Paeds MCQBank Flashcards
<6yo
itchy macules affect face and extremities -> vesicles & pustules
* HONEY-COLOURED CRUSTS
?diagnosis/organism
IMPETIGO
infection of skin
caused by Staph aureus and group A beta-haemolytic strep (strep pyogenes)
tx: topical hydrogen peroxide 1% cream (if unsuitable - topical fusidic acid or mupirocin)
Management of asthma
SABA (used throughout)
+ low dose ICS (or LTRA if <5yo)
+ LABA/LTRA (if >5yo) OR LTRA (if <5yo)
Increase ICS dose
Consider remove LABA if not working
specialist care
3yo
rash, low grade fever, oval shaped vesicles on palms & soles
ulcers in mouth
?diagnosis/organism
HAND FOOT AND MOUTH
caused by coxsackie virus
fever & cold-like symptoms
rash behind ears & spread to face and neck -> trunk and extremities
non-confluent & maculo-papular rash
Forchheimer spots (petechiae on soft palate)
rash disappear after 3-5 days
?diagnosis/organism
RUBELLA
caused by togavirus
Notifiable disease!
symptomatic tx
return to school 6 days after onset of rash
‘slapped cheek’ rash on cheeks (usually sparing nasolabial areas)
followed by erythematous, maculopapular rash of trunk and proximal limbs
fades into a lacy rash
frequent clearing and recurrences for weeks
FIFTH DISEASE / SLAPPED CHEEK SYNDROME/ ERYTHEMA INFANTIOSUM
Parvovirus B19
disseminated purpuric rash starts on the face and spreads down the trunk & proximal limbs
sparing of the hands and soles of feet
mucosal involvement can occur
new lesions appear for several days as papules, vesicles and crusted lesions
?diagnosis/organism
CHICKEN POX
Varicella Zoster (Herpes Simplex type 3)
Tx: adequate fluid intake, bathe lesions with calamine lotion, oral aciclovir, antibiotics, avoid contact with pregnant women
Exclusion from school: 5 days from rash onset
fever & coryzal symptoms
rose-pink macular non-pruritic rash that appears as the fever subsides
rash initially on the trunk and then spread centrifugally to face and limbs
exanthem is prominent over the thighs and buttocks - each macule is surrounded by a fine halo.
?diagnosis/organism
ROSEOLA INFANTUM / exanthema subitum / sixth disease
due to herpes simplex type 6 OR 7
symptomatic tx
rash seen on forehead and neck -> spreads to trunk and limbs over 3-4 days
may become confluent rash in some areas
the rash then fades in the order of appearance
white spots in mouth (Koplik spot)
Forchheimer spots
leaves behind brown discolouration and accompanied by fine desquamation
also associated with fever, cough, coryza and conjunctivitis
?diagnosis/organism
MEASLES / RUBEOLA
due to single-standed RNA morbilivirus from the paramyxovirus family
Tx: supportive
coryzal symptoms for 1-3 days followed by:
- persistent cough
- tachypnoea and/or chest recession
- wheeze and/or crepitations on ausculatation
low grade fever (<39) and reduced feeding can also be seen
?diagnosis/organism
BRONCHIOLITIS
due to RSV
Sore throat, pyrexia, lymphadenopathy
maculopapular, pruritic rash develops when take ampicillin/amoxicillin
malaise, anorexia, headache
palatal petechiae
splenomegaly
?diagnosis/organism
GLANDULAR FEVER / INFECTIOUS MONONUCLEOSIS
due to EBV/ CMV/ HHV-6
scaphoid-looking abdomen
USS- shows the double-bubble sign
duodenal atresia
small erythematous papules and vesicles and occasionally pustules on face of 6 weeks baby
lesions are surrounded by diffuse blotchy erythema - giving it a distinct halo
self-limiting - disappear in 2 weeks
sometimes recur 6 weeks later
?diagnosis/organism
ERYTHEMA TOXICUM NEONATORUM
not known pathophysiology ? reaction to heat/allergic reaction/mild graft vs host disease
supportive as self-resolving
5yo
fever, sore throat, headache, nausea, myalgia, malaise, rash covering all body and limbs (small papules on erythema that blanches)
rash is course like sandpaper and skin may start to peel (desquamation)
rash is MORE marked over the flexor regions
area of mouth is spared
Forchheimer spots
enlarged tonsils
strawberry red tongue & covered with white topping - ‘WHITE STRAWBERRY TONGUE’ first and then the coating peels off and then becomes red strawberry tongue
?diagnosis/organism
SCARLET FEVER
due to Group A beta-haemolytic strep (strep pyogenes)
Ix: Anti-streptolysin O titres
Tx: penicillin for 10 days OR azithromycin if penicillin allergic for 10 days
can return to school 24 hrs after commencing abx
5yo
rhinorrhoea, sore throat, cough, low grade fever
1-2 days later: barking cough, hoarse voice, inspiratory stridor
CXR: steeple sign
?diagnosis/organism
CROUP
due to parainfluenza virus
14 yo
nasal discharge (watery -> now purulent & blood stained)
fever
inflamed pharynx covered with grey membrane
enlarged lymph nodes
difficulty swallowing
BULL-NECK APPEARANCE
?diagnosis/organism
DIPTHERIA
due to corynebacterium diptheria
tx: antitoxin to be given within 24 hours, benzylpenicillin IV followed by IV penicillin for 10-14 days
