Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr 4 - Paediatrics > Corrections - Vaccinations, Infections & ENT > Flashcards

Corrections - Vaccinations, Infections & ENT Flashcards

1
Q

Mx of wound if tetanus vaccination history is incomplete or unknown?

A

Regardless of wound severity –> booster dose of vaccine.

Tetanus prone & high risk wounds –> booster dose of vaccine + tetanus immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 7 examples of live attenuated vaccines?

A

1) BCG

2) MMR

3) Influenza (intranasal)

4) Oral rotavirus

5) Oral polio

6) Yellow fever

7) Oral typhoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is included in the ‘6 in 1’ vaccine?

A

Diptheria
Tetanus
Hep B
Polio
Pertussis
Hib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where in the childhood immunisation schedule is the Meningitis B vaccine given?

A

2 months
4 months
12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is the HPV vaccine offered?

A

Boys and girls aged 12-13 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most suitable management option for epistaxis where the bleed site is difficult to localise?

A

Anterior packing

(Note - cautery with silver nitrate requires bleeding vessels to be visible).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mx of bleeding 5-10 days post tonsillectomy?

A

Admit for IV Abx as usually due to wound infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who should all post-tonsillectomy haemorrhages be assessed by?

A

ENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who should be vaccinated against Hep A?

A

1) people travelling to or going to reside in areas of high or intermediate prevalence, if aged > 1 year old

2) people with chronic liver disease

3) patients with haemophilia

4) MSM

5) IVDU

6) individuals at occupational risk: laboratory worker; staff of large residential institutions; sewage workers; people who work with primates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is oral polio a live vaccine?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is Little’s area in the nasal septum a common site for epistaxis to originate?

A

As it is the confluence of 4 arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is there a hep C vaccine?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe a ‘clean’ wound in regards to tetanus

A
  • Wounds less than 6 hours old
  • Non-penetrating with negligible tissue damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe a ‘tetanus prone’ wound

A
  • puncture-type injuries acquired in a contaminated environment e.g. gardening injuries
  • wounds containing foreign bodies
  • compound fractures
  • wounds or burns with systemic sepsis
  • certain animal bites and scratches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe a ‘high risk’ tetanus prone wound

A
  • heavy contamination with material likely to contain tetanus spores e.g. soil, manure
  • wounds or burns that show extensive devitalised tissue
  • wounds or burns that require surgical intervention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In epistaxis that has failed all management (e.g. cautery, and anterior and posterior packing), what is the next step?

A

Ligation of the sphenopalatine artery in theatre.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is the first dose of the MMR vaccine typically administered?

A

Around 12 months of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Mx of quinsy?

A

IV Abx + surgical drainage

Tonsillectomy should be considered in 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What vaccine do people receive between the ages of 13 and 18?

A

3 in 1 teenage booster (tetanus, diptheria and polio)

Men ACWY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is the BCG vaccine given at birth?

A

If the baby is deemed at risk of tuberculosis (e.g. Tuberculosis in the family in the past 6 months).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is a bone marrow biopsy indicated in ITP?

A

If there are atypical features e.g.

  • lymph node enlargement/splenomegaly, high/low white cells
  • failure to resolve/respond to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does the BCG vaccine provide the most protection against?

A

TB meningitis in children

Note –> the BCG vaccine is unreliable in protecting against pulmonary TB.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When is the rotavirus given?

A

2 months and 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of vaccine is the rotavirus vaccine?

A

Oral, live attenuated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Initial management of epistaxis?

A

Pinch the nasal ala (nostrils) firmly and lean forward for 20 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mx of tetanus wound if patient has had 5 doses of tetanus vaccine, with the last dose < 10 years ago?

A

No booster vaccine nor immunoglobulins required, regardless of how severe the wound is.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How many tetanus vaccinations are there in the UK schedule?

A

5 –> 2 months, 3 months, 4 months, 3-5 years and 13-18 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When is the final tetanus dose given?

A

13-18 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What type of vaccine is the influenza vaccine?

A

Inactivated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which 2 vaccines are routinely offered to pregnant women in the UK?

A

Influenza + pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How soon ago must patients have received their last tetanus dose to not require a booster vaccine nor immunoglobulins with a wound?

A

<10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Features of botulism (i.e. infection with clostridium botulinum)?

A
  • patient usually fully conscious with no sensory disturbance
  • FLACCID paralysis
  • diplopia
  • ataxia
  • bulbar palsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What vaccines should patients diagnosed with chronic hepatitis be offered?

A

Annual influenza + one off pneumococcal vaccine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is the influenza vaccine given in children?

A

Intranasally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When is the influenza vaccine in children given?

A

Dose at 2-3 years then annually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Contraindications for influenza vaccine in children?

A

1) immunocompromised

2) aged < 2 years

3) current febrile illness or blocked nose/rhinorrhoea

4) current wheeze (e.g. ongoing viral-induced wheeze/asthma) or history of severe asthma –> wait until child is better

5) egg allergy

6) pregnancy/breastfeeding

7) if the child is taking aspirin (e.g. for Kawasaki disease) due to a risk of Reye’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What type of vaccine is the influenza vaccine in children?

A

Live

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the most common infective cause of diarrhoea in HIV patients?

A

Cryptosporidium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What investigation may be indicated in Cryptosporidium diarrhoea in HIV?

A

Modified Ziehl-Neelsen stain (acid-fast stain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What may a modified Ziehl-Neelsen stain (acid-fast stain) reveal in Cryptosporidium infection?

A

Characteristic red cysts of Cryptosporidium

41
Q

Mx of Cryptosporidium infective diarrhoea in HIV?

A

Supportive therapy

42
Q

What is the mainstay of treatment of PCP?

A

Co-trimoxazole (trimethoprim + sulfamethoxazole)

43
Q

What organism causes typhoid?

A

Salmonella typhi

44
Q

Features of typhoid?

A
  • systemic upset: headache, fever, arthralgia
  • relative bradycardia
  • abdominal pain, distension
  • constipation (although Salmonella is a recognised cause of diarrhoea, constipation is more common in typhoid)
  • rose spots: present on trunk in 40% of patients
45
Q

What are 3 recognised medical benefits of circumcision?

A

1) reduces the risk of penile cancer

2) reduces the risk of UTI

3) reduces the risk of acquiring sexually transmitted infections including HIV

46
Q

Give 4 medical indications for circumcision?

A

1) phimosis

2) recurrent balanitis

3) balanitis xerotica obliterans

4) paraphimosis

47
Q

What is it important to exclude before circumcision?

A

Hypospadias (as the foreskin may be used in surgical repair)

48
Q

What anaesthetic is circumcision performed under?

A

Local or GA

49
Q

What is Ludwig’s angina?

A

A life-threatening cellulitis which occurs on the floor of the mouth.

Infection is rapidly progressive and can cause potential airway obstruction.

50
Q

Risk factors for Ludwig’s angina?

A

1) Recent infection or injury to area

2) Diabetes

3) Oral malignancy

4) Alcoholism

5) Malnutrition

6) Immunocompromised status

51
Q

What type of pneumonia does a peripheral blood smear showing red blood cell agglutination indicate?

A

Mycoplasma pneumoniae

52
Q

What childhood infection is characterised by a prodrome of irritability, conjunctivitis & fever?

A

Measles

53
Q

What childhood infection is characterised by white spots (‘grain of salt’) on buccal mucosa (Koplik spots)?

A

Measles

54
Q

Which childhood infection can cause vesicles in the mouth and on the palms and soles of the feet?

A

Hand, foot and mouth disease (coxsackie A16 virus)

55
Q

What virus is hand, foot and mouth disease caused by?

A

coxsackie A16 virus

56
Q

What condition are Koplik spots pathognomonic of?

A

Measles

57
Q

When do Koplik spots in measles appear?

A

Appear 1 to 2 days before the onset of the rash and may persist for a further one to two days.

58
Q

Where does rash typically begin in measles?

A

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

59
Q

Where does rash typically begin in rubella?

A

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

60
Q

What is known as ‘slapped cheek syndrome’?

A

Erythema infectiosum caused by parvovirus B19

61
Q

What condition does large swollen tonsils together with a palpable mass in the left hypochondriac region indicate?

A

Infectious mononucleosis

62
Q

Is Scarlet fever a notifiable disease?

A

Yes

63
Q

Features of Hep A?

A
  • flu-like prodrome
  • abdominal pain: typically right upper quadrant
  • tender hepatomegaly
  • jaundice
  • deranged liver function tests
64
Q

What is Kaposi’s sarcoma caused by?

A

HHV-8

65
Q

How does Kaposi’s sarcoma present?

A

Purple papules or plaques on the skin or mucosa (e.g. GI and respiratory tract).

Skin lesions may later ulcerate.

Note - respiratory involvement may cause massive haemoptysis and pleural effusion

66
Q

What is the 1st line HIV screening of asymptomatic individuals or patients with signs and symptoms of chronic infection?

A

Combined HIV antibody/antigen tests e.g. HIV-1/2 Ab/Ag Immunoassay

67
Q

Why is shellfish a common source of hep A?

A

as the virus is transmitted via the faecal-oral route

68
Q

Cirrhosis, malignancy & RHF are 3 common causes of hepatomegaly.

How does the liver feel in RHF?

A

Rirm, smooth, tender liver edge. May be pulsatile.

69
Q

What can acute toxoplasmosis in the immunocompetent patient mimic?

A

Acute EBV infection (low-grade fever, generalised lymphadenopathy with prominent cervical lymph nodes and malaise).

70
Q

What accounts for around 50% of cerebral lesions in patients with HIV?

A

Cerebral toxoplasmosis

71
Q

What is oral hair leukoplakia associated with?

A

EBV infection

72
Q

Is oral hairy leukoplakia malignant?

A

No

73
Q

What is acute epididymo-orchitis in sexually active younger adults most commonly caused by?

A

Chlamydia trachomatis

74
Q

What lymph nodes are typically affected in rubella infection?

A

1) Suboccipital

2) Postauricular

75
Q

What is the strongest risk factor for anal cancer?

A

HPV infection

76
Q

What does triple antiretroviral therapy consist of in HIV?

A

2x nucleoside reverse transcriptase inhibitors (NRTI) + 1x protease inhibitor

77
Q

How often is CD4 count checked in HIV?

A

First diagnosis

Every 3-6 months

78
Q

What is the most common and important viral infection in solid organ transplant recipients?

A

Cytomegalovirus

79
Q

Mx of cytomegalovirus infection in solid organ transplant recipients?

A

Ganciclovir

80
Q

When is the decision made to start Abx without a LP in meningitis?

A

If the LP cannot be done within the first HOUR, give IV Abx after blood cultures have been taken.

81
Q

CSF findings in viral meningitis?

A

Raised lymphocytes & raised proteins

82
Q

What is the steroid of choice in bacterial meningitis?

A

Dexamethasone

83
Q

When should steroids be avoided in bacterial meningitis?

A
  • Septic shock
  • Meningococcal septicaemia
  • Immunocompromised
  • Meningitis following surgery
84
Q

What 2 vaccines are pregnant women offered?

A

Whooping cough (pertussis) + injectable influenza (not nasal - this is a live vaccine)

85
Q

What is the most common cause of viral meningitis in adults?

A

Enteroviruses e.g. Coxsackie B virus

86
Q

If SAH is suspected but a CT head done >6 hours after symptom onset is normal, what should be done next?

A

LP to confirm or exclude the diagnosis

87
Q

What is used as prophylaxis for contacts of patients with meningococcal meningitis?

A

Oral ciprofloxacin (or rifampicin)

But ciprofloxacin is 1st line

88
Q

Fontanelle in meningitis in neonates?

A

Typicall bulging

89
Q

Fontanelle in sepsis in neonates?

A

Typically sunken

90
Q

What condition do Koplik spots indicate?

A

Measles

91
Q

What is the most common complication of measles?

A

Otitis media

(as the respiratory virus can easily spread to the ear canals).

92
Q

What is pituitary apoplexy?

A

Sudden enlargement of a pituitary tumour (usually non-functioning macroadenoma) 2ary to haemorrhage or infarction.

93
Q

What are some precipitating factors for pituitary apoplexy?

A
  • HTN
  • Pregnancy
  • Trauma
  • Anticoagulation
94
Q

features of pituitary apoplexy?

A

1) Sudden onset headache (similar to that seen in SAH)

2) Vomiting

3) Neck stiffness

4) Visual field defects: classically bitemporal superior quadrantic defect

5) Extraocular nerve palsies

6) Features of pituitary insufficiency e.g. hypotension/hyponatraemia 2ary to hypoadrenalism

95
Q

What investigation is diagnostic for pituitary apoplexy?

A

MRI

96
Q

Mx of pituitary apoplexy?

A

1) Urgent steroid replacement due to loss of ACTH

2) Careful fluid balance

3) Surgery

97
Q

What is a dendritic ulcer?

A

An ulcer or inflammation on the cornea caused by HSV-1.

Complication of eczema herpeticum.

98
Q

How can herpetic keratitis be diagnosed?

A

Fluorescein stain –> stained dendritic ulcer.

99
Q
A

Yr 4 - Paediatrics (78 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions