Infection

Question 1

presentation of chicken pox

Answer 1

fever initially
itchy rash starting on head/trunk before spreading
initially macular then papular then vesicular

Question 2

fever, irritable, conjunctivitis is a prodrome for which infection

Answer 2

measles

Question 3

koplike spots

Answer 3

white spots on buccal mucosa

- measles

Question 4

maculopapular rash becoming confluent and blotchy

- what infection?

Answer 4

measles

Question 5

presentation of mumps

Answer 5

fever, malaise, muscular pain

parotitis - earache/pain on eating (unilateral then bilateral)

Question 6

presentation of rubella

Answer 6

pink maculopapular rash initially on face then spread to body
occipital/post auricular lymphadenopathy

Question 7

what causes erythema infectiosum

Answer 7

parvovirus b19

Question 8

presentation erythema infectiosum

Answer 8

‘slapped cheek’- rash on face

fever, lethargy, headache

Question 9

cause of hand, foot + mouth

Answer 9

coxsackie A16 virus

Question 10

fine punctate erythema sparing the area around the mouth

Answer 10

scarlet fever

Question 11

what causes scarlet fever

Answer 11

a reaction to erythrogenic toxins produced by Group A haemolytic streptococci

Question 12

roseola infantum is caused by what infection

Answer 12

human herpes virus 6

Question 13

presentation of roseola infantum

Answer 13

high fever followed later by maculopapular rash (typically 3 days of fever, rash appears on 4th day)

• Nagayama spots: papular enanthem on the uvula and soft palate
• diarrhoea + cough also common

Question 14

most common cause of meningitis in neonates

Answer 14

Group B strep

Question 15

most common cause of meningitis in older children

Answer 15

Neisseria meningitides

Strep. Pneumoniae

Question 16

symptoms of meningitis

Answer 16

fever 
neck stiffness
vomiting
headache
photophobia
altered consciousness / seizures

neonates can present with bulging fontanelles, poor feeding, lethargy, hypotonia - ‘floppy baby’

Question 17

what is meningococcal septicaemia?

what are the clinical signs?

Answer 17

meningococcal infection has entered the bloodstream

- NON BLANCHING RASH

Question 18

What is kernig’s test?

Answer 18

tests for meningeal irritation – indicative of meningitis

• get patient to lie on back and flex hip + knee, then straighten knee keeping hip flexed
• stretches meninges – causes pain in meningitis

Question 19

investigation of meningitis

Answer 19

lumbar puncture at L3/L4 vertebral level

• bacterial: cloudy, high protein, low glucose, high neutrophils
• viral: clear, high lymphocytes, normal protein + glucose

Question 20

management of meningitis in child

• < 3 months
• > 3 months

Answer 20

< 3 months: cefotaxime + amoxicillin

> 3 months: ceftriaxone + steroids (dexamethasone 4 x daily)

Question 21

how long should a child with chickenpox be kept off school for

Answer 21

until all the lesions have crusted over

Question 22

how long should a child with whooping cough be kept off school for

Answer 22

2 days after commencing antibiotics or 21 days from onset of symptoms if no antibiotics given

Question 23

how long should a child with scarlet fever be kept off school for

Answer 23

24 hours after commencing antibiotics

Question 24

what infections do not require school exclusion

Answer 24

conjunctivitis 
slapped cheek 
Roseola 
Infectious Mononucleosis 
Hand Foot + Mouth

Question 25

how long should a child with D + V be kept off school for

Answer 25

until symptoms have settled for 48 hours

Question 26

how long should a child with mumps be kept off school for

Answer 26

5 days from onset of swollen glands

Question 27

how long should a child with measles or rubella be kept off school for

Answer 27

4 days from onset of rash

Question 28

most common complication of measles

Answer 28

otitis media

Question 29

presentation of sclarlet fever

Answer 29

fever, sore throat, strawberry tongue, flushed, ‘sandpaper’ rough rash

Question 30

tx of scarlet fever

Answer 30

penicillin 10 days

Question 31

what is a contraindication to LP in suspected meningitis

Answer 31

meningococcal septicaemia - blood culture + PCR instead 
any sign of raised ICP:
- papilloedema
- focal neurological signs 
- disseminated intravascular coagulation

Question 32

most common cause of death in children with measles

Answer 32

pneumonia