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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
management of polio
notification and contacts bed rest analgesia physio no treatment
26
how is the polio vaccine given
combined- tetanus/ diphtheria/ inactivated polio vaccine (Td/IPV)
27
clinical presentation of TB
most kids are asymptomatic fever weight loss cough - doesnt get better after 3 weeks night sweats
28
investigations for tb
chest xray mantoux interferon -gamma release assays (if mantoux testing is not available or impractical)
29
management for active tb
RIPE for 2 months rifampicin isoniazid (with pyridoxine) pyrazinamide ethambutol then isoniazid (pyridoxine) and rifampicin for 4 months (10 months if CNS involvement)
30
why is pyridoxine given with isoniazid
to prevent peripheral neuropathy (given after puberty in children as this complication doesnt occur in young children)
31
why is mantoux test contraindicated if bcg vaccination has been given
gives false positive as individual has already been exposed tuberculin protein from bcg vaccination
32
management for latent tb
isoniazid (with pyridoxine) and rifampicin for 3 months
33
who is bcg vaccine offered to
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
main route of HIV infection in children
mother to child transmission occurs during pregnancy, at delivery, through breastfeeding
35
symptoms of HIV
mouth ulcers various degree of immunosuppression (e.g. recurrent bacterial infections) chronic diarrhoea weight loss lymphadenopathy parotitis fever
36
management for child born to HIV positive mother
regular HIV DNA PCR tests until 18months start on ART
37
what determines whether treatment is given and what is the treatment
ART (antiretroviral therapy) based in clinical status, HIV viral load and CD4 count
38
management for encephalitis
IV aciclovir - suspected, encephalitis, HSV, VZV IV ganciclovir- CMV supportive treatment
39
which strains of HSV mainly affect children
children >3months - HSV-1 ; localised to temporal and frontal lobes neonates - HSV-2; brain involvement is usually generalised
40
which virus would you expect to be the cause of encephalitis in someone with immunodeficiency
CMV
41
clinical presentation for encephalitis
fever altered consciousness seizures unusual behaviour
42
investigations for encephalitis
lp - send csf fro viral pcr (ct if lp contraindicated) MRI after lp hiv testing
43
contraindications for lp
infected skin over puncture site increased ICP trauma /mass to lumbar vertebra
44
what is toxic shock syndrome
severe systemic reaction to staphylococcal exotoxins which is characterised by fever >39deg, hypotension, diffuse erythematous, macular rash
45
what is the toxin causing toxic shock syndrome
tsst-1 superantigen toxin
46
clinical presentation of toxic shock syndrome
fever low bp blanching erythematous rash late sign - peeling hands and feet (1-2 weeks after onset)
47
organ involvement in toxic shock syndrome
myositis gi - vomting renal dysfunction - increased creatinine altered consciousness thrombocytopaenia
48
management for toxic shock syndrome
intensive care support areas of infection should be removed abx - cephalosporins (e.g. ceftriaxone) and clindamycin
49
transmission of coxsackie's disease
faeco-oral
50
what is hand foot and mouth disease
painful vesicular lesions on the hands, feet and mouth and tongue caused by coxsackie a virus
51
how does hand foot and mouth disease usually typically first present
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
management for hand foot and mouth disease
supportive - adequate fluid intake, analgesia highly contagious so avoid sharing towels, bedding etc
53
what is nappy rash
contact dermatitis in the nappy area
54
what is nappy rash caused by
friction between skin and nappy contact with urine and faeces
55
when is nappy rash common
9-12 months
56
what can occur as a result of nappy rash
candida infection
57
presentation of nappy rash with candida infection
erythematous rash involving flexure regions satellite lesions well demarcated scaly border circular pattern to the rash spreading outwards
58
management of nappy rash
avoid irritants emollients use highly absorbent nappies change nappy and clean skin asap after wetting or soiling
59
management for nappy rash with candida infection
anti fungal cream - clotrimazole, miconazole abx- fluclox

Paediatrics (16 decks)

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