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Paediatrics Y4 > 34. Paediatric Infection – Cases > Flashcards

34. Paediatric Infection – Cases Flashcards

1
Q

What is a sign of raised ICP in neonates?

A

Full fontanelle

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2
Q

Bacterial LP results:

A

Cloudy, neutrophils +++, raised protein, <60% of blood glucose

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3
Q

Viral LP results:

A

Clear, lymphocytes++, raised protein, normal glucose

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4
Q

TB LP results:

A

Opalescent, lymphocytes++, raised protein, <60% of blood glucose

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5
Q

What infection would have normal glucose on LP?

A

Viral

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6
Q

If lymphocytes present in LP what could the infection be?

A

Viral, TB

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7
Q

If <60% of blood glucose present in LP what could the infection be?

A

Bacterial or TB

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8
Q

Septic screen:

A
  • IV cannula and abx (ceftriaxone, cefotaxime + amoxicillin <3month old)
  • Bloods
  • Urine (clean catch, MCS)
  • Lumbar puncture (MCS, protein, glucose, virology)
  • CXR
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9
Q

Top 3 organisms causing meningitis:

A
  • Group B strep
  • E. Coli
  • Listeria
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10
Q

Follow up in meningitis:

A
  • Hydrocephalus (head circumference)
  • Hearing
  • Developmental delay?
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11
Q

Meningococcal sepsis:

A
  • Neisseria meningitidis – gram negative diplococci
  • Disseminated intravascular coagulation (tissue ischaemia)
  • Rapidly overwhelming sepsis and death
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12
Q

Management of meningococcal sepsis:

A
  • Broad spectrum Abx: Ceftriaxone, Cefotaxime

- Primary care: IM benzylpenicillin

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13
Q

Disease caused by Group A step?

A

Scarlet fever

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14
Q

Disease caused by staph aureus?

A

Toxic shock, staphylococcal scalded skin syndrome

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15
Q

Disease caused by Epstein-Barr Virus?

A

Glandular fever

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16
Q

Kawasaki disease:

A

Inflammatory condition of unknown aetiology in children <5yo
5 days of fever + 4/5 signs (rash, bilateral conjunctivitis, unilateral lymphadenopathy, oral mucositis, peripheral oedema)

17
Q

Kawasaki disease increases risk of cardiac abnormalities:

A

Cardiac artery aneurysm

18
Q

Management of Kawasaki disease:

A
  • Anti-inflammatory (IVIG 2g/kg/12h, Aspirin 30-50mg/kg/day, Corticosteroids)
  • ECG (at the time of diagnosis and at 2 weeks and at 6 weeks)
  • Anti-platelet (low dose aspirin 2-5mg/kg, risk of acute MI)
19
Q

Fever with vesicles:

A
  • Varicella (chicken pox)
  • Herpes simplex virus
  • Hand foot and mouth (coxsackie virus)
20
Q

Management of chicken pox/ varicella zoster:

A
  • Supportive, conservative
  • Fluids and antipyretics
  • Calamine lotion
21
Q

Complications of chicken pox:

A
  • 2nd infection (group A strep) – 2nd wave of fever; also encephalitis or pneumonitis
  • Can be severe in immunodeficiency and malignancy
  • Also warn in on steroids >7d, avoid varicella contact and take VZ IG (immunoglobulins) to protect
22
Q

Kocher score:

A
  • Septic arthritis score:

Non weight bearing, Temperature >38.5*, ESR>40mm/hr, WBC>12

23
Q

Septic arthritis causes:

A

Common (staph aureus, kingella kingae)

Rare (Strep pneumonia, group A strep)

24
Q

Treatment for septic arthritis:

A

Surgical washout as per orthopaedics

25
Q

Abx for septic arthritis:

A
  • Co-amoxiclav
  • IV until improving clinically and inflammatory markers low (CRP <20)
  • 3-4 weeks for septic arthritis
  • 4-6 weeks for osteoarthritis
26
Q

Septic arthritis due to staph aureus treatment:

A
  • High dose IV flucloxacillin

- If heart murmur present -> potential endocarditis (ECHO, ECG, blood tests)

27
Q

Initial treatment for malaria:

A
  • Fluid bolus 10ml/kg 0.9% saline
  • IV ceftriaxone 80mk/kg
  • IV artesunate (preferred treatment than quinine)
  • Artemisinin-based combination therapy for uncomplicated malaria (2 drugs in 1)
28
Q

Artemisinin-based drug examples:

A

Artesunate, artemether

29
Q

2nd class combination therapy for malaria:

A

Lumefantrine, mefloquine

30
Q

What parasite causes malaria?

A

Plasmodium falciparum

31
Q

7 Features in severe malaria:

A
  1. Cerebral malaria
  2. Respiratory distress/metabolic acidosis
  3. Severe anaemia
  4. Prostration (child unable to sit normally or unable to drink water)
  5. Hypoglycaemia
  6. Electrolyte disturbance
  7. Circulatory shock

Paediatrics Y4 (33 decks)

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