Infectious diseases Flashcards
(133 cards)
1
Q
When are Koplik spots found?
A
Measles
24-48 hours before the exanthem
2
Q
What are the stages of subacute sclerosing panencephalitis?
A
- Dementia
- Epilepsy and myoclonus
- Decerebration (increased tone, vegetative state, coma)
3
Q
What is the treatment for scabies?
A
Permethrin
Wash all clothing and linen
4
Q
When are renal ultrasounds indicated for UTIs?
A
Severe UTI
Recurrent febrile UTIs
Atypical UTI (i.e. non-E.coli)
Children younger than 2 with a febrile UTI
For structural abnormalities
5
Q
Why are pregnant women vaccinated for pertussis?
A
To provide passive immunity to their children
6
Q
What is the triad of Reye syndrome?
A
- Preceding viral illness
- Acute encephalopathy
- Liver failure
* Due to aspirin use in children with a viral infection*
7
Q
How long is a patient with scarlet fever infectious for?
A
24 hours after penicillin is given
8
Q
How does the rash of meningococcus progress?
A
Red rash → petechiae → purpura
9
Q
What vaccinations are given at 4 years?
A
Diptheria, tetanus, pertussis, polio
10
Q
What is Brudzinski sign?
A
Pain and hip flexion with passive neck flexion
11
Q
What bacteria is the most common cause of osteomyelitis?
A
Staphylococcus auerus
12
Q
When is a child with erythema infectiosum contagious?
A
During the prodrome only
13
Q
Which TORCH infection is associated with Hutchinson teeth, a congenital dental malformation involving notches and widely shaped central incisors?
A
Syphilis
14
Q
What vaccinations are given at 4 months?
A
Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio
Pneumococcal
Rotavirus
15
Q
What is the pathophysiology of DIC secondary to sepsis?
A
Cytokines → hypercoagulation with hypofibrinolysis → microthrombi → impaired perfusion and tissue necrosis
16
Q
What chemoprophylaxis is given to people who have had contact with Neisseria meningitidis?
A
Ciprofloxacin oral
OR
Ceftriaxone IM (hurts)
Contacts within the past week
17
Q
Which TORCH infection is associated with saddle nose and a short maxilla?
A
Syphilis
18
Q
What vaccination is given at birth?
A
Hepatitis B
19
Q
How do meningococci stain?
A
Gram negative diplococci
20
Q
Passive infant immunity through breast milk occurs through which immunoglobulin?
A
IgA
21
Q
What is the most common cause of meningitis in newborns?
A
Group B Streptococcus
22
Q
What drug can be given for RSV prevention?
A
Palivizumab
Monoclonal antibody that provides passive immunisation to RSV infection
Indications: infants at risk for severe bronchiolitis e.g. prematurity, heart or lung disease, immunocompromised states
Monthly IM administration during RSV season for the first year of life
23
Q
What does a non-blanching rash in children suggest?
A
Meningococcal
24
Q
What is the major complication of measles?
A
Subacute sclerosing panencephalitis
A lethal, generalised, demyelinating inflammation of the brain
25
A sandpaper rash is characteristic of which disease?
Scarlet fever
26
What is the treatment for *Staphylococcus* impetigo?
Flucloxacillin
27
Which TORCH infection is associated with CN VIII deafness?
Syphilis
28
How is meningococcus spread?
Secretions from the back of the nose and throat
Requires close and prolonged contact, not easily spread
Bacteria do not last long outside of the body
29
Which TORCH infections present with a blueberry muffin appearance, indicative of extramedullay haematopoesis?
Rubella + CMV
30
Which organism causes pertussis?
*Bordetella pertussis*
31
Is tonsillitis more commonly viral or bacterial?
Viral
If bacterial - *S. pyogenes* (Group A strep)
32
What is the most common cause of croup?
Parainfluenza virus (75%)
Followed by respiratory syncytial virus
33
What is the pathophysiology of Waterhouse-Friderichsen syndrome?
Bacterial endotoxins → coagulopathy → haemorrhagic necrosis of the adrenal gland
34
What features are suggestive of pyelonephritis in a child with bacteriuria?
Fever
Loin pain
Tenderness
*If any of these features are present treat as pyelonephritis (common in children)*
35
Gastroenteritis that occurs in an outbreak is most likely?
Norovirus
36
Which population is predisposed to eczema herpeticum?
Atopic people
37
Which TORCHes infection presents with recurrent infections and diarrhoea?
HIV
38
What is the triad of congenital rubella?
1. Patent ductus arteriosus
2. Cataracts
3. Deafness
39
What causes hand, foot and mouth disease?
Coxsackie A
40
What vaccinations are given at 6 weeks?
Diptheria, tetanus, pertussis, *Haemophilus influenzae* type b, hepatitis B, polio
Pneumococcal
Rotavirus
41
What cause scabies?
*Sarcoptes scabiei* mite
42
Do premature infants recieve their vaccinations at chronological or corrected age?
Chronological
43
When are Pastia's lines seen?
Scarlet fever
Most pronounced in the groin, underarm and elbow creases
44
What is the most common cause of meningitis in children and teens?
*Neisseria meningitidis*
45
Why do infants with bronchiolitis have hyperinfilation in CXR?
Mucous plugs act as a one way valve → air goes in but not out → air-trapping and hyperinflation
46
Viral infection followed by extension of commensals from the larynx into the trachea describes which disease?
Bacterial tracheitis
47
What cardiovascular defects are associated with congenital rubella?
Patent ductus arteriosis
Pulmonary artery hyperplasia
48
What are the three most suggestive signs of sepsis from meningococcal disease?
1. Cold hands and feet
2. Leg pain
3. Abnormal skin colour e.g. pallor, mottling
49
What is the tetrad of HSP?
1. Palpable purpura
2. Arthritis/arthralgia
3. GI symptoms
4. Renal disease
50
What are the TORCH infections?
T - toxoplasmosis
O - others; syphilis, varicella zoster, parvovirus B19, listeriosis
R - rubella
C - cytomegalovirus
H - herpes simplex
51
How is tonsillitis treated?
Supportive
Antibiotics only used in groups at risk of complications of *S. pyogenes* infection e.g. high rates of rheumatic fever, existing heart disease
52
Which TORCH infection is associated with saber shins?
Syphilis
## Footnote
*Sharp anterior bowing of the tibia*
53
When is the peak incidence of bronchiolitis?
2-6 months of age
Primarily affects children \<2
More common in winter
54
Which pathogen is most commonly involved in otitis media?
*S. pneumoniae*
Bacterial superinfection following URTI
55
How is hand, foot and mouth disease treated?
Supportive
Hygeiene
*Lesions are contagious until they dry up*
56
How is Kawasaki disease treated?
IV immunoglobulin
High dose aspirin
57
Which pathogen may cause meningitis with myalgia and a petechial/purpuric rash?
*Neisseria meningitidis*
58
How is a diagnosis of epiglottitis confirmed?
Pharyngoscopy
Cherry-red epiglottis
*Not needed for a diagnosis*
59
What causes the induction of prostaglandins, particularly PGE2, during fever?
Pyogenic cytokines arriving at the anterior hypothalamus
60
Why is the rash from meningococcal sepsis non-blanching?
Neisseria meningitidis has direct toxicity to the endothelium of blood vessels → bleeding into the skin
61
What are the distinctive clinical features of a child with epiglottitis?
Tripoding
Drooling
Muffled voice with painful speech
Distress
62
What is the classic triad of congenital toxoplasmosis?
1. Chorioretinitis
2. Hydrocephalus
3. Intracranial calcifications
63
What vaccinations are given in year 7?
Diptheria, tetanus, pertussis
Human papillomavirus (2 doses)
64
What are the features of Kawaski disease?
C - conjunctivitis
R - rash
A - adenopathy
S - strawberry tongue
H - hands and feet (oedema and erythema)
and burn
65
What are the 3 C's of measles?
Conjunctivitis
Cough
Coryza
66
What is the major complication of Kawasaki disease?
Coronary artery aneurysm
67
When does Forchheimer sign occur?
Rubella
Petechiae on the soft palate and uvula during the prodromal period
68
What is the most common causative agent of bacterial tracheitis?
*Staphylococcus aureus*
69
Which TORCHes infection presents with hearing loss, seizures, petechial rash and blueberry muffin rash?
CMV
70
What is the most common cause of gastroenteritis in young children?
Rotavirus
71
How long is a child with rubella infectious for?
1-2 weeks before the rash appears → 5 days after
72
What are 3 risk factors for bronchiolitis?
1. Prematurity
2. Congenital heart disease
3. Congenital lung disease
4. Immunodeficiency
73
When is a child with varicella zoster contagious?
24 hours before the rash until all crusted
74
What follow up imaging is performed if a renal ultrasound is suggestive of vesiculoureteric reflux?
Micturating cystourethrogram
75
What vaccinations are given at 12 months?
Meningococcal ACWY
Pneumococcal
Measles, mumps, rubella
76
What is the immediate treatment if meningococcal meningitis is suspected?
IV ceftriaxone/cefotaxime
77
What vaccination is given in years 10-11?
Meningococcal ACWY
78
What vaccinations are given at 18 months?
Diphtheria, tetanus, pertussis
Measles, mumps, rubella, varicella
*Haemophilus influenzae* type b
79
Palivizumab is used to prevent what disease?
Bronchiolitis (RSV)
80
What are the two most common causes of meningitis in infants (1 month - 2 years)
* Streptococcus pneumoniae*
* Neisseria meningitidis*
81
Which antibiotic is used for otitis media?
Amoxicillin
Indications: bilateral infection, symptoms not resolving, severe illness, immunosuppression
82
What is the most common cause of bronchiolitis?
Respiratory syncytial virus
83
What is erythema marginatum?
Cutaneous manifestation of rheumatic fever
Centrifugally expanding pink rash with a well-defined outer border and central clearing
Non-pruritic
84
What is the classic triad of meningitis?
Fever, headache, neck stiffness
85
Which TORCH infection often presents with foetal hydrops?
Parvovirus
*Due to aplastic anaemia*
86
What causes roseola?
Herpes virus 6
87
What is the formal name for croup?
Laryngotracheitis
88
Where does the rash of measles spread on the body\>
Cephalocaudal
89
Which TORCH infection presents with encephalitis and herpetic (vesicular) lesions?
HSV-2
90
What causes eczema herpeticum?
Herpes simplex 1/2
91
Where does the rash from rubella start?
Behind the ears
92
How is acute cystitis treated?
Trimethoprim + sulfamethoxazole
5 days (10 days for pyelonephritis)
93
Does vomiting predominate in rotavirus or norovius?
Norovirus
*Diarrhoea is more severe in rotavirus*
94
What imaging finding is characteristic of croup?
Steeple sign (subglottic narrowing)
95
What is Kernig sign?
Pain with leg flexion in meningitis
96
Why is dexamethasone given to infants with meningitis?
Reduces the risk of hearing loss (Hib) and may improve mortality (pneumococcus)
Thought to reduce the overwhelming inflammatory response to administration of antibiotics - give before antibiotics
97
How is eczema herpeticum treated?
Oral acyclovir
Dermatologic emergency
98
What vaccinations are given at 6 months?
Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio
99
How is encephalitis treated?
Acyclovir
## Footnote
*In case the cause is HSV - rare but devestating*
100
What is the characteristic x-ray sign of epiglottitis?
Thumbprint sign
Enlarged epiglottis with supraglottic narrowing
101
What causes impetigo?
*Staphylococcus aureus*
Group A B-haemolytic *Streptococcus* if low SES
102
How does *Streptoccocus pneumoniae* (pneumococci) stain?
Gram positive diplococci
103
What causes scarlet fever?
TOXINS from Group A Streptococcus
104
What type of immunoglobulin can cross from maternal blood into the placenta?
IgG
105
What are the most common causes of viral meningitis?
Enterovirus: coxsackie and echovirus
Herpes simplex
EBV
More common in teens and young adults
*Less severe than bacterial meningitis and a full recovery can be expected*
106
What is the most common cause of Waterhouse-Friderichsen syndrome?
Meningococcal meningitis
## Footnote
*(Neisseria meningitidis)*
107
Why do infants with bronchiolotis have atelectasis on CXR?
Mucous plugs trap air in the bronchioles → air diffuses into the bloodstream → airways collapse
108
How is herpetic gingivostomatitis managed?
Supportive management with analgesia
Acyclovir if immunocompromised
109
When is dexamethasone given during the treatment of meningitis?
Before administration of Abx
Prevents overwhelming inflammatory response
110
What immunisation is given at birth?
Hepatitis B
111
What immunisations are given at 6 weeks?
Diptheria, tetanus, pertussis, *Haemophilus influenzae* type b, hepatitis B, polio
Pneumococcal
Rotavirus
112
What immunisations are given at 4 months?
Diptheria, tetanus, pertussis, *Haemophilus influenzae* type b, hepatitis B, polio
Pneumococcal
Rotavirus
113
What immunisations are given at 6 months?
Diptheria, tetanus, pertussis, *Haemophilus influenzae* type b, hepatitis B, polio
114
What immunisations are given at 12 months?
Meningococcal ACWY
Pneumococcal
Measles, mumps, rubella
115
What immunisations are given at 18 months?
Diptheria, tetanus, pertussis
Measles, mumps, rubella, varicella
*Haemophilus influenzae* type b
116
What immunisations are given at 4 years?
Diptheria, tetanus, pertussis, polio
117
What immunisations are given in year 7?
Diptheria, tetanus, pertussis
Human papillomavirus (2 doses)
118
Give three ways by which GAS infection can be confirmed (current or recent)
1. Throat culture
2. Rapid streptococcal antigen test
3. Antistreptolysin antibody
4. Antideoxyribonuclease B antiboody
119
What are the major criteria for rheumatic fever?
1. Carditis
2. Arthritis
3. Chorea
4. Erythema marginatum
5. Subcutaneous nodules
120
What are anti-deoxyribonuclease B antibodies tested for?
Group A strep
121
Which vaccines are live-attenuated?
MMR
Rotavirus
Varicella
Zoster
Yellow fever
Tyhoid
Japanese encephalitis
BCG
122
Does SSSS involved the mucosa?
NO
123
How is Sydenham's chorea treated?
Usually no treatment
Carbamazepine or valproic acid, if necessary
124
Following acute rheumatic fever, how long is secondary prevention with benzathine penicillin continued for?
3-4 weekly
Minimum of 10 yearts after more recent episode or until age 21 (whichever is longer)
125
Which organism often causes infection following fresh water exposure?
Pseudomonas aeruginosa
126
What are the most common causes of ophthalmia neonatorum?
Conjunctivitis in the first month of life
Chlamydia or gonorrhoea
127
What are the possible complications of meningitis?
SIADH
Cerebral oedema
Hearing loss
Waterhouse-Friderischsen syndrome
Epilepsy
Cognitive deficits, CP
128
How many annual URTIs is normal for a young child?
8-10
129
What is cat scratch disease?
Benign, self-limiting illness caused by *Bartonella henselae,* transmitted by cats
Mild constitutional symptoms, papules/vesicles, lymphadenopathy
130
Which helminth causes threadworm/pinworm?
*Enterobius vermicularis*
131
Which medication is in Combantrin?
| (anti-helminth chocolates)
Pyrantel
132
What is the triad of infectious mononucleosis?
1. Fever
2. Generalised non-tender lymphadenopathy
3. Exudative pharyngitis/tonsilitis
133
Which childhood vaccination is associated with febrile seizures?
MMR
