Infectious Disease part 1

Question 1

Define sepsis

Answer 1

SIRS + suspected/ proven infection (bacteraemia)

Question 2

Define SIRS

Answer 2

Systemic inflammatory response syndrome Presents as Fever or hypothermia, tachycardia, tachypnoea, leucocytosis or leucocytopaenia

Question 3

normal resp rate, heart rate and systolic Bp based on age

Answer 3

Resp rate: <1 - 30-40 1-2 25-35 2-5 25-30 5-12 20-25 >12 15-20 Heart rate: <1 110-160 1-2 100-150 2-5 95-140 5-12 80-120 >12 60-100 Systolic BP: <1 80-90 1-2 85-95 2-5 85-100 5-12 90-110 >12 100-120

Question 4

cause of SIRS

Answer 4

trauma haemorrhage burns pancreatitis liver disease toxins/ drugs others

Question 5

define paediatric severe sepsis

Answer 5

sepsis + multi-organ failure >1 of: -resp failure -renal failure -neurological failure -haematological failure -liver failure

Question 6

Define ARDS

Answer 6

Acute resp response syndrome -Inflammatory response of the lungs

Question 7

Paediatric sepsis what age group is most likely to be affected

Answer 7

newborn and infant and boys more than girls

Question 8

responsible pathogens for paediatric sepsis in neonates (<1 month)

Answer 8

group B streptococci eschericha coli listeria monocytogenes

Question 9

responsible pathogens for paediatric sepsis in children

Answer 9

streptococcus pneumoniae meningococci group A streptococci staph aureus

Question 10

Pathophysiology of paediatirc sepsis

Answer 10

endothelium, neutrophils and monocytes cause microvascular occlusion, vascular instability, sepsis and multi organ failure

Question 11

Paediatric sepsis symptoms (12)

Answer 11

fever or hypothermia, cold hands/ feet, mottled skin, prolonged cap refill, chills/rigors, limb pain, vomiting, diarrhoea, muscle weakness, muscle/joint aches, skin rash, diminished urine output

Question 12

Low, medium and high risk symptoms for sepsis in a child from categories: Colour Activity Respiratory Circulation and hydration Other

Answer 12

Question 13

What is the paediatric sepsis 6 recognition tool?

Answer 13

Question 14

Sepsis treatment

Answer 14

ABCDEFG Antibiotics with broad-spectrum (cephalosporins or amoxicillin if neonate) and good CSF penetration Paediatric sepsis 6: O2, Obtain IV access and bloods IV antibiotics Fluid Early inotropic support (consider) Involve senior/ specialist help early

Question 15

sepsis investigations

Answer 15

Blood: FBC (Leucocytosis, thrombocytopaenia) CRP (elevated) Coagulation factors (deranged due to DIC) U&Es, LFTS (renal and hepatic dysfunction) Blood gas (metabolic acidosis, raised lactate) Glucose (hypoglycaemia) Culture CSF: Cell count and culture (increasing wcc, antigent testing, PCR) Protein and glucose (increased protein level, low glucose) Urine culture Skin biopsy culture Imaging- CT/MRI head

Question 16

responsible pathogens for paediatric meningitis in neonates

Answer 16

Group B streptococci E.coli Listeria monocytogenes

Question 17

Responsible pathogens for paediatric meningitis in children

Answer 17

Streptococcus pneumoniae, Meningococci (Neisseria meningitidis), Haemophilus influenza

Question 18

Meningitis +/- sepsis symptoms in children (7)

Answer 18

Nuchal rigdity Headaches photophobia diminished consciousness Focal neurological abnormalities Seizures Meningociccal rash

Question 19

Meningitis +/- sepsis symptoms in neonates (4)

Answer 19

Lethargy, irritability, Bulging fontanelle, Seizures

Question 20

Streptococcus pneumoniae describe

Answer 20

Gram positive diplo-cocci Transmission by droplets Colonises upper airway Viral infections predisposing factor for invasive disease

Question 21

Pneumococcal disease presentation

Answer 21

menigism pus in brain swollen ear

Question 22

Pneumococcal meningitis complications

Answer 22

brain damage hearing loss hydrocephalus

Question 23

Haemophilus influenza type B describe

Answer 23

Gram-negative bacteria encapsulated H.ingluenzae- resisyt phagocytosis and complement-mediated lysis Viral infection predisposing factor for invasive disease

Question 24

Complication of meningococcal disease

Answer 24

amputation skin scarring cognitive impairment epilepsy hearing loss

Question 25

Types of meningococcus in the nasopharynx

Answer 25

A,B,C,W,X,Y

Question 26

Meningococcal disease virulence factor

Answer 26

Endotoxin= lipooligosaccharide

Question 27

Against what strains of meningitis can you get a vaccine

Answer 27

Meningococcal diseasem Haemophilus influenzae B, Pneumococcal disease