Fever in a Child

Question 1

What are some signs of measles?

Answer 1

Koplik spot
Rash
Conjunctivitis

Question 2

How does the rash present with roseola?

Answer 2

Appears when the fever elapses

Question 3

Which viral infections do you worry about in pregnant women?

Answer 3

Parvo
Rubella
Varicella

Question 4

What do you do in women with exposure to those viruses?

Answer 4

Check vaccination status
Ultrasound
Followup

Question 5

What are the management principles with a fever alone?

Answer 5

In of itself it’s not dangerous
Bringing it down won’t prevent febrile convulsions
Treat if symptomatic

Question 6

When do you worry about a fever?

Answer 6

If it’s been going on for 5 days +

- do an FBE

Question 7

What constitutes a septic screen?

Answer 7

FBE, CRP, UEC, Film, Cultures
Urine MCS
+/- CSF with MCS
+/- CXR

Question 8

What are the empirical abx for septicaemia of unknown origin?

Answer 8

Normal CSF - flucloxacillin and Gent

Unknown CSF - Flucloxacillin and 3rd gen cephalosporin (ceftaxime or ceftriaxone)

Question 9

When does a blood culture come back?

Answer 9

48 hours

Question 10

How long do you treat

Answer 10

Until results are negative

Question 11

What do you need to know about if a patient has a convulsion in the context of an illness?

Answer 11

Focal or generalised - what were the eyes during, facial changes, legs and arms
History of febrile convulsions
Development
Family history of seizure/epilepsy

Question 12

What are the ddx for the causes of febrile convulsion?

Answer 12

Benign
Meningitis, encephalitis
Mass lesion
Bleed

Question 13

What is a febrile convulsion?

Answer 13

Tonic-clonic seizure in the context of febrile illness

Question 14

What do you tell parents about febrile convulsions?

Answer 14

Doesn’t increase chance of epilepsy
Controlling the fever doesn’t prevent them
Call the ambulance if longer than 5minutes or child goes blue
What to do when they occur
See your GP after

Question 15

What are the abx for UTI?

Answer 15

Mild: oral trimethoprim/Bactrim (+/- IM gent)
Severe: IV benpen and gent

Question 16

How do you measure temperature?

Answer 16

Neonate - rectal is best
Tympanic
Forehead
Sublingual

Question 17

At what age do you always investigate a febrile child?

Answer 17

Under 3 months

Question 18

At what age do you always admit and treat a febrile child?

Answer 18

Under 1 month old

Question 19

Up to what age can you do a suprapubic aspirate?

Answer 19

12 months

Question 20

When do you always do urine in a febrile child?

Answer 20

If under 3 months
If over 3 months and unwell
If well but under 12 months (boys) or 2 years (girls)