- Rest and paracetamol - Notifiable disease

Paediatrics Flashcards by Holly Davies

What are the 5 main features of Kawasaki disease?

Conjunctivitis, bilateral without exudate
Rash, polymorphic
Adenopathy, unilateral cervical (>1.5cm)
Strawberry tongue, cracked lips, pharyngitis
Hands and feet, erythema then desquamation

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What is the treatment for Kawasaki disease?

High does IV immunoglobulin + aspirin

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Why is aspirin not normally given in children?

Risk of Reye’s syndrome - causes brain and liver damage

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What is the most common cardiac abnormality caused by Kawasaki disease?

Coronary artery aneurysms

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What organism causes measles?

RNA paramyxovirus

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How long is measles infective for?

From prodrome till 5 days after rash starts

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What are the features of measles prodrome?

Cough
Conjunctivitis
Coryza
Cranky
Fever

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How would you describe a measles rash?

Maculopapular, starts behind ears, becomes confluent, lasts for a few days

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Management of measles

Supportive
Isolation
Vaccination of close contacts
Notifiable disease

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What is the name for the small red spots often seen on the oral mucosa in measles?

Koplik’s spots

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What is the most common complication of measles?

Otitis media

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What organism causes rubella?

RNA rubella virus

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How long is rubella infective for?

5 days before and after rash appears

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Give the 3 main signs and symptoms of rubella

Low-grade fever
Maculopapular rash (starts on face)
Suboccipital lymphadenopathy

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What complications can rubella cause in pregnancy?

Foetal malformations, including:

deafness
cataracts
heart defects
intellectual disabilities

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What organism causes mumps?

RNA paramyxovirus

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How long is mumps infective for?

7 days before and 9 days after parotid swelling begins

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Give the 3 main signs/symptoms of mumps

Prodromal malaise
Fever
Painful, bilateral parotid swelling

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What is the most common complication of mumps in males?

Orchitis -> infertility in 25% of teens/adults

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Management of mumps

Rest and paracetamol

- Notifiable disease

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What organism causes roseola infantum?

Herpes virus 6

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What are the signs and symptoms of roseola infantum?

Temperature for a few days, followed by a maculopapular rash, usually mild and self-limiting

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How long should a child be off school for if they have roseola infantum?

No school exclusion

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What is the most common complication associated with roseola infantum?

Febrile convulsions

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What organism causes erythrovirus/slapped cheek?

Parvovirus B19

Signs and symptoms of slapped cheek

- Mild unwellness for a few days - fever, coryza | - Followed by macular erythema rash on cheeks

How long should a child be off school for if they have slapped cheek?

No school exclusion - not infectious by the time rash develops

What organism causes hand, foot and mouth disease?

Coxsackie virus A16 or enterovirus

What are the main signs and symptoms of hand, foot and mouth disease

Child mildly unwell, vesicles on palms, soles and mouth

Management of hand foot and mouth disease

Supportive, no school exclusion

What organism causes chickenpox/shingles?

Varicella-Zoster virus

Can chickenpox be caught off someone with shingles?

Yes

How long is chickenpox infective for?

4 days before rash, until all lesions have crusted over (approx. 5 days)

What are the main signs and symptoms of chickenpox?

- Initial temperature | - Rash: macules -> papules -> vesicles -> crusting

Management of chickenpox in a normal child

- Keep cool, trim nails | - Calamine lotion

How long should a child be off school for if they have chicken pox?

Until all lesions crusted

Management of chickenpox in an immunosuppressed child

IVIg

What is the most common complication of chickenpox?

secondary bacterial infection of lesions

What organism most commonly causes epiglottitis?

Hib - now vaccinated against

Give 3 risk factors for epiglottitis

- children not vaccinated - male gender - immunosuppression

Give 5 clinical features of epiglottitis

- dyspnoea - dysphagia - drooling - stridor - dysphonia - high-grade fever - dehydration

What position might a child be in if they have epiglottitis?

Tripod position

Investigations for epiglottitis

- Throat swabs - Blood cultures - FBC, CRP/ESR - Lateral neck x-ray

What sign is seen on a lateral neck x-ray of a child with epiglottitis?

Thumb-print sign

Management of epiglottitis

- Secure airway - Oxygen - IV antibiotics - cefotaxime/ceftriaxone - IV steroids - Nil by mouth until airway improved

What organism causes scarlet fever?

Strep. pyogenes

Signs and symptoms of scarlet fever

Sore throat | 12-48 hrs later - 'pin-prick' blanching rash, facial flushing with circumoral pallor, strawberry tongue

Treatment of scarlet fever

Penicillin/clarithromycin 10 days

What pathogen most commonly causes tonsillitis?

Group A strep. (strep pyogenes)

What is the biggest risk factor for tonsillitis?

Smoking

What are the 5 criteria of the feverPAIN score?

- Fever in past 24hrs - Purulence (pus on tonsils) - Attend rapidly (within 3 days of onset) - severely Inflammed tonsils - No cough or coryza

What does a high feverPAIN score indicate?

Tonsillitis likely caused by strep. infection -> antibiotics

Management of acute tonsillitis

- Analgesia - paracetamol, ibuprofen, topical difflam | - Antibiotics if bacterial - feverPAIN, Centor

What is the criteria used to determine if tonsillectomy is appropriate?

The SIGN criteria, at least 7 episodes in a year

What organism causes glandular fever?

Epstein-Barr virus

How is glandular fever spread?

Saliva - kissing

How long is the incubation period of glandular fever?

Up to 6 weeks

Give 5 clinical features of glandular fever

- Sore throat - Snoring - Swollen neck - Feverish - Headaches - Nausea and vomiting - General tiredness and aches - Hepatosplenomegaly

What investigation is diagnostic for glandular fever?

Monospot test

Management of glandular fever

Supportive

Give 3 complications of glandular fever

- Post-viral fatigue - GBS - Splenic rupture - avoid contact sport for 4-6wks