high yield- viral/ bacterial infections Flashcards
how does meningitis present in general + in neonates?
SPECIFIC TO NEONATES:
- bulging fontanelle
- hypothermia
- poor feeding
- hypotonia
GENERAL:
- NON BLANCHING RASH
- neck stiffness
- photophobia
- fever
- vomiting
- loss of consciousness + seizures
tests for suspected meningitis?
Kernigs Test: (Kernigs= Knee)
+ve test= pain
-bend knee 90 degrees, slowly stretch
Brudkinskis Test
+ve test= involuntary flexion of hip + knee
-patient lies down and brings chin to chest
LUMBAR PUNCTURE!! (between L3-L4)
Appearance of bacteria, viral and TB cause of meningitis on lumbar puncture?
Bacteria= cloudy Viral= clear TB= cloudy
protein in sample from lumbar puncture of bacteria, viral and TB cause of meningitis?
bacteria= low viral= normal TB= low
glucose in sample of lumbar puncture in patient with bacterial, viral or TB meningitis?
bacterial= low
viral= normal
TB=low
WCC in sample from lumbar puncture of someone with bacterial, viral or TB meningitis?
bacterial= High (neutrophils) Viral= high (15-1000 lymphocytes) TB= high (30-300 lymphocytes)
bacteria culture of lumbar puncture for bacterial, viral or TB meningitis
bacteria= bacteria in culture viral= no bacteria TB= bacteria in culture
cause of meningitis 0-3 months?
GEL
Group B strep (specific <3 months)
E.coli (specific <3 months)
L. monocytogens (also found >60 years and immunocompromised)
cause of meningitis 3months- 6 years?
H. influenza (only found in 3 months- 6 years)
N. meningitidis
Strep. pneumoniae
cause of meningitis 6-60 years?
N. meningitis
Strep. pneumoniae
cause of meningitis >60 years?
N. meningitidis
Strep. pneumoniae
L. monocytogenes (only found in <3 months, >60 years and immunocompromised)
meningitis treatment community GP?
call 999
administer IM or IV benzylpenicillin
POST EXPOSURE:
-rifampicin + ciprofloxacin (ciprofloxacin is preferred)
(we cam Really Close to catching meningitis)
meningitis treatment hospital?
- Lumbar puncture
- Bloods for culture
<3 months amoxicillin + cefotaxime
>3 months cefTRIaxone + dexamethasome
(only give dexamethasome if bacteria)
causes of UTI?
E.coli (80%):
-gram neg rod shaped anaerobe, coliform bacterium
Vesicoureteric reflux (35%)
treatment for lower UTI?
<3 months= amoxicillin + genatmycin
>3 months= trimethoprim + notrofurentoin
cause of measles?
RNA virus
-paramyxovirus
presenation of measles?
- Kolpik spots (white spots on buccal mucosa)
- Rash starts behind ears and spreads across body
mEARsles
treatment for measles?
- tell public health
- supportive
most common complication from measles?
otitis media
most common cause of death from measles?
pneumonia
what may occur 1-2 week after exposure to measles?
encelopathy
cause of rubella?
togavirus
presentation of rubella?
- fever
- pink/ red maculopapular rash on face + body
- lymphadenopathy
when is fetus at highest risk of rubella and why?
first 8-10 weeks of pregnancy
Rubella is a TRCH organism and so can cause cerebral palsy
cause of scarlet fever?
group A strep pyogenes
scarlet fever presentation?
- strawberry tongue
- fine punctuate erythema (rash) that starts on trunk and spares to soles, palms and around the mouth
- sore throat
Scarlet fevere, Sore throat, Strawberry tongue
treatment for scarlet fever?
- oral penicillin (10 days)
- notify public health
- can return to school 24 hours after antibiotics start
cause of chickenpox?
varicella zoster
presentation of chicken pox?
- brief fever
- very itchy rash
macular> papular> vesicles > scabs
treatment to stop chicken pox itch?
-Calamine lotion
‘calmine calms the itch’
cause of mumps?
paramyxovirus
presentation mumps?
- fever, fatigue
- parotitis (earache/ pain on eating)
treatment for mumps?
-rest + paracetamol
complication post pubertal males with mumps?
Orchiditis (inflammation of testes)
cause of erythema infectiosum (slapped cheeks)?
Parvovirus B19
presentation erythema infectiosum?
- red cheeks
- erythema on face, proximal + extensor surfaces
complications of erythema infectiosum?
- sickle cell anaemia (sickle cell crisis)
- aplastic anaemia
- spontaneous abortions in pregnancy <20wks
cause of hand, foot and mout?
Coxsackie virus A16
treatment for hand, foot and mouth?
self limiting
goes away after about 1 week