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Paediatric infection Flashcards

(94 cards)

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1
Q

incubation period of measles

A

7-14 days

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2
Q

define SSPE

A

subacute scerlosing panencephalitis

-type of encephalitis occurs after measles infections
-at least 2 to 10 years for symptoms to develop after MEASLES infections

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3
Q

infectivity period of measles

A

1-2 days before syx to 4 days afteer appearnace of rash

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4
Q

prodrome of measles 4

A

prodrome (3-5 days)
-fever, coryza, cough, conjunctivitis and Kopliks spots (small red/white dots on inside of cheeks)

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5
Q

features of measles after prodrome 3

A

then maculopapular rash starts behind the eyes, migrates to face and trunk then to limbs
-also cervical lymphadenopathy
-high fever

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6
Q

complications of measles 8

A

otitis media

lympadenitis

interstilal pneumonitis

secondary bacterial brnachopneumonia

myocarditis

post-infectious demyelening encephalomyelitis

SSPE

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7
Q

treatment for measles

A

supportive

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8
Q

prevention for measles

A

MMR vaccine

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9
Q

incubation period of chicken pox (Varicella Zoster)

A

14-21 days

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10
Q

infectivity period of chicken pox (Varicella Zoster)

A

2 days before until 5 days post rash

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11
Q

prodrome of chicken pox (Varicella Zoster) 4

A

48hrs of fever, malaise, headahce and abdo pain

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12
Q

clinical features of chicken pox (varicella zoster) after prodrome 1

A

followed by:
-itchy crops of erythematous macules, evolve into papules then vesicles containing serous fluid
*-different stages of vesciles present simultaneously

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13
Q

where do chicken pox (Varicella Zoster) usually start

A

on trunk then spread to limbs

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14
Q

complicatinos of chicken pox (Varicella Zoster) 9

A

secondary bacterial infection

pneumonia

encephalitis

progressive dissemeniated variclella

cerebellar ataxia

thrombocytopenia

purpura fulminans

post infectious encephalitis

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15
Q

which secondary bacterial infections are common in chicken pox (Varicella Zoster) 2

A

group A streoptococcus

S. aureus

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16
Q

treatment for chicken pox (Varicella Zoster) 2

A

supportive,

aciclovir in high risk patients

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17
Q

prevention for chicken pox (Varicella Zoster) 2

A

vaccination for high risk patients

post exposure prophylaxis w varicella zoster immunoglobulin (IVIG) for severe disease
-especially if immunocompormised

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18
Q

incubcation periods of mumps

A

14-21 days

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19
Q

infectivity period of mumps

A

1-2days prior to parotid swelling
9 days after

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20
Q

prodrome of mumps 3

A

prodrome- mumps, anorexia, headache

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21
Q

clinical features of mumps after prodrome 2

A

followed by painful uni/bilateral salivary ± submandibular gland swelling

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22
Q

complications of mumps 9

A

menignoencephalitis

deafness

orchitis

epididymitis

pancreatits

nephritis

myocarditis

arthitis

thrydoiditis

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23
Q

treatment for mumps 1

A

supportive

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24
Q

prevention of mumps 1

A

MMR vaccine

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25
incubation of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)
4-14 days
26
infectivity period of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)
not infectious once rash appears
27
prodrome of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 2
low grade fever general malaise
28
features of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) after prodrome 4
few days of maculopapular spots on cheeks -coalesce to give slapped cheeks appearance fine rash extends to trank & limbs fades w central cleaning giving a lacy appearance assocaited: -arthralgia -arthitis
29
complciations of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)
aplastic crisis in chornic haemolytic disease eg sickle cell disease, thalassaemia and immunocompormised
30
treatment for erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 1
supportive
31
prevention of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 1
none
32
incubation period of rubella
14-21 days
33
infectivity period of rubella
1-2 days before to 7 days after the rash appears
34
prodrome of rubella 2
coryza tender cervical lymphadenopathy
35
clinical features of rubella after prodrome 3
fine maculopapular rash -starts on face from where it fades as it spreads down the drunk arthralgia palatal petechiae
36
complicaitons of rubella 3
encephalitis thrombocytopenia congenital rubella syndrome (most feotal dameg if esposed in 1st 10 weks of pregnancy)
37
treatment of rubella 1
supportive
38
prevention of rubella 1
MMR
39
incubation of roseola infantum/ sixth disease (human herpes virus 6)
7-14 days
40
infectivty period of roseola infantum/ sixth disease (human herpes virus 6)
until fever subsides
41
prodrome of roseola infantum/ sixth disease (human herpes virus 6) 2
sudden onset high fever milkd coryza no other physical findings
42
clinical features of roseola infantum/ sixth disease (human herpes virus 6) after prodrome 2
day 3-4 fever resolves -maculopapular rash appears on trunk/ limbs and lasts for 1-2days
43
complications of roseola infantum/ sixth disease (human herpes virus 6) 2
febrile convulstions- one of the commonest causes of febrile convulsions in 6-18 mnth olds -usually on first day of illness encephalitis
44
treatment for roseola infantum/ sixth disease (human herpes virus 6) 1
supportive
45
prevention for roseola infantum/ sixth disease (human herpes virus 6) 1
none
46
incubation period of pertussis
7-14 days
47
infectiveity period of pertussis
whilst coughing risk of transmision greated in catarrhal phase
48
phases of pertussis 3
*-in chronological order catarrhal phase paroysmal phase convalescent stage
49
features of catarrhal phase of pertussis
lwo grade fever coryza conjunctivtis 1-2 weeks
50
features of paroxysmal phase of pertussis 4
*-follows catarrhal phase paroxysm of severe cough withor without whoop post-tussive vomiting cyannosis apnoea can last for 2-8 weeks
51
features of convalescent phase of pertussis 1
cough subsides over weeks to months
52
complications of pertussis 3
apneoa secondary bacterial pneumonia weight loss secondary to feeding dificulties and post-tussive vomiting
53
severe complciations of pertussis 8
subsewuent bornchietisis otitis media seizures encephalopahty subocnjunctival, subarachnoid or intraventitrrilcuar haemorrhage umbilial or inguinal hernia rupture of diaphragm
54
diagnosis of pertussis 3
pernasal swab for PCR testing culture lymphocytosis
55
treatment of pertussis 2
supportive -low threshold for admission if neonates macroslides
56
benefits of using macroslides in pertussis infection 3
modify course of early disease later reduce infectivitivty and reduce secondrary bacterial complciatiosn
57
preveniton of pertussis
vaccination
58
most common cuases of bacterial meningitis in uk children 2 (3 others)
Neisseria meningitdis (mainly B)- 60-70% of cases -incidence decreasing with routine vaccinatin streptococcus pneumonia around 30% H. Infunzae, TB and group B strep the rest
59
common cause of viral meningitis 1
enterovirus
60
common cuase of menigoencephalitis 1
herpes simplex
61
neonates cause of meningitis 1
50-60% of cases are due to Group B strep (colonisation of the birth canal)
62
other causes of noenates meningitis 2
listeria monocytogenes (eg mother eating unpasteurieiszed cheese during pregnancy) gram-neg organmis s like E.coli
63
presenation of meningitisin children 10
*-bacterial meningitis MEDICAL EMERGENCY fever headache vomiting neck stiffness photophobia lethargy decreased level of consciousness seizures postive kernigns and brudzinski tests
64
define kernings test
hip flexed-> extended knee= pain
65
define brudzinkis sign
neck flexed-> hip & knee flex
66
presenation of infants with meningitis 7
unexplained fever lethargy high pitched/ iritable cry that cannot be soothed by parents poor feeding apnoeic or cyanotic attacks posturing seizures
67
advanced sign of meningitis in infants
bulging fontanelle -sign of rasied ICP *-can be masked by dehydration
68
diagnosis of meningitis 1
lumbar puncture
69
contraindications to a lumbar puncture 4
cardiovascular compormise signs of raised ICP (risk of cerebral herniation) abnormla clotting studies/ low platelets (risk of subdural or epidural haematoma) skin infection at lumbar puncture site (risk of introducing infectoin)
70
signs of raised ICP 8
GCS<9 or drop of 3 or more relative bradycardia and hypertension focal neuro signs abnormal posute/posturing unequal dilated or poorly repsonsive pupils papilloedema abnormal dolls eyes mvoemeonts
71
CSF analysis in meningitis -White cell count cut off for children and neonates
children >5cells /mcl neonates >20 cells/mcl
72
type of WCC seen in CSF of bacterial meningitis
polymorphs
73
type of WCC seen in CSF of viral mengitis after 24 hours
lymphocytes
74
protein and glucose in CSF of bacterial/TB meningitis
elevated protein >0.4g/L decreased glucose <0.6 CSF:blood ratio
75
important point on gram staining for bacterial mengitis
60% of bacterial meningitis are negavtive for staining -DO A CULTURE
76
CSF investigations for TB meningitis 2
ZN/auramine stain mycobacterial culture
77
when to do PCR of CSF for what type sof meningitis 6
pneumococcus meningococcus HiB HSC VZV enterovirus
78
emperical treatment for suscpected bacterial meningitis : <6wks 6wks-3mnths >3mnth
<6wks- cefotaxime, amox, gent 6wks-3mnths- cefotaxime >3mnths- cefotaxime and dexamethasone
79
when should dexamethazone be used in menigitits, what age and why
if no petechiae or purpuric lesions child over 3 months reduces risk of deafness from Hib meningitis
80
definitve treawtment for N. meningitiidis meningitis 2
7 days IV cefotaxime/ceftriaxone
81
definitive treatment for S. pneumoniae meningitis 2
14 days IV cefotaxime/ceftriaxone
82
if somneone has confirmed meningitis who should also be informed and what sohuld occur
refer to public health contact tracing for chemoprophylaxis
83
complications of meningitis 7
hydrocephalus deafness- routine hearing tests after meningitis in children neuromotor disordeers seizures visual disorders speech/ language disordrs learning difficulties and behaviorual problems '
84
what is released in meningococcal sepsis (1) and what do they do (4)
endotoxins from cell wall cuase activation of proinflammaotry cytokines leading to: -capillary leak -coagulopathy -myocardial depression -metabolic derangement (low K, Ca, Mg & Ph)
85
presentation of meningococcal sepsis 2
fever petechial/purpuric rash (may be erytheamtous at onset) *-can rapdily deteriotate and lead to severe sepsis and septic shock
86
presenation of septic shcok 6
breahting difficulties tachycardia hypotension cool extremities leg pain CRT>2s decreaed GCS
87
managemnet of meningococcal sepsis 5
high flow O2 15l via facemask w reservoir bag signs of shcok IV fluid bolus -20ml/kg 0.9% saline -repeat -if more than two= DW PICU/anaestjeitc team for ventilation/intubation/inotropic support IV cefotaxime (50mg/kg) correct metabolic derangement treat coagulopathy
88
what causes acute epiglottitis
Haemophilus influenzae type B -rare but serious *use to be children mainly affected but since immunisation now more adults
89
features of acute epiglottitis 5
rapid onset high temp stridor drooling of saliva TRIPOD POSITION - paitent finds it easier to breath if they are leaning forward and extending their neck in a seated posiotin
90
diagnosis of acute epiglottitis 2
direct visulisation -ONLY BY SENIOR STAFF -risk of acute airway obstruction x-ray aswell
91
xray findings in acute epiglottitis 1 *why is xray helpful here
lateral view- show swelling of epiglottis - 'thumb sign' *Xray also helpful to assess for foreign body
92
xray findings in croup
posterior-anterior view show subglottic narrowing -'steeple sign'
93
management of acute epiglottitis 4
immediate senior involmemet -endotracheal intubation may be necessary to protect teh airway Oxyrgen IV ABx (cefotaxime)
93
management of acute epiglottitis 4
immediate senior involmemet -endotracheal intubation may be necessary to protect teh airway Oxyrgen IV ABx

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