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Paediatrics > Infection, Inflammation and Fever > Flashcards

Infection, Inflammation and Fever Flashcards

1
Q

What are the vascular causes for fever in children?

A

Kawasacki Syndrome, Systemic Erythematous Lupus and Juvenile Idiopathic Arthritis

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2
Q

What are the inflammatory/infection causes for fever in children?

A

Everything! Chest infections, meningitis/encephalitis, skin infections (cellutitis and impetigo), gastroenteritis, UTIs

Inflammatory Bowel Disease, Coeliac Disease

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3
Q

What are the autoimmune causes for fever in children?

A

Systemic Erythematous Lupus and Juvenile Idiopathic Arthritis

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4
Q

What are the iatrogenic or idiopathic causes for fever in children?

A

Drug reactions

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5
Q

Questions to ask to localise a fever for Central Nervous System disease?

A

Any visual changes?

Any bright lights, or not being able to handle the light?

Do any positions make head pain worse?

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6
Q

Questions to ask to localise a fever for ENT?

A

Is the child pulling their ear?

Is the ear looking inflamed?

Have they experienced difficulty swallowing or denying food?

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7
Q

Questions to ask to localise a fever for respiratory disease

A

Cough? Productive?

Stridor?

Breathlessness?

Recession and increased work of breathing?

Cyanosis?

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8
Q

Questions to ask to localise a fever for abdominal disease?

A

Change in bowel habits (diarrhoea)?

Vomiting?

Abdominal pain?

Jaundice or icterus?

Distension?

Changes to stool colour, consistency etc?

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9
Q

Questions to ask to localise a fever urinary disease?

A

Dysuria, frequency, urgency?

Changes to colour of urine?

Changes to smell of urine?

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10
Q

Questions to ask to localise a fever to joint disease?

A

Swellings in the joints?

Red, painful joints?

Struggling to move in that region?

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11
Q

Physical signs of dehydration in children?

A

Sunken fontanelle, tachycardia, dry mucous membranes, reduced skin turgor

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12
Q

What is Kernig’s Sign?

A

Signs of meningitis

An inability to straighten the leg when the hip s flexed at 90oC

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13
Q

What does IO stand for paediatric management?

A

Interosseous

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14
Q

What do the lumbar puncture results for normal children look like?

A

Low neutrophils

Low Lymphocytes

<1.0 Protein

> 0.6 Glucose

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15
Q

What do the lumbar puncture results for bacterial meningitis in children look like?

A

High neutrophils (but may be normal)

Low lymphocytes

High Protein (>1.0)

<0.4 Glucose

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16
Q

What do the lumbar puncture results for viral meningitis in children look like?

A

Low neutrophils

High lymphocytes (but may be normal)

Low to normal Protein (0.4-1.0)

Normal glucose

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17
Q

What do the lumbar puncture results for TB meningitis in children look like?

A

Low Neutrophils

High lymphocytes

High protein

Low to normal Glucose

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18
Q

Common causes of bacterial meningitis ages 0-3 months?

A

Group b Streptococcus

E.coli

Listeria monocytogenes

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19
Q

Common causes of bacterial meningitis ages 3 months - 5 years?

A

Niesseria Meningitides

Streptococcus penumoniae

Haemophilus Influenza B (same thing that causes epiglottitis)

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20
Q

Common causes of bacterial meningitis ages over 5 years?

A

Niesseria Meningitides

Streptococcus penumoniae

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21
Q

What are the common causes for viral meningitis?

A

Enteroviruses

But it can be caused by many other viruses

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22
Q

Which steroid is used in bacterial meningitis for some serious cases?

A

Dexamethasone

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23
Q

What are the indications for the use of dexamethasone in bacterial meningitis?

A

Frank purulent pus

CSF white cell count >1000/mcL (very high)

Above result, with >1g Protein

Bacteria on gram stain

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24
Q

What are some reasons not to do a lumbar puncture?

A

Evidence of raised intracranial pressure

Child is too unstable

Extensive or spreading purpuric rash

Bleeding disorder

Infection at site of proposed LP

25
Q

What is the go to antibiotic for bacterial meningitis over 3 months old?

A

Ceftriaxone

26
Q

What is Kawasaki’s Disease?

A

Vasculitis of unknown aetiology. It causes multi-system involvement and inflammation of the small to medium sized arteries which results in aneurysms.

27
Q

Which ages does Kawasaki’s Disease mainly affect?

A

Less than 5 years old

(Peak incidence between 2 and 3 years old)

28
Q

How many phases are there for Kawasaki’s Disease and what are these phases called?

A

3

Acute

Subacute

Convalescent

29
Q

How long does the acute phase of Kawasaki last?

A

1 - 2 weeks

30
Q

What happens during the acute phase of Kawasaki Disease?

A

Hectic fever - really bad, unresolvable fever

Conjunctival erythema

Dry, cracked lips

Strawberry Tongue

31
Q

What happens during the subacute phase of Kawasaki Disease?

A

Fever resolves

Desquamation of the skin (fingers and toes)

Platelet count increases

Coronary artery aneurysms

32
Q

Hwo long is the subacute phase of Kawasaki?

A

2 weeks

33
Q

What marks the beginning of the Convalescent phase of Kawasaki?

A

The disappearance of the symptoms seen in the first two phases

34
Q

What are the main treatments for Kawasaki Disease?

A

Intravenous immunoglobulins (IVIG)

Aspirin

35
Q

What are the clinical features of Toxic Shock Syndrome?

A

Fever, coryzal symptoms, including headache, exhaustion, aching body

36
Q

How is Toxic Shock Syndrome (TSS) managed?

A

IV fluids

IV antibitoics

37
Q

What bacteria is Scarlet Fever caused by?

A

Group B streptococcus

38
Q

What are the symptoms of Scarlet Fever?

A

Fever

Sore throat

Strawberry tongue

Sandpaper rash

(malaise, headache, nausea and vomiting)

39
Q

How is Scarlet Fever managed?

A

Penicillin [or Azithromycin is penicillin-allergic]

40
Q

What is Henoch-Schonlein Purpura?

A

IgA Vasculitis

Inflammation of the small blood vessels that causes a petechial/purpuric rash

41
Q

What is a common complication of Iga Vasculitis (Henoch-Schonlein Purpura)?

A

Kidney disease (glomerulonephritis) - IgA Nephritis

42
Q

What are the clinical features of henoch-schonlein purpura?

A

Petechial/Purpuric rash

Swollen joints (Arthralgia)

Kidney problems

Abdominal/GI involvement

43
Q

What is the most common preceeding illness to Henoch-Schonlein Purpura?

A

Upper respiratory infection (possibly triggering abnormal IgA activation)

44
Q

How is HSP (henoch-schonlein purpura) managed?

A

Steroids [namely Prednisolone]

Azathioprine (5-ASA)

45
Q

What is the organism that causes Measles?

A

Single stranded RNA Paromyxovirus

46
Q

What happens in Measles

A

The organism infects the upper airway and the surrounding lymph nodes

47
Q

What are the clinical features of Measles?

A

Fever, conjunctivitis, coryza, cough and Koplik Spots (on the back of the throat)

48
Q

How many phases of Measles are there

AND

What are they called?

A

4

Incubation

Prodromal

Exanthematous

Recovery

49
Q

How is Measles managed?

A

Routine support care

Fluids and antipyretics

50
Q

What is in a full paediatric SEPSIS screen?

A

FBC

CRP (LP if this is greater than 10)

Blood cultures

ECG

Throat swab

51
Q

What does a skin biopsy of Henoch-Schonlein Vasculitis show?

A

Leukocytoclastic vasculitis with IgA deposition

52
Q

What is Immune Thrombocytopenic Purpura?

A

Purpura that is caused by destruction of criculating platelets in the body, by the body’s own immune system, leading to bleeding.

53
Q

What are the clinical features of Immune Thrombocytopenic Purpura?

A

Purpuric rash

Epistaxis or other mucosal bleeding

(Intracranial bleeding, however this is not common)

54
Q

What is the organism that causes Lyme Disease?

A

Borrelia burgdorferi (bacteria)

55
Q

What is the classical sign of Lyme Disease?

A

Erythema Chronicum Migrans

56
Q

What disease does Parvovirus characteristically cause?

A

Slapped Cheek Syndrome

57
Q

What is the distinct Newborn test done of their 5th day of life?

A

Guthrie Heel Prick Test

This tests for many different conditions such as Cystic Fibrosis, PKU, SCID, Sickle Cell and Congential hypothroidism. some other disease are identified as well.

58
Q

Which antibiotic is given to a child with bacterial tonsilitis?

A

Phenoxymethylpenicilin (if they aren’t allergic to penicillin)

Clarithyromycin (if they are allergic to penicillin)

59
Q

What does a ToRCHS Screen look for?

A

Toxopalsmosis

Rubella

Cytomegalovirus

Herpes Simplex Virus

Syphillis

Paediatrics (10 decks)

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