Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y4 paediatrics > Infectious diseases > Flashcards

Infectious diseases Flashcards

(116 cards)

Start Studying
1
Q

Macular/maculopapular viral rashes

A

Roseola infantum
Slapped cheek
Measles
Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Macular/maculopapular bacterial rashes

A

Scarlet fever
Rheumatic fever
Typhoid fever
Lyme’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Macular/maculopapular rash other causes

A

Kawasaki’s disease
Juvenile RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Vesicular, bullous or pustular viral rashes

A

Herpes simplex
Varicella
Hand-foot-and-mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vesicular, bullous or pustular bacterial rashes

A

Boils
Impetigo
Staphylococcal scalded skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vesicular, bullous or pustular rashes other causes

A

Erythema multiforme
TEN
SJS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Petechial/purpuric viral rashes

A

Enterovirus
Adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Petechial/purpuric bacterial rashes

A

Meningococcal
Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Petechial/purpuric rashes other causes

A

HSP
Thrombocytopenia
Vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cellulitis

A

Bacterial infection that affects the dermis and the deeper subcutaneous tissues

Clinical diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cellulitis clinical features

A

Commonly occurs on shins → usually unilateral

Erythema → well-demarcated margins

Swelling

Systemic upset - fever, malaise & nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cellulitis classification

A

Eron classification

I - no signs of systemic toxicity & no uncontrolled co-morbidities

II - person is either systemically unwell/systemically unwell but a co-morbidity that may complicate resolution of infection

III - significant systemic upset/unstable co-morbidities/limb-threatening infection due to vascular compromise

IV - sepsis syndrome/severe life-threatening infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cellulitis admission criteria

A

Eron class III/class IV cellulitis

Severe or rapidly deteriorating cellulitis

Very young (< 1 year) or frail

Immunocompromised

Significant lymphoedema

Facial cellulitis/periorbital cellulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cellulitis mx

A

Guided by Eron classification

I - oral flucloxacillin, clarithromycin/erythromycin/doxycycline for penicillin allergic

II - admission may not be required if facilities are available in the community & can be monitored closely

III-IV - admit, IV co-amoxiclav/clindamycin/cefuroxime/ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Epiglottitis

A

Acute, life threatening condition, most commonly caused by an infection

Epiglottis = flap of cartilage behind the tongue, designed to protect the larynx during swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Epiglottitis pathophysiology

A

H. influenzae and strep pneumoniae may locally invade the epiglottis → inflammation

Inflammation starts on the lingual surface of the epiglottis before spreading to other laryngeal structures → aryepiglottic folds, the arytenoids and supraglottic larynx

Children are at a higher risk of acute airway obstruction as epiglottis is much more floppy, broader, longer & angled more obliquely to the trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Epiglottitis risk factors

A

Children not receiving the HiB vaccine

Male gender

Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Epiglottitis clinical features

A

4 D’s - dyspnoea, dysphagia, drooling & dysphonia

Symptoms < 12 hours & typically no cough

High grade fever, sore throat, dehydration & signs of partial airway obstruction

Stridor is a late sign

Some children may adopt a tripod position → patient leans forward on outstretched arms with neck extended & tongue out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Epiglottitis ix

A

Shouldn’t be examined → high risk of airway obstruction

Throat swabs - bacterial and viral

Blood tests - FBC, cultures & CRP

Lateral neck x-ray

  • thumb-print sign
  • thickened aryepiglottic folds
  • increased opacity of the larynx and vocal cards

CT/MRI only if not responding to the initial treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Epiglottitis mx

A

Secure the airway

Oxygen

Nebulised adrenaline

IV antibiotics - cefotaxime/ceftriaxone

IV steroids

IVI - resus and maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Epiglottitis complications

A

Mediastinitis - infection spreads to retropharyngeal space

Deep neck space infection

Pneumonia

Meningitis

Sepsis/bacteraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Neonatal HSV aetiology

A

Can occur when the baby comes into contact with primary vesicles in the maternal genital tract during delivery

Risk is low with recurrent herpes infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neonatal HSV clinical features

A

Vesicular lesions on the skin

Eye involvement

Oral mucosa involvement, without internal organ involvement

Disseminated features - seizures, encephalitis, hepatitis, sepsis

Features commonly appear in first week of birth but manifestation can be as late as fourth week of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neonatal HSV ix

A

Identifying presence of virus in the newborn - PCR, virus culture, DFA testing

MRI brain - cases of suspected encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Neonatal mx
Parenteral acyclovir with intensive supportive therapy for severe cases Elective c-section/intrapartum IV acyclovir may be advised if active primary herpes lesions are present on mother at term OR primary outbreak within 6 weeks of labour
26
8 weeks vaccine
- 6 in 1 vaccine (diphtheria, tetanus, pertussis, polio, haemophilus influenza type B (Hib) and hepatitis B) - meningococcal type B - rotavirus (oral vaccine)
27
12 weeks vaccine
- 6 in 1 vaccine - pneumococcal - rotavirus
28
16 weeks vaccine
- 6 in 1 vaccine - meningococcal type B
29
1 year vaccine
- 2 in 1 (haemophilus influenza type B and meningococcal type C) - pneumococcal - MMR vaccine - meningococcal type B
30
Yearly from age 2-8 vaccine
influenza vaccine (nasal vaccine)
31
3 years 4 months vaccine
- 4 in 1 (diphtheria, tetanus, pertussis and polio) - MMR vaccine
32
12-13 years vaccine
HPV vaccine
33
14 years vaccine
- 3 in 1 (tetanus, diphtheria and polio) - meningococcal groups A, C, W & Y
34
Malaria
Disease caused by Plasmodium protozoa which is spread by the female Anopheles mosquito
35
Malaria protective factors
Sickle-cell trait G6PD deficiency HLA-B53 Absence of Duffy antigens
36
Features of severe malaria
Schizonts on a blood film Parasitaemia > 2% Hypoglycaemia Acidosis Temperature > 39 Severe anaemia Complications
37
Malaria complications
Cerebral malaria - seizures, coma Acute renal failure - blackwater fever, secondary to intravascular haemolysis ARDS Hypoglycaemia DIC
38
Uncomplicated falciparum malaria management
Artemisinin-based combination therapies as first-line E.g. artesunate + amodiaquine
39
Severe falciparum malaria management
Parasite count > 2% → parenteral mx irrespective of clinical state IV artesunate Parasite count > 10%, exchange transfusion should be considered
40
Non-falciparum features
General features of malaria - fever headache, splenomegaly Plasmodium vivax/ovale - cyclical fever every 48 hours, plasmodium malariae - cyclical fever every 72 hours Plasmodium malariae - associated with nephrotic syndrome
41
Non-falciparum management
Artemisinin-based combination therapy or chloroquine ACTs avoided in pregnant women Patients with ovale/vivax - given primaquine following acute mx with chloroquine to destroy liver hypnozoites & prevent relapse
42
Measles clinical features
Prodromal phase - irritable, conjunctivitis, fever Koplik spots - typically develop before the rash, white (’grain of salt’) on the buccal mucosa Rash - starts behind ears then to the whole body, discrete maculopapular rash becoming blotchy & confluent - desquamation that typically spares the palms & soles may occurs after a week Diarrhoea (10%)
43
Measles ix
Measles-specific IgM and IgG serology (ELISA) - most sensitive 3-14 days after onset of the rash Measles RNA detection by PCR - best for swabs taken 1-3 days after rash onset
44
Measles mx
Mainly supportive Vitamin A in children < 2 years Admission may be considered in immunosuppressed/pregnant patient Notifiable disease → inform public health
45
Measles complications
Otitis media Pneumonia Encephalitis Subacute sclerosing panencephalitis - 5-10 years after illness Febrile convulsions Keratoconjunctivitis, corneal ulceration Diarrhoea Increased risk of appendicitis Myocarditis
46
Measles mx of contacts
Child not immunised against measles comes into contact → MMR should be offered - given within 72 hours
47
Meningitis
- inflammation of the meninges - meningococcal septicaemia = meningococcus (N. meningitidis) infection in the bloodstream - causes ‘non-blanching rash’ → DIC & subcutaneous haemorrhages - bacterial meningitis - neisseria meningitidis & strep pneumoniae; in neonates = GBS
48
Meningitis presentation
Fever Neck stiffness Vomiting Headache Photophobia Altered consciousness Seizures Meningococcal septicaemia → non-blanching rash Neonates & babies → hypotonia, poor feeding, lethargy, hypothermia & bulging fontanelle Kernig’s test & Brudzinski’s test
49
Management of bacterial meningitis
- community - suspected meningitis & a non blanching rash should receive an urgent stat injection (IM/IV) of benzylpenicillin prior to transfer to hospital - hospital → blood culture & LP for CSF should be performed prior to starting abx - if pt is acutely unwell → abx should not be delayed - sent blood tests for meningococcal PCR - typical abx: - under 3 months: cefotaxime & amoxicillin (cover listeria) - above 3 months: ceftriaxone - vanc can be added if there is a risk of penicillin resistant pneumococcal infection - steroids → reduce frequency & severity of hearing loss and neurological damage - notifiable disease
50
Meningitis post exposure prophylaxis
Risk highest for people that have had close prolonged contact within the 7 days prior to the onset of the illness Single dose of ciprofloxacin
51
Viral meningitis
Most common causes - HSV, enterovirus & VZV Sample of CSF should be sent for viral PCR testing Supportive treatment, aciclovir can be used to treated suspected/confirmed HSV or VZV infection
52
Meningitis complications
Hearing loss Seizures & epilepsy Cognitive impairment and LD Memory loss Cerebral palsy
53
Mumps
- viral infection spread by respiratory droplets - incubation period is 14-25 days
54
Mumps clinical features
Initial period of flu-like symptoms known as the prodrome - fever - muscle aches - lethargy - reduced appetite - headache - dry mouth Parotid gland swelling after flu-like symptoms, either unilateral/bilateral Abdominal pain Testicular pain & swelling Confusion, neck stiffness & headache
55
Mumps mx
Diagnosis confirmed with PCR testing on a saliva swab Blood/saliva can be tested for antibodies to the mumps virus Notifiable disease Supportive management → rest, fluids & analgesia
56
Mumps complications
Pancreatitis Orchitis Meningitis Sensorineural hearing loss
57
Preseptal cellulitis
Infection of the soft tissues anterior to the orbital septum - the eyelids, skin and subcutaneous tissue of the face Can progress to orbital cellulitis
58
Preseptal cellulitis epidemiology
Most commonly occurs in children - 80% of pts are < 10 - median age is 21 months More common in the winter due to the increased prevalence of RTIs
59
Preseptal cellulits aetiology
Staph aureus Staph epidermidis Streptococci Anaerobic bacteria
60
Preseptal cellulitis clinical features
Red, swollen, painful eye of acute onset Fever Oedema of the eyelids Partial/complete ptosis of the eye due to swelling Orbital signs - must be absent
61
Preseptal cellulitis ix
Bloods Swab of any discharge present Contrast CT may help to differentiate between preseptal and orbital cellulitis
62
Preseptal cellulitis mx
All cases should be referred to secondary care for assessment Oral abx are frequently sufficient → co-amoxiclav Children may require admission for observation
63
Orbital cellulitis
Result of an infection affecting the fat & muscles posterior to the orbital septum, within the orbit but not involving the globe Usually caused by a spreading URTIs Medical emergency requiring hospital admission & urgent senior review
64
Orbital cellulitis risk factors
Childhood - 7-12 years Previous sinus infection Lack of Hib vaccination Recent eyelid infection/insect bite on eyelid Ear or facial infection
65
Orbital cellulitis clinical features
Redness and swelling around the eye Severe ocular pain Visual disturbance Proptosis Ophthalmoplegia/pain with eye movements Eyelid oedema & ptosis Drowsiness +/- N&V in meningeal involvement
66
Orbital cellulitis ix
FBC - WBC elevated, raised inflammatory markers Clinical examination - complete ophthalmological assessment CT with contrast Blood culture & microbiological swab to determine the organism
67
Orbital cellulitis mx
Admission to hospital with IV abx
68
OM
- infection in the middle ear - often preceded by a viral URTI → bacteria enter from the back of the throat through the eustachian tube
69
OM bacteria
Most common - streptococcus pneumoniae Other common causes: haemophilus influenzae, moraxella catarrhalis & staph aureus
70
OM presentation
Ear pain Reduced hearing in the affected ear General symptoms of URTI → fever, cough, coryzal symptoms, sore throat & generally unwell Can cause balance issues & vertigo when the infection affects the vestibular system Can be discharge if tympanic perforation Non-specific symptoms in young children → fever, vomiting, lethargy or poor feeding
71
OM examination
Bulging, red, inflamed looking membrane If perforation → may see discharge in the ear canal & hole in the tympanic membrane
72
OM mx
Consider referral to paediatrics for assessment or admission if symptoms are severe or there is diagnostic doubt Most cases of otitis media will resolve without antibiotics Simple analgesia to help with pain and fever First line antibiotic → amoxicillin for 5 days - alternatives are erythromycin and clarithromycin
73
OM complications
Otitis media with effusion Hearing loss (usually temporary) Perforated eardrum Recurrent infection Mastoiditis Abscess
74
Rubella
Viral infection caused by the togavirus
75
Rubella timeline
Outbreaks more common around winter and spring Incubation period is 14-21 days Individuals are infectious from 7 days before symptoms appear to 4 days after onset of the rash
76
Rubella features
Prodrome - low grade fever Rash - maculopapular, initially on face before spreading to the whole body, usually fades by 3-5 days Lymphadenopathy - suboccipital & postauricular
77
Rubella complications
Arthritis Thrombocytopaenia Encephalitis Myocarditis
78
Features of congenital rubella syndrome
Sensorineural deafness Congenital cataracts Congenital heart disease Growth retardatation Hepatosplenomegaly Purpuric skin lesions
79
Suspected rubella in pregnant women diagnosis
Discussed immediately with local health protection unit IgM antibodies are raised in women recently exposed to the virus Very difficult to distinguish rubella from parvovirus B19 → important to check parvovirus B19 serology
80
Suspected rubella in pregnant women management
Discussed with local HPU Advised to keep away from those who might have rubella Non-immune mothers should be offered the MMR vaccination in post-natal period - should not be administered to women known the be pregnant/attempting to become pregnant
81
Tonsillitis
Inflammation of the palatine tonsils as a result of either a bacterial or viral infection
82
Tonsillitis organisms
Viral - adenovirus, EBV Bacteria - group A strep
83
Tonsillitis risk factors
Smoking
84
Tonsillitis clinical features
Sore throat Fever Pain on swallowing Red, inflamed & enlarged tonsils Anterior cervical lymphadenopathy
85
Tonsillitis Centor criteria
Can be used to estimate the probability that tonsilitis is due to bacterial infection & will benefit from abx Score > 3, appropriate to offer abx Fever > 38 Tonsillar exudates Absence of cough Tender anterior cervical lymph nodes
86
FeverPAIN score
Higher score = more chance of bacterial infection Fever during previous 24 hours Purulence Attended within 3 days of the onset of symptoms Inflamed tonsils No cough or coryza
87
Tonsillitis mx
1st line - Penicillin V 500mg QDS for 5-10 days Alternative in penicillin allergy: clarithromycin/erythromycin PO BD for 5 days Delayed prescriptions can be considered
88
Tonsillitis complications
Peritonsillar abscess Otitis media Scarlet fever Rheumatic fever
89
Tonsillitis post-streptococcal conditions
Post-streptococcal glomerulonephritis Post-streptococcal reactive arthritis
90
Toxic shock syndrome
Severe systemic reaction to staphylococcal exotoxins, the TSST-1 superantigen toxin
91
Toxic shock syndrome diagnostic criteria
Temperature > 38.9 Hypotension: systolic BP < 90 mmHg Diffuse erythematous rash Desquamation of rash, especially of the palms and soles Involvement of three or more organ systems: eg, GI (D&V), mucous membrane erythema, renal failure, hepatitis, thrombocytopenia, CNS involvement
92
Toxic shock syndrome mx
Removal of infection focus IV fluids IV abx
93
Viral exanthema
First disease - measles Second disease - scarlet fever Third disease - rubella Fourth disease - duke's disease Fifth disease - parvovirus B19 Sixth disease - roseola infantum
94
Scarlet fever
Associated with group A strep infection, usually tonsilitis (not caused by a virus !) Caused by an exotoxin produced by streptococcus pyogenes
95
Scarlet fever presentation
Characterised by a red-pink, blotchy, macular rash with rough ‘sandpaper’ skin that starts on the trunk & spreads outwards Fever Lethargy Flushed face Sore throat Strawberry tongue Cervical lymphadenopathy
96
Scarlet fever mx
Phenoxymethylpenicillin for 10 days - kept off school until 24 hours after starting antibiotics Notifiable disease
97
Scarlet fever associations
Post-streptococcal glomerulonephritis Acute rheumatic fever
98
Duke's disease
Never used in clinical practice Used to describe the non-specific viral rashes
99
Parvovirus B19 presentation
Mild fever, coryza and non-specific viral symptoms After 2-5 days → rash appears quite rapidly as a diffuse bright red rash on both cheeks Few days later → a reticular mildly erythematous rash affecting the trunk & limb appears that can be raised and itchy
100
Parvovirus B19 mx
Self limiting & rash and symptoms usually fade over 1-2 weeks Once rash has formed can go back to school
101
Parvovirus B19 complications
Aplastic anaemia Encephalitis or meningitis Pregnancy complications including fetal death Rarely → hepatitis, myocarditis or nephritis
102
Roseola infantum
Caused by human herpesvirus 6 and less frequently by human herpesvirus 7
102
Roseola infantum clinical features
1-2 weeks after infection with a high fever (up to 40 degrees) that comes on suddenly, lasts for 3-5 days & then disappears suddenly Coryzal symptoms, sore throat & swollen lymph nodes Rash → when fever settles, appears for 1-2 days, not itchy
103
Roseola infantum mx
Make a full recovery within a week Do not need to be kept off nursery if they are well enough to attend
104
Roseola infantum complications
Febrile convulsions due to high temperature Immunocompromised patients → myocarditis, thrombocytopenia and Guillain-Barre syndrome
105
No school exclusion
Conjunctivitis Fifth disease (slapped cheek) Roseola Infectious mononucleosis Head lice Threadworms Hand, foot and mouth
106
Scarlet fever school exclusion
24 hours after commencing antibiotics
107
Whooping cough school exclusion
2 days after commencing abx OR 21 days from onset of symptoms if no abx
108
Measles school exclusion
4 days from onset of rash
109
Rubella school exclusion
5 days from onset of rash
110
Chickenpox school exclusion
All lesions crusted over
111
Mumps school exclusion
5 days from onset of swollen glands
112
D&V school exclusion
Until symptoms have settled for 48 hours
113
Impetigo school exclusion
Until lesions are crusted and healed OR 48 hours after commencing abx treatment
114
Scabies school exclusion
Until treated
115
Influenza school exclusion
Until recovered

Y4 paediatrics (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions