Infections Flashcards
WHAT IS KAWASAKI
A SYSTEMIC VASCULITIS
WHO IS COMMONLY AFFECTED BY KAWASAKI
CHILDREN AGED 4M-6Y
WHAT IS THE PRESENTATION OF KAWASAKI
WEEK ONE
- FEVER LASTING 5 DAYS
- CONJUNCTIVITIS
- STRAWBERRY TONGUE AND CRACKED LIPS
- CERVIACLE LYMPHADENOPATHY
- POLYMORPHUS RASH
WEEK 2-4
- RED OEDEMATUS PALMS AND SOLES THAN THEN CAUSES PEELING OF SKIN ON DIGITS
WEEK 3-8
- CARDIOVASULAR SIGNS
HOW DO YOU DIAGNOSE KAWASAKI
FEVER LASTING 5 DAYS PLUS 4 OTHER SYMPTOMS
BLOODS:
RAISED ESR, CRP, PLATELETS
ECHO AT WEEKS 6+8 TO ASSESS CARDIAC INVOLVEMENT
WHAT IS THE CARDIOVASCULAR RISK ASSOCIATED WITH KAWASAKI
CORONARY ANEURISM
HOW DO YOU TREAT KAWASAKI
IvIg x10D
ASPRIN
CLOPIDROGEL (ANTIPLATELET)
INFLIXIMAB IF THERES PERSISTENT FEVER
WHAT WOULD THE CARDIAC SIGNS OF KAWASAKI BE
GALLOP RYTHUMN
MYOCARDITIS
PERICARDITIS
CORONARY AND PERIFERAL ANEURISMS
HOW DO YOU MANAGE A GIANT CELL ANURISM
WARFRIN AND FOLLOW UP
WHAT CELLS DOES HIV AFFECT
MACROPHAGES
DESRIBE HOW MOTHER CHILD HIV TRANSMISSION OCCURS
AT BIRTH
BREAST FEEDING
EN UTERO
HOW DO YOU DIAGNOSE HIV IN A CHILD
DNA PCR IN A CHILD OVER 18M
BEFORE 18 MONTHS THEN YOU CAN ONLY ASSESS FOR NEGATIVE DIAGNOSIS
- COMPLETION OF ANTENATAL ANTIVIRALS
- X2 NEGATIVE PCR
- X1 PCR AFTER 18 MONTHS
WHY CANT YOU REALLY DIAGNOSE A CHILD WITH HIV BEFORE 18M
MATERNAL ANTIBODIES STILL ARE PRESENT
IF UNTREATED WHEN DOES CHILD HIV TURN TO AIDS
VARYING FROM 1Y +
WHAT ARE MILD PRESENTATIONS OF HIV
LYMPHADENOPATHY
PAROTITIS
WHAT ARE MODERATE PRESENTATIONS OF HIV
RECURRENT BACTERIAL INFECTIONS
CANDIDIASIS
CHRONIC DIARRHOEA
LYMPHOCYTIC INTERSTITIAL PNEUMONITIS
WHAT ARE SEVERE PRESENTATIONS OF HIV
OPPORTUNISTIC INFECTIONS
SEVERE FAILURE TO THRIVE
ENCEPHALOPATHY
MALIGNANY
WHAT IS THE TREATEMENT FOR HIV AIDS IF CD4 IS 200-350
2 NEUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS
1 NON NEUCLOSIDE REVERSE TRANSCRIPTASE INHIBITORS
WHAT IS THE TREAMENT FOR HIV AIDS OF CD4 >350
2 NEUCLOSIDE REVERSE TRANSCRIPTASE INHIBITORS
1 PROTEASE INHIBITORS
WHAT IS ALWAYS GIVEN TO HIV PATIENTS
PCP (CO-TRIMOXAZOLE) IF OVER AGE OF 4
ALL VACCIENES BUT NOT BCG
WHAT ARE GENERAL SIGNS OF A HIV CHILD ON PRESENTATION
PERSISTENT LYMPHADENOPATHY
HEPATOSPLENOMEGALY
RECURRANT FEVER
THROMBOCYTOPENIA
HOW DO YOU REDUCE THE RISK OF VERTICAL TRANSMISSION IN HIV
ANTIRETROVIRAL DRUGS IN PREGNANCY // BEFORE
NOT BREAST FEEDING
AVOIDING PROLONGED ROM
NO INSTRUMENTAL DELIVARIES
WHAT IS ENCEPHALITIS
INFLAMMATION OF THE BRAIN
WHAT ARE CAUSES OF ENCEPHALITIS
MAINLY VIRAL
- HSV
- ENTEROVIRUS (MOST COMMON)
- POST INFECTIOS TO CHICKEN POX AND MEASLES
- HIV
WHAT IS THE PRESENTATION OF ENCEPHALITIS
FEAVER
HEADACHE
DECREASED CONCIOUSNESS
HOW DO YOU DIAGNOSE ENCEPHALITIS
BLOOD CULTURES
SWABS (SKIN AND THROAT)
LP
IMAGING
WHAT IS THE COMMON ISSUE FACED WHEN DIAGNOSING ENCEPHALITIS
ORGANSIM CAN ONLY BE FOUND IN 50% OF CASES
WHAT IS THE MANAGEMENT OF ENCEPHALITIS
TREAT AS MENINGITIS/HSV ENCEPHALITIS UNTIL PROVEN OTHERWISE THEN
SUPPORTIVE UNLESS HSV ENCEPHALITIS
THEN USE ACYCLOVIR
+- PHENYTOIN (ANTICONVUSLANT)
WHAT IS MENINGITIS
INFLAMMATION OF THE MENINGES
USUALLY DUE TO BACTERIA:
PRECEEDED BY BACTEREMIA CAUSING A SEVERE IMMUNE RESPONSE
WHAT PATHOGENS USUALLY CAUSE MENINGITIS AT 0-3M
GBS
E COLI
LISTERIA
WHAT PATHOGENS USUALLY CAUSE MENINGITIS AFETR 3M
NISSERIA MENINGITIDES
STREP. PNEUMONIA
H. INFUENZA
MININGOCOCCUS (V BAD)
WHAT IS THE PRESENTATION OF MENINGITIS IN AN ONLDER CHILD
FEVER
PHOTOPHOBIA
HYPOTONIA
DROWSINESS
NECK STIFFNESS
SHOCK
SEIZURES
PURPURIC NON BLANCHING RASH
HOW DO YOU INVESTIGATE MENINGITIS
BLOOD CULTURES
BLOOD GLUCOSE
GASSES
COAG SCREEN + LACTATE
MSU
THROAT SWAB
LP
PCR
YOU DO AN LP IN A ?MENINGITIS CHILD THE CSF IS:
- TURBID
- POLYMORPHS
- HIGH PROTEIN
- V. LOW GLUCOSE
WHAT IS THE PATHOGEN TYPE
BACTERIAL
YOU DO AN LP IN A ?MENINGITIS CHILD THE CSF IS:
- CLEAR
- LYMPHOCTURES
- NORMAL PROTEIN
- LOW GLUCOSE
WHAT IS THE PATHOGEN TYPE
VIRAL
YOU DO AN LP IN A ?MENINGITIS CHILD THE CSF IS:
NORMAL (BUT CAN BE TURBID)
- LYMPHOCYTES
- VERY HIGH PROTEIN
- VERY LOW GLUCOSE
WHAT IS THE PATHOGEN TYPE
TB
WHAT IS THE MANAGEMENT OF MENINGITIS
SUPPORTIVE
ABX
DEXAMETHOSONE BUT NOT IN INFANTS
WHAT ARE THE ABX TO TREAT MENINGITIS
CEFPTAXIME FOR 21DAYS
WHAT IS THE TREATEMENT FOR CHILDREN UNDER 3M WITH MENINGITIS
CEFOTAMINE + AMOXICILLIN FOR 14D
WHEN IS PROFYLAXIS GIVEN TO CLOSE CONTACTS AND WHAT IS THE ABX USED
WHEN THE MENINGITIS IS CAUSED BY NISSERIA MENINGITIDIS OR H INFLUENA
RIFAMPACIN
WHAT ARE THE COMPLICATIONS OF MENINGITIS
DEATH
CEREBRAL INFARCTION
SUBDURAL EFFUSION - H INFLUENZA
HYDROCEPHALUS
CEREBRAL ABCESS
LOCAL VASCULITIS
HEARNING LOSS
WHAT ARE VIRAL CAUSESOF MENINGITIS
ENTEROVIRUS
EBV
ADENOVIRUS
MUMPS
WHAT IS HSV
A COMMON VIRAL INFECTION THAT GOES THROUGH PERIODS OF LATENCY AND LONG TERM PERSISTANCE
WHAT ARE THE TYPES OF HSV
HSV 1 - LIP AND SKIN LESIONS
HSV 2 - GENITAL LESIONS
WHAT IS THE PRESENTATION OF HSV
PAINFUL VISICULAR LESIONS ON GUMS AND LIPS
- GINGIVOSTOMATITIS AT MUCOCUTANEOUS JUNCTIONS
HIGH FEVER AND IRRITABLE CHILD
BLEPHERITIS AND CONJUNCTIVITIS
ENCEPHALITIS/ESEPTIC MENINGITIS
ECZEMA HERPETICUM
HERPETIC WHITLOWS
WHAT COMPLICATIONS OF HSV THAT CAN MANIFEST DURING A PRIMARY/ACUTE ATTACK
ECZEMA HERPATICUM LEADING TO SERIOUS SECONDARY INFECTIONS
CONREAL SCARRING FROM BLEPHERITIS AND CONJUNCTIVITIS
WHAT IS THE TREATEMENT FOR HSV
TOPICAL ACYCLOVIS
IV ACYCLOVIR IN ENCEPHALIIS OR IN IMMUNOCOMPRIMESED
WHAT IS SCOLDED SKIN SYNDROME
A SKIN INFECTION BY STAPHYLOCOCCUS OR GROUP A STREP
WHAT IS THE PATHOPHYSIOLOGY OF SCALDED SKIN SYNDROME
BACTERIA RELEASESUPERTOXINS WHICH CAUSE THE SEPARATION OF EPITHELIAL SKIN THROUGH TO THE GRANSULAR LAYER
WHAT IS THE PRESENTATION OF SCALDED SKIN SYNDROME
FEVER
REDNESS
PEELING SKIN
LESIONS
RAW SKIN
WHAT IS THE TREATEMENT OF SCALDED SKIN SYNDROME
IV ABX
ANALGESIA
FLUID BALANCE
WHAT ABX WOULD YOU USE FOR SCALDED SKIN SYNDROME
FLUCLOXACILLLIN
CEFALEXIN
CLINAMYCIN
WHAT IS THE PRESENTATION OF PRIMARY TB
90% ASYMPTOMATIC
IF HOST CANNOT CONTAIN THE TB
- FEVER
- ANOREXIA
- WEIGHT LOSS
- COUGH
- CHEST X RAY
- LYMPHADENOPATHY
- SOB
- GHON PRIMARY COMPLEX
WHAT IS THE PRESENTATION OF POST PRIMRY TB
COUGH
FEVER
NIGHT SWEATS
WEIGHT LOSS
CHEST PAIN
MENINGITIS Sx
BONE AND JOINT PAIN
POTTS DISEASE
WHAT WOULD TUBERCULUS PLEURITIS CAUSE AS A CARDINAL Sx
CHEST PAIN
WHAT WOULD TUBERCULUS CNS INVOLVEMENT CAUSE AS A CARDINAL Sx
MENINGITIS Sx
WHAT WOULD MILLARY TUBERCULUS CAUSE AS A CARDINAL Sx
BONE AND JOINT PAIN
HOW WOULD YOU DIAGNOSE ACTIVE TB
SPUTUM SAMPLE
GASTRIC WASHING W THREE DAYS NG TUBE
URINALYSIS
IF SUGGESTIVE:
LYMPH NODE EXTUSION
CSF
C XRAY
HOW WOULD YOU DIAGNOSE EXPOSURE TO TB
MANTOUX TEST
IGRA
WHAT IS THE MANTOUX TEST
A PUREFIED PROTEIN DERIVATIVE TEST TO CHECK SENSITIVITY OF THE IMMUNE SYSTEM TO TB
A CHILD HAS HAD THEIR BCG VACCIENE AND THEIR MANTOUX COMES BACK WITH A SWELL OF >15MM
IS THIS RESULT POSITIVE OR NEGATIVE FOR TB
POSITIVE
A CHILD HASNT HAD THEIR BCG VACCIENE AND THEIR MANTOUX COMES BACK WITH A SWELL OF >10MM
IS THIS RESULT POSITIVE OR NEGATIVE FOR TB
POSITIVE
WHAT IS IGRA
INTERFERON GAMMA RELEASE ASSEYIS A BLOOD TEST ASSESSING T CELL STIMULATION TO ANTIGENS
WHAT HAPPENS TO MANTOUX AND IGRA IF PATIENT IS HIV POSITIVE AND HAS HAD TB
BOTH ARE NEGATIVE
HOW DO YOU TREAT TB
RIFAMPACIN - 6M
ISONIAZID-6M
PYRAZINAMIDE-2M
ETHAMBUTOL - 2M
WHAT ARE THE SIDE EFFECTS OF THE TB DRUGS
RIFAMPACIN - RED/ORANGE URINE
ISONIAZID-PERIFERAL NEURITIS
PYRAZINAMIDE-DECREASED VISUAL ACUITY
ETHAMBUTOL - INCREASED URIC ACID CAUSING GOUT
WHEN WOULD YOU GIVE PYRIDOXINE WITH ISONIAZID
POST PUBERTY TO DECREASE CHANCES OF PERIFERAL NEURITIS
WHAT IS POLIO
A SERIOUS VIRAL INFECTION
WHAT IS THE PRESENTATION OF POLIO
ASYMTOMATIC MAINLY
CAN HAVE
- HIGH FEVER
- SORE THROAT
- HEADACHE
- ABDO PAIN
- N+V
- PARALYSIS- CAN BE TEMOPRARY OR PERMANENT BUT CAN ALSO BE LIFE THREATNING
WHAT IS THE MANAGEMENT FOR POLIO
SUPPORTIVE CARE =/- VENTILATION
PHYSIO IF AFFECTED BY PARALYSIS
WHAT CAN BE LONG TERM PROBLEMS OF POLIO
DEGREES OF PARALYSIS
MUSCLE WEAKNESS
MUSCLE ATROPHY
TIGHT JOINTS
DEFORMITIED IE TWISTED FEET
POST POLIO SYNDROME
WHAT IS POST POLIO SYNDROME
LATE ONSET (15+YRS AFTER POLIO)
CNS SYMPTOMS
- DECREASED MUSCULAR FUNCTION
- ACUTE WEAKNESS
- PAIN
- FATIGUE
WHAT IS THE VACCIENE SCHEDULE FOR POLIO
THE 6-IN-1 AT:
- 8W
- 12W
- 16W
THE 4-IN-1 AT
- 3 1/2 Y
TEENAGE BOOSTER
- AT 14Y
WHAT PATHOGEN CAUSES WHOOPING COUGH
BORDATELLA PERTUSIS
HOW DOES WHOOPING COUGH PRESENT IN OLDER CHILDREN
WEEK 1
- CORYZAL SYMPTOMS
- PROXYMAL SPASMODIC COUGH
- VOMITING
- TURNING BLUE DURING COUGH
- COUGH WORSE AT NIGHT
WEEK 7 - END OF COUGH
WHAT IS THE PRESENTATION OF WHOOPING COUGH IN INFANTS
APNAOE
WHOOP IN COUGH
SUNJUNCTIVAL HAEMORROIDS
WHAT ARE COMPLICATIONS OF WHOOPING COUGH
PNEUMONIA
CONVULSIONS
BRONCHIECTASIS
WHAT INVESTIGATIONS ARE REQUIRED FOR WHOOPING COUGH
PERI NASAL SWABS AND CULTURES
BLOODS: V RAISED LYMPHOCYTES
WHAT IS THE MANAGEMENT OF WHOOPING COUGH
INFANTS AND YOUNG CHILDREN ISOLATED
ERYTHOMYCIN (ONLY WITHIN THE FIRST THREE WEEKS)
GIVE ERYTHROMYCIN PROFYLAXIS TO CLOSE CONTACTS
DESCRIBE THE VACCIENE SCHEDULE FOR WHOOPING COUGH
PREGNANCY
VACCIENE AT 2, 3, 4 MONTHS
AND AGAIN AT 3.5Y AS THE 4-IN-1
WHAT IS THE PATHOGEN THAT CAUSES DIPTHERIA
CORYNEA-BACTERIUM DIPTHERIAE
WHAT IS THE PRESENTATION OF DIPTHERIA
HIGH FEVER
CYANOSIS
BRASSY BARKING COUGH (DIPTHERIC CROUP)
BULL NECK LYMPHADENOPATHY
GREY PSEUDOMEMBRANES
FOUL SMELLING BLOODY NASAL DISCHARGE
WHAT COMPLICATIONS CAN ARISE DUE TO DIPTHERIA
ARRYTHMIAS
SKIN LESIONS\MOCARDITIS
NERVE PALSEYS
WHAT ARE THE INVESTIGATIONS FOR DIPTHERIA
THROAT SWAB + CULTURES
OR CLINICALLY:
URTI + GREY PSUDOMEMBRANES
HOW WOULD YOU TREAT DIPTHERIA
METRONIDAZOLE
ERYTHROMYCIN
FOR 14 DAYS
DIPTHERIA ANTITOXIN
WHAT IS QUINAVAXEM
THE VACCIENE FOR DIPTHERIA
WHAT IS THE VACCIENE SCHEDULE FOR DIPTHERIA
6
10
14 WEEKS
WHAT IS RUBELLA
A RARE VIRAL DISEASE WHICH IS ACQUIRED CONGENITALLY CAN HAVE VERY SERIOUS COMPLICATIONS
WHAT IS THE PRESENTATION OF RUBELLAIF ACQUIRED IN CHILDHOOD
MILD FEVER
MACHULOPAPULAR RASH - NON ITCHY
LYMPHADENOPATHY - SUBOCCIPITAL AND POST AURICULAR
WHAT ARE THE CHARACTERISTIC FEATURES OF A RUBELLA RASH
STARTED AT FACE/BEHIND EARS
SPREADS CENTRIFUGALLY AROUND THE BODY
FADES AFTER 3-5 DAYS
WHEN ARE COMPLICATIONS MORE LIKELY TO HAPPEN WITH RUBELLA
IF ACQUIRED BY ADULT
OR
EN UTERO
WHAT ARE COMPLICATIONS (NOT EN UTERO) OF RUBELLA
ARTHERITIS
ENCEPHALITIS
THROMBOCYTOPENIA
MYOCARDITIS
WHEN IS IT NECESSARY TO TEST SERIGICALLY FOR RUBELLA
IN PREGNANCY
WHAT ARE COMMON COMPLICATIONS OF CONGENITALLY ACQUIRED RUBLELLA
ACQUIRED UNDER 8W
DEAFNESS
CHD
CATARACTS
ACQUIRED AT 13-16W
IMPAIED HEARING
AFTTER 18 W MINIMAL DAMAGE
WHAT ARE LESS COMMON COMPLICATIONS OF CONGENITAL RUBELLA
PDA
RETINOPATHY
INTREACEREBRAL CALCIFICATION
IUGR
NEUROLOGICAL DISABILITY
WHAT IS CHORIORETINITIS
A COMPLICATION OF CONGENITALLY ACQUIRED RUBELLA WHICH DEVELOPS IN ADULHOOD
WHAT IS THE MANAGEMENT OF CONGENITALLY ACQUIRED RUBELLA
PYRIMETHAMINE
SULFADIAZINE
FOR 1 YEAR
WHAT IS THE PATHOGEN THAT CAUSES CHICKEN POX
VARICELLA ZOSTER
DESCRIBE THE PRESENTATION OF VARICELLA ZOSTER
FEVER - 4 D
RASH
FROM A FEW - 500 LESIONS STARTING AT THE TRUNK AND MOVING TO THE PERIFERIES
DESCRIBE THE COURSE OF THE VARICELLA ZOSTER RASH
PAPULES
PAPULES + VESICLES
VESICLES + PUSTULES
CRUSTS
IF THE LESIONS OF VARICELLA ZOSTER ARE LASTING MORE THAN 10 D WHAT CAN THIS MEAN
DEFECTIVE CELLULAR IMMUNITY
WHAT COMPLICATIONS CAN OCCUR WITH VARICELLA ZOSTER
SECONDARY BACTERIAL INFECTIONS
ENCEPHALITIS
PURPURA FULMINANS
AN IMMUNOCOMPRIMISED PATIENT WITH CHICKEN POX (VZ) HASNT BEEN TREATED, WHAT ARE THEY AT RISK OF
VESICLE RUPTURE CAUSING HAEMORRAGE AND DEATH
WHAT ARE THE SIGNS OF ENCEPHALITIS
ATAXIA
OTHER CEREBELLAR SIGNS
IN VARICELLA OSTER ENCEPHALITIS WHAT IS THE RECOVERY PERIOD
SOLF RESOLVES WITHIN 1 MONTH
WHAT IS PURPURA FULMINANS
A RARE COMPLICATION OF CHICKEN POX CAUSING VASCULITIS IN SKIN AND SUB CUTANEOUS TISSUE LEADING TO NECROSIS
HOW DO YOU TREAT VARICELLA ZOSTER
SUPPORTIVE UNLESS:
IMMUOCOMPRISED (IV ACYCLOVIR OR IvIg in t cell immunity- HIV)
TEENAGERS+ADULTS (PO ACYCLOVIR)
WHAT IS SHINGLES
LATENT VARICELLA ZOSTER
WHAT IS THE PRESENTATION OF SHINGLES
VESICULAR ERUPTION IN DEROTOMAL DISTRIBUTION
NEUROPATHIC PAIN
WHAT IS MEASLES
AN UNCOMMON VIRAL DISEASE, LESS SEVERE IN YOUNG AGE
A CHILD PRESENTS WITH A HISTORY OF
- HUGH FEVER PEAKING AT DAY 5
- DISCRETE MACULOPAPULAR RASH STARTING BEHIND EARS AND MOING DOWN THE BODY
- WHICH BEGAN DESQUAMATING AT THE SECOND WEEK
- COUGH, CORYZA, CONJUNCTIVITIS
- KOPLIK SPOTS
WHAT IS THE DIAGNOSIS
MEASLES
WHAT ARE KOPLICK SPORTS
WHITE SPOTS ON BUCCAL MUCOSA AGAINST A BRIGHT RED BACKGROUND
WHAT ARE COMPLICATIONS OF MEASLES
ENCEPHALITIS
SUBACUTE SCLEROSING PANCEPHALITIS
WHAT IS THE PRESENTATION OF MEASLES ENCEPHALITIS AND POSSIBLE COMPLICATIONS
LETHARGY
HEADACHES
IRRITABILITY
SEIZURES
COMA
CAN LEAD TO LEARNING DISABILITIES AND DEAFNESS
WHAT IS SUBACUTE SCLEROSING PANCEPHALITIS
MANIFESTS 7Y AFTER INFECTION
COMMIN IN THOSE WHO GOT MEASLES BEFORE AGEOF 2
CAUSED BY VIRUS VARIENT REMAINING IN CNS
DEMENTIA LEADING TO DEATH
WHAT ARE TREATEMENTS FOR MEASLES
ISOLATION
SUPPORTIVE SYMPTOMATIC Tx
IN IMMUNOCOMPRIMISED: VIRAL ANTIBODIES AND ANTIVIRAL RIBARININ
WHAT IS IMPETIGO
LOCALISED AND HIGHLY INFECTION SKIN INFECTION CAUSED BY STAPHYLOCOCCUS
WHAT IS THE PRESENTATION OF IMPETIGO
ERYTHEMATOUS MACULES TURNING TO VESICLES AND POSTULES
THESE RUPTURE TURNING INTO HONEY COLOURED CRUSTED LESIONS
WHAT ARE TREATEMENTS FOR IMPETIGO
TOPICAL MUPIROCIN
PO FLUCLOXACILLIN/CO-AMOXICLAV
KEEP OUT OF SCHOOL UNTILLESIONS DRY
WHAT ARE BOILS
INFECTIONS OF HAIR FOLLICLES / SWEAT GLANDS
DUE TO STAPH. A
WHAT IS THE TREATEMENT FOR BOILS
FLUCLOXACILLIN
WHAT DO PERSISTENT BOILS SUGGEST
PATIENT OR CLOSE CONTACTS ARE NASAL CARRIERS
