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Paediatrics > infectious disease > Flashcards

infectious disease Flashcards

1
Q

what is diphtheria

A

acute URTI which can also affect the skin
caused by Corynebacterium diphtheriae

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2
Q

risk factors for diphtheria

A

poor hygiene
poor living conditions
lack of immunisation

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3
Q

route of transmission for diphtheria

A

via resp route or contact with exudate from skin lesions

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4
Q

clinical presentation of diphtheria

A

nasal discharge that is initially watery but become purulent and blood-stained
enlarged cervical lymph nodes
difficulty swallowing
thick grey-white coating that can cover the back of the throat, nose and tongue

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5
Q

differential diagnosis of diphtheria

A

oral thrush
tonsillitis
guillain barre syndrome

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6
Q

management of diphtheria

A

abx
contacts should be given erythromycin or penicillin (abx prophylaxis)

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7
Q

complications of diphtheria

A

paralysis
difficulty swallowing and nasal speech
cardiac complications

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8
Q

what is whooping cough

A

highly contagious resp infection caused by bordetella pertussis

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9
Q

what are the 3 phases of whooping cough

A

catarrhal phase
paroxysmal phase
convalescent phase

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10
Q

what is the catarrhal phase

A

lasts 1-2 weeks and presents similarly to common lrti

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11
Q

what is the paroxysmal phase

A

last about 1 week
characterised by bouts of paroxysmal coughing

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12
Q

what is the convalescent phase

A

lasts 2-3weeks
gradual improvement in cough frequency and severity

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13
Q

clinical presentation of whooping cough

A

coryzal symptoms
fever
cough- severe coughing starts ~1 week after
post-tussive vomiting

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14
Q

investigations for whooping cough

A

nasal/ throat swab
blood cultures
pcr

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15
Q

management for whooping cough

A

hospital if 6months or younger
abx

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16
Q

what abx to give in whooping cough

A

macrolide

under 1month - clarithromycin
over 1yrs - azithromycin or clarithromycin

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17
Q

what can result in after vigorous coughing in whooping cough

A

epistaxis
subconjunctival haemorrhages

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18
Q

complications of whooping cough

A

pneumonia
convulsions
bronchiectasis

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19
Q

when is abx most effective in whooping cough

A

most effective when given during catarrhal phase
within first 21 days

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20
Q

what is polio

A

infection caused by the poliovirus

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21
Q

complications of polio

A

meningitis
paralysis

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22
Q

route of transmission of polio

A

faeco-oral
resp

highly contagious

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23
Q

clinical presentation of polio

A

most are asymptomatic or flu-like illness

non-paralytic polio - flu-like symptoms and meningitis

paralytic polio- flu-like symptoms and then variable severity

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24
Q

clinical features of paralytic polio

A

myalgia, muscle spasms and meningism

asymmetrical, flaccid motor paralysis, predom. lower-limb

bulbar form of paralysis - resp failure, bulbar symptoms e.g. dysphagia and dysphonia

25
Q

management of polio

A

notification and contacts

bed rest
analgesia
physio

no treatment

26
Q

how is the polio vaccine given

A

combined- tetanus/ diphtheria/ inactivated polio vaccine (Td/IPV)

27
Q

clinical presentation of TB

A

most kids are asymptomatic

fever
weight loss
cough - doesnt get better after 3 weeks
night sweats

28
Q

investigations for tb

A

chest xray
mantoux
interferon -gamma release assays (if mantoux testing is not available or impractical)

29
Q

management for active tb

A

RIPE for 2 months
rifampicin
isoniazid (with pyridoxine)
pyrazinamide
ethambutol

then isoniazid (pyridoxine) and rifampicin for 4 months (10 months if CNS involvement)

30
Q

why is pyridoxine given with isoniazid

A

to prevent peripheral neuropathy
(given after puberty in children as this complication doesnt occur in young children)

31
Q

why is mantoux test contraindicated if bcg vaccination has been given

A

gives false positive as individual has already been exposed tuberculin protein from bcg vaccination

32
Q

management for latent tb

A

isoniazid (with pyridoxine) and rifampicin for 3 months

33
Q

who is bcg vaccine offered to

A

infants (0-12months) parent or grandparent who was born in a tb prone country

infants (0-12 months) living in areas of the UK where incidence of tb is high

previously unvaccinated children (1-5yrs) with a parent or grandparent who was born in a country with high incidence of tb

previously unvaccinated, tuberculin-negative children (6-16yrs) with a parent or grandparent who was born in a country with high incidence of tb

34
Q

main route of HIV infection in children

A

mother to child transmission
occurs during pregnancy, at delivery, through breastfeeding

35
Q

symptoms of HIV

A

mouth ulcers
various degree of immunosuppression (e.g. recurrent bacterial infections)
chronic diarrhoea
weight loss
lymphadenopathy
parotitis
fever

36
Q

management for child born to HIV positive mother

A

regular HIV DNA PCR tests until 18months
start on ART

37
Q

what determines whether treatment is given and what is the treatment

A

ART (antiretroviral therapy)
based in clinical status, HIV viral load and CD4 count

38
Q

management for encephalitis

A

IV aciclovir - suspected, encephalitis, HSV, VZV

IV ganciclovir- CMV

supportive treatment

39
Q

which strains of HSV mainly affect children

A

children >3months - HSV-1 ; localised to temporal and frontal lobes

neonates - HSV-2; brain involvement is usually generalised

40
Q

which virus would you expect to be the cause of encephalitis in someone with immunodeficiency

A

CMV

41
Q

clinical presentation for encephalitis

A

fever
altered consciousness
seizures
unusual behaviour

42
Q

investigations for encephalitis

A

lp - send csf fro viral pcr (ct if lp contraindicated)
MRI after lp
hiv testing

43
Q

contraindications for lp

A

infected skin over puncture site
increased ICP
trauma /mass to lumbar vertebra

44
Q

what is toxic shock syndrome

A

severe systemic reaction to staphylococcal exotoxins
which is characterised by fever >39deg, hypotension, diffuse erythematous, macular rash

45
Q

what is the toxin causing toxic shock syndrome

A

tsst-1 superantigen toxin

46
Q

clinical presentation of toxic shock syndrome

A

fever
low bp
blanching erythematous rash

late sign - peeling hands and feet (1-2 weeks after onset)

47
Q

organ involvement in toxic shock syndrome

A

myositis
gi - vomting
renal dysfunction - increased creatinine
altered consciousness
thrombocytopaenia

48
Q

management for toxic shock syndrome

A

intensive care support
areas of infection should be removed
abx - cephalosporins (e.g. ceftriaxone) and clindamycin

49
Q

transmission of coxsackie’s disease

A

faeco-oral

50
Q

what is hand foot and mouth disease

A

painful vesicular lesions on the hands, feet and mouth and tongue
caused by coxsackie a virus

51
Q

how does hand foot and mouth disease usually typically first present

A

typical URTI - tiredness, sore throat, dry cough and raised temp
1-2 days after mouth ulcers appear followed by blistering red spots across the body

52
Q

management for hand foot and mouth disease

A

supportive - adequate fluid intake, analgesia

highly contagious so avoid sharing towels, bedding etc

53
Q

what is nappy rash

A

contact dermatitis in the nappy area

54
Q

what is nappy rash caused by

A

friction between skin and nappy
contact with urine and faeces

55
Q

when is nappy rash common

A

9-12 months

56
Q

what can occur as a result of nappy rash

A

candida infection

57
Q

presentation of nappy rash with candida infection

A

erythematous rash involving flexure regions
satellite lesions
well demarcated scaly border
circular pattern to the rash spreading outwards

58
Q

management of nappy rash

A

avoid irritants
emollients
use highly absorbent nappies
change nappy and clean skin asap after wetting or soiling

59
Q

management for nappy rash with candida infection

A

anti fungal cream - clotrimazole, miconazole
abx- fluclox

Paediatrics (16 decks)

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