paeds infxn

Question 1

what causes roseola infantum?

Answer 1

HSV 6 (sometimes 7, but rarer)

Question 2

do children with roseola infantum need to be excluded from school?

Answer 2

no

Question 3

what are the symptoms of roseola infantum?

Answer 3

fever
maculopapular rash
nagayama spots: papular enanthem on the uvula and soft palate
febrile convulsions
diarrhroea and cough
eyelid swelling and lymphoedema

Question 4

how is roseola treated?

Answer 4

symptomatic treatment

Question 5

what causes hand foot and mouth?

Answer 5

coxsackie a
enterovirus
Picornaviridae family of viruses

very contagious

Question 6

what are the symptoms of hand foot and mouth

Answer 6

sore throat
fever
oral ulcers
followed later by vesicles on the palms and soles of the feet

Question 7

how is hand foot mouth treated?

Answer 7

symptomatic and hydration

Question 8

do children need to be excluded for hand foot mouth?

Answer 8

no

Question 9

what causes scarlet fever?

Answer 9

group A haemolytic strep usually strep pyogenes

Question 10

how is scarlet fever spread?

Answer 10

respiratory droplets

Question 11

what are the symptoms of scarlet fever?

Answer 11

fever
malaise
headache
nausea
sore throat
STRAWBERRY TONGUE
sandpaper (pinprick) circumollar pallour 
peeling after rash

Question 12

how is scarlet fever diagnosed?

Answer 12

throat swab, but start treating before results

Question 13

how is scarlet fever treated?

Answer 13

pencillin V

if allergic, azithromycin

Question 14

do children with scarlet fever need exclusion?

Answer 14

yes, until 24 hrs after Abx

Question 15

is scarlet fever notifiable?

Answer 15

yes. students out of school for 24hrs following starting Abx

Question 16

what are the complications of scarlet fever?

Answer 16

otitis media
rheumatic fever
glomerulonephritis

Question 17

what is slapped cheek also known as

Answer 17

erythema infectiosum

Question 18

what causes slapped cheek?

Answer 18

parvovirus B19

Question 19

how does slapped cheek present?

Answer 19

fevery illness

rose red rash on cheeks that may spread to body, sparing palms and soles

Question 20

what does heat trigger in a person previously infected with slapped cheek?

Answer 20

recurrence of the rash

Question 21

what is the treatment for slapped cheek?

Answer 21

supportive

Question 22

do children with slapped cheek need to be excluded?

Answer 22

no, they are no longer infectious by time rash appears

but pregnant women should be avoided

Question 23

which stage of pregnancy should women avoid slapped cheek?

Answer 23

first 20 weeks

Question 24

what do pregnant women who come into contact with slapped cheek need to do?

Answer 24

let antenatal care know so that she can be checked for IgG IgM

Question 25

what are complications of slapped cheek?

Answer 25

aplastic crises in sickle cell | pancytopaenia in immunosuppressed

Question 26

what virus causes measles?

Answer 26

RNA paramyxovirus

Question 27

how is measles spread?

Answer 27

droplets

Question 28

what are the symptoms of measles?

Answer 28

``` conjunctivitis fever Koplik spots before rash rash starts behind ears then to whole body maculopapular rash becomes confluent ```

Question 29

how is measles diagnosed?

Answer 29

IgM

Question 30

how is measles managed?

Answer 30

supportive | hospitalisation of pregnant/immunocompromised

Question 31

what are the complications of measles?

Answer 31

otitis media pneumonia encephalitis

Question 32

is measles notifiable?

Answer 32

yes

Question 33

which virus causes chickenpox?

Answer 33

varicella zoster virus

Question 34

how is chickenpox spread?

Answer 34

respiratory route

Question 35

how does Chicken pox present?

Answer 35

fever, itchy rash on head/trunk and spreads initially macular then papular then vesicular

Question 36

how is Chicken pox treated?

Answer 36

keep cool trim nails calamine lotion

Question 37

how long is Chicken pox infectious?

Answer 37

1-2 days before rash until the rash crusts over.

Question 38

what should you give immunocompromised patients/neonates who get Chicken pox?

Answer 38

IV acyclovir | if no rash, but exposure - Varicella zoster Ig

Question 39

what are some rate complications of chicken pox?

Answer 39

pneumonia encephalitis disseminated haemorrhagic chickenpox arthritis, nephritis, pancreatitis

Question 40

how does rubella present?

Answer 40

fever maculopapular rash suboccipital, post-auricular LN

Question 41

what is the problem with rubella?

Answer 41

risk of pregnant contracting - congenital rubella syndrome, esp before 20 weeks

Question 42

what causes rubella?

Answer 42

rubella virus (a togavirus)

Question 43

what are the effects of congenital rubella syndrome?

Answer 43

``` sensorineural deafness congenital cataracts congenital heart disease (e.g. patent ductus arteriosus) growth retardation hepatosplenomegaly purpuric skin lesions 'salt and pepper' chorioretinitis microphthalmia cerebral palsy ```

Question 44

is rubella notifiable?

Answer 44

yes

Question 45

when should rubella vaccine be given to pregnant women who are not immune?

Answer 45

after birth

Question 46

what causes Whooping cough?

Answer 46

bordatella pertussis

Question 47

what are the symptoms of whooping cough?

Answer 47

``` coryza coughing bouts (esp nocte and after feeding) inspiratory whoop (not always present) central cyanosis when crying infants may have apnoeic spells!! ```

Question 48

how might infant with whooping cough present?

Answer 48

apneoic spells cough persisting post-cough vomiting whooping (may not always be present)

Question 49

how is whooping cough diagnosed?

Answer 49

nasal swab culture

Question 50

infants under which age with whooping cough should be admitted?

Answer 50

6 months

Question 51

what is the treatment for whooping cough?

Answer 51

macrolide - clarithromycin erythtromycin etc if cough started less than 21 days ago

Question 52

why are antibiotics given in whooping cough?

Answer 52

eradicate illness and reduce spread | Abx do not alter course of disease

Question 53

how long should children with whooping cough be kept away from school?

Answer 53

48 hours post Abx 21 days post cough onset if no abx

Question 54

what are the complications of whooping cough?

Answer 54

subconjunctival haemorrhages pneumonia bronchiectasis seizures

Question 55

how are contacts for pertussis treated?

Answer 55

erythromycin prophylactic

Question 56

is pertussis notifiable?

Answer 56

yes

Question 57

what causes kawasaki disease?

Answer 57

cause: vasculitic

Question 58

what are the symptoms of kawasaki?

Answer 58

1. high-grade fever which lasts for > 5 days 2. conjunctival infection 3. bright red, cracked lips 4. strawberry tongue 5. cervical lymphadenopathy 6. red palms and soles of the feet which later peel

Question 59

how is kawasaki diagnosed?

Answer 59

clinical

Question 60

what is the treatment for kawasaki?

Answer 60

aspirin IVIG Echo to screen for coronary aneurysm

Question 61

what are the complications of kawasaki?

Answer 61

coronary aneurysm

Question 62

what bacteria cause impetigo?

Answer 62

strep pyogenes | staph aureus

Question 63

how does impetigo present?

Answer 63

golden crusty rash around the mouth

Question 64

how is impetigo treated?

Answer 64

topical fucidic acid if systemic, oral fluclox if allergic, erythromycin

Question 65

how long should children be out of school for impetigo?

Answer 65

until crusted | or 48 hours after abx tx

Question 66

which organism causes meningitis in neonates?

Answer 66

group b strep (prolonged labour, premature) E. Coli listeria

Question 67

which organisms cause meningitis in children?

Answer 67

N. Meningitidis strep pneumoniae haemophilus influenzae

Question 68

how is meningitis treated in children?

Answer 68

IV amoxicillin and cefotaxime (younger than 3m) amoxicillin to cover listeria IV cefotaxime in older than 3m

Question 69

which prophylaxis for meningitis contacts?

Answer 69

ciprofloxacin preferred over rifampicin

Question 70

what is the treatment for threadworm?

Answer 70

``` oral mebendazole (antihelminitic) for the whole household even if asymptomatic ```