Infectious diseases Flashcards
Management of meningitis in children
<3 months = amoxicillin and cefotaximine
>3 months = cefotaximine
Recent travel = add vancomycin
?steroids if greater than 3 months and bacteria present on LP (no LP if meningococcal sepsis)
What ages is the 6 in 1 given
8 weeks, 12 weeks, 16, weeks
Which type of vaccines can cause infections in immunocompromised patients
Live attenuated vaccines
5 common live attenuated vaccines
MMR BCG Chicken pox Nasal influenza Rotavirus
At what months is the 6 in 1 given
2, 3, 4
Other than 6 in 1, what two other vaccines are given at 2 months
and then at 3 months
2: Men B and rotavirus
3: Pneumococcal and rotavirus
what vaccines are given at 3 months
Men B and 6in1
When is the MMR given
1 year and 3years 4 months
When is men B vaccine given
2 months, 4 months, 12 months
When is Men C given
1 year (2 in 1 with HiB)
What vaccines are given at 1 year
2 in 1 (HiB MenC)
Pneumococcal
MMR
Men B
What vaccine is given between 2 and 8
Influenza yearly
What is Gardsil and what does it protect
HPV
16 and 18 : cervical cancer
6 and 11: genital and other cancers
Temperature in under 3 month year old children that causes GPs to call ambulance/ convey to ED
38.0C
Why does menigococcal sepsis cause a non-blanching rash
DIC and subcutaneous haemorrhages
What bacteria causes a non blanching rash
Nisseria meningitidis
Two special tests to look for meningeal irritation
Kernigs: pt on back, hip and knee at 90 degrees, straighten knee -> back pain
Brudzinskis test: pt on back, lifting head causes flexing of knees and hips
What would a positive kernigs test suggest
Meningeal irritation
What would a positive Brudzinskis test suggest
Meningeal irritation
How to perform Brudzinkis test
Flex neck whilst lying down
Positive result if pt flexs hips and knees
What is Kernigs test
Pt on back, knees and hips at 90 degrees
Straighten knee
Back pain in positive
As well as standard bloods, cultures and ?LP, what else should be sent in ?meningitis
Meningococcal PCR
When would vancomycin be given to a child with a meningitis infection
Recent travel
If the LP is suggestive of bacterial meningitis, other than fluids and abx; what else may be given
Dex 4 times a day for 4 days to CHILDREN OVER 3 MONTSH
What should be used for meningitis post exposure prophylaxis
Ciprofloxacin
3 most common causes of viral meningitis
HSV
entrovirus
VZV
When is an LP taken
Between L3 and L4 as spinal cord ends at L2
High protein in a LP dx
Bacterial
Key complication of meningitis
Hearing loss
What is encephalitis
Inflammation of brain
Most common cause of encephalitis in UK
HSV
Type 1 in children (from cold sores)
Type 2 in neonates (from genital warts) contracted from birth
Triad of infectious mononucleosis
Fever
Sore throat
Fatigue
Itchy rash after amoxicillin ->
EBV/ infectious mononucleosis
2 tests for EBV and methodology
Hetrophile antibodies (non specific antibodies made by body in response)
Monospot test (pts blood to horse RBCs) Paul-Bunnell test (pts blood to sheep RBCs)
Can take up to 6 weeks to work
Can also use IgM (infection) and IgG (immune) ab test
Main complications of EBV
Splenic rupture (avoid contact sports)
Renal failure
Haemolytic anamia
Signs and symptoms of infectious mononucleosis
fever, sore throat, fatigue
Lymphadenopathy, splenomegaly
Mumps incubation period and length of disease
2-3 weeks incubation period
1 week self limiting
Mumps prodrome symptoms then key symptom
Flu like then parotid swelling
3 key complications of mumps
Pancreatitis
Orchitis
Meningitis/ encephalitis
(hearing loss)
What cell does HIV history
CD4
LSCS in mum with HIV (low risk baby) management
IV zidovudine
Mum with HIV low risk baby (CD<50) vs high (CD>50) management
Zidovudine for 4 weeks
Zidovudine, lamivudine and nevirapine for 4 weeks
When is breastfeeding recommend to HIV mothers
Never
It is always possible to transmit disease even if undetectable
How should babies from HIV mothers be managed at birth
Hep B vaccine and Hep b Ig infusion
additional vaccine at 1 and 12 months
Can hep B mothers breast feed
Yes
Can hep c mothers breast feed
Yes
