Infectious disease

Question 1

What size vessels does Kawasaki disease affect?

Answer 1

Medium-sized vessels

Question 2

What age group in children does Kawasaki disease typically affect?

Answer 2

Under 5 years old

Question 3

What is the major complication with Kawasaki disease?

Answer 3

Coronary artery aneurysm

Question 4

Give the key clinical features of Kawasaki disease

Answer 4

Persistent high fever (39c+ more than 5 days)

Widespread erythematous maculopapular rash

Desquamation on palms and soles

Strawberry tongue

Cracked lips
Cervical lymphadenopathy
Bilateral conjunctivitis

Question 5

Give investigations useful for Kawasaki disease

Answer 5

FBC (low Hb, low white cells, high platelets)
LFT (low albumin, high liver enzymes)
Inflammatory markers (raised ESR)
Urinalysis (raised WBC without infection)
Echocardiogram (?aneurysm)

Question 6

What are the 3 phases of Kawasaki disease?

Answer 6

1. Acute
2. Subacute
3. Convalescent (recovery)

Question 7

What are the 2 first line medical treatments for Kawasaki disease?

Answer 7

High dose aspirin (reduce thrombosis risk)

IV IG (reduce risk of coronary artery aneurysm)

NB: Aspirin allowed despite Reyes syndrome - ONLY DISEASE IN CHILDREN WHERE ASPIRIN ALLOWED!

Question 8

Which drug can cause Reye’s syndrome? Which disease is the only one where aspirin is used in children?

Answer 8

Aspirin

Kawasaki disease

NB: Reye’s syndrome is liver and brain damage.