NG tube, TPN)
66
# HIV Spread
* mother- to child transmission- during PG, at delivery, through breastfeeding * infected blood products- abuse, contaminated needles
67
# HIV Sx of mild HIV
* lymphadenopathy * parotitis
68
# HIV Sx of moderate HIV
* Recurrent bacterial infections * candidiasis * chronic diarrhea * lymphocytic interstitial pneumonitis (LIP)
69
# HIV Sx of severe HIV
* opportunistic infections- pneumocystis carinii pneumonia * severe failure to thrive * encephalopathy * malignancy
70
# HIV * Dx of <18 months * >18 months
* <18 months- HIV DNA PCR * >18 months- HIV Ab
71
# HIV How to know the infant is not infected anymore
Two negative PCR within first 3 months of life at least two weeks after the completion of postnatal antiretroviral therapy
71
# HIV confirmatory test that the infant is free of HIV
loss of transplacental maternal HIV Ab from the infant's circulation after 18 months of age
71
# HIV screening Dx
all infants born to HIV infected mothers needs to be tested whether they are symptomatic or not
72
# HIV Rx
* ART- combo of 3-4 drugs * Prophylaxis against Pneumocystis jiroveci carinii pneumonia- Co- trimoxazole * MDT approach
73
# HIV immunization
* no live vaccines- BCG not given
74
# HIV MDT consists of
* Pediatrician * venerologist * Psychiatrist * social workers
75
# HIV prevention
* antenatal ART * offer LSCS * avoid breastfeeding
76
# Malaria MO
* Plasmodium vivax * Plasmodium falciparum * Pl ovale * Pl malariae
77
# Malaria incubation period
7- 10 days
78
# Malaria spread
Female anopheles mosquito
79
# Malaria Sx
* high- grade cyclical fever * diarrhea, vomiting * flu- like Sx * Jaundice * Anemia, thrombocytopenia * Chills, rigors
80
Hepatosplenomegaly High- grade fever chills and rigors Recent travel Hx to Africa
Malaria!
81
# Malaria complications
* severe anemia * hepatic, liver failure * renal failure * cerebral malaria
82
# Malaria Dx
* thick film- +/- to malaria * thin film- the causative species
83
# Malaria Rx
* Quinine * Artemether * Artesunate
84
# Malaria Rx for Pl vivax malaria
* Chloroquine * Primaquine
85
# Malaria Cerebral edema risk is highest
Pl falciparum
86
# Malaria Malaria MO that are mostly seen in SL
* Pl falciparum * Pl vivax
87
# Malaria Immediate Dx test
RAT
88
# Malaria Prevention
* prophylaxis- primaquien before traveling to high risk areas * mosquito nets, repellants * cleaning breeding areas
89
# Malaria Best drug for the hepatic form of Pl vivax
Primaquine
90
# Malaria ADRS of Quinine
hypoglycemia
91
# Malaria ADRS for Primaquine, Chloroquine
G6PD deficiency. Not given during PG
92
# Typhoid MO
Salmonella typhi Salmonella paratyphi
93
# Typhoid Incubation period
7-14 days
94
# Typhoid spread
Feco- oral route
95
# Typhoid Salmonella is G+ or G-?
G- flagellated
96
# Typhoid Clinical features
* Worsening fever, headache, cough, abd pain, anorexia, malaise, myalgia * GI Sx- Starts with constipation upto diarrhea * mild to mod soft splenomegaly, bradycardia, rose- colored spots on the trunk
97
# Typhoid Complications
* GI perforation - Peritonitis * Myocarditis * Hepatitis * Nephritis * Meningitis * Osteomyelitis
98
# Typhoid Dx
* 1st week- Blood culture * 2nd week- urine and stool culture * after first week BM culture can be done * Standard agglutination test (SAT)- after one week. H Ag and O Ag
99
# Typhoid SAT which antigen is most specific of typhoid
O Ag
100
# Typhoid Rx
iv 3rd Gen cephalosporin + azithromycin - cefotaxime +clarithromycin (7-10 days)
101
# Typhoid Prevention
* Practicing safe food hygiene methods * vaccination against typhoid (3 yearly)
102
# Typhoid Typhoid vaccine is included in the EPI or not
not included
103
Constipation, fever turning into abd pain, diarrhea Hx of food intake from outside Rose spots Relative bradycardia
Typhoid
104
# Typhoid Carriers
MO lodge in the gall bladder and cholecystectomy should be offered
105
# Typhoid Typical Abdomen
Doughy abdomen
106
# Typhoid Drug used in the past but not given anymore
Chloramphenicol - aplastic anemia
107
# Typhoid Why is ciprofloxacin not given to children
cause cartilage, growth problems
108
# Typhoid 3rd Gen cephalosporins cover
Both G+ and G- but mostly G- coverage
109
# Leptospirosis MO
Leptospira
110
# Leptospirosis Incubation period
7-14 days
111
# Leptospirosis Spread
Via contaminated soil or water mainly muddy water, paddy fields. Bacteria infect domestic and wild animals and are excreted in animal urine to soil or water
112
# Leptospirosis Clinical features during the first week
* fever, chills * headache * muscle soreness in the calves * redness of the eyes- conjunctivitis, conjunctival suffusions * Abd pain, nausea, vomiting * skin rash over the shins ( pretibial)
113
# Leptospirosis how long does the fever last
around a week and it settles for 1-3 days and again returns with additional Sx * Uveitis, iritis * Meningitis * Hepatitis * Lymphadenitis
114
# Leptospirosis Dx
* IgG, IgM in blood samples * Culture of leptospira- body fluids or tissue * Dark field microscopy
115
# Leptospirosis Ix
* FBC * LFT * RFT * Coagulation studies
116
# Leptospirosis Complications
* Hepatitis, Jaundice * Bleeding * Kidney failure * Irregular heart rhythm * Hemorrhagic pneumonitis * Meningitis
117
# Leptospirosis Hepatitis and Jaundice
Weil's disease
118
# Leptospirosis Rx- prophylaxis
* <8 y/o- PO amoxicillin * >8y/o- doxycycline
119
# Leptospirosis Rx
* iv penicillin
120
# Leptospirosis why is doxycycline not given to children <8 years
cause teeth abnormalities- teeth staining
121
# Leptospirosis Prevention
* Personal hygiene- protective boots * Avoid muddy waters * Vaccination of pets
122
# Scrub typhus MO
Rickettsia (Orientia tsutsugamishi)
123
# Scrub typhus Incubation period
5-20 days
124
# Scrub typhus Spread
* Bite of an infected mite larvae or chigger * Transmitted to humans and rodents by the mites * Children goes to jungles, tree areas with no shirts
125
# Scrub typhus Sx
* Chigger bites * Headache * Fever * Shaking chills * Conjunctivitis * Lymphadenopathy * Spotted rash on trunk * splenomegaly * Hepatomegaly
126
# Scrub typhus chigger bite
Painless, localized itch, an eschar seen on the groin, axilla, genitalia, neck
127
# Scrub typhus Eschar
Resembles cigarette burn marks
128
# Scrub typhus complications
* CNS, pulmonary, cardiac involvement * Renal failure * Shock * DIC
129
# Scrub typhus Dx
* Early lymphopenia * Late lymphocytosis * Decreased CD4:CD8 ratio * Thrombocytopenia * Increased AST, ALT * Hypoalbuminemia * IgM, IgG elevated
130
# Scrub typhus Rx
* >8y/o- Doxycycline * <8y/o- Azithromycin
131
# Scrub typhus Prevention
* Vector control * Protective clothing
132
# Congenital Rubella Sx
* LBW * Microcephaly * Cataracts * PDA * Pulm Stenosis * Hepatosplenomegaly * Thrombocytopenia * Rash
133
# CMV Sx
* LBW * Microcephaly * Chorioretinitis * Brain calcification * Hepatosplenomegaly
134
# CMV Dx
Urine sample for CMV
135
# CMV Mx
* Anti- viral * Acyclovir
136
# Toxoplasmosis Sx
* Hydrocephalus * Diffuse calcification in basal ganglia * Eye abnormalities
137
# Toxoplasmosis Vector
Domestic pets
138
# Toxoplasmosis Mx
Anti- parasitic drugs
139
# Congenital infection Signs
* Baby too small <2.5kg * PG mom has fever+ rash * SGA baby * Microcephaly * Abnormal eyes- cataracts * PDA * Bleeding manifestations * Hepatosplenomegaly
140
# Congenital infections TORCH
* toxoplasmosis * Rubella * CMV * Hepatitis, HIV, Herpes

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