Infections in Paeds (fever) Dr julian

Question 1

child has fever,

what three differentials should run through you mind?

Answer 1

Sepsis
Meningitis
Resp infection

Question 2

along with fever what do children stop doing when ill?

risk of this?

Answer 2

stops E+D

2° dehydration

Question 3

Dehydration signs in kids?

Answer 3

dry nappy, dry mucous membranes, poor perfusion, decreased skin turgor

Question 4

kid has sepsis and goes into schock.

define compensated shock?

define decompensated shock ?

Answer 4

BP maintained

low BP

Question 5

Compensated shock signs?

-4

Answer 5

tachycardia
poor perfusion (high cap refill)
↓tone
pale cold skin

Question 6

why is there ↓tone?

Answer 6

Brain not getting blood

Question 7

why is there tachycardia?

Answer 7

keep BP up

Question 8

petechial rash sign of what?

Answer 8

meningococcal septicaemia

Question 9

is low BP a late or early sign?

Answer 9

late sign

Question 10

signs of decompensated shock?

-1

Answer 10

compensated signs get much worse but now very low BP

Question 11

for septic baby which antibiotic is given?

and route?

Answer 11

IV ceftriaxone

Question 12

Meningitis signs in children?

-4

Answer 12

Irritable

Neck stiffness

Tense bulging anterior fontanelle

Non-blanching rash (Meningitidis)

Question 13

describe an irritable baby?

how would they look

Answer 13

looks in pain
high pitched cry
whimpers
will not respond to parents back arches

Question 14

irritability basically tells you what?

Answer 14

SERIOUS infection happening

Question 15

if dehydrated what happens to anterior fontanelle?

Answer 15

goes flat

Question 16

if high ICP what happens to anterior fontanelle?

Answer 16

Tense & bulging

Question 17

child has respiratory infection.

Signs of Resp Distress in children?
-4

Answer 17

Tachypnoea
Recession
Use accessory muscles
Expiratory grunt

Question 18

why do you get recession?

Answer 18

child ribs not ossified

Question 19

how can you tell if child is using accessory muscles?

how will they look basically

Answer 19

head bob

Question 20

why does head bob happen?

which muscle is making it happen basically

Answer 20

Sternocleidomastoid muscle

Question 21

why does a child do an Expiratory grunt when in distress,

explain it?

Answer 21

Expiratory grunt is child making +ve pressure to keep alveoli open.

Question 22

Pneumonia antibiotic in babies?
-1 drug name

usual route?

Answer 22

amoxicillin

oral

Question 23

what causes petechiae in terms of physical mechanics?

Answer 23

capillary vessels breaking and leaking

Question 24

Define febrile convulsion?

Answer 24

seizures caused by fever

Question 25

age range for febrile convulsion?

Answer 25

6 months – 5 years

Question 26

febrile convulsion:

When does it occur in infection course?

Answer 26

occurs early in viral infection when temp rises rapidly

Question 27

febrile convulsion:

Character of seizure?

Answer 27

tonic clonic and very brief

Question 28

child has febrile convulsions.

Chance of it happening again in future infection?

Answer 28

1/3

Question 29

how do you manage kids who has had a febrile convulsion?

Answer 29

send to CAU

Question 30

If Child keep getting febrile convulsions what can parents do?
(-2 drug names)

Answer 30

teach parents how to use rectal diazepam or buccal midazolam

Question 31

are febrile convulsions a RF for epilepsy?

Answer 31

yes