infectious disease Flashcards
What is the top cause of death for children under 5.
infectious disease
What are the common symptoms in Malaria?
fever (39.5), tiredness, abdominal pain, travel from africa, hepatomegaly and splenomegaly
What are the blood test you should order if you are suspecting malaria?
FBC looking for anaemia, LFT looking for derangement, blood films, parasite films thick and thin, malarial antigen test
what is the most severe form of malaria?
P. Falciparum. this can lead to cerebral malaria.
what is the most common form of malaria?
P. vivix it is associated with splenomegaly
what is the rarest form of malaria
p ovale, and it is also less dangerous
What is the least dangerous malaria
P. Malariae
what is the incubation time for malaria
between 6 days to 3 months
what is the treatment for Malaria?
artemisinin based combination therapy the exact treatment depends on the type of malaria
what is the treatment for P. falciparum?
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.
how many sample do you have to receive before you can exclude malaria?
three samples taken within 24- 48 hours
what is a sign you can look for on your abc for malaria?
thrombocytopenia
what enzyme do you need to screen for before starting malaria treatment?
g6pd deficiency
what enzyme do you need to screen for before starting malaria treatment?
g6pd deficiency
what are the major features of severe or complicated malaria?
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%.
what are the symptoms of TB
weight loss, night sweats, and cough.
what can you do if you suspect tb in a child?
gastric lavage, sputum sample two early morning samples
what kinds of tests can you do on a sputum sample for tb
stain for acid fast bacilli and per test culture for full resistance profile.
would you wait for cultures to come back before starting treatment for TB?
no you would start rifampicin, isoniazid, ethambutol, and pyrazinamide
when should you use tuberculin skin test over interferon gamma release assay?
if the child is under 5 than TST is better.
if the tuberculin skin test is negative what does that mean?
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
what is the treatment for latent TB
a 3 month course of isoniazid with pyridoxine and rifampicin.
what are the symptoms of hepatitis A?
history of travel to an endemic area (south america), jaundice, hepatomegaly, lethargy, abdominal pain, eaten local food.
what is the testing that you would do in HEP A infection?
serological testing hep A IGM and IGG
does hep a cause chronic infection?
no (b and C do)
what is the treatment for hepatitis A?
supportive treatment
how are Hep B and C contracted?
through blood and body fluids
what happens when children get HBV infection?
90% of infants will develop chronic infection and liver failure, and 40% of children will develop chronic infection.
what are the symptoms of campylobacter gastroenteritis?
bloody diarrhoea, with suck contacts after eating contaminated food.
what is the treatment for gastroenteritis?
supportive therapy with oral rehydration salts.
what is the definition of diarrhoea
3 or more loose or liquid stools per day (or more frequent than what is normal for the child).
what are the common causes of bacterial diarrhoea
campylobacter, chlorea, enterotoxin e coli, shigella, typhoid
what is the most common cause of viral diarrhoea
rota virus, calciciviruses, noroviruses.
what are the parasitic causes of diarrhoea
amoebic dysentry, cyptospirisium, giardia
what is the definition of a fever?
greater than 38C
what can cause a fever?
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
what are some examples of viral fevers focuses
URTI, gastroenteritis, chickenpox, measles
what re some bacterial causes of fever focuses?
pneumonia, UTI, meningococcus
what are some inflammatory or autoimmune causes of fever?
Kawasaki disease, juvenile idiopathic arthritis
what are the red light features of a fever?
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).
what are the causes of a non blanching rash
meningococcal meningitis, viral enterovirus, other: thrombocytopenia, HSP
what is the ddx for a maculopapular rash
measles, rubella, herpes virus 6 (roseola infantum), fifth disease (parvovirus B19), enterovirus. bacterial: group A strep (sandpaper rash)
what is the ddx for vesicular rash:
coxsackie A (hand foot and mouth disease), varicella zoster virus (chicken pox shingles), herpes simplex
what is the ddx for a desquamation rash?
bacterial: post streptococcal infection
other: Kawasaki disease
how long are you contagious for with parvovirus B19
24 hours after fever has resolved
what are the symptoms of scarlet fever?
sore throat, fever and swollen tonsils and neck glands.
rash: scarlet develops with sandpaper like texture
strawberry tongue with peeling skin during recovery phase
what does triple therapy mean?
cefotaxime
broad spectrum coverage but also penetrates the CNS), gent covers gram negative, ampicillin (for listeria
when is chickenpox still contagious?
1-2 days before rash onset until all the lesions are crusted over and no lesions have appeared for 24 hours.
what are the rare complications of chicken pox?
nec fasciitis, toxic shock syndrome, encephalitis, aseptic meningitis, cerebellitis, pneumonitis
how do we treat a fever of unknown origin?
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.
what are the features if Kawasaki disease
fever for 5 days polymorphous rash adenopathy (cervical) mucus membrane changes non purulent conjunctival infection
how long does the fever in Kawasaki disease last?
10 days
what is the risk of coronary artery aneurysm without IVIG treatment
25%
what is the followup for Kawasaki
aspirin, with echo in 6 weeks
when should primary immunodeficiency be suspected?
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.
what is the workup for primary immunodeficency
FBC CXR IgA, IgG, IgM b and T cell subsets vaccine response hiv ab
