Infection

Question 0

What organisms are commonly the cause of meningitis in neonates?

Answer 0

Group B strep
E-Coli
Staph aureus
Listeria

Question 1

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

Answer 1

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

Question 2

What does the vaccine DTaP/IPV/ HiB

aka the 5in1 vaccine protect against?

Answer 2

Diphtheria 
Tetanus
Pertussis (whooping cough)
Polio
Haemophilia influenza B

Question 3

When is the vaccine DTaP/IPV/ HiB

aka the 5in1 given?

Answer 3

2months
3months
4months

Question 4

What is the success rate of the rota virus vaccination?

Answer 4

70%

Question 5

When do children receive the MMR vaccine?

Answer 5

12-13 months
And
3 years 4 months old

Question 6

What is the incubation of chicken pox?

Answer 6

14-21 days

Question 7

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

Answer 7

Infectious for 5 days

Question 8

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

Answer 8

IV if immunocompromised

Oral if has atopic eczema

Question 9

What virus causes infectious mononucleosis?

Answer 9

Epstein-Barr virus

Question 10

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

Answer 10

Staph aureus
Gonorrhoea
Chlamydia

Question 11

What is opthalmia neonatoum?

Answer 11

A purilent conjunctivitis occurring within 3 weeks of life

Question 12

What virus causes measles?

Answer 12

Paramyxovirus

More specifically the morbillavirus

Question 13

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

Answer 13

Starts behind the ears and spreads across face and trunk.

Question 14

When is measles infective?

Answer 14

4 days before and 4 days after the rash.

Question 14

Why is a vitamin A deficiency bad combined with measles?

Answer 14

At greater risk of blindness and even death - crazy.

Question 15

What is the treatment for measles?

Answer 15

Supportive treatment.

Also it is a notifiable disease

Question 16

Who do you inform if you have a notifiable disease?

Answer 16

Proper office of local health protection team.

Who in turn inform the health protection agency

Question 17

What investigation do you do to identify measles?

Answer 17

Salivary swab or serum sample for measles specific IGM

Taken within 6 weeks

Question 18

What causes diptheria?

Answer 18

Corynebacterium diptheriae

Question 19

What organism causes tetanus?

Answer 19

Clostridium tetani

Question 20

What does tetanus do? Why is it dangerous?

Answer 20

Causes progressive painful muscle spasms

If it involves respiratory muscles can lead to death

Question 21

What can polio cause?

Answer 21

Anterior horn cell damage leading to paralysis and pain.

Question 22

What are the complications of mumps?

Answer 22

Aseptic meningitis, sensorineural deafness, orchitis (infertility)

Question 23

What antibiotic should be avoided in tonsillitis and why?

Answer 23

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

Question 24

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?

Answer 24

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

Question 25

What are the leptomeninges?

Answer 25

The arachnoid and pia mater

Question 26

Name 4 mains symptoms of meningitis in older children

Answer 26

Headache Fever Neck stiffness Altered mental state

Question 27

What is kernings a sign?

Answer 27

Pain on lower leg extension whilst the hip is flexed

Question 28

What is brudzinskis sign?

Answer 28

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

Question 29

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

Answer 29

Group b strep Ecoli Staph a Listeria monocytogenes

Question 30

What are the common bacterial causes of meningitis?

Answer 30

Neisseria meningitidis Strep pneumonia HiB - not so much

Question 31

What happens to proteins to glucose bacterial meningitis?

Answer 31

Protein is raised and glucose is low

Question 32

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

Answer 32

CSF glucose should be two thirds of the serum glucose

Question 33

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

Answer 33

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

Question 34

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

Answer 34

Pneumococcal or meningococcal

Question 35

What are the complications of meningitis?

Answer 35

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

Question 36

What type of bacteria is neisseria meningitidis?

Answer 36

Gram negative diplodocus

Question 37

What type of bacteria is streptococcus pneumonae?

Answer 37

Gram positive alpha haemolytic anaerobe | Grow in grape like clusters

Question 38

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

Answer 38

Meningococcal

Question 39

Commonest cause of sepsis in neonate?

Answer 39

Group B strep

Question 40

Why might myocardial dysfunction occur in sepsis?

Answer 40

Inflamm cytokines and circulating toxins depress myocardial contractility

Question 41

Name two major complications of sepsis?

Answer 41

Multiorgan failure | DIC

Question 42

What signs should you look for in dehydration?

Answer 42

``` Prolonged CRT Abnormal skin turgor Weak pulse Mucous membranes Respiratory pattern Cold peripheries ```

Question 43

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

Answer 43

``` Antidiuretic hormone (adh) (Aka vasopressin) ```

Question 44

Where is ADH released from? | Where does it act?

Answer 44

Released from hypothalamus, acts on kidneys

Question 45

What does ADH do to the urine production?

Answer 45

Less urine produced But increased conc So basically more water is absorbed back into body

Question 46

What infections can cause SAIDH?

Answer 46

Pneumonia | Meningitis

Question 47

Should antibiotics be prescribed for otitis media?

Answer 47

No Just need pain relief

Question 48

What is a delayed antibiotic prescription given in otitis media?

Answer 48

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

Question 49

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

Answer 49

Age less than two with bilateral OM With perforation of discharge in ear canal If less than 3mo or with severe fever consider admission

Question 50

What antibiotics would you prescribe for OM?

Answer 50

5 day course of penicillin

Question 51

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

Answer 51

3 in 6mo | 4 in 12mo

Question 52

What can be done in recurrent OM?

Answer 52

Grommits

Question 53

What is the proper term for grommits?

Answer 53

Tympanostomy tubes

Question 54

Which vaccine is thought to help prevent recurrent otitis media?

Answer 54

Pneumococcal

Question 55

What is the proper term for glue ear?

Answer 55

Otitis media with effusion

Question 56

How is glue ear different to acute otitis media?

Answer 56

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

Question 57

How common is glue ear in children age 2? Age 7?

Answer 57

20% 8%

Question 58

Is glue ear more common in girls or boys?

Answer 58

Boys

Question 59

What is the pneumococcal vaccine given?

Answer 59

2 mo 4 mo 1 year

Question 60

What does DTaP stand for?

Answer 60

Diptheria Tetanus Accellular pertussus

Question 61

What does IPV stand for?

Answer 61

Inactivated polio virus

Question 62

When is the influenza vaccine given?

Answer 62

Age 2 and 3 | Also to high risk children such as those with asthma or immunocompromised

Question 63

How is the influenza vaccine administered in toddlers?

Answer 63

Nasal spray

Question 64

When is the meningitis C vaccine given?

Answer 64

3 months 1 year 14 years

Question 65

When is the pneumococcal vaccine given?

Answer 65

2 months 4 months 1 year (65 years old)

Question 66

What are the vaccines given at 2 months old?

Answer 66

5in1 Pneumococcal Rotavirus

Question 67

What are the vaccines given at 3 months old?

Answer 67

5in1 Men C Rotavirus

Question 68

What are the vaccines given at 4 months old?

Answer 68

5 in 1 | Pneumococcal

Question 69

What vaccines are given at 14 years old?

Answer 69

3 in 1 (diptheria, tetanus, polio) | Men C

Question 70

When is the influenza vaccine given?

Answer 70

Age 2 and 3 | Also to high risk children such as those with asthma or immunocompromised

Question 71

How is the influenza vaccine administered in toddlers?

Answer 71

Nasal spray

Question 72

When is the meningitis C vaccine given?

Answer 72

3 months 1 year 14 years

Question 73

When is the pneumococcal vaccine given?

Answer 73

2 months 4 months 1 year (65 years old)

Question 74

What are the vaccines given at 2 months old?

Answer 74

5in1 Pneumococcal Rotavirus

Question 75

What are the vaccines given at 3 months old?

Answer 75

5in1 Men C Rotavirus

Question 76

What are the vaccines given at 4 months old?

Answer 76

5 in 1 | Pneumococcal

Question 77

What vaccines are given at 14 years old?

Answer 77

3 in 1 (diptheria, tetanus, polio) | Men C