Infectious Diseases Flashcards

(54 cards)

1
Q

what is SIRS

A

fever or hypothermia
tachycardia
tachypnoea
Leucocytosis or leucocytopaenia

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2
Q

what is ARDS

A

acute respiratory response syndrome - inflammatory response of the lungs

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3
Q

organisms causing sepsis in neonates

A

group b strep
e. coli
listeria monocytogenes

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4
Q

organisms causing sepsis in children

A

strep pneumoniae
meningococci
group a strep
staph a

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5
Q

with a diagram describe the pathophysiology of sepsis

A

see notes

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6
Q

symptoms of sepsis

A
  • Fever or hypothermia
  • Cold hands/feet, mottled
  • Prolonged capillary refill time
  • Chills/rigors
  • Limb pain
  • Vomiting and/or diarrhoea
  • Muscle weakness
  • Muscle/joint aches
  • Skin rash
  • Diminished urine output
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7
Q

organisms causing meningitis in neonates

A

o Group B streptococci
o Escherichia coli
o Listeria monocytogenes

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8
Q

organisms causing meningitis in children

A

o Streptococcus pneumoniae
o Meningococci
o Haemophilus influenza

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9
Q

symptoms of meningitis

A
•	Nuchal rigidity
•	Headaches, photophobia
•	Diminished consciousness
•	Focal neurological abnormalities
•	Seizures
•	In neonates:
o	Lethargy, irritability
o	Bulging fontanelle
o	“nappy pain”
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10
Q

toxic shock syndrome is caused bt what bacteria?

A

strep and staph

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11
Q

treatment of meningitis

A

• Supportive
o A, B, C, D, E
• Causative treatment
o Antibiotics with good penetration in CSF and broad spectrum
o 3rd generation cephalosporins (+ amoxicilline if neonate)
• Chemoprophylaxis
o Close household contacts
o Meningococcus B and streptococcus group A

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12
Q

diagnosis of meningitis

A

• Blood: FBC; leucocytosis, thrombocytopaenia
o CRP; elevated
o Coagulation factors; low levels due to DIC
o Blood gas; metabolic acidosis
o Glucose; hypoglycaemia
• CSF: pleocytosis, increased protein level, low glucose
• Blood and CSF cultures (antigen testing, PCR)
• Urine culture, skin biopsy culture
• Imaging: CT-cerebrum

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13
Q

streptococcus pneumoniae: shape

A

gram +ve duplo-cocci

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14
Q

streptococcus pneumoniae: where does it colonise

A

upper airways

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15
Q

streptococcus pneumoniae: transmission

A

droplet

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16
Q

streptococcus pneumoniae: predisposing factor for invasive disease

A

viral infections

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17
Q

complications of pneumococcal meningitis

A

brain damage
hearing loss
hydrocephalus

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18
Q

Haemophilus Influenza Type B: shape

A

gram -ve bacterium

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19
Q

Haemophilus Influenza Type B: infections

A

bacteraemia
meningitis
pneumonia
epiglottis

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20
Q

meningococcal disease virulence factor

A
  • Endotoxin = lipooligosaccharide

* Association endotoxin levels and mortality

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21
Q

streptococci: shape

A

gram +ve cocci

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22
Q

streptococci: antibiotic

23
Q

staphylococci: shape

A

gram +ve cocci

24
Q

staphylococci: antibiotic

A

flucloxacillin

25
scarlet fever: incubation
2-4 days
26
scarlet fever: symptoms
``` maliase fever tonsillitis start exanthema strawberry tongue squamation of hands and feet ```
27
scarlet fever: organism
group a beta-haemolytic strep
28
scarlet fever: virulence factors
m-protein | exotoxins
29
scarlet fever: complications
o Erysipelas, cellulitis, impetigo o Streptococcal toxic shock o Rheumatic fever 0.3-3% o Glomerulonephritis
30
scarlet fever: treatment
penicillin 10 days
31
impetigo: organism
s pyogenes | s aureus
32
Staphylococcal scalded skin syndrome: what causes it
exotoxins of s aureus
33
Staphylococcal scalded skin syndrome: who
< 5, mostly newborns
34
Staphylococcal scalded skin syndrome: signs
fever widespread redness fluid filled blisters that rupture easily esp in skin folds
35
Kawasaki Disease: clinical features
``` • Fever for at least 5 days and • 4 of: o Bilateral conjunctival infection o Changes of the mucous membranes o Cervical lymphadenopathy o Polymorphous rash o Changes of the extremities • Peripheral oedema • Peripheral erythema • Periungual desquamation ```
36
Kawasaki Disease: pathophysiology
* Self-limited vasculitis of medium-sized arteries * KD reported in all racial and ethnic groups * Highest prevalence in Japan and Hawaii * Increased risk in siblings and twins * Aetiology unknown but infectious cause suggested
37
Kawasaki Disease: treatment
* Immunoglobulins * Aspirin * Other immunosuppressive agents
38
VZV: incubation
14 (10-21) days
39
VZV: features
o Mild malaise and fever (kids are not sick) o Exanthema: papules  vesicles  pustules  crustae  (scarring) o New lesions during 5-7 days o Itching
40
VZV: complications
o Secondary strep/staph infections of the skin (10-15%) | o Meningoencephalitis, cerebrellitis, arthritis)
41
VZV: therapy
o (val)aciclovir
42
VZV: prevention
o Vaccination (active/passive)
43
HSV: clinical features
stomatitis | recurrent cold sores
44
HSV: complications
o (kerato) conjunctivitis o Encephalitis o Systemic neonatal infections o Immunocompromised children
45
HSV: therapy
o Self-limiting | o (val)acyclovir
46
HSV in neonates
``` • Birth canal/direct contact • Day 4-21 of life • 70-80% disseminated/CNS infections o Sepsis o Meningoencephalitis o Hepatitis (jaundice, bleeding) • 20-30% skin/eye/mouth (SEM) disease • 2-3/100,000 • High mortality o Without acyclovir > 50% o With acyclovir 20-30% ```
47
hand foot and mouth disease: cause
enteroviruses | coxsackie A16 and enterovirus 71
48
hand foot and mouth disease: incubation period
3-6 days
49
hand foot and mouth disease: age
<10
50
hand foot and mouth disease: when in year
summer and early autum
51
hand foot and mouth disease: clinical
o Exanthema and enathema o Painful lesions o Recovery in 5-10 days
52
vesicular rashes diagnostics
``` • Clinical diagnosis • Smear of vesicle (ulcer base) o Tzanck test: no differentiation HSV/VZV • PCR (fluids, CSF, blood) • Serology (past infection) ```
53
presenting symptoms of primary immunodeficiency
invasive fungal infections
54
clinical presentation on neonatal candidemia
o Sepsis syndrome o 2nd/3rd week of life o Thrombocytopaenia o Hyperglycaemia