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HD 2 > Bacterial, Fungal & Protozoal Infections In Childhood > Flashcards

Bacterial, Fungal & Protozoal Infections In Childhood Flashcards

1
Q

Neonatal death makes up how many % of childhood death?

A

40%

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2
Q

What is the biggest cause of neonatal death?

A

Preterm birth complications

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3
Q

What are the two biggest causes of non-neonatal childhood death (other than ‘other disorders’)?

A

Pneumonia

Diarrhoea

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4
Q

Are bacteria prokaryotes or eukaryotes?

A

Prokaryotes

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5
Q

Give two examples of eukaryotes.

A

Fungi

Protozoa

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6
Q

What is the diameter of prokaryotes in uM? What about eukaryotes?

A

0.2-2

10-100

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7
Q

What is the difference in chromosomes between pro and eukaryotes?

A

Pro – single, circular chromosome

Eu – multiple, linear chromosomes

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8
Q

What is the difference in nucleus between pro and eukaryotes?

A

Pro has no nucleus

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9
Q

Which don’t have organelles – eu or prokaryotes?

A

Pro

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10
Q

How do prokaryotes divide? How to eukaryotes divide?

A

Binary fission

Mitosis

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11
Q

Why do infections cause morbidity and mortality? (2)

A

Toxins

Immunopathology

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12
Q

What is an exotoxin?

A

Protein secreted by the pathogen

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13
Q

Give an example of a bacterial infection that causes damage via its exotoxin?

A

Cholera (causes diarrhoea)

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14
Q

What bacteria causes diphtheria?

A

Corynebacterium diphtheria

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15
Q

What are the signs/symptoms of diphtheria? (3)

A

Sore throat, fever, pseudo-membrane

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16
Q

How does diphtheria affect the heart? (2)

A

Myocarditis

Heart block

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17
Q

How does diphtheria affect the nerves? (3)

A

Difficulty swallowing
Paralysis
Diplopia

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18
Q

What exotoxin does diphtheria release? How does this work?

A

Diphtheria toxin (A and B subunits) – inhibits protein synthesis

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19
Q

What is an endotoxin? When is it released? What does it lead to?

A

Part of the outer membrane of Gram-negative bacteria
Released during lysis of the organism
Leads to macrophage activation

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20
Q

What cytokines are involved in the pathogenesis of meningococcal disease?

A

IL-6

TNF-alpha

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21
Q

What is the pathogenesis of meningococcal disease?

A

Activation of inflammatory cascade via LPA –> myocardial depression, endothelial dysfunction, coagulopathy –> capillary leak and shock

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22
Q

Why are infections different in children to adults? (6)

A

Immunological immaturity and lack of memory
Thinner skin
Shorter airways
Anatomy of Eustachian tube (more susceptible to otitis)
Exposure
Hygiene, nursery/daycare

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23
Q

What do infections often present with?

A

Fever

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24
Q

What is the definition of fever?

A

Temperature > 37.8

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25
Q

How much lower than rectal temp is taking temp via mouth?

A

0.5 degree lower

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26
Q

How much lower than rectal temp is taking temp via axilla?

A

1 degree lower

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27
Q

Give some examples of severe bacterial illnesses. (8)

A 
Septicaemia
Meningitis
Pneumonia
Epiglottitis
Septic arthritis
Osteomyelitis
Tuberculosis
Tetanus
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28
Q

Give some examples of common bacterial illnesses. (5)

A 
Tonsillitis 
Otitis media
Urinary tract infection
Gastroenteritis
Impetigo
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29
Q

What organisms cause septicaemia and meningitis? (3)

A

Streptococcus pneumoniae
Neisseria meningitidis (mostly Group B)
Haemophilus influenzae B

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30
Q

How do you recognise septicaemia? (5)

A 
Tachycardia
Tachypnoea
Prolonged capillary refill
Low BP (late sign)
Rash
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31
Q

How is meningitis diagnosed?

A

LP

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32
Q

What are the symptoms of meningitis? (6)

A 
High temperature
Headache
Vomiting
Not able to tolerate bright lights
Drowsy
Stiff neck
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33
Q

What is the difference in appearance of CSF in bacterial vs viral meningitis vs TB?

A

Bacterial – cloudy
Viral – clear
TB - opalescent

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34
Q

What cells are present in bacterial vs viral meningitis vs TB?

A

Bacterial - neutrophils

Viral and TB – lymphocytes

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35
Q

How does the protein in CSF compare in bacterial vs viral meningitis vs TB?

A

Higher in bacterial (and much higher in TB)

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36
Q

How does the glucose in CSF compare in bacterial vs viral meningitis?

A

Bacterial – low

Viral - normal

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37
Q

What are the top three organisms in young infants?

A

Group B streptococcus
E Coli
Listeria

38
Q

What antibiotic may be given in older children?

A

Ceftriaxone

39
Q

What antibiotics may be given in young infants (<3 months)? (2)

A

Cefotaxime or ceftriaxone

Amoxicillin also needed for Listeria cover

40
Q

What is the neonatal period?

A

First 28 days of life

41
Q

What causes neonatal sepsis?

A

Maternal colonization with pathogens (colon or vaginal canal)

42
Q

When does early onset sepsis occur?

A

48 hrs

43
Q

What does late onset sepsis cause?

A

Meningitis

Bones and joint problems

44
Q

How many % of neonatal sepsis cases’ mothers have GBS?

A

15-40%

45
Q

Name 3 gram-positive cocci bacteria.

A

Staphylococcus
Streptococcus
Enterococcus

46
Q

Name 4 gram-positive bacilli bacteria.

A

Corynebacterium
Listeria
Bacillus (cereus, anthracis)
Clostridium (tetani, botulinum, difficile)

47
Q

Steptococcus pneumoniae - how many % of people have this as normal flora?

A

5-70% people

48
Q

What predisposes to pneumococcal infection? (3)

A

Absent / non-functional spleen
Hypogammaglobulinaemia
HIV infection

49
Q

Absent/non-functional spleen - name three possible causes. (3)

A

Congenital asplenia
Traumatic removal
Hyposplenism (eg sickle cell)

50
Q

Splenectomy means people are more vulnerable to…? What is given daily for the rest of their lives?

A

Encapsulated bacteria

Pencillin

51
Q

Name 3 encapsulated bacteria.

A

Pneumococcus
HiB
Meningococcus

52
Q

Non-invasive conditions? (4)

A

Acute otitis media
Sinusitis
Conjunctivitis
Pneumonia

53
Q

Invasive conditions? (5)

A 
Septicaemia
Meningitis
Peritonitis
Arthritis
Osteomyelitis
54
Q

Pneumococcus causes empyema. How is it managed? (2)

A

Chest drain +/- urokinase

Video-assisted thoracoscopic surgery

55
Q

What are the two types of vaccine for pneumococcus?

A

Pneumococcal polysaccharide vaccine (PPV) e.g. Pneumovax (23 serotypes)

Pneumococcal conjugate vaccine (PCV) e.g.
Prevenar (13 serotypes)

56
Q

When are pneumococcus vaccines given?

A

Given at 2, 4 and 12 months

57
Q

How do conjugate vaccines work?

A
  • B cell binds bacterial polysaccharide epitope linked to tetanus toxoid protein
  • Antigen is internalised and processed
  • Peptides from protein component are presented to the T cell
  • Activated B cell produced antibody against polysaccharide antigen on the surface of the bacterium
58
Q

What proportion of people globally are infected with mycobacterium tuberculosis?

A

1/3

59
Q

How many people globally have mycobacterium tuberculosis DISEASE?

A

15 million

60
Q

How is a TB cavity formed?

A

Childhood exposure causes primary pulmonary infection
A successful immune response leads to a well adult with immunity
Late reactivation of pulmonary disease forms a cavity

61
Q

How does TB cause progressive pulmonary disease? What does this lead to?

A

Childhood exposure causes primary pulmonary infection
An inadequate immune response leads to progressive pulmonary disease (can be fatal)
This can spread via blood/lymph, causing miliary extrapulmonary disease (can be fatal)

62
Q

What bacteria causes tetanus? What type of bacteria is this?

A

Clostridium tetani

Gram positive bacillus

63
Q

Where are Clostridium tetani spores found?

A

Soil

64
Q

What does the tetanus toxin (exotoxin) interact with?

A

NMJ

65
Q

How does tetanus present in infants? (5)

A 
Weakness
Lethargy
Poor suck
Spasms
Fits
66
Q

How many fungi species have been named? How many cause disease?

A

> 100,000

<500

67
Q

What are the two types of fungi?

A

Yeasts

Moulds

68
Q

Give an example of a yeast.

A

Candida

69
Q

Give an example of a mould.

A

Aspergillus

70
Q

Which is more common - superficial or invasive mycoses? In whom does invasive mycoses occur?

A

Superficial

Invasive mycoses occur in immunocompromised hosts

71
Q

Give two examples of superficial mycoses? How are they treated?

A

Candidiasis (nappy rash)
Tinea corporis (ringworm)
Topical antifungal e.g. Nystatin

72
Q

Give two examples of invasive mycoses.

A

Candidaemia

Pulmonary aspergillosis

73
Q

Who and what can candidaemia affect? How is it treated?

A

Preterm babies
Kidneys and brain
Long course of IV antifungal

74
Q

Who does pulmonary aspergillosis affect?

A

Child with chronic granulomatous disease (affects neutrophil function)

75
Q

What is neutropenia? What are the causes?

A

Low neutrophil count
Congenital e.g. Kostmann disease
Aquired e.g. chemotherapy

76
Q

How does chronic granulomatous disease cause impaired function of neutrophils?

A

Causes impaired oxidative burst

77
Q

What is another cause of impaired function of neutrophils?

A

Leukocyte adhesion defect (cannot migrate to sites of infection)

78
Q

What are the congenital causes of T cell defects? (2)

A

Severe combined immunodeficiency (SCID)

Wiskott-Aldrich syndrome

79
Q

What is an acquired cause of T cell defects?

A

HIV

80
Q

What are the three main classifications of protozoa?

A

Sporozoa
Amoebae
Flagellates

81
Q

SPOROZOA - give three examples.

A 
Plasmodium species (malaria)
Toxoplasma gondii (toxoplasmosis)
Cryptosporidium (diarrhoea)
82
Q

AMOEBAE - give an example.

A

Entamoeba histolytica (amoebic dysentery)

83
Q

FLAGELLATES - give three examples.

A

Giardia (diarrhoea, malabsorption)
Trypanasoma (sleeping sickness, Chagas)
Leishmania (leishmaniasis)

84
Q

What are the four main species that cause malaria?

A

P. falciparum – most severe, cerebral malaria
P. vivax
P. ovale
P. malariae

85
Q

Which species causes cerebral malaria?

A

P. falciparum

86
Q

What are the non-specific symptoms of malaria? (4)

A

Fever, lethargy, vomiting, diarrhoea

87
Q

What does severe malaria cause? (4)

A

Anaemia
Respiratory distress
Cerebral malaria (coma, seizures)
Hypoglycaemia

88
Q

How many children die each year of malaria?

A

1 million

89
Q

What new treatments are there for malaria?

What is the benefit of these?

A

Artemisinin derivatives
Combination treatment (eg Coartem: artemether-lumefantrine)
More rapid reduction in parasitaemia

90
Q

What causes congenital toxoplasmosis?
What are the oocysts excreted by?
Where does it multiple?

A

Toxoplasma gondii
Cats
Macrophages

HD 2 (25 decks)

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