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Paeds > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

What are inactivated vaccines

A

Killed versions of pathogens

Safe for immunocompromised patients

Polio, flu, hep A, rabies

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2
Q

What are subunit and conjugate vaccines

A

Contain part of organism

Safe for immunocompromised patients

Pneumococcus, meningitis, hep B, whooping cough, haemophilus influenza B, HPV, shingles

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3
Q

What are live attenuated vaccines

A

Weakened version of pathogen

Can cause infection

MMR, BCG, chickenpox, nasal influenza, rotavirus

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4
Q

What are toxin vaccines

A

Cause immunity to toxins, not pathogen itself

Diphtheria, tetanus

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5
Q

What vaccines are included in the vaccine schedule

A

8 weeks: 6 in 1 (diphtheria, tetanus, pertussis, polio, haemophilus influenza B, hep B), meningococcal B, rotavirus (oral)

12 weeks: 6 in 1 (again), pneumococcal, rotavirus (again)

16 weeks: 6 in 1 (again), meningococcal B (again)

1 year: 2 in 1 (haemophilus influenza B, meningococcal C), pneumococcal (again), MMR, meningococcal B (again)

Yearly from 2-8: influenza (nasal)

3 year 4 months: 4 in 1 (diphtheria, tetanus, pertussis, polio), MMR (again)

12-13 years: HPV

14 years: 3 in 1 (tetanus, diphtheria, polio), meningococcal ACWY

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6
Q

What strains does the HPV vaccine protect against

A

6 and 11: genital warts

16 and 18: cervical cancer

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7
Q

What are the signs of paediatric sepsis

A

Deranged physical observations

Prolonged capillary refill time

Fever or hypothermia

Deranged behaviour

Poor feeding

Inconsolable or high pitched crying

Weak cry

Reduced consciousness

Reduced body tone

Cyanosed, mottled, pale, ashen skin

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8
Q

What are the 4 categories that make up the traffic light system for paediatric sepsis

A

Colour

Activity

Respiration

Circulation and hydration

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9
Q

How should babies under 3 months with a temperature be managed

A

Urgently treat for sepsis until proven otherwise

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10
Q

What is the immediate management for paediatric sepsis

A

Call for senior help early

Oxygen

IV access

Bloods (normal, clotting, blood gas)

Urine dip

Antibiotics (within 1 hour)

IV fluids (20ml/kg bolus, repeat as needed)

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11
Q

What are the further management steps for paediatric sepsis

A

Chest X-ray

Abdominal and pelvic ultrasound

Lumbar puncture

Meningococcal PCR

Serum cortisol

Continue antibiotics for 5-7 days

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12
Q

What are the common causes of meningitis in children and neonates

A

Children: neisseria meningitidis, streptococcus pneumoniae

Neonates: group B strep

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13
Q

How might a patient with meningitis present

A

Fever

Neck stiffness

Vomiting

Headache

Photophobia

Altered consciousness

Seizures

Non-blanching rash

Neonates and babies: hypothermia, poor feeding, lethargy, hypotonia, bulging fontanelles

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14
Q

What are the investigations for meningitis

A

Lumbar puncture if: < 1 month with fever, 1-3 months with fever and unwell, < 1 year with fever and other features of serious infection

Kernig’s test

Brudzinski’s test

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15
Q

What is the management for meningitis in the community

A

Urgent stat IV/IM benzylpenicillin

Urgent transfer to hospital

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16
Q

What is the management for meningitis in hospital

A

Blood cultures

Lumbar puncture

Steroids (dexamethasone)

Notifiable disease

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17
Q

What is involved in post-exposure prophylaxis for meningitis

A

Close contacts for past 7 days

Single dose antibiotic (ciprofoxacin)

Within 24 hours of diagnosis

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18
Q

What is viral meningitis

A

Caused by herpes simplex or enterovirus varicella zoster

Usually milder than bacterial meningitis

Often only need supportive care

Give aciclovir

19
Q

What would a lumbar puncture show in bacterial meningitis

A

Cloudy

High protein

Low glucose

High neutrophils (WCC)

Bacteria in culture

20
Q

What would a lumbar puncture show in viral meningitis

A

Clear

Slightly raised or normal protein

Normal glucose

High lymphocytes (WCC)

Negative culture

21
Q

What are the complications of meningitis

A

Hearing loss

Seizures and epilepsy

Cognitive impairment

Learning disability

Memory loss

Cerebral palsy

22
Q

What is encephalitis

A

Inflammation of the brain

Usually viral: herpes simplex, varicella zoster, cytomegalovirus, Epstein-Barr

23
Q

How might a patient with encephalitis present

A

Altered consciousness

Altered cognition

Unusual behaviour

Acute onset focal neurological symptoms

Acute onset focal seizures

Fever

24
Q

What are the investigations for encephalitis

A

Lumbar puncture

CT head

MRI brain

EEG

Swab of area (look for causative organism)

HIV test

25
Q

What is the management for encephalitis

A

IV antivirals: aciclovir for herpes simplex/varicella zoster, ganciclovir for cytomegalovirus

Repeat lumbar puncture (ensure successful treatment before stopping antivirals)

Follow up support and rehabilitation

26
Q

What are the complications of encephalitis

A

Lasting fatigue

Prolonged recovery

Changes in personality

Changes in memory and cognition

Learning disability

Headaches

Chronic pain

Movement disorders

Sensory disturbance

Seizures

Hormonal imbalance

27
Q

What is infectious mononucleosis

A

Infection with Epstein-Barr virus

Aka mono, glandular fever

Transmitted through infected saliva

28
Q

How might a patient with infectious mononucleosis present

A

Fever

Sore throat

Fatigue

Lymphadenopathy

Tonsillar enlargement

Splenomegaly

29
Q

What are the investigations for infectious mononucleosis

A

Specific antibody tests (IgG, IgM)

Heterophile antibodies: not specific to EBV, take 6 weeks to be produced, aka monospot test

30
Q

What is the management for infectious mononucleosis

A

Usually self limiting

Acute illness lasts 2-3 weeks

Advise to avoid alcohol and contact sports

31
Q

What are the complications of infectious mononucleosis

A

Splenic rupture

Glomerulonephritis

Haemolytic anaemia

Thrombocytopenia

Chronic fatigue

Lymphoma

32
Q

What is mumps

A

A viral infection

Droplet spread

14-25 day incubation

Usually self limiting

Lasts around 1 week

A notifiable disease

33
Q

How might a patient with mumps present

A

Initial flu-like symptoms

Parotid swelling (painful)

Fever

Muscle aches

Lethargy

Reduced appetite

Headaches

Dry mouth

Symptoms of complications (abdominal pain for pancreatitis, testicular pain for orchitis)

34
Q

What are the investigations for mumps

A

Saliva swab for PCR and antibody testing

35
Q

What is the management for mumps

A

Supportive care (rest, fluids, simple analgesia)

36
Q

What are the complications of mumps

A

Pancreatitis

Orchitis

Meningitis

Sensorineural hearing loss

37
Q

What is HIV

A

RNA retrovirus

Destroys CD4+ T helper cells

Initial seroconversion flu-like illness

Asymptomatic phase

Symptoms due to being immunocompromised

38
Q

How is HIV transmitted

A

Unprotected anal, vaginal, or oral sex

Vertical transmission

Exposure to bodily fluids

39
Q

What are the investigations for babies of HIV positive parents

A

HIV viral load test at 3 months

HIV antibody test at 24 months

40
Q

What is the management for HIV

A

Antiretroviral therapy

Normal childhood vaccines

Prophylactic co-trimoxazole

Treat opportunistic infections

41
Q

What is hepatitis B

A

DNA virus

Transmitted through contact with bodily fluids

Most neonates fully recover in 2 months (some have chronic infection)

42
Q

Which children should be screened for hep B

A

Have hep B positive mother (screen at 12 months)

Migrants from endemic areas

Close hep B contact

43
Q

What is the management for hep B

A

Babies of hep B positive mothers: hep B vaccine and hep B immunoglobulin infusion at birth

Safe to breastfeed as long as baby is vaccinated

44
Q

What is the management for hep C

A

Test babies of positive mothers at 18 months

Able to breastfeed (stop if nipples crack)

Usually resolves spontaneously

Regular monitoring (liver function, hep C viral load)

Children over 3: pegylated interferon, ribavirin

Treatment delayed until adulthood if possible

Paeds (17 decks)

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