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Infectious Diseases Flashcards

(56 cards)

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1
Q

How is paediatric sepsis defined?

A

Systemic inflammatory response syndrome (SIRS) with the presence of a suspected or proven infection

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2
Q

How is systemic inflammatory response syndrome characterised?

A

Fever or hypothermia
Tachycardia
Tachypnoea
Leucocytosis or leukocytopenia

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3
Q

What additional features can be present in paediatric sepsis?

A

Shock and organ dysfunction

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4
Q

How is sepsis + multi-organ failure characterised?

A 
At least two of the following:
•	Respiratory failure
•	Renal failure
•	Neurological failure
•	Haematological failure
•	Liver failure
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5
Q

What does septic shock refer to?

A

Cardiovascular failure

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6
Q

What are the risk factors for paediatric sepsis?

A

Boys are more commonly affected by sepsis than girls and incidence decreases with age, with neonates being the most at risk. Being a preterm baby is a risk factor for neonatal sepsis

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7
Q

What are the causative organisms of sepsis in neonates?

A

Group B streptococci
E. coli
Listeria monocytogenes

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8
Q

What are the causative organisms of sepsis in children?

A

Streptococcus pneumoniae
Meingococci
Group A streptococci
Staphylococcus aureus

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9
Q

What are the symptoms of paediatric sepsis?

A 
Fever or hypothermia
Cold hands/feet, mottled
Prolonged capillary refill time >2secs
Chills/rigors
Limb pain
Vomiting and/or diarrhoea
Muscles weakness
Muscle/joint aches
Skin rash
Diminished urine output
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10
Q

How is sepsis treated in children?

A

Supportive treatment- airways, breathing, circulation, glucose
Causative treatment- broad spectrum Abx, cephalosporins

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11
Q

What is included on the sepsis six in children?

A 
Give high flow O2
Obtain IV access and take bloods
Give IV antibiotics
Consider fluid resuscitation
Consider inotropic support- adrenaline
Involve senior help early
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12
Q

What investigations can be done for paediatric sepsis?

A

Bloods- FBC, CRP, coagulation factors, Us&Es, LFTs, blood gases, glucose, culture
CSF- cell count and culture, protein and glucose
Urine culture
Skin biopsy culture
Imaging- CT/MRI head

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13
Q

What are the causative organisms of meningitis in neonates?

A

Group B streptococci
E coli
Listeria monocytogenes

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14
Q

What are the causative organisms of meningitis in children?

A

Streptococci pneumoniae
Meningococci (Neisseria meningitidis)
Haemophilus influenzae

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15
Q

What are the symptoms of meningitis +/- sepsis in children?

A 
Nuchal rigidity
Headache
Photophobia
Diminished consciousness
Focal neurological abnormalities
Seizures
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16
Q

What are the symptoms of meningitis +/- sepsis in neonates?

A

Lethargy
Irritability
Bulging fontanelle
Seizures

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17
Q

What additional treatment can be given for paediatric meningitis?

A

Steroids

Chemoprophylaxis for close household contacts

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18
Q

What is streptococcus pneumoniae?

A

A gram-positive diplo-cocci that colonises the upper airways

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19
Q

How is streptococcus pneumoniae transmitted?

A

It is transmitted by droplets, with viral infections acting as a predisposing factor for invasive disease

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20
Q

What are the possible complications of pneumococcal meningitis?

A

Brain damage
Hearing loss
Hydrocephalus

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21
Q

What kind of bacteria are streptococci and staphylococci?

A

Gram positive cocci

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22
Q

What is the causative organism in Scarlet fever?

A

Group A strep

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23
Q

What is the timeline for scarlet fever?

Study These Flashcards
A
  1. Contact
  2. Incubation for 2-4 days
  3. Malaise, fever and pharyngitis
  4. Rash
  5. Squamation
  6. Strawberry tongue
24
Q

What age is most commonly affected by scarlet fever?

Study These Flashcards
A

<10

Mean age = 4

25
How is group A streptococci treated?
10 days of penicillin
26
What are the complications of group A strep?
Erythematous rash Urticaria Haematuria Impetigo
27
Where is staph A carried in the general population?
Widespread carriage | Common in nasal passages, perineum and axillae
28
What infections are caused by staph A?
``` Impetigo Cellulitis Infected eczema Ulceration Staphylococcal scalded skin syndrome Toxic shock syndrome ```
29
What is Kawasaki disease?
A self-limiting vasculitis of medium sized arteries
30
What are the symptoms of Kawasaki disease?
``` Five days of fever PLUS: -Bilateral conjunctival injection -Cracker lips/strawberry tongue -Cervical lymphadenopathy -Polymorphous rash -Changes to extremities ```
31
What is the main aim of treatment of Kawasaki's disease?
Prevention of coronary aneurysms
32
How is Kawasaki's disease treated?
``` Immunoglobulins Aspirin Steroids Other immunosuppressive agents Cardiology assessment ```
33
What are the causes of a maculopapulous rash?
``` Measles Rubella Enterovirus Cytomegalovirus Human herpes virus 6 and 7 Parovirus B19 EBV ```
34
What are the causes of a vesicobullous rash?
Varicella-zoster virus Herpes simplex virus Enterovirus
35
What are the causes of a petechial and purpuric rash?
Rubella Cytomegalovirus Enterovirus
36
What are the presentations of varicella-zoster virus?
Primary infection- varicella, chickenpox | Recurrent infection- zoster
37
What is the incubation period for varicella-zoster virus?
10-21 (most commonly 14) days
38
What are the clinical features of varicella-zoster virus?
Mild malaise and fever Itch Generally not unwell Exanthema
39
What are the possible complications of varicella-zoster virus?
Secondary strep/staph skin infections Meningoencephalitis Cerebellitis Arthritis
40
How is varicella-zoster virus treated?
Usually conservative | Can give acyclovir if immunosuppressed
41
What are the warning signs of a serious VZV infection?
High fever New lesions after day ten Inflamed lesions General malaise
42
What are the different kinds of herpes simplex virus?
HSV 1- oral form | HSV 2- genital form
43
What is the clinical presentation of herpes simplex virus?
Stomatitis and recurrent cold sores
44
What are the possible complications of herpes simplex virus?
Keratoconjunctivitis Encephalitis Systemic neonatal infections Immunocompromised children
45
How is HSV treated?
Conservative | Acyclovir
46
What is the mortality rate of neonatal HSV?
50% without acyclovir | 20-30% with acyclovir
47
When does neonatal HSV onset?
DOL 4-21
48
What are the features of disseminated neonatal HSV?
Sepsis Meningoencephalitis Hepatitis (jaundice, bleeding)
49
What are the causative organisms of hand-foot-mouth disease?
Coxsackie A16 | Enterovirus 71
50
When is hand-foot-mouth disease most common?
Most commonly affects children <10 | Most common in the summer and autumn months
51
What is the incubation period of hand-foot-mouth disease?
3-6 days
52
What are the clinical features of hand-foot-mouth disease?
Exanthema Painful lesions Recovery in 5-10 days Can cause complicated illness in neonates
53
What are the differences between primary and secondary immunodeficiency?
Primary immunodeficiencies: -Rare - >300 disorders -Occurs when there is a missing or improper function of the body’s immune system -Usually caused by single gene defects -Can affect one or multiple components of the immune system. Secondary immunodeficiencies: -More common -Acquired diseases or affects of treatment damaging the immune system. Common examples include HIV infection, prolonged steroid use and patients being treated for malignancy
54
What are the warning signs of primary immunodeficiency?
Four or more new ear infections in one year Two or more serious sinus infections in one year Two or more months on antibiotics with little effect Two or more pneumonias within one year Failure to thrive Recurrent, deep skin or organ abscesses Persistent oral thrush or fungal skin infection Need for IV Abx to clear infection Two or more deep seated infections (ie sepsis) Family history of primary immunodeficiency
55
What is the simplified version of the warning signs of primary immunodeficiency?
``` Serious Persistent Unusual Recurrent Family history ```
56
What investigations can be used for immunodeficiency?
``` Full blood count Immunoglobulins HIV test Functional antibodies Lymphocyte subsets NBT (nitroblue tetrazolium test) Complement ```

Paediatrics (22 decks)

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