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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
How much lower than rectal temp is taking temp via mouth?
0.5 degree lower
26
How much lower than rectal temp is taking temp via axilla?
1 degree lower
27
Give some examples of severe bacterial illnesses. (8)
``` Septicaemia Meningitis Pneumonia Epiglottitis Septic arthritis Osteomyelitis Tuberculosis Tetanus ```
28
Give some examples of common bacterial illnesses. (5)
``` Tonsillitis Otitis media Urinary tract infection Gastroenteritis Impetigo ```
29
What organisms cause septicaemia and meningitis? (3)
Streptococcus pneumoniae Neisseria meningitidis (mostly Group B) Haemophilus influenzae B
30
How do you recognise septicaemia? (5)
``` Tachycardia Tachypnoea Prolonged capillary refill Low BP (late sign) Rash ```
31
How is meningitis diagnosed?
LP
32
What are the symptoms of meningitis? (6)
``` High temperature Headache Vomiting Not able to tolerate bright lights Drowsy Stiff neck ```
33
What is the difference in appearance of CSF in bacterial vs viral meningitis vs TB?
Bacterial – cloudy Viral – clear TB - opalescent
34
What cells are present in bacterial vs viral meningitis vs TB?
Bacterial - neutrophils | Viral and TB – lymphocytes
35
How does the protein in CSF compare in bacterial vs viral meningitis vs TB?
Higher in bacterial (and much higher in TB)
36
How does the glucose in CSF compare in bacterial vs viral meningitis?
Bacterial – low | Viral - normal
37
What are the top three organisms in young infants?
Group B streptococcus E Coli Listeria
38
What antibiotic may be given in older children?
Ceftriaxone
39
What antibiotics may be given in young infants (<3 months)? (2)
Cefotaxime or ceftriaxone | Amoxicillin also needed for Listeria cover
40
What is the neonatal period?
First 28 days of life
41
What causes neonatal sepsis?
Maternal colonization with pathogens (colon or vaginal canal)
42
When does early onset sepsis occur?
48 hrs
43
What does late onset sepsis cause?
Meningitis | Bones and joint problems
44
How many % of neonatal sepsis cases' mothers have GBS?
15-40%
45
Name 3 gram-positive cocci bacteria.
Staphylococcus Streptococcus Enterococcus
46
Name 4 gram-positive bacilli bacteria.
Corynebacterium Listeria Bacillus (cereus, anthracis) Clostridium (tetani, botulinum, difficile)
47
Steptococcus pneumoniae - how many % of people have this as normal flora?
5-70% people
48
What predisposes to pneumococcal infection? (3)
Absent / non-functional spleen Hypogammaglobulinaemia HIV infection
49
Absent/non-functional spleen - name three possible causes. (3)
Congenital asplenia Traumatic removal Hyposplenism (eg sickle cell)
50
Splenectomy means people are more vulnerable to...? What is given daily for the rest of their lives?
Encapsulated bacteria | Pencillin
51
Name 3 encapsulated bacteria.
Pneumococcus HiB Meningococcus
52
Non-invasive conditions? (4)
Acute otitis media Sinusitis Conjunctivitis Pneumonia
53
Invasive conditions? (5)
``` Septicaemia Meningitis Peritonitis Arthritis Osteomyelitis ```
54
Pneumococcus causes empyema. How is it managed? (2)
Chest drain +/- urokinase | Video-assisted thoracoscopic surgery
55
What are the two types of vaccine for pneumococcus?
Pneumococcal polysaccharide vaccine (PPV) e.g. Pneumovax (23 serotypes) Pneumococcal conjugate vaccine (PCV) e.g. Prevenar (13 serotypes)
56
When are pneumococcus vaccines given?
Given at 2, 4 and 12 months
57
How do conjugate vaccines work?
- 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
What proportion of people globally are infected with mycobacterium tuberculosis?
1/3
59
How many people globally have mycobacterium tuberculosis DISEASE?
15 million
60
How is a TB cavity formed?
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
How does TB cause progressive pulmonary disease? What does this lead to?
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
What bacteria causes tetanus? What type of bacteria is this?
Clostridium tetani | Gram positive bacillus
63
Where are Clostridium tetani spores found?
Soil
64
What does the tetanus toxin (exotoxin) interact with?
NMJ
65
How does tetanus present in infants? (5)
``` Weakness Lethargy Poor suck Spasms Fits ```
66
How many fungi species have been named? How many cause disease?
>100,000 | <500
67
What are the two types of fungi?
Yeasts | Moulds
68
Give an example of a yeast.
Candida
69
Give an example of a mould.
Aspergillus
70
Which is more common - superficial or invasive mycoses? In whom does invasive mycoses occur?
Superficial | Invasive mycoses occur in immunocompromised hosts
71
Give two examples of superficial mycoses? How are they treated?
Candidiasis (nappy rash) Tinea corporis (ringworm) Topical antifungal e.g. Nystatin
72
Give two examples of invasive mycoses.
Candidaemia | Pulmonary aspergillosis
73
Who and what can candidaemia affect? How is it treated?
Preterm babies Kidneys and brain Long course of IV antifungal
74
Who does pulmonary aspergillosis affect?
Child with chronic granulomatous disease (affects neutrophil function)
75
What is neutropenia? What are the causes?
Low neutrophil count Congenital e.g. Kostmann disease Aquired e.g. chemotherapy
76
How does chronic granulomatous disease cause impaired function of neutrophils?
Causes impaired oxidative burst
77
What is another cause of impaired function of neutrophils?
Leukocyte adhesion defect (cannot migrate to sites of infection)
78
What are the congenital causes of T cell defects? (2)
Severe combined immunodeficiency (SCID) | Wiskott-Aldrich syndrome
79
What is an acquired cause of T cell defects?
HIV
80
What are the three main classifications of protozoa?
Sporozoa Amoebae Flagellates
81
SPOROZOA - give three examples.
``` Plasmodium species (malaria) Toxoplasma gondii (toxoplasmosis) Cryptosporidium (diarrhoea) ```
82
AMOEBAE - give an example.
Entamoeba histolytica (amoebic dysentery)
83
FLAGELLATES - give three examples.
Giardia (diarrhoea, malabsorption) Trypanasoma (sleeping sickness, Chagas) Leishmania (leishmaniasis)
84
What are the four main species that cause malaria?
P. falciparum – most severe, cerebral malaria P. vivax P. ovale P. malariae
85
Which species causes cerebral malaria?
P. falciparum
86
What are the non-specific symptoms of malaria? (4)
Fever, lethargy, vomiting, diarrhoea
87
What does severe malaria cause? (4)
Anaemia Respiratory distress Cerebral malaria (coma, seizures) Hypoglycaemia
88
How many children die each year of malaria?
1 million
89
What new treatments are there for malaria? | What is the benefit of these?
Artemisinin derivatives Combination treatment (eg Coartem: artemether-lumefantrine) More rapid reduction in parasitaemia
90
What causes congenital toxoplasmosis? What are the oocysts excreted by? Where does it multiple?
Toxoplasma gondii Cats Macrophages

HD 2 (25 decks)

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