Infectious Disease Flashcards
Vaccination schedule?
2 months - 6in1, PCV, MenB, rotavirus
4 months - 6in1, MenB, rotavirus
6 months - 6in1, PCV, MenC
12 months - MMR, MenB
13 months - HiB/MenC, PCV
Junior Infants - MMR and 4in1
First Year - HPV, Tdap and Men ACWY
What vaccines are in the 6in1?
diphtheria
tetanus
polio
pertussis
Hep B
haemophilus influenza B
What vaccines are in the MMR vaccine?
measles
mumps
rubella
What vaccines are in the 4in1 vaccine?
diphtheria
tetanus
polio
pertussis
What vaccines are in the Tdap vaccine?
tetanus
low dose pertussis
low dose diphtheria
Causes of bacterial meningitis?
children and adults -> NHS
neonates -> GBS, E coli, Listeria
Presentation of meningitis?
fever
neck stiffness
photophobia
headache
vomiting
reduced consciousness
seizures
neonates -> hypotonia, poor feeding, lethargy, irritability, hypothermia, bulging fontanelle
Special tests for meningitis?
Kernig’s test (lying on back with hip flexed and straighten knee- pain and resistance = positive)
Brudzinski’s test (lie on back and flex neck- knee and hip flexion = positive)
Mx of meningitis?
in community give stat dose of IM benzylpenicillin before transfer
ideally LP before antibiotics but don’t delay
<3 months -> amoxicillin + cefotaxime
>3months -> ceftriaxone
dexamethasone to reduce hearing loss and neuro damage
acyclovir to cover for viral
prophylaxis to close contacts -> stat dose of ciprofloxacin or rifampicin
Causes of viral meningitis?
herpes simplex virus
enterovirus
varicella zoster virus
Lumbar puncture viral vs bacterial?
bacterial cloudy, viral clear
protein high in bacterial, normal in viral
glucose low in bacterial, normal in viral
neutrophil-predominant in bacterial, lymphocyte-predominant in viral
Complications of meningitis?
sensorineural hearing loss
seizures and epilepsy
cognitive impairment and learning disability
memory loss
cerebral palsy
Most common cause of encephalitis?
viruses
bacterial and fungal v rare
Viral causes of encephalitis?
HSV (most common)
VZV
CMV
EBV
enterovirus
adenovirus
influenza
polio, mumps, rubella (always ask about vaccines)
Presentation of encephalitis?
altered consciousness
altered cognition
unusual behaviour
acute onset of focal neurological symptoms
acute onset of focal seizures
fever
Investigations for encephalitis?
LP
CT (if LP contraindicated)
MRI
EEG
swabs
HIV testing
Contraindications for LP?
GCS<9
haemodynamically unstable
active seizures
post-ictal
meningococcal septicaemia
raised ICP
Mx of encephalitis?
acyclovir (HSV, VZV)
ganciclovir (CMV)
Complications of encephalitis?
prolonged recovery
fatigue
change in personality or mood
change to memory or cognition
learning disability
headache
chronic pain
movement disorders
sensory disturbance
seizures
hormonal imbalance
What is infectious mononucleosis caused by?
Ebstein-Barr Virus
Presentation of infectious mononucleosis?
fever
sore throat
fatigue
lymphadenopathy
tonsillar enlargement
splenomegaly (rarely splenic rupture)
rash after penicillins
Complications of infectious mononucleosis?
splenic rupture
glomerulonephritis
haemolytic anaemia
thrombocytopenia
chronic fatigue
malignancy (Burkitt’s lymphoma)
Most common complication post-meningitis?
sensorineural hearing loss
Protection against mumps provided by the MMR vaccine?
80%
Presentation of mumps?
pro-drome flu-like symptoms a few days before parotid swelling
fever
muscle aches
lethargy
reduced appetite
headache
dry mouth
parotid gland swelling
testicular pain (orchitis)
abdo pain (pancreatitis)
confusion, neck stiffness, photophobia (meningitis, encephalitis)
Mx of mumps?
diagnosis confirmed by PCR of saliva
notifiable disease
supportive management
Complications of mumps?
orchitis
pancreatitis
meningitis
encephalitis
sensorineural hearing loss
Prevention of HIV transmission during birth?
normal vaginal delivery if viral load <50
C section considered if >50 and done in all >400
IV zidovudine if >10,000
Prophylaxis for HIV in neonates?
low-risk babies where maternal viral load <50 should get zidovudine for 4wks
high-risk babies should get zidovudine, lamivudine and nevirapine for 4wks
Breast feeding in mothers with HIV?
never acceptable
Testing of children with HIV positive parents?
HIV viral load at 3 months
HIV antibody test at 24 months
(antibody test may be falsely positive up to 18 months due to maternal antibodies that crossed the placenta)
