Common childhood diseases – a guide for GP - DONE Flashcards
1
Q
The most common symptoms:
A
- Fever!!!
- Cough
- Sneezing
- Diarrhea
- Vomiting
- Pain (ear, throat, abdomen)
2
Q
The most common diagnoses:
A
- Respiratory tract infections
- Urinary tract infections
- Acute otitis media
- Pharyngitis
- Gastroenterocolitis
- Allergy
3
Q
How do you treat fever?
A
- Paracetamol (Acetaminophen)
- Ibuprophen
4
Q
Paracetamol (Acetaminophen) - Dose per os:
A
per os 10-15mg/kg bm/dose
5
Q
Paracetamol (Acetaminophen) - Dose per rectum:
A
per rectum 15mg/kg bm/dose
6
Q
Ibuprophen - dose:
A
5-10mg/kg bm/dose
7
Q
Ibuprophen - dose per rectum:
A
- 60mg when the body mass i < 12,5kg
- 125mg when the body mass > 12,5kg
8
Q
What are the differences between Acetaminophen and Ibuprophen?
A
- Similar analgetic effect (in moderate to severe pain)
- Ibuprofen - better antipyretic effect
- Both are safe for short term use
9
Q
Exanthema subitum =
A
roseaola infantum
10
Q
Exanthema subitum (roseaola infantum) - etiology:
A
Viral infection: HHV 6, HHV 7
11
Q
Exanthema subitum (roseaola infantum) - Period of incubation:
A
5-15 days
12
Q
Exanthema subitum (roseaola infantum) - Age of onset:
A
6months - 2 (4) years old children
13
Q
Exanthema subitum (roseaola infantum) - Prevention:
A
- no prevention
- no vaccination
14
Q
Exanthema subitum (roseaola infantum) - Clinical symptoms:
A
- Fever >39*C (3-5 days) and later - rash (it lasts 1-2 days, location: back, neck, face, abdomen)
- Sometimes: diarrhoea, cough, lymphadenopath
- Fever convulsions
15
Q
Exanthema subitum (roseaola infantum) - Complications:
A
Rare
16
Q
Exanthema subitum (roseaola infantum) - Complications:
A
- Leucopenia with granulocytopenia (vaccinations not allowed 4 weeks after infection)
17
Q
Exanthema subitum (roseaola infantum) - Treatment:
A
only symptomatical
18
Q
Infectious erythema =
A
Fifth disease
19
Q
Erythema infectiosum (fifth disease) - Etiology:
A
Viral infection: Parvovirus B 19
20
Q
Erythema infectiosum (fifth disease) - Period of incubation:
A
14-30days
21
Q
Erythema infectiosum (fifth disease) - Vaccination:
A
- No vaccination
22
Q
Erythema infectiosum (fifth disease) - Symptoms:
A
- Butterfly’s shap on the face, “the most beautiful rash” (face, later girlands on arms, trunk and extermities), retreats and turns back by 1-3 weeks. It dissapears without scars and without peeling epidermis.
- Leukopenia with lymphocytosis
23
Q
Erythema infectiosum (fifth disease) - Treatment:
A
Only symptomatical
24
Q
Erythema infectiosum (fifth disease) - Prognosis:
A
Good
25
Erythema infectiosum (fifth disease) - Complications:
- Heamolytic anemia
| - joint pains
26
Erythema infectiosum (fifth disease) - Prevention:
Isolation
27
Herpetic stomatitis - Etiology:
Viral infection: HSV 1
28
Herpetic stomatitis - Vaccination:
No vaccination
29
Herpetic stomatitis - Period of incubation:
2-14 days
30
Herpetic stomatitis - Clinical symptoms:
- Fever
- inflammation of herpetic oral + skin follicular changes
- labial cold sore
31
Herpetic stomatitis - Complications:
Neuro-infection
32
Herpetic stomatitis - Treatment:
- only symptomatic
| - Acyclovir orally and/or outside cream
33
Herpetic stomatitis - Prevention:
- Isolation
- Hand washing
- No kissing
34
Urinary tract infection:
- When fever lasts more than 2 days
- And there are no symptoms for infectious disease
- no symptoms typical for respiratory tract infection....
- You HAVE TO EXAMINE the urine!!
35
What requires hospitalisation?
- Prolonged fever of unknown origin requires hospitalisation. In order to establish the reason and administrate appropriate treatment.
36
Pharyngitis - etiology:
- 80% caused by virus
| - 20% caused by bacteria
37
Pharyngitis - Symptoms if viral:
- conjuctivits
- malaise
- fatigue
- hoarseness
- lowgrade fever
- mouth-breathing
- vomiting
- abdominal pain
- diarrhea
38
Pharyngitis - Symptoms if mononucleosis:
- 15-30 years of age
- sore throat (injection with excudatives)
- posterior cervical lymphadenopathy
- hepatosplenomegaly
- Treatment: amoxicillin - 90% develop a classic maculopapular rash
39
Mononucleosis - etiology:
Viral infection: Epstein-Barr Virus
40
Mononucleosis - period of incubation:
33-49 days
41
Mononucleosis - Infectiousness:
low infectiousness
42
Mononucleosis - vaccination:
No vaccination
43
Mononucleosis - Symptoms:
- fever
- posterios cervical lymphadenopathy
- Exanthema - spotty or lumpy (after treatment with amoxicillin)
- Sore throat with exudation in palatal tonisls
- Ecchymosis on palate
- Catarrh of nose, swelling of eyelids
44
Mononucleosis - Treatment:
- only symptomatical
45
Mononucleosis - Prognosis:
good
46
Mononucleosis - Possible complications:
- hematological
- neurological
- cardiological
47
Streptococcal pharyngitis - etiology:
Streptococcus pyogenes
48
Streptococcal pharyngitis - symptoms:
- Sudden beginning, fever >38°C
- Strong pain of throat
- anterior cervical lymphadenopathy
- Nausea, vomiting, stomachache
- General symptoms (breaking, muscular pains, headache)
- Sore throat, pharyngeal erythema and swelling, tonsillar exudates, edematous uvula, palatine petechiae
49
Streptococcal pharyngitis - slide 27 about strep score:
slide 27
50
Pharyngitis - treatment - Virus:
80% caused by viruses; treatment:
- antipyretic treatment
- antiinflammatory treatment
- analgetic treatment
51
Pharyngitis - treatment - Bacteria:
20% caused by bacteria;
treatment:
- antibiotics
52
Streptococcal pharyngitis - treatment:
- oral penicillin or cephalosporin
- 10 days
slide 30 for more
53
Streptococcal pharyngitis - prognosis:
good
54
Streptococcal pharyngitis - possible complications:
- abscess
| - recurrence
55
Streptococcal pharyngitis - vaccination:
no vaccination
56
Pharyngitis - treatment:
- Untreated patients are infectious - during acute phase and one additional week.
- Treated patients are infectious: 24 first hours of antibiotictherapy
- Antibiotictherapy: shortness the infectious period, reduces the duration of symptoms by about one day, prevents complications
57
Scarlet fever - Etiology:
- Gr A Streptococus
| - B-hemoliticus
58
Scarlet fever - Period of incubation:
1-7 days
59
Scarlet fever - Pattern:
- spares the face (although circumoral pallor is characteristical)
60
Fiłatow triangle
slide 33
61
Scarlet fever - Symptoms:
- Fever
- Bright red tongue with a "strawberry" appearance, may
spread to cover the uvula.
Characteristical rash, which:
- is fine, red, and rough textured;
- it blanches upon pressure
- appears 12–48 hours after the fever
- generally starts on the chest, armpits, and behind the ears
- spares the face (although circumoral pallor is characteristic) is worse in the skin folds.
- Pastia lines - the rash runs together in the arm pits and groins, appear and can persist after the rash is gone
62
Strawberry tongue:
is the appearance of tongue with inflamed red papillae, giving an appearance of strawberry
63
Scarlet fever rash:
By the sixth day of the infection the rash usually fades, but the affected skin may begin to peel.
64
Scarlet fever - treatment:
oral penicillin for 10 days
65
Scarlet fever - Possible complications:
- poststreptococcal glomerulonephritis or reactive arthritis
- rheumatic fever
- cervical lymphadenitis
- fascitis/myositis syndrome
- endocarditis
- mastoiditis
- meningitis
- otitis media
66
Respiratory tract infections - phases:
I - exudative phase
II - obturative phase
III - cell mediated (bacterial) phase
67
Exudative phase - symptoms:
- fever
- pain
- dry cough
68
Exudative phase - treatment:
- antipyretic
- analgetic
- antiinflammatory drugs
- anticough syrupes
- vasoconstrictive nasal drops
not longer than 4-5 days!
69
Obturative phase - symptoms:
- cough with expectation
| - obturation
70
Obturative phase - treatment:
- antipyretic
- antianalgetic
- antiinflammatory drugs
- mucolitic drugs
71
Obturative phase - not reccommended:
- relieving cough syrups
| - vasocontrictive nasal drops
72
Bacterial (cell mediated) phase - symptoms:
- cough with expectation
| - fever (again)
73
Bacterial (cell mediated) phase - treatment:
- antipyretic
- antianalgetic
- antiinflammatory drugs
- mucolitic drugs
- antibiotics
74
Bacterial (cell mediated) phase - Not recommended:
- reliefing cough syrupes
- vasoconstrictive nasal drops
- antihistaminic drugs
75
Community aquired pneumonia - etiology:
- Viral
- Bacterial:
* typical:
§ Strep pneumonia
§ Haemophilus influenzae
§ Moraxella Catarrhalis
* Atypical
76
Typical pneumonia - symptoms:
- fever
- productive cough
- malaise
- fatigue
- diarrhea, abdominal pain (in young children)
77
Typical pneumonia - treatment:
- beta-lactams:
* amoxicillin (high dose!
* cefuroxim
* amoxicillin with clavulanic acid
Attention:
- 15% strep. pneumonia is resistant to penicillin
- 6% haemophilus influenzae produce betalactamases
78
Atypical respiratory tract infections - symptoms:
- prolonged cough (dry, distrubing, persistant, paroxymal, worsening at night)
- subfever lasting several days or weeks
- good general condition
- severe changes in X-rays (not correlated with a good general status)
- peripheral eosinophilic pleocytosis.
79
Mycoplasmal pneumonia - X-ray:
Reticular inflammation
80
Atypical infections - treatment:
- macrolides
- tetracycline (>12 years of age)
- fluoroquinolones (>16 years of age)
Treatment should last 10-14 days, in complicated cases 2-4 weeks
