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Paediatrics > Infection > Flashcards

Infection Flashcards

0
Q

What organisms are commonly the cause of meningitis in neonates?

A

Group B strep
E-Coli
Staph aureus
Listeria

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1
Q

What organism causes meningitis in children 3 month to 5 yo?

A

Meningococcus (N. Meningitidis)
Pneumococcus (strep. Pneumonae)
And???

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2
Q

What does the vaccine DTaP/IPV/ HiB

aka the 5in1 vaccine protect against?

A 
Diphtheria 
Tetanus
Pertussis (whooping cough)
Polio
Haemophilia influenza B
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3
Q

When is the vaccine DTaP/IPV/ HiB

aka the 5in1 given?

A

2months
3months
4months

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4
Q

What is the success rate of the rota virus vaccination?

A

70%

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5
Q

When do children receive the MMR vaccine?

A

12-13 months
And
3 years 4 months old

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6
Q

What is the incubation of chicken pox?

A

14-21 days

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7
Q

How long after the onset of the rash in chicken pox is the child infectious?

A

Infectious for 5 days

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8
Q 
When might you give a child which chickenpox
IV
Or 
oral
Aciclovir
A

IV if immunocompromised

Oral if has atopic eczema

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9
Q

What virus causes infectious mononucleosis?

A

Epstein-Barr virus

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10
Q

Neonatal conjunctivitis is a notifiable disease. What organisms cause it?

A

Staph aureus
Gonorrhoea
Chlamydia

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11
Q

What is opthalmia neonatoum?

A

A purilent conjunctivitis occurring within 3 weeks of life

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12
Q

What virus causes measles?

A

Paramyxovirus

More specifically the morbillavirus

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13
Q

Where does the rash start in measles? And how does it spread?

A

Starts behind the ears and spreads across face and trunk.

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14
Q

When is measles infective?

A

4 days before and 4 days after the rash.

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14
Q

Why is a vitamin A deficiency bad combined with measles?

A

At greater risk of blindness and even death - crazy.

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15
Q

What is the treatment for measles?

A

Supportive treatment.

Also it is a notifiable disease

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16
Q

Who do you inform if you have a notifiable disease?

A

Proper office of local health protection team.

Who in turn inform the health protection agency

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17
Q

What investigation do you do to identify measles?

A

Salivary swab or serum sample for measles specific IGM

Taken within 6 weeks

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18
Q

What causes diptheria?

A

Corynebacterium diptheriae

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19
Q

What organism causes tetanus?

A

Clostridium tetani

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20
Q

What does tetanus do? Why is it dangerous?

A

Causes progressive painful muscle spasms

If it involves respiratory muscles can lead to death

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21
Q

What can polio cause?

A

Anterior horn cell damage leading to paralysis and pain.

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22
Q

What are the complications of mumps?

A

Aseptic meningitis, sensorineural deafness, orchitis (infertility)

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23
Q

What antibiotic should be avoided in tonsillitis and why?

A

Amoxicillin

Because if it is caused by ebv then may cause widespread rash

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24
Q

If a child has signs and symptoms of meningitis and the CSF have signs of bacterial infection but nothing grows in culture what may have happened?

A

The child may have had oral antibiotic tx leading up to the lumbar puncture

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25
Q

What are the leptomeninges?

A

The arachnoid and pia mater

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26
Q

Name 4 mains symptoms of meningitis in older children

A

Headache
Fever
Neck stiffness
Altered mental state

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27
Q

What is kernings a sign?

A

Pain on lower leg extension whilst the hip is flexed

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28
Q

What is brudzinskis sign?

A

When the neck is flexed the child flexes knee and hip involuntarily

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29
Q

What are the most common cause of meningitis in neonates (up to 3 month)?

A

Group b strep
Ecoli
Staph a
Listeria monocytogenes

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30
Q

What are the common bacterial causes of meningitis?

A

Neisseria meningitidis
Strep pneumonia
HiB - not so much

31
Q

What happens to proteins to glucose bacterial meningitis?

A

Protein is raised and glucose is low

32
Q

What is the normal ratio between glucose in CSF and the blood stream?

A

CSF glucose should be two thirds of the serum glucose

33
Q

What cells would you see in CSF in bacterial or viral meningitis?

A

Bacterial - neutrophils
Viral - lymphocytes
( although bacterial infection may start with high neutrophils)

34
Q

Which of the 2 main bacterial causes are more likely to cause neurological impairment post meningitis infection?

A

Pneumococcal or meningococcal

35
Q

What are the complications of meningitis?

A 
Hearing loss 
Local vasculitis leading to cranial nerve palsys or focal lesions 
Seizures/ epilepsy
Sub dural effusion
Hydrocephalus 
Cerebral abscess
36
Q

What type of bacteria is neisseria meningitidis?

A

Gram negative diplodocus

37
Q

What type of bacteria is streptococcus pneumonae?

A

Gram positive alpha haemolytic anaerobe

Grow in grape like clusters

38
Q

What sis the most common cause of septic shock in children?

A

Meningococcal

39
Q

Commonest cause of sepsis in neonate?

A

Group B strep

40
Q

Why might myocardial dysfunction occur in sepsis?

A

Inflamm cytokines and circulating toxins depress myocardial contractility

41
Q

Name two major complications of sepsis?

A

Multiorgan failure

DIC

42
Q

What signs should you look for in dehydration?

A 
Prolonged CRT
Abnormal skin turgor
Weak pulse
Mucous membranes 
Respiratory pattern 
Cold peripheries
43
Q

After an infection SAIDH can occur, what hormone is increased?

A 
Antidiuretic hormone (adh) 
 (Aka vasopressin)
44
Q

Where is ADH released from?

Where does it act?

A

Released from hypothalamus, acts on kidneys

45
Q

What does ADH do to the urine production?

A

Less urine produced
But increased conc

So basically more water is absorbed back into body

46
Q

What infections can cause SAIDH?

A

Pneumonia

Meningitis

47
Q

Should antibiotics be prescribed for otitis media?

A

No

Just need pain relief

48
Q

What is a delayed antibiotic prescription given in otitis media?

A

Can be collected if child had not improved within 4 days or gets worse

49
Q

Who would you give antibiotics too in children with otits media?

A

Age less than two with bilateral OM

With perforation of discharge in ear canal

If less than 3mo or with severe fever consider admission

50
Q

What antibiotics would you prescribe for OM?

A

5 day course of penicillin

51
Q

How many episodes do you have to have to have recurrent OM?

A

3 in 6mo

4 in 12mo

52
Q

What can be done in recurrent OM?

A

Grommits

53
Q

What is the proper term for grommits?

A

Tympanostomy tubes

54
Q

Which vaccine is thought to help prevent recurrent otitis media?

A

Pneumococcal

55
Q

What is the proper term for glue ear?

A

Otitis media with effusion

56
Q

How is glue ear different to acute otitis media?

A

In glue ear there is fluid in the middle ear but no symptoms or signs of acute inflammation

57
Q

How common is glue ear in children age 2?

Age 7?

A

20%

8%

58
Q

Is glue ear more common in girls or boys?

A

Boys

59
Q

What is the pneumococcal vaccine given?

A

2 mo
4 mo
1 year

60
Q

What does DTaP stand for?

A

Diptheria
Tetanus
Accellular pertussus

61
Q

What does IPV stand for?

A

Inactivated polio virus

62
Q

When is the influenza vaccine given?

A

Age 2 and 3

Also to high risk children such as those with asthma or immunocompromised

63
Q

How is the influenza vaccine administered in toddlers?

A

Nasal spray

64
Q

When is the meningitis C vaccine given?

A

3 months
1 year
14 years

65
Q

When is the pneumococcal vaccine given?

A

2 months
4 months
1 year

(65 years old)

66
Q

What are the vaccines given at 2 months old?

A

5in1
Pneumococcal
Rotavirus

67
Q

What are the vaccines given at 3 months old?

A

5in1
Men C
Rotavirus

68
Q

What are the vaccines given at 4 months old?

A

5 in 1

Pneumococcal

69
Q

What vaccines are given at 14 years old?

A

3 in 1 (diptheria, tetanus, polio)

Men C

70
Q

When is the influenza vaccine given?

A

Age 2 and 3

Also to high risk children such as those with asthma or immunocompromised

71
Q

How is the influenza vaccine administered in toddlers?

A

Nasal spray

72
Q

When is the meningitis C vaccine given?

A

3 months
1 year
14 years

73
Q

When is the pneumococcal vaccine given?

A

2 months
4 months
1 year

(65 years old)

74
Q

What are the vaccines given at 2 months old?

A

5in1
Pneumococcal
Rotavirus

75
Q

What are the vaccines given at 3 months old?

A

5in1
Men C
Rotavirus

76
Q

What are the vaccines given at 4 months old?

A

5 in 1

Pneumococcal

77
Q

What vaccines are given at 14 years old?

A

3 in 1 (diptheria, tetanus, polio)

Men C

Paediatrics (12 decks)

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