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YR5 Specialties > Paeds INFECTION > Flashcards

Paeds INFECTION Flashcards

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1
Q

Recall a long-term complication of mumps, rubella and polio

A

Mumps: infertile boys, deafness

Rubella: severe deformities to pregnancy

Polio: massive respiratory problems

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2
Q

In what age range does Kawasaki disease present?

A

6 months to 4 years: peak at 1 year

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3
Q

What is Kawasaki’s disease?

A

Systemic vasculitis

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4
Q

What is the main cause of mortality in KD?

A

Coronary aneurism

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5
Q

What are the signs and symptoms of Kawasaki disease?

A

CRASH + Burn
C: conjunctivitis
R: rash (polymorphous, begins at hands + feet)
A: Adenopathy
S: Strawberry tongue
H: hands + feet swollen

Burn (fever >5 days)

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6
Q

How is kawasaki disease diagnosed?

A

CLINICALLY
Do bloods + echo to guide management

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7
Q

How is kawasaki disease managed?

A

ADMISSION
IV Ig + high dose aspirin

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8
Q

By what vector is malaria spread?

A

Female anopheles mosquito

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9
Q

How fast is the onset of malaria after innoculation?

A

7-10 days

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10
Q

What are the signs and symptoms of malaria?

A

Cyclical fever with spikes
D+V
Jaundice
Anaemia
Thrombocytopaenia
Flu-like Sx

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11
Q

What are the appropriate investigations for malaria?

A

3 thick + thin blood films (thick = parasite, thin = species)
Malaria rapid antigen detection tests

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12
Q

What is used for anti-malarial prophylaxis?

A

Quinine

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13
Q

How should malaria be managed?

A

Arrange immediate admission
Notify PHE
Treatment is very variable
Non-falciparum: chloroquinine

Mild falciparum (not vomiting): ACT (Artemisinin Combination Therapy) + Atovaquone-proguanil

Severe/ complicated falciparum: IV Artesunate is 1st line

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14
Q

What is the route of transmission of typhoid?

A

Faeco-oral

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15
Q

What are the signs and symptoms of typhoid?

A

May be bradycardic
Cough
Malaise
Anorexia
Diarrhoea or constipation by 2nd week
Rose spots on trunk

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16
Q

How is typhoid diagnosed?

A

Blood culture is diagnostic

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17
Q

How should typhoid be managed?

A

1st line = IV ceftriaxone
2nd line = PO azithromycin

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18
Q

What is the vector of dengue virus?

A

Aedes aegyptii mosquito

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19
Q

Where is dengue usually imported from?

A

SE Asia + South Africa

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20
Q

What are the expected FBC abnormalities in Dengue?

A

Low WCC
Low platelets
Low Hb

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21
Q

What are the signs and symptoms of dengue?

A

Retro-orbital headache
Sunburn-like rash
High fever + myalgia
Hepatomegaly + abdo distention

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22
Q

What is dengue haemorrhagic fever?

A

Secondary infection by a different strain that causes severe capillary leakage –> hypotension + haemorrhagic manifestations
Due to partial host reponse augmenting severity of host infection

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23
Q

How should dengue haemorrhagic fever be managed?

A

Fluid resuscitation

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24
Q

What is the gold standard investigation for dengue diagnosis?

A

PCR viral antigen, serology IgM

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25
What is the pathogen that causes mumps?
Mumps paramyxovirus
26
How is mumps transmitted?
Respiratory secretions
27
For how long is mumps infectious?
5 days before + 5 days after parotid swelling
28
What are the signs and symptoms of mumps?
Asymptomatic in 30% Headache, fever + parotid swelling
29
Recall the 2 key investigations for mumps
Oral fluid IgM sample Amylase in blood is raised
30
How should mumps be managed?
Notify HPU, isolate for 5 days from time of parotid swelling Supportive care (rest, analgesia) Safety net for complications
31
What are the possible complications of mumps?
Mumps orchitis (leading to infertility) Viral meningitis (encephalitis) Deafness (unilateral and transient)
32
How is measles transmitted?
Respiratory secretions
33
For how long is measles infectious?
4 days before + 4 days after rash
34
Recall the signs and symptoms of measles
Prodrome of high fever, irritability, conjunctivitis + febrile convulsions Maculopapular rash (face/ neck --> hands/ feet) Koplick spots (small white spots surrounded by red ring in mouth) Cough No lymphadenopathy
35
What investigations should be done in suspected measles?
1st line is measles serology (IgM/ IgG) from Oral fluid test (OFT) 2nd line is PCR of blood/ saliva
36
How should measles be managed?
Notify HPU Isolate for 4 days following development of rash Rest + supportive tx Immunise close contacts Safety net complications of encephalitis/ SSPE/ otitis media (most common), pneumonia
37
What is SSPE?
Sub-acute Sclerosing Panencephalitis Seen 7 years after measles infection Measles has been dormant in CNS Signs + Sx = dementia + death
38
What type of virus causes rubella?
Togavirus
39
What is the infectious period of rubella?
1 week before to 5 days after rash onset
40
Recall the signs and symptoms of rubella
Prodrome of mild fever or sometimes asymptomatic Pink maculopapular rash (face --> whole body) which fades pretty quickly In 20% there are Forcheimer spots (red spots on soft palate) Lymphadenopathy (none in measles) No koplik spots or conjuntivitis
41
How should rubella be investigated?
Rubella serology (IgG and IgM) from oral fluid test RT-PCR is 2nd line
42
How should rubella be managed?
Notify HPU, isolate for 4 days after development of rash Supportive care Safety net the complications (haemorrhagic complications due to thrombocytopaenia)
43
Recall some other names for this roseola infantum
Fifth disease/ erythema infectiosum/ slapped cheek
44
How is parvovirus B19 transmitted?
Respiratory secretions/ vertically
45
Which cells does pB19 infect?
RBC precursors
46
What is the infectious period of parvovirus?
10 days before to 1 day after rash develops
47
Recall the signs and symptoms of parvovirus B19
1st: asymptomatic or coryzal illness for 2-3 days then latent for 7-10 days 2nd: most commonly, erythema infectiosum - 'red slapped cheek' rash on face Progresses to maculopapular ('lace like') rash in trunk and limbs
48
How should parvovirus B19 be investigated?
B19 serology (IgG and IgM) - similar to rubella 2nd line is RT-PCR
49
How should pB19 be managed?
Supportive (fluids, analgesia, rest) No need to stay off school or avoid pregnant women (once rash develops it's not really infectious) Complications to safety net = anaemia, lethargy, pregnancy
50
What is the infectious period of VZV?
48 hours before rash to last crusted over lesion
51
What are the stages of the rash appearance in chickenpox?
Papule --> vesicle --> crust
52
How should VZV be investigated?
Clinical dx
53
How shoulod VZV be managed?
Supportive No ibuprofen Keep home from school
54
What advice would you give to parents if their child has VZV?
Keep nails short
55
When should you admit in VZV?
Pneumonia, encephalitis, dehydration Secondary bacterial superinfection (sudden high fever, toxic shock, necrotising fasciitis) Purpura fulminans: large necrotic loss of skin from cross-activation of anti-viral Abs
56
What is the pathogen that causes hand, foot and mouth disease?
Usually coxsackie A16 Atypical: coxsackie A6 Severe: enterovirus 71
57
What are the signs and symptoms of hand, foot and mouth disease?
Painful, itchy, vesicular lesions on hands, feet, mouth + buttocks Mild systemic features: fever, sore throat, spots in mouth- develop into ulcers
58
How should hand, foot and mouth disease be managed?
Supportive Will clear in 7-10 days Safety net for dehydration
59
What pathogen causes roseola infantum?
HHV6
60
What is another name for roseola infantum?
6th disease
61
Describe the epidemiology of roseola infantum
Most children infected by age 2: it's highly infectious for the whole period of disease
62
What are the signs and symptoms of roseola infantum?
High fever + malaise for 3-4 days, followed by generalised macular rash (small pink spots) that goes neck- arms Non-itchy Febrile convulsions in 10-15% Sore throat, lymphadenopathy, coryzal Sx, D+V Nagayama spots (spots on the uvula + soft palate)
63
How should roseola infantum be investigated?
HHV6/7 serology (IgG or IgM) Measles + rubella serology: as have a similar presentation
64
How should roseola infantum be managed?
Supportive No need to stay off school Safety net the complications: febrile convulsions
65
How should children be investigated for HIV?
<18 months: PCR of virus at birth, on discharge, at 6w, 12w + 18 months >18 months: antibody detection via ELISA
66
How should childhood HIV be managed?
Cord clamped ASAP + bathed straight after birth Zidovudine monotherapy for 2-4w (if low/med risk) or PEP combination 4w (if high risk) Women not to breastfeed Give all immunisations

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