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Part 2 Paediatrics > infectious disease > Flashcards

infectious disease Flashcards

1
Q

What is the top cause of death for children under 5.

A

infectious disease

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2
Q

What are the common symptoms in Malaria?

A

fever (39.5), tiredness, abdominal pain, travel from africa, hepatomegaly and splenomegaly

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3
Q

What are the blood test you should order if you are suspecting malaria?

A

FBC looking for anaemia, LFT looking for derangement, blood films, parasite films thick and thin, malarial antigen test

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4
Q

what is the most severe form of malaria?

A

P. Falciparum. this can lead to cerebral malaria.

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5
Q

what is the most common form of malaria?

A

P. vivix it is associated with splenomegaly

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6
Q

what is the rarest form of malaria

A

p ovale, and it is also less dangerous

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7
Q

What is the least dangerous malaria

A

P. Malariae

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8
Q

what is the incubation time for malaria

A

between 6 days to 3 months

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9
Q

what is the treatment for Malaria?

A

artemisinin based combination therapy the exact treatment depends on the type of malaria

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10
Q

what is the treatment for P. falciparum?

A

first you need to know if the parasite is resistant to chloroquine. you would normally assume that is unless you were in a resource poor setting, then would give an artemisinin based combination therapy. for example: artemether plus lumefantrine. these come in combination medication.

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11
Q

how many sample do you have to receive before you can exclude malaria?

A

three samples taken within 24- 48 hours

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12
Q

what is a sign you can look for on your abc for malaria?

A

thrombocytopenia

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13
Q

what enzyme do you need to screen for before starting malaria treatment?

A

g6pd deficiency

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13
Q

what enzyme do you need to screen for before starting malaria treatment?

A

g6pd deficiency

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14
Q

what are the major features of severe or complicated malaria?

A

seizures or loc, renal impairment (this is why we do a UE), acidosis (which is why we do a blood gas), hypoglycemia (which is why we do a blood glucose), pulmonary oedema (which is why we may need to do a chest X-ray), haemoglobin less than 8, DIC (which is why we do a coat profile), paracyte load greater than 10%.

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15
Q

what are the symptoms of TB

A

weight loss, night sweats, and cough.

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16
Q

what can you do if you suspect tb in a child?

A

gastric lavage, sputum sample two early morning samples

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17
Q

what kinds of tests can you do on a sputum sample for tb

A

stain for acid fast bacilli and per test culture for full resistance profile.

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18
Q

would you wait for cultures to come back before starting treatment for TB?

A

no you would start rifampicin, isoniazid, ethambutol, and pyrazinamide

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19
Q

when should you use tuberculin skin test over interferon gamma release assay?

A

if the child is under 5 than TST is better.

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20
Q

if the tuberculin skin test is negative what does that mean?

A

if there is a definitive history of exposure than you treat as latent TB. TST can take up to 6 weeks to become positive. less than 2 years old are at her risk of getting disease

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21
Q

what is the treatment for latent TB

A

a 3 month course of isoniazid with pyridoxine and rifampicin.

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22
Q

what are the symptoms of hepatitis A?

A

history of travel to an endemic area (south america), jaundice, hepatomegaly, lethargy, abdominal pain, eaten local food.

23
Q

what is the testing that you would do in HEP A infection?

A

serological testing hep A IGM and IGG

24
Q

does hep a cause chronic infection?

A

no (b and C do)

25
Q

what is the treatment for hepatitis A?

A

supportive treatment

26
Q

how are Hep B and C contracted?

A

through blood and body fluids

27
Q

what happens when children get HBV infection?

A

90% of infants will develop chronic infection and liver failure, and 40% of children will develop chronic infection.

28
Q

what are the symptoms of campylobacter gastroenteritis?

A

bloody diarrhoea, with suck contacts after eating contaminated food.

29
Q

what is the treatment for gastroenteritis?

A

supportive therapy with oral rehydration salts.

30
Q

what is the definition of diarrhoea

A

3 or more loose or liquid stools per day (or more frequent than what is normal for the child).

31
Q

what are the common causes of bacterial diarrhoea

A

campylobacter, chlorea, enterotoxin e coli, shigella, typhoid

32
Q

what is the most common cause of viral diarrhoea

A

rota virus, calciciviruses, noroviruses.

33
Q

what are the parasitic causes of diarrhoea

A

amoebic dysentry, cyptospirisium, giardia

34
Q

what is the definition of a fever?

A

greater than 38C

35
Q

what can cause a fever?

A

a wide range of ddx, therefore hx is important. infectious (viral or bacterial), medications (incl vaccines), heat exposure, allergies, cancer, auto-immune disease, inflammatory disease

36
Q

what are some examples of viral fevers focuses

A

URTI, gastroenteritis, chickenpox, measles

37
Q

what re some bacterial causes of fever focuses?

A

pneumonia, UTI, meningococcus

38
Q

what are some inflammatory or autoimmune causes of fever?

A

Kawasaki disease, juvenile idiopathic arthritis

39
Q

what are the red light features of a fever?

A

colour: pale motels ashen or blue, activity: lethargy, unrousable, Respiratory: grunting, tachypnoea, RR greater than 60, moderate to severe chest drawing, circulation: reduced cap refill, other: age less than three months with a temp greater than 38, non blanching rash, bulging fontanelle, neck stiffness, status epileptics, FNS, seizures (focal).

40
Q

what are the causes of a non blanching rash

A

meningococcal meningitis, viral enterovirus, other: thrombocytopenia, HSP

41
Q

what is the ddx for a maculopapular rash

A

measles, rubella, herpes virus 6 (roseola infantum), fifth disease (parvovirus B19), enterovirus. bacterial: group A strep (sandpaper rash)

42
Q

what is the ddx for vesicular rash:

A

coxsackie A (hand foot and mouth disease), varicella zoster virus (chicken pox shingles), herpes simplex

43
Q

what is the ddx for a desquamation rash?

A

bacterial: post streptococcal infection
other: Kawasaki disease

44
Q

how long are you contagious for with parvovirus B19

A

24 hours after fever has resolved

45
Q

what are the symptoms of scarlet fever?

A

sore throat, fever and swollen tonsils and neck glands.
rash: scarlet develops with sandpaper like texture
strawberry tongue with peeling skin during recovery phase

46
Q

what does triple therapy mean?

A

cefotaxime

broad spectrum coverage but also penetrates the CNS), gent covers gram negative, ampicillin (for listeria

47
Q

when is chickenpox still contagious?

A

1-2 days before rash onset until all the lesions are crusted over and no lesions have appeared for 24 hours.

48
Q

what are the rare complications of chicken pox?

A

nec fasciitis, toxic shock syndrome, encephalitis, aseptic meningitis, cerebellitis, pneumonitis

49
Q

how do we treat a fever of unknown origin?

A

if well and urine clear discharge with 48 hour follow-up. send urine for culture if fever greater than 24 hours or age less than 1 year.

50
Q

what are the features if Kawasaki disease

A 
fever for 5 days
polymorphous rash
adenopathy (cervical) 
mucus membrane changes 
non purulent conjunctival infection
51
Q

how long does the fever in Kawasaki disease last?

A

10 days

52
Q

what is the risk of coronary artery aneurysm without IVIG treatment

A

25%

53
Q

what is the followup for Kawasaki

A

aspirin, with echo in 6 weeks

54
Q

when should primary immunodeficiency be suspected?

A 
recurrent sinus, ear or lung infections within 1 year 
poor response to abx
failure to thrive, 
family history of PID
persistent thrush or skin access.
55
Q

what is the workup for primary immunodeficency

A 
FBC
CXR
IgA, IgG, IgM 
b and T cell subsets
vaccine response 
hiv ab

Part 2 Paediatrics (8 decks)

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