Childhood infections

Question 1

Koplik spots are pathognomonic of…

Answer 1

Measles

Question 2

What do Koplik spots look like?

Answer 2

“Grains of salt” on the buccal mucosa

Question 3

Describe the rash seen in measles?

Answer 3

Starts behind ear then whole body; discrete lesions become blotchy and confluent

Question 4

Management of measles?

Answer 4

Supportive

Notifiable disease- inform public health

Question 5

Contact prophylaxis in measles?

Answer 5

Unimmunized children should be given MMR within 72hrs of contact

Question 6

Whata re the complications of measles?

a) neuro
b) GI
c) eyes
d) lungs
e) heart

Answer 6

a) encephalitis, febrile convulsions
b) diarrheoea, increased appendicitis risk, subacute sclerosing panencephalitis
c) corneal ulceration, keratoconjunctivitis
d) pneumonia
e) myocarditis

Question 7

Diagnostic investigation for measles?

Answer 7

IgM antibodies detectable within a few days of rash onset

Question 8

PMHx Recurrent viral/fungal/parasitic infections + cardiac disease + cleft lip/palate

Answer 8

Di George syndrome

Question 9

Presents with recurrent infections including abscesses and atypical infections

Answer 9

Chronic granulomatous disease

Question 10

Fever + malaise + strawberry tongue + widespread pinhead rash which spares the face?

Answer 10

Scarlet fever

Question 11

Scarlet fever is caused by reaction to…

Answer 11

Erythrogenic toxins released by Group A strep (usually strep pyogenes)

Question 12

Management of scarlet fever? (2)

Answer 12

Oral penicillin/azithromycin

Notifiable illness

Question 13

What are the potential complications of scarlet fever? (3)

Answer 13

Otitis media (commonest)
Rheumatic fever
Acute glomerulonephritis

Question 14

Fever/malaise + parotitis (“earache”, “pain on eating”)

Answer 14

Mumps

Question 15

Pink maculopapular rash initially on face before spreading + suboccipital and postauricular lymph nodes

Answer 15

Rubella

Question 16

Sore throat and fever + vesicles in mouth, palms and soles

Answer 16

Hand foot and mouth disease

Question 17

What is hand foot and mouth disease caused by?

Answer 17

Coxsackie virus

Question 18

“Slapped-cheek” rash

Answer 18

Parvovirus B19/fifth disease/erythema infectiousum

Question 19

Meningitis in children: organisms

a) neonatal
b) 1 month to 6 years
c) greater than 6

Answer 19

a) GBS, E-coli, listeria
b) neisseria, strep pneumoniae, haemophilus
c) neisseria, strep pneumoniae

Question 20

Treatment of threadworms?

Answer 20

Anti-helminthic (e.g. mebendazole). Single dose for all members of household

Question 21

30% of children who present with UTI have what abnormality of the urinary tract?

Answer 21

Vesico-ureteric reflux (VUR)

Question 22

Investigation in suspected VUR? What are the positive findings?

Answer 22

Cysturethrogram

Dilated tortuous ureters
Dilated renal pelvis and calyces

Question 23

Child aged 6-24 months presents with a high fever + pink maculopapular rash when the fever settles

Answer 23

Roseola infantum

Question 24

What is roseola infantum caused by?

Answer 24

Human herpes virus 6

Question 25

Complications of varicella? (4)

Answer 25

Encephalitis
Pneumonitis
DIC
Bacterial superinfection with staph

Question 26

What is the commonest complication of roseola infantum?

Answer 26

Febrile convulsions