Common Childhood Illnesses

Question 1

General appearance of feverish child

Answer 1

Sloppy
Sleepy
Irritable

Question 2

Normal RR and HR for:

Neonate

Answer 2

RR: 60
HR: 160

Question 3

Normal RR and HR for:

<1 yr old

Answer 3

RR: 35-45
HR: 110-160

Question 4

Normal RR and HR for:

5-12 yr old

Answer 4

RR: 20-25
HR: 80-120

Question 5

Normal RR and HR for:

12+ year old

Answer 5

Adult range

Question 6

Normal RR and HR for:

1-5 yr old

Answer 6

RR: 25-35
HR: 95-140

Question 7

Approach to assessing child for fever

Answer 7

1. General appearance
   - Happy, smiling child versus floppy, irritable, sleepy child
2. Vital signs – Heart Rate (HR), Respiratory Rate (RR), Capillary Refill Time (CRT), temperature
3. Look for fever source – ENT examination, Chest examination
4. Assess for rashes
   - Red? (erythema)
   - Disappears on pressure? (Blanching, non-blanching)
   - Flat (Macule) or Raised (papule)
   - Raised with fluid (vesicle) or raised with pus (pustule)
5. If no obvious fever source – consider testing for UTI

Question 8

Macule vs papule?

Answer 8

Flat (Macule)

Raised (papule)

Question 9

3 common childhood illnesses?

Answer 9

Infections
Rashes
Chronic conditions

Question 10

5 infection types common in children

Answer 10

URTI
LRTI
Gastroenteritis
UTI
Meningitis

Question 11

Features of upper and lower RTI in children

Answer 11

URTI **

• Most common
• ENT e.g. coryza, otitis media, pharyngitis, croup
• Mostly viral

LRTI
- E.g. Pneumonia and whooping cough

Question 12

Most common URTIs in children

**mostly viral

Answer 12

Acute otitis media
- Ear pain and tenderness

Tonsillitis

• Sore throat, otalgia, headache and malaise
• Tonsils are visibly enlarged with pus from crypts.
• Pharyngeal mucosa in inflamed

Pharyngitis
- Dysphagia, erythematous pharyngeal and tonsillar mucosa, malaise

Croup

• Commonly 0-2yr old
• Inspiratory stridor* due to laryngeal oedema and thick secretions
• Barking cough*
• Hoarse voice, fever
• Worse at night
• Lasts up the 7 days, worst in first 2 days

Question 13

Common infectious rashes in children

Answer 13

Chicken pox (varicella zoster virus)

Hand, foot and mouth (coxsackie virus)

Scarlet fever (group A beta haemolytic strepococci)

Impetigo (staph aureous or strep pyogenes)

Fifth disease/ Slapped cheek disease (erythrovirus type B19)

Ringworm (fungal: tinea corporis)

Eczema

Question 14

Features of childhood chickenpox

Viral agent

Answer 14

Infectious period: 3 days before rash development and <6 days after first lesion appears

Location: Face, trunk and a lil on limbs

Progression: Macular (flat) lesions –> papular –> vesicular –> pustular. Peak at 48 hrs with intense itch

Virus: Varicella zoster

Question 15

Features of hand foot and mouth

Viral agent

Answer 15

Duration: 7-10 days of symptoms

Prodrome: 1/2 days of sore throat, dyspagia, pyrexia, lost appetite, malaise
–> mouth lesions 1/2 days after fever + skin lesions on hand and feet

Coxsackie virus

Question 16

Scarlet fever:
infectious agent?
How long?
who?
S/S?

Answer 16

infectious agent: Group A beta haemolytic streptococci

How long? 2-4 day incubation period (respiratory transmission)

Who? Most commonly 2-8 year olds
Typical symptoms/signs:
-High fever
- Headache, malaise, N/V
- Blanching maculopapular rash at torso –> whole body
- Enlarged red tonsils covered with a white exudate
-Furred tongue with enlarged papillae - “white strawberry tongue”

Question 17

Impetigo:
Features?
Causative agent?
Presentation?

Answer 17

Features? Highly contagious infection

Causative agent? Staph aureus or strep pyogenes (or both)

Presentation?

• Macules/papules/pustules on face or extremities
• Classic honey coloured or golden
• Gummy crusts in a strep infection

Question 18

Fifth disease / slapped cheek disease:
Infectious agent?
Who?
Progression?
Recurrence?

Answer 18

Infectious agent?
Erythrovirus type B19

Who?
School-aged children

Progression?
Incubation for 13-18 days
--> 4 day prodrome of mild fever and sore throat, coryza, headache, nausea 
--> Maculopapular on cheeks for 1-4 days
--> Spread to extremities and trunk

Recurrence?

Question 19

define catarrhal

Answer 19

Inflammation of a mucous membrane with increased production of mucus, esp affecting the nose and throat in the common cold. the mucus so formed.

Question 20

Ringworm:
Fungal agent?
Progression?

Answer 20

Fungal agent: Tinea corporis

Progression:
Single or mnuultiple small and scaly patches in groin/axillae
–>enlargement or form into plaques with clear centre
–> Itchy and erythematous annular patches

Question 21

Eczema:
Where?
Features?

Answer 21

Where?
Popliteal fossa and antecubital fossa

Features?

• Itch
• Erythema
• Oozing and wheeping
• crusting –> fissuring and scaling
• Risk of secondary infection due to itch