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Paediatrics > Infections > Flashcards

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)
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2
Q

What are five viral causes of Meningitis?

A
  • Mumps
  • Coxsackie
  • HSV
  • Echovirus
  • Poliomyelitis
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3
Q

What is the Kerning’s sign?

A
  • Unable to straighten leg greater than 135degrees without pain while lying down
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4
Q

Give 8 signs/symptoms of meningitis

A
  • Fever
  • Headache
  • Neck stiffness
  • Photophobia
  • Positive Kernig’s sign
  • Bulging fontanelle
  • Petechial/purpuric rash
  • Convulsions
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5
Q

What blood marker is raised in viral meningitis?

A
  • Lymphocytes = 10-1000
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6
Q

What CSF markers are raised in bacterial meningitis?

A
  • Neutrophils = 100-10,000
  • Protein = >1
  • Lymphocytes = >100 (not that raised
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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
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8
Q

What would you treat community acquired meningitis/purpura with?

A
  • IM benzyl penicillin
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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
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10
Q

What social precautions do you need to take when dealing with meningitis?

A
  • Inform public health

- Prophylaxis of rifampicin to household contacts

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11
Q

What other Ddx could there be for meningitis?

A
  • Subarachnoid Haemorrhage
  • Tonsilitis
  • Pneumonia
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12
Q

What are the 2 types of Purpura?

A
  • Henoch-Schonlein Purpura (HSP)

- Idiopathic thrombocytopaenic purpura (ITP)

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13
Q

What causes HSP?

A

IgA mediated autoimmune vasculitis

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14
Q

What are risk factors for HSP?

A
  • Viral illness recently

- Aged 3-10

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15
Q

What are the signs for HSP?

A
  • Purpuric rash
  • Distrbuted over buttocks, thighs and legs
  • Arthritis/arthalgia
  • Abdo pain
  • Melaena
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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
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17
Q

What is the main treatment for purpura?

A
  • Supportive

- Steroids

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18
Q

What type of bacteria is Neisseria meningitides?

A
  • Gram -ve diplococcus
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19
Q

Which strain of Meningococcus is there a vaccine against?

A
  • Meningococcus B and C
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20
Q

Which strain of Meningococcus is more common?

A
  • Meningococcus B
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21
Q

Which organism causes staphylococcal toxic shock syndrome?

A

S. Aureus exotoxins

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22
Q

How would you treat a preterm neonate with septicaemia?

A

IV benzyl penicillin

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23
Q

How would you treat an older neonate with septicaemia?

A

Gentamicin

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24
Q

What is used as prophylaxis for those who have been in close contact with someone with septicaemia?

A

Rifampicin

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25
Q

Which virus causes Chicken pox?

A

Varicella Zoster Virus

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26
Q

How does a Chicken pox rash progress?

A

Macule - papule - vesicle with erythema - scabs

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27
Q

How does VZV encephalitis present?

A

Ataxia

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28
Q

What is the incubation period for Chicken pox?

A

11-21 days

29
Q

When is Chicken pox infective?

A

4 days before rash and until the lesions have scabbed

30
Q

What is a complication of chicken pox?

A

Shingles

Dormant virus stays in posterior root ganglia and emerges along dermatomes

31
Q

What investigations are required in suspected Chicken Pox?

A

None

32
Q

When is the risk of illness with Chicken Pox increased?

A
  • Immunosuppression
  • CF
  • Severe eczema
  • Neonates
33
Q

What lotion can be used to sooth itching?

A

Calamine

34
Q

If there are dangerous risk factors in Chicken Pox, what treatment can be given?

A

Anti-VZV Ig

Acyclovir

35
Q

Give 3 differentials for Chicken Pox

A
  • Hand, foot and mouth
  • Scabies
  • Rickettsia
36
Q

What is the main treatment for bacterial conjunctivitis?

A

Chloramphenicol

37
Q

What is a treatment option for allergic conjunctivitis?

A

Antihistamines

Sodium chromoglycate = mast cell stabiliser

38
Q

What is Infectious Mononucleosis?

A

Glandular Fever

39
Q

What investigations would you perform for Glandular fever?

A
  • FBC

- Positive agglutination test - mononuclear spot test

40
Q

What do you not prescribe in glandular fever?

A

Amoxicillin

41
Q

What is Kawasaki Disease?

A
  • Autoimmune vasculitis
42
Q

What is the median age for Kawasaki’s disease?

A

10 months

43
Q

Name 6 symptoms for Kawasaki’s disease

A 
C = conjunctivitis
R = Rash
A = Adenopathy
S = Strawberry tongue
H = Hands = erythematous
B = Burn = Fever >5days
44
Q

What investigations are diagnostic for Kawasaki’s disease?

A

Raised:

  • ESR
  • CRP
  • Bilirubin
  • AST
  • Platelets
  • alpha 2 globulin
45
Q

How would you treat Kawasaki’s disease?

A
  • IV immunoglobulin
  • Aspirin
  • Follow-up with echo, MRI of brain for aneurysm identification and treatment
46
Q

Name 4 DDx of Kawasaki’s disease?

A
  • Rheumatic Fever
  • Measles
  • Steven-Johnson Syndrome
  • EBV
47
Q

What investigations would you perform to test for a food allergy?

A
  • Skin prick test
  • IgE antibody tire
  • Remove suspected allergen and monitor Sx
48
Q

How would you manage a food allergy?

A
  • Standardised controlled food challenge

- Epipen in emergency

49
Q

What condition commonly develops into peri-orbital cellulitis?

A

Sinusitis

50
Q

Which 3 organisms commonly cause Peri-Orbital Cellulitis?

A

Streptococci
Staph.A
Haemophilus

51
Q

Which signs indicate severe Peri-Orbital Cellulitis

A
  • Diplopia, proptosis, reduced acuity, pupillary signs

- CNS signs - vomiting and drowsiness

52
Q

How would you treat Peri-Orbital Cellulitis in severe case?

A

IV Co-amoxiclav or Flucloxicillin

53
Q

Which dermatological pathological signs do you look for in Measles?

A
  • Koplick spots on buccal mucosa

- Macular rash - starts on face and behind ears moving downwards

54
Q

What are the three C’s for Measles?

A

Cough
Coryza
Conjunctivitis

55
Q

What causes Measles?

A

RNA Paramyxovirus

56
Q

What is the incubation period for Measles?

A
  • 10-14 days

- Infectious 3-5days before and 4 days after rash

57
Q

What is a severe complication of Measles?

A

Sub-acute sclerosing pan-encephalitis

  • 4-10years after attack
  • Slow progressive neurological degeneration
58
Q

What investigations would you perform for Measles?

A

Salivary IgM antibody from NPA

IMMUNISATION HISTORY

59
Q

During which trimester of pregnancy would contraction of Rubella be dangerous?

A

1st

60
Q

Give 3 complications of Rubella?

A

Thrombocytopaenia
Encephalitis
Arthritis

61
Q

What is the incubation period for Rubella?

A
  • 14-21 days

- Infectious for 7days before and 6 days after onset of rash

62
Q

Give 4 complications of contracting rubella during pregnancy?

A
  • Death
  • Congenital heart disease
  • Mental retardation
  • Deafness and Cataracts
63
Q

How would you test for Rubella?

A

Salivary IgM/IgG

64
Q

Give 4 symptoms that can be present in a child born with HIV?

A
  • Failure to thrive
  • Recurrent oral candidiasis
  • Hepatosplenomegaly
  • Severe bacterial infections
65
Q

When is HIV serology not reliable?

A

1st 18months of life due to maternal IgG being detectable

66
Q

What is the management for HIV in a child?

A

HAART

Antibiotic prophylaxis - Co-trimoxazole

67
Q

What is the maternal treatment for HIV?

A
  • AZT during labour and after birth
  • Avoidance of breast feeding
  • Lower-segment caesarean section
68
Q

Name 3 differentials for a stiff neck

A
  • Tonsillitis
  • Pneumonia
  • Subarachnoid Haemorrhage

Paediatrics (11 decks)

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