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Paediatrics > 2: Infections - Chicken Pox and Viral Rashes > Flashcards

2: Infections - Chicken Pox and Viral Rashes Flashcards

1
Q

What causes chicken pox

A

VZV

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2
Q

When is chicken pox infectious

A

2d before rash until 5d after

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3
Q

How long is chicken pox incubated for

A

2W

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4
Q

How long does the prodrome of chickenpox last

A

2 days

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5
Q

How does the prodrome of chicken pox present

A

Fever

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6
Q

Describe exanthem of chicken pox

A
  • Rash that starts on the trunk and spreads to face and extremities
  • All stages of the rash are visible on the body at the same time
  • Sevre pruritus
  • Fever, headache, myalgia
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7
Q

What is unique about the rash in chicken pox

A

All stages of the rash are visible at the same time

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8
Q

When is a person with chicken pox infective

A

2d before rash until 5d after

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9
Q

What is first-line for chicken pox

A

Advice:

  • Calmine lotion
  • Keep cool
  • Avoid scratching
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10
Q

How long should children with chicken pox be excluded from school

A

When rash has fully crusted over (usually 5 days)

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11
Q

What should immunocompromised patients or neonates with suspected peripartum exposure be given

A

IVIG

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12
Q

If an immunocompromised person has chickenpox what is given

A

Oral acyclovir

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13
Q

What drug should NOT be given in chickenpox and why

A

NSAIDs as it increases risk secondary infection with Group A streptococcus which can cause necrotising fasciitis

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14
Q

What is roseola infantum also known as

A

Exanthem Subitum

3-Day Fever

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15
Q

What causes Roseola Infantum

A

HHV6

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16
Q

What age does roseola infantum occur

A

6 months - 2 years

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17
Q

How does roseola infantum present

A

High-Fever that lasts 3-days

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18
Q

What may fever in roseola infantum be associated with

A

Nagayama spots of the uvula

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19
Q

What happens when fever ends in roseola infantum

A

Maculopapular rash onsets

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20
Q

Explain rash in Roseola Infantum

A

Maculopapular rash starts on trunk and spreads to face and extremities

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21
Q

What is associated with roseola infantum

A

Febrile Convulsions (15%)

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22
Q

how should roseola infantum be managed

A

Supportive

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23
Q

What causes hand, foot and mouth disease

A

Coxsackie A16

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24
Q

How does hand, foot and mouth disease present clinically

A

Sore throat, Fever
Oral Ulcers
Vesicles on palms and soles

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25
Q

What is used to manage hand, foot and mouth

A

Supportive

Advise: maintain fluid-intake

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26
Q

Explain school exclusion in hand, foot and mouth

A

Do not need school exclusion

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27
Q

What age group does measles occur

A

<12 months

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28
Q

What are the stages of measles

A

Pro-Drome
Exanthem
Recovery

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29
Q

What is a way to remember the prodrome of measles

A

3C’s

Conjunctivitis
Coryza
Cough

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30
Q

What will be present in prodrome of measles

A

Kopliks spots

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31
Q

What are koplik spots

A

White spots on an erythematous base in the mouth

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32
Q

How does exanthem of measles present

A
  • Fever
  • Generalised lymphadenopathy
  • Rash that starts behind the ears and then spreads to the remaining body. It starts as patchy and then becomes confluent
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33
Q

Describe the rash in measles

A

Starts as blotchy and then becomes confluent

34
Q

What is the recovery phase of measles

A

Rash fades leaving brown discolouration

35
Q

What are two pathognomic features of measles

A

Rash starts behind the ears

Koplik spots

36
Q

How is measles prevented

A

MMR

37
Q

When is MMR vaccine given

A

1-year

3-4 years

38
Q

Is measles notifiable

A

Yes

39
Q

How is measles managed

A

Maintain Fluid

NSAIDs/paracetamol for symptomatic relief

40
Q

How long should child with measles be off school

A

4-days

41
Q

What is the most common complication of measles

A

Otitis media

42
Q

What is the most common cause of death in measles

A

Pneumonia

43
Q

What neurological disorder can measles acutely present with

A

Encephalitis

Febrile Convulsions

44
Q

What long-term neurological disorder can measles cause

A

Sub-acute sclerosing encephalitis

45
Q

How does subacute sclerosing encephalitis present `

A

Progressing neurological dysfunction

46
Q

What ophthalmological condition can measles cause

A

Keratoconjunctivitis

47
Q

In which age group does mumps occur

A

5-14 years

48
Q

What causes mumps

A

Parmyxovirus

49
Q

When is mumps most infectious

A

3d before until 9d after parotid gland swelling

50
Q

Describe clinical presentation of mumps

A

Pro-Drome:
- Fever

  • Swelling of the parotid gland = presents with tenderness, ear ache and unilateral swelling
51
Q

What tests are positive in first-week of mumps

A

IgM

Salivary PCR

52
Q

What tests are positive in later stages of mumps

A

Viral Culture
FBC - Lymphocytosis
Amylase - raised

53
Q

How is mumps prevented

A

MMR vaccine at 1-year and 3-4 years

54
Q

Is mumps a notifiable disease

A

Yes

55
Q

What is used to treat mumps

A

Paracetamol as anti-pyretic

56
Q

What are 4 complications of mumps

A
  • Orchitis
  • Unilateral hearing loss
  • Pancreatitis
  • Aseptic meningoencephalitis
57
Q

What % males with mumps develop orchitis

A

25

58
Q

Describe hearing loss in mumps

A

Unilateral SNHL

59
Q

When does rubella occur

A

Childhood

60
Q

In what months is rubella more common

A

Winter and Spring

61
Q

What causes rubella

A

Togaviridae

62
Q

What % of rubella is asymptomatic

A

50

63
Q

Which patients with rubella are more likely to be asymptomatic

A

Younger patients more likely to have milder disease compared to older children and adults

64
Q

Explain presentation of pro-drome or rubella

A
  • Sub-occipital and post-auricular lymphadenopathy
  • Fever
  • Headache
  • Conjunctivitis
  • Mild sore throat
65
Q

What is a key-feature of prodrome of rubella

A

Sub occipital and post auricular lymphadenopathy

66
Q

Describe exanthem of rubella

A
  • Non confluent rash starts on the face and migrates to the trunk
67
Q

How is rubella prevented

A

MMR at 1-year and 3-4years

68
Q

How is rubella managed

A

Supportive

69
Q

What are two complications of rubella

A

TTP

If pregnant women acquires rubella - can cause congenital rubella syndrome

70
Q

What is slapped cheek syndrome referred to as

A

Erythema Infectiosum

71
Q

What age does slapped cheek syndrome occur

A

5-15 years

72
Q

What causes slapped cheek syndrome

A

Parvovirus B19 Syndrome

73
Q

When are individuals with slapped cheek syndrome infectious

A

Before virus onset

74
Q

Explain clinical presentation of children with slapped cheek syndrome

A

Coryzal symptoms. Then followed by erythematous rash of the face, sparing peri-oral region, spreads to trunk

75
Q

Describe rash in slapped cheek

A

Starts on face, spreads too trunk. Starts as confluent, becomes maculopapular and then develops to reticular appearance

76
Q

When is the rash in slapped cheek more prominent

A

In heat or sunlight

77
Q

What complication do 10% of children with slapped cheek develop

A

Symmetrical poly arthritis

78
Q

When will symmetrical poly arthritis resolve

A

3-4 Weeks

79
Q

Describe management of slapped cheek

A

Supportive. If poly arthritis develops a short course of prednisolone is given

80
Q

When can parvovirus B19 impact pregnancy

A

Before 20W

81
Q

What does parvovirus B19 before 20W cause

A

Hydrops foetalis

82
Q

In patients with sickle cell disease what can parvovirus B19 infection cause

A

Transient aplastic crisis - due to suppressing erythropoiesis for 1W

Paediatrics (61 decks)

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