immunology paeds Flashcards
immunisations at 2 months
dtap polio hib rota pneumo hep b men b
immunisations at 3 months
dtap polio hib rota men c
immunisations at 4 months
dtap polio hib pneumo men b
immunisations at 1 year
hib mmr men b pneumo
immunisations 2-8
influenza
immunisations 3-4
dtap polio mmr
immunisations at 12-13
hpv
immunisations at teens
dtp men ACWY
live vaccines to not be used
bcg mmr influ yellow fever typhoid dtap
innactivated vaccines
rubella influenza
HAVE EGGS
mmr and influ
broad spec antibiotics in those less than 3 months
ceftriaxone
broad spec antibiotics in those more than 3 months
cefotaxime
prophylaxisis to kissing contacts
rifampicin
if lp contraindicated in mengitis what to do
ct
lp signs in bac men
cloudy appearance, neutrophils but dec glucose
lp sign sign tb men
clear appearance with really elevated protein and really dec glucose
lp signs in viral men
clear or haxy appearnace with lymphocytes like in tb but the glucose will be normal here
six causes of purpura
hsp, thrombocytopenia, steroids, DIC, Haemophilla, mengiococcal
hsp causes fatalities to this organ and how
renal by caussing nephrotoc syn thereofre they will reg need urine dipstick to monitor it
whats the rash of hsp like
is systemic erythematous macular rash on legs and bum ooh
rash of thrombocytopenia
widespread and they bleed from nose and purpruic membrane
baby boy with excessive bleeding prolonged time following tooth removal
haemophillia
complication of haemophillia
haemarthosis- bleed into joint and fdamage it
treat haemhorrhage in haemophilia
factor replacement
the blood film of DIC patient
haemolytic anaemia fragmented RBC and abnormal coag screen therefore FBC so important to check - first line for this purpura stuff
first line invx for purpura stuff
FBC
differnece between purpura and petichiae
purpura is lager non blanching rash than petichiae
HSP WHAT IS IT
throught to be some kind of igA vasculitis
what number for the platelets would require transfusion
<20
anaemia in purpura
hypochromic microcytic
which lp result has high opening pressures
bacterial
broad spec antibiotic in more than 3 months old
ceftriaxone
contacts recieve what as prophylaxis
ciprofloxacin
Mumps management
ribavirin
centor criteria
FENT FEVER EDEMA NO COUGH TENDER LYMPHNODES
more than one makes likely toto be group A strep
Chickenpox treatment and when is it infected till
Calamine lotion and chloramphenamine
infective until lesion is crusted over
Complication of group A strep
rheumatic fever causing polyarthritic arthritis then mitral stenosis
major criteria in Rheumatic fever (2 of this needed or one of this)
JONES JOINT INVOLVMENT O LOOKS LIKE A O MYOCARDITIS N- NODULES SUBCUTAEOUS Erythema marginatum S sydenhams chorea
minor criteria rheumatic fever (one of this or two of major one of minor needed)
CAFE PAL C crp increased A arthralgia F fever E elevated ESR
p - prolonged PR
a - ANAEMESIS RHEUMATIS
LEUKOCYTOSIS
Measles prodrome
irritable fever conjunctivitis
then
KOPLICK spots in mouth
measles rash spread
starts behind the ‘easles’ (ears) then spreas to whole body
Slapped chick fifith disease and erythema infectiosum rash spread
slapped check rash spreads to arms and extensor surfaces
Which disease is a rash that spares the face?
scarlet fever - occurs after a group A haemolytic streptococci infection as it is a reaction to the toxins produced by this bacteria
Which disease causes a strawberry tongue ?
scarlet fever - yahhhh
disease with 24 hr after antibotics exclusion
scarlet fever
school exclusion criteria for whooping cough
2 days after antibiotics ( 21 days from onset of symptoms if no antibiotics)
School exclusion criteria for measles and rubella
4 days from onset of rash
school exclusion criteria for chickenpox
5 days from onset of rash
school exclusion criteria for 5 days from onset of swollen glands
mumps
school exclusion critia for imeptigo
untill lesions have crusted over
which disease is the exclusion criteria until treated
scabies
Which disease is the exclusion criteria untill recovered
influenza
Features of moderate croup
barking cough
stridor
some resp distress- sternal wall retractions
but no agitation
the child is concentrating still interested in the surroundings
Features of severe croup
frequent bark cough
prominent stridor
resp distress - sternal wall retractions
significant distress and agitation
TACHYCARDIA AND HYPOXAEMIA - differentiates severe from moderate
Treatment of moderate and severe croup
admission
admit also if 6 months old, upper airway abnormalities (laryngomalacia, DS)
uncertain diagnosis with differentials that are serious like epiglottitis
What does everyone with croup reieve
single dose oral dexamethasone
Septic screen contents for < 3 months old
FBC Blood cultures crp urine check chest xray stool culture
Fraser guidlines (5)
young person
- understand the professional advice
- cannot be persuaded to inform parents
- likely to being or continue having sex without contrceptin
- if they dont recieve the contraception their physical or mental health are likely to suffer
- young persons best intersts are needed to recieve contraception advice and contraception without their parental consent
Can you accept that a compentent child refusal to be treated
no you can treat in best interest
