Paediatrics Infections and ENT

Question 1

What is Measles ?

Answer 1

Should be in incubation for 10-14 days.

Firstly, it presents with fever, conjunctivitis, coryza, and lymph nodes

Later, it develops Kolpik’s spots on the mouth and about 4th day it will appear with a maculopapular rash

Question 2

what are the complications of Measles?

Answer 2

Bronchopneumonia
Corneal ulcer
Gastroenteritis
rarely encephalitis

Question 3

What is the management for Measles ?

Answer 3

Paracetamol
Fluids

Question 4

What to suggest if it has secondary infections from Measles ?

Answer 4

Secondary infection must be treated with Antibiotics-n

Question 5

What is Rubella ?

Answer 5

Also called as german measles

incubation for 14-21 days

Question 6

When does rubella appear as infectious ?

Answer 6

7 days before and 7 days after the rash appears

Question 7

How does Rubella present with ?

Answer 7

Fever

Lymph nodes (sub-occipital)

Maculopapular rash lasts for 3 days

Question 8

What are the complications of Rubella?

Answer 8

Arthritis, thrombocytopaenia & Encephalitis –rare

cause BIRTH DEFECT IN PREGNANCY

Question 9

What is the management for Rubella ?

Answer 9

Arthritis, thrombocytopaenia & Encephalitis –rare

Question 10

Wghat is the management of rubella?

Answer 10

Paracetamol and fluids

Which would last for

Question 11

what is the risk to the baby if the mother is infected with Rubella ?

Answer 11

Cataract
Deafness
Cerebral Palsy
Retardation
Microcephaly

if they’re >16 weeks, the minimal risk is deafness

Question 12

What is Erythema infectiosum - 5th disease ?

Answer 12

Slapped cheek disease

Question 13

5th disease presents with ?

Answer 13

Fever and Rash
Facial red maculopapular rash
(slapped cheeks)

Question 14

Cause of 5th disease ?

Answer 14

Parvovirus

Question 15

What is the management of 5th disease ?

Answer 15

Paracetamol
Fluids

Question 16

If there is a Non vesicular rash identified in pregnancy, what would you do ?

Answer 16

Seek for specialist advice
Test for B19 parovirus , IgE, igM

If found, therapeutic abortion is generally recommended after proven the rubella infection during the first trimester

Question 17

What is Roseola infantum (sixth disease) ?

Answer 17

Occur in children under 2 years

Question 18

How does the Roseola infantum present with ?

Answer 18

High fever
Sore throat
lymph nodes
maculopapular rash appears at 3rd day as fever subsides

Question 19

What is the management of Roseola infantum ?

Answer 19

Paracetamol
Fluids

It lasts upto 7 days

Question 20

How does Chicken pox appear ?

Answer 20

Papule ( fluid or pus)
Ulcer
Blister

Question 21

How long is the incubation period for Chicken pox?

Answer 21

10 -21 days
but its infectious 2 days before and 5 days after rash has stopped

Question 22

How does Chicken pox presents?

Answer 22

Fever
aches and pains
itchy

Question 23

What is the formation of rash ?

Answer 23

It comes in over the space ( comes in a wave as it disappears and a new wave will come again) of a week where firstly it is macule, papule, vesicle, then sometimes pustule , and scabs over (crust over and then it wont be contagious)

Question 24

What is the complication of chicken pox ?

Answer 24

Pneumonia
encephalitis
birth defects

Question 25

What is the management for chickenpox?

Answer 25

Drink plenty of fluid, ice lollies Paracetamol for discomfort but not ibuprofen Cut the nails Apply Calamine Lotion Antihistamine for itchiness Take a cool bath, pat but do not rub

Question 26

What is Mumps ?

Answer 26

A contagious viral infection in children and the incubation period is 16- 21 days . It can spread through droplets and saliva spread ( cough/sneeze)

Question 27

How does mums present?

Answer 27

Fever Malaise Tender parotid glands and sometimes submandibular glands

Question 28

what is the complication of Mumps ?

Answer 28

Epididymo-orchitis Meningitis Pancreatitis

Question 29

What is the management of Mumps ?

Answer 29

Paracetamol and fluids Lats for 10 days

Question 30

Kissing disease formally called as EBV-Glandular fever-infectious mononucleosis ?

Answer 30

Mostly occur in teenagers /young adult and they present with sore throat more than 1 week

Question 31

Kissing disease is caused by ?

Answer 31

EBV (herpes family)

Question 32

What is the incubation period for kissing disease ?

Answer 32

4 - 14 days

Question 33

What is Glandular fever?

Answer 33

Glandular fever (infectious mononucleosis) is a viral infection that most often affects teenagers and young adults

Question 34

What are the symptoms of Glandular fever ?

Answer 34

Sore throat fever malaise ( could go on for several months )

Question 35

What are the signs of Glandular fever ?

Answer 35

Lymph nodes splenomegaly palatal petechiae rash 20%

Question 36

What is the investigation of Glandular fever ?

Answer 36

FBC shows atypical lymphocyte- white cell look a bit strange Monospot/Paul Bunell test for antibodies

Question 37

What is the management of Glandular fever ?

Answer 37

Self limiting fluid rest paracetamol salty gargles no alcohol

Question 38

What is Cradle Cap- infantile seborrheic dermatitis?

Answer 38

It is acute, reddened scaling of the scalp in the nappy area, face, chest, back, and limb flexures. It usually starts <2 weeks of age

Question 39

What is the appearance of infantile seborrheic dermatitis (craddle cap) ?

Answer 39

Coarse Yellow scales on the scalp spreads to other areas

Question 40

What is the management of craddle cap ?

Answer 40

If mild, settles in few weeks but rarely after 3 months You can massage the craddle cap area by using arachis oil, olive oil, baby oil or salicylic acid in aqueous cream into the scalp prior to using a mild shampoo. ketoconazole 2% cream od or shampoo bd

Question 41

Pharyngitis ? (gas)

Answer 41

Group A Streptococcal pharyngitis/tonsilitis

Question 42

How does pharyngitis occur?

Answer 42

Very common in children especially in winter and it presented with Fever Lymph nodes on the anterior neck Absence of cough Scarlatiniform rash especially in children Fever PAIN Score 4/5 or the centor rules strongly suggest it

Question 43

How does the Centor rules work?

Answer 43

Scoring 1 point for each including Tonsillar exudate /erythema +1 NODES +1 Cough +1 Fever +1 Age 3-4 years +1 Age 15 -45 years 0 Age over 45 years -1 points

Question 44

Describe Fever PAIN score?

Answer 44

Score 1 for each point Fever over 38°c.  Purulence (pharyngeal/tonsillar exudate). Attend rapidly (3 days or less) Severely inflamed tonsils No cough or coryza

Question 45

What is the management of Pharyngitis ?

Answer 45

1. Delayed antibiotic prescribing strategy: fever pain score of  2/3 2. Antibiotics: Group A Strep confirmed by rapid antigen testing, or Fever pain scores 4 or 5 Centor score of 3 or 4 Low threshold for infants, aged, immunosuppressed Very severe symptoms

Question 46

What abx do you use for pharyngitis ?

Answer 46

Phenoxymethylpenicillin as the first-choice antibiotic.

Question 47

What is the alternative option to manage pharyngitis if patients are allergic to penicillin ?

Answer 47

Clarithromycin but give pregnant women erythromycin if they're allergic to penicillin allergy