Infectious Diseases Flashcards
What are the three stages of chicken pox (Varicella zoster virus)
- Prodrome - Myalgia, Anorexia, nausea, headache
- Rash - Vesicles - clear fluid - crops, effects the palm and soles, proximal limbs, face and trunk.
- After 5 days Crusting of vesicles (non infectious). Fall off after 1-2 weeks.
When is varicella zoster infectious?
2 days before the onset of the rash and 5 days after (or when all vesicles are crusted over)
Treatment for varicella zoster?
Acyclovir - 800 mg 5 times a day for 7 days?
Conservative management - drinking fluids, short nails, cotton and loose clothing
Paracetamol
camomile lotion & chlorphenamine for itching.
What are the stages of rash in varicella zozter?
- Small, macules and erythema
- papules
- pustules
which patients would you refer/seek specialist advice for exposure with varicella zoster and what would you do?
- Pregnant woman (Antibody test IGG) and if negative give prophylaxis (HVIC immunoglobulins)
- immunocompromised - Same day referral to hospital
- Neonates - Same day referral to hospital
Can you get Varicella Zoster on mucous membranes and genitals?
Yes
Should children go to school when they have varicella zoster?
NO - wait until all papules / pustules are crusted over.
How do you assess for tonsillitis?
FeverPAIN or Centor Score (this replaces inflamed tonsils with lymphadenopathy) Fever over 38 P - Purulence A - Attended in 3 days I - Inflamed tonsils N - No cough
If 3/4 then consider antibiotics
If 2/3 then delayed antibiotics
How long does it take for sore throat to recover?
1 week in total
gets better after 3-4 days
What sore throat is caused by Hemophillus influenza B ?
Epiglottitis
A patient is drooling, inspiratory stridor, and has a tripod position what condition is this?
Epiglottitis - Medical emergency DO not Look into the mouth.
Sore throat
What bacteria causes tonsilitis and how is it diagnosed?
- Streptococcus pyogenes (strep a)
- Rapid antigen test
- Throat culture
What symptoms do you get with a sore throat?
Children: Abdominal pain, headaches, nausea and vomiting (all have this in tonsilitus)
Pharyngitis Vs tonsilitis?
Pharyngitis is behind the soft palate - red erythemous
Tonsilits - inflammation of the tonsils
What treatment do you give for sore throat?
- If 3/4 on fever pain or 3/4 on Centor score - Antibiotics - Phenoxymethylpenicillin (Penicilan V)
- Hydration -oral liquids
- paracetamol and Ibuprofen
- Throat lozenges
What types of sore throats can you get?
- Glandular fever - (tested by mononucleosis spot)
- Epistein barr - Kissing, fever, sore throat, adenopathy, splenomegaly (recovers between 1- 2 weeks)
- Strep a - tonsilitis
- influenza a and b, rhinovirus - Pharyngitis
- Measels - Koplik spots (white/grey on buccal mucosa)
Peritonsillar abscess (quinsy) - signs and symptoms?
Most common in 2-4 years old
- Uvular deviation
- one sided swelling of peri -tonsillar
- Trismus
- fever.
- muffled voice
What can herpes simple virus 1 cause?
Herpes Labialis (COLD SORES) Gingivostomatitis (Ruptured vesicles forming ulcers in the mouth with a yellow/white base)
How do you treat Herpes Labialis and Gingivostomatits?
Oral Acyclovir - should be taken as soon as you have prodromal symptoms (itching, tingling, paraesthesia, fever, sore throat)
use for 5 days.
Usually a self limiting infection 7-14 days (should start to improve after 5 days
Conservative:
Lip barrier creams, oral mouthwashes (over the counter)
Wash hands
do not kiss or share items until healed
What can trigger HSV1
- Ultraviolet light, trauma, fatigue, stress, emotional stress, menstruation, oral surgical procedures
Red flags for ulcers?
Persistent ulcers for more than 3 weeks.
What are the symptoms of atypical angina
Constricting discomfort chest pain on exertion or emotional stress
which is relieved by rest and GTN spray
Plus with Abdominal discomfort, breathlessness or nausea
Treatment of Angina
Bisoprolol or CCB (e.g. veramapril)
