childhood_infections_flashcards

Question 1

What are the initial symptoms of Chickenpox?

Answer 1

Fever initially

Question 2

Describe the rash associated with Chickenpox.

Answer 2

Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular

Question 3

How severe is the systemic upset in Chickenpox?

Answer 3

Systemic upset is usually mild

Question 4

What are the prodromal symptoms of Measles?

Answer 4

Prodrome: irritable, conjunctivitis, fever

Question 5

What are Koplik spots and where are they found?

Answer 5

White spots (‘grain of salt’) on buccal mucosa

Question 6

Describe the rash progression in Measles.

Answer 6

Starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

Question 7

What are the main symptoms of Mumps?

Answer 7

Fever, malaise, muscular pain

Question 8

Describe the pattern of parotitis in Mumps.

Answer 8

Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

Question 9

Describe the rash in Rubella.

Answer 9

Pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day

Question 10

What type of lymphadenopathy is associated with Rubella?

Answer 10

Suboccipital and postauricular lymphadenopathy

Question 11

What is another name for Erythema infectiosum?

Answer 11

Also known as fifth disease or ‘slapped-cheek syndrome’

Question 12

What virus causes Erythema infectiosum?

Answer 12

Caused by parvovirus B19

Question 13

List the initial symptoms of Erythema infectiosum.

Answer 13

Lethargy, fever, headache

Question 14

Describe the rash in Erythema infectiosum.

Answer 14

‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces

Question 15

What causes Scarlet fever?

Answer 15

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci

Question 16

List the main symptoms of Scarlet fever.

Answer 16

Fever, malaise, tonsillitis

Question 17

Describe the tongue appearance in Scarlet fever.

Answer 17

‘Strawberry’ tongue

Question 18

Describe the rash in Scarlet fever.

Answer 18

Fine punctate erythema sparing the area around the mouth (circumoral pallor)

Question 19

What virus causes Hand, foot and mouth disease?

Answer 19

Caused by the coxsackie A16 virus

Question 20

List the symptoms of Hand, foot and mouth disease.

Answer 20

Mild systemic upset: sore throat, fever

Question 21

Where are the vesicles found in Hand, foot and mouth disease?

Answer 21

Vesicles in the mouth and on the palms and soles of the feet

Question 22

summarise childhood infections

Answer 22

Question 23

Theme: Childhood infections

A. Shingles
B. Rubella
C. Chickenpox
D. Scarlet fever
E. Coxsackie A16
F. Parvovirus B19
G. Measles
H. Mumps
I. Meningococcal septicaemia

For each one of the following scenarios select the most appropriate diagnosis

34. A 4-year-old boy presents with fever and a sore throat. Examination reveals tonsillitis and a furred tongue with enlarged papillae. There is a blanching punctate rash sparing the face
35. A 3-year-old girl with a two day history of fever and malaise. Developed a pink maculopapular rash initially on the face before spreading. Suboccipital lymph nodes are also noted
36. A 4-year-old boy presents with fever, malaise and a ‘slapped-cheek’ appearance

Answer 23

Theme: Childhood infections

A. Shingles
B. Rubella
C. Chickenpox
D. Scarlet fever
E. Coxsackie A16
F. Parvovirus B19
G. Measles
H. Mumps
I. Meningococcal septicaemia

For each one of the following scenarios select the most appropriate diagnosis

34. A 4-year-old boy presents with fever and a sore throat. Examination reveals tonsillitis and a furred tongue with enlarged papillae. There is a blanching punctate rash sparing the face

The correct answer is: Scarlet fever

35. A 3-year-old girl with a two day history of fever and malaise. Developed a pink maculopapular rash initially on the face before spreading. Suboccipital lymph nodes are also noted
    The correct answer is: Rubella
36. A 4-year-old boy presents with fever, malaise and a ‘slapped-cheek’ appearance
    The correct answer is: Parvovirus B19

Question 24

Theme: Childhood infections

A. Shingles
B. Rubella
C. Chickenpox
D. Scarlet fever
E. Coxsackie A16
F. Parvovirus B19
G. Measles
H. Mumps
I. Meningococcal septicaemia

For each one of the following descriptions select the most appropriate diagnosis

28. The prodrome is characterised by fever, irritability and conjunctivitis
29. May cause vesicles in the mouth and on the palms
30. May cause a crop of white spots on the inside of the mouth

Answer 24

Theme: Childhood infections

A. Shingles
B. Rubella
C. Chickenpox
D. Scarlet fever
E. Coxsackie A16
F. Parvovirus B19
G. Measles
H. Mumps
I. Meningococcal septicaemia

For each one of the following descriptions select the most appropriate diagnosis

28. The prodrome is characterised by fever, irritability and conjunctivitis
    Measles
29. May cause vesicles in the mouth and on the palms
    Coxsackie A16
30. May cause a crop of white spots on the inside of the mouth
    Measles

Question 25

Theme: Infectious diseases A. Human Immunodeficiency Virus (HIV) B. Human Coronavirus-NL63 (seasonal coronavirus) C. Scarlet fever D. Chickenpox E. Hand, foot and mouth disease F. Kawasaki Disease G. Parvovirus B19 Infection H. Genital herpes I. Non-specific viral rash J. Schistosomiasis Please select answers to the questions from the list of infectious diseases presented. 50. Which of the above is a notifiable disease? 51. A 5-year-old child is bought to see you with a rash. His mother reports that he has had a sore throat and low-grade fever for a couple of days. Yesterday he developed a spotty rash on his face, particularly around his mouth, and she has now noticed this spread to his extremities, including his hands, feet and buttocks. He is up to date with immunisations and has had a chickenpox vaccine privately. What is the most likely diagnosis? 52. Which of the above conditions requires treatment with antibiotics?

Answer 25

Theme: Infectious diseases A. Human Immunodeficiency Virus (HIV) B. Human Coronavirus-NL63 (seasonal coronavirus) C. Scarlet fever D. Chickenpox E. Hand, foot and mouth disease F. Kawasaki Disease G. Parvovirus B19 Infection H. Genital herpes I. Non-specific viral rash J. Schistosomiasis Please select answers to the questions from the list of infectious diseases presented. 50. Which of the above is a notifiable disease? **Scarlet fever** Registered medical practitioners have a statutory duty to notify the local health protection team of suspected cases of certain infectious diseases. Scarlet fever is the only condition above on the list of notifiable diseases. Human Coronavirus-NL63 is an example of a seasonal coronavirus which causes a generally mild and self-limiting respiratory tract infection and is not notifiable. COVID-19 (SARS-CoV-2) is a notifiable disease. None of the other conditions listed are notifiable diseases in the UK. 51. A 5-year-old child is bought to see you with a rash. His mother reports that he has had a sore throat and low-grade fever for a couple of days. Yesterday he developed a spotty rash on his face, particularly around his mouth, and she has now noticed this spread to his extremities, including his hands, feet and buttocks. He is up to date with immunisations and has had a chickenpox vaccine privately. What is the most likely diagnosis? **Hand, foot and mouth disease** Hand, foot and mouth disease is the most likely diagnosis. It often presents with a prodrome of sore throat and fever, and then a rash develops initially on the mouth and lips, then spreads to the hands and feet. The rash may also affect the genitals and buttocks but rarely elsewhere in the body. It is most commonly caused by the Coxsackie A16 virus. This child has been vaccinated against chickenpox. This is part of the childhood vaccination schedule in some countries and is available privately in the UK. The vaccine is over 90% effective so chickenpox is unlikely in this child. It presents with a very itchy vesicular rash primarily affecting the head, neck and trunk. It can also affect the limbs and mouth. Parvovirus B19 infection is the causative agent of erythema infectiosum (fifth disease). It typically presents with a mild prodrome of headache, runny nose, sore throat and low-grade fever followed by a symptom-free period of 7-10 days, after which a classic 'slapped cheek' rash appears. A few days later an erythematous macular rash develops on the extremities, mainly on the extensor surfaces. Many viruses can cause a rash, in addition to other symptoms such as fever and cough, which is not characteristic enough to identify the virus causing the rash. This can be described as a non-specific viral rash. However, this child's presentation is typical of hand, foot and mouth disease. 52. Which of the above conditions requires treatment with antibiotics? **Scarlet fever** Scarlet fever presents with a fever followed by a sandpaper rash 1-2 days later, typically on the neck, chest and scapular region. The trunk and legs are then affected later. Patients may have a sore throat, haemorrhagic spots on the palate, red exudative tonsils, cervical lymphadenopathy, headache, vomiting, abdominal pain, and myalgia. They may also get skin peeling and white tongue (desquamation). Scarlet fever is a bacterial infection caused by Group A beta-haemolytic streptococci. It is typically treated with 10 days of oral penicillin, or azithromycin if penicillin-allergic. It is a notifiable disease in the UK. Kawasaki disease is an idiopathic systemic vasculitis mostly affecting children aged 6 months to 5 years. The mainstay of treatment is aspirin and intravenous immunoglobulin (IVIg). Schistosomiasis is an infection caused by a parasitic worm and is treated with praziquantel. The other conditions listed are viral infections and generally, antibiotics are not required unless there is a secondary bacterial infection.