Infections Flashcards
1
Q
What are five bacterial causes of Meningitis?
A
- Neisseria meningitidis
- Strep. pneumonia
- Haemophilus influenzae type B
- Group B strep (newborn)
- E. coli and listeria (newborn)
2
Q
What are five viral causes of Meningitis?
A
- Mumps
- Coxsackie
- HSV
- Echovirus
- Poliomyelitis
3
Q
What is the Kerning’s sign?
A
- Unable to straighten leg greater than 135degrees without pain while lying down
4
Q
Give 8 signs/symptoms of meningitis
A
- Fever
- Headache
- Neck stiffness
- Photophobia
- Positive Kernig’s sign
- Bulging fontanelle
- Petechial/purpuric rash
- Convulsions
5
Q
What blood marker is raised in viral meningitis?
A
- Lymphocytes = 10-1000
6
Q
What CSF markers are raised in bacterial meningitis?
A
- Neutrophils = 100-10,000
- Protein = >1
- Lymphocytes = >100 (not that raised
7
Q
What investigations would you perform for meningitis suspicion?
A
- DO NOT WAIT TO PRESCRIBE ABX
- Lumbar puncture
- FBC, U+Es, Culture
- Glucose
- CRP
- CXR
- Urine
8
Q
What would you treat community acquired meningitis/purpura with?
A
- IM benzyl penicillin
9
Q
What intravenous medication would you give to treat meningitis for <3months and >3months?
A
- IV Cefotaxime <3months + ampicillin or amoxicillin
- IV Ceftrioxone >3 months
- ± benzyl penicillin - in community
10
Q
What social precautions do you need to take when dealing with meningitis?
A
- Inform public health
- Prophylaxis of rifampicin to household contacts
11
Q
What other Ddx could there be for meningitis?
A
- Subarachnoid Haemorrhage
- Tonsilitis
- Pneumonia
12
Q
What are the 2 types of Purpura?
A
- Henoch-Schonlein Purpura (HSP)
- Idiopathic thrombocytopaenic purpura (ITP)
13
Q
What causes HSP?
A
IgA mediated autoimmune vasculitis
14
Q
What are risk factors for HSP?
A
- Viral illness recently
- Aged 3-10
15
Q
What are the signs for HSP?
A
- Purpuric rash
- Distrbuted over buttocks, thighs and legs
- Arthritis/arthalgia
- Abdo pain
- Melaena
16
Q
What’s the difference in platelet count between HSP and ITP?
A
- HTP has a normal platelet count whereas ITP has a drastically increased count
17
Q
What is the main treatment for purpura?
A
- Supportive
- Steroids
18
Q
What type of bacteria is Neisseria meningitides?
A
- Gram -ve diplococcus
19
Q
Which strain of Meningococcus is there a vaccine against?
A
- Meningococcus B and C
20
Q
Which strain of Meningococcus is more common?
A
- Meningococcus B
21
Q
Which organism causes staphylococcal toxic shock syndrome?
A
S. Aureus exotoxins
22
Q
How would you treat a preterm neonate with septicaemia?
A
IV benzyl penicillin
23
Q
How would you treat an older neonate with septicaemia?
A
Gentamicin
24
Q
What is used as prophylaxis for those who have been in close contact with someone with septicaemia?
A
Rifampicin
25
Which virus causes Chicken pox?
Varicella Zoster Virus
26
How does a Chicken pox rash progress?
Macule - papule - vesicle with erythema - scabs
27
How does VZV encephalitis present?
Ataxia
28
What is the incubation period for Chicken pox?
11-21 days
29
When is Chicken pox infective?
4 days before rash and until the lesions have scabbed
30
What is a complication of chicken pox?
Shingles
| Dormant virus stays in posterior root ganglia and emerges along dermatomes
31
What investigations are required in suspected Chicken Pox?
None
32
When is the risk of illness with Chicken Pox increased?
- Immunosuppression
- CF
- Severe eczema
- Neonates
33
What lotion can be used to sooth itching?
Calamine
34
If there are dangerous risk factors in Chicken Pox, what treatment can be given?
Anti-VZV Ig
| Acyclovir
35
Give 3 differentials for Chicken Pox
- Hand, foot and mouth
- Scabies
- Rickettsia
36
What is the main treatment for bacterial conjunctivitis?
Chloramphenicol
37
What is a treatment option for allergic conjunctivitis?
Antihistamines
| Sodium chromoglycate = mast cell stabiliser
38
What is Infectious Mononucleosis?
Glandular Fever
39
What investigations would you perform for Glandular fever?
- FBC
| - Positive agglutination test - mononuclear spot test
40
What do you not prescribe in glandular fever?
Amoxicillin
41
What is Kawasaki Disease?
- Autoimmune vasculitis
42
What is the median age for Kawasaki's disease?
10 months
43
Name 6 symptoms for Kawasaki's disease
```
C = conjunctivitis
R = Rash
A = Adenopathy
S = Strawberry tongue
H = Hands = erythematous
B = Burn = Fever >5days
```
44
What investigations are diagnostic for Kawasaki's disease?
Raised:
- ESR
- CRP
- Bilirubin
- AST
- Platelets
- alpha 2 globulin
45
How would you treat Kawasaki's disease?
- IV immunoglobulin
- Aspirin
- Follow-up with echo, MRI of brain for aneurysm identification and treatment
46
Name 4 DDx of Kawasaki's disease?
- Rheumatic Fever
- Measles
- Steven-Johnson Syndrome
- EBV
47
What investigations would you perform to test for a food allergy?
- Skin prick test
- IgE antibody tire
- Remove suspected allergen and monitor Sx
48
How would you manage a food allergy?
- Standardised controlled food challenge
| - Epipen in emergency
49
What condition commonly develops into peri-orbital cellulitis?
Sinusitis
50
Which 3 organisms commonly cause Peri-Orbital Cellulitis?
Streptococci
Staph.A
Haemophilus
51
Which signs indicate severe Peri-Orbital Cellulitis
- Diplopia, proptosis, reduced acuity, pupillary signs
| - CNS signs - vomiting and drowsiness
52
How would you treat Peri-Orbital Cellulitis in severe case?
IV Co-amoxiclav or Flucloxicillin
53
Which dermatological pathological signs do you look for in Measles?
- Koplick spots on buccal mucosa
| - Macular rash - starts on face and behind ears moving downwards
54
What are the three C's for Measles?
Cough
Coryza
Conjunctivitis
55
What causes Measles?
RNA Paramyxovirus
56
What is the incubation period for Measles?
- 10-14 days
| - Infectious 3-5days before and 4 days after rash
57
What is a severe complication of Measles?
Sub-acute sclerosing pan-encephalitis
- 4-10years after attack
- Slow progressive neurological degeneration
58
What investigations would you perform for Measles?
Salivary IgM antibody from NPA
| IMMUNISATION HISTORY
59
During which trimester of pregnancy would contraction of Rubella be dangerous?
1st
60
Give 3 complications of Rubella?
Thrombocytopaenia
Encephalitis
Arthritis
61
What is the incubation period for Rubella?
- 14-21 days
| - Infectious for 7days before and 6 days after onset of rash
62
Give 4 complications of contracting rubella during pregnancy?
- Death
- Congenital heart disease
- Mental retardation
- Deafness and Cataracts
63
How would you test for Rubella?
Salivary IgM/IgG
64
Give 4 symptoms that can be present in a child born with HIV?
- Failure to thrive
- Recurrent oral candidiasis
- Hepatosplenomegaly
- Severe bacterial infections
65
When is HIV serology not reliable?
1st 18months of life due to maternal IgG being detectable
66
What is the management for HIV in a child?
HAART
| Antibiotic prophylaxis - Co-trimoxazole
67
What is the maternal treatment for HIV?
- AZT during labour and after birth
- Avoidance of breast feeding
- Lower-segment caesarean section
68
Name 3 differentials for a stiff neck
- Tonsillitis
- Pneumonia
- Subarachnoid Haemorrhage
