infection and immunity

Question 1

immunisation schedule
6 in 1?

Answer 1

diphetheria,
tetanus,
whooping cough,
polio,
Hib and
hepatitis B

2 month!!
3 months!!

Question 2

Men B vaccine schedule?

Answer 2

2, 4, 12,13 months

Question 3

4 in 1 pre shcool?

Answer 3

diphtheria, tetanus, whooping cough and polio

3/4 years old

Question 4

MMR

Answer 4

12 month
3/4

Question 5

caput succedaneum does not cross suture lines?

Answer 5

false it does
localised oedema

Question 6

Amber signs for circulation and hydration in an unwell feverish child

Answer 6

tachycardia which is defined as
>160 in less than 1 year old
>150 upto 2 year old
>140 if 2-5

poor feeding
reduced urine output
dry mucus membrane
crt >3s

Question 7

Red sign in feverish child
circulation and hydration

Answer 7

reduced skin turgor

Question 8

Red sign in feverish child respiratory

Answer 8

grunting
RR>60
chest indrawing

Question 9

Amber sign - feverish child
Respiratory

Answer 9

nasal flaring
tachypnoea >50
>40

oxygen sats of 95
crackles in chest

Question 10

Red sign- feverish child
Colour

Answer 10

pale
mottled
ashen
blue

Question 11

when should you consider hospital admission if amber signs ?

Answer 11

<3 months UTI with no other focus
no underlying cause of fever

test for UTI
CXR
consider LP <12months

Question 12

malaria management?
uncomplicated

Answer 12

Artemisinin combination therapy

chloroquinine
hydroxychloroquine

Question 13

rash
cough
fever
conjunctivitis

Answer 13

measles

Question 14

what was the autism link to vaccines?

Answer 14

wakefield study - poorly designed
small sample size 12

Question 15

complications of measles

Answer 15

pneumonia
encephalitis
SSPE - subacute sclerosing panencephalitis

Question 16

symptomatic paracetamol / ibruprofen dose

Answer 16

10-15mg/kg
5-10mg/kg

Question 17

what is staphylococcal scalded skin syndrome

Answer 17

rare
severe
blistering skin disorder

exotoxin causes this to occur

Question 18

mx of SSSS?

Answer 18

hospital admission
mx is staph aureus antibiotic flucloxacillin

analgesia
emollient
iv fluids

Question 19

parovirus b19
associated with?

Answer 19

aplastic anaemia
so sometimes you need RBC transfusion

Question 20

scarlet fever management?
cause?

Answer 20

group A streptoccous pyogenes
10 days phenoxymethylpenicillin

Question 21

how is the measles rash described?

Answer 21

macular (flat) red (exanthema)

Question 22

what does a rubella infection present like?

Answer 22

low grade fever
sore throat
rash that starts on face > body

spotty red rash
lymphadenopathy may precede

Question 23

kawasaki management?

Answer 23

IVIG
high dose aspirin
2nd line is steroids and infliximab (inhibits tnf-alpha)

do an Echo - coronary artery aneurysm (high risk then give aspirin and warfarin treatment maybe)

Question 24

acute otitis media
what is it?

Answer 24

painful ear infection

bacetrial superinfection with streptoccus pneumoniae
h influenzae
moraxella catarrhalis following a URT viral

Question 25

signs / symptoms of acute otitis media?

Answer 25

otalgia fever anorexia middle ear inflammation signs erythema / bulging tympanic membrane

Question 26

mx of acute otitis media?

Answer 26

if mild - supportive otherwise amoxicillin

Question 27

how is sinusitis managed?

Answer 27

reassure <10 days (usually viral) high dose intranasal steroid consider backup abx