Infectious diseases Flashcards by Owen Vineall

How does diptheria present

Fever
Sore throat
Cough
Recent travel
Cervical lymphadenopathy- very bulky

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Main complication of diptheria

Myocarditis- presents with tachycardia out of proportion or with HB

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What suspect if grey exudate on tonsils

Diphteria

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Organism causing diphteria

Gram positive bacterium Corynebacterium diphtheriae

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What presents with bulky (bull neck) lymphadenopathy

Diphteria

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Investigation for diphteria

culture of throat swab

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Management of diphteria

Diphteria antitoxin
IM penicillin

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Management of EBV

Bed rest and analgesia
School inclusion not necessary
Admission if dehydration or splenic rupture

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Complications of EBV

Splenic rupture
Dehydration

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White exudate
Palatal petechiae
Splenomegaly
Cervical lymphadenopathy

EBV

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Investigations for EBV

Over 12 in second week do blood film- see over 20% atypical (activated) lymphocytes
Under 12- if ill over a week do serology

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Management of measles (uncomplicated)

Advise about fluid intake
Paracetamol and NSAID
School exclusion until 4 days after rash development
Safety net about pneumonia and encephalitis

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When to admit with measles

Signs of pneuomonia or encephalitis
Infant
Immunocompromised

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What adjunct can be used in management of measles if under 2

Vitamin A
Ask paediatrician for advice

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If suspect rubella how investigate

Ensure do not live with someone who is pregnant
Oral fluid sample for NAAT

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How is rubella managed

Adequate fluid intake
Paracetamol or NSAID

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Complications of mumps

Epididymo-orchitis
Pancreatitis
Meningitis
Oophrotis

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Mumps presentation

Parotitis
Coryza

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Mumps management

Oral fluid intake
Paracetamol
NSAID
Review in 1 week
Safety net about meningitis and epidiymo-orchitis

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Management of mumps if very immunocompromised/HIV but no immunisation

MMR vaccine

When is only time admit for mumps

If meningitis or encephalitis in a child
Red flag signs

Presentation of malaria

Fever- can be cyclical
D&V
Flu like symptoms
Jaundice
Severe fatigue

Blood findings of malaria

Anaemia
Thrombocytopenia

Diagnosing malaria

Thick and thin blood films

Presentation of typhoid

1st week Headaches Cough Abdo pain Wt loss Rash- rose spots 2nd week Constipation and diarrhoea

What are rose spots seen in

Typhoid

Difference between travellers diarrhoea and dysentery

Travellers diarrhoea- diarrhoea from rotavirus, ecoli most likely Dystentery- diarrhoea with mucous or blood

Causes of bloody diarrhoea

CHESS Campylobacter Haemorragic e coli Entamoeba histolytica Salmonellla Shigella

What is dengue shock syndrome

when a previously infected child has a subsequent infection with a serologically different strain of the virus. Unfortunately, the partially effective host immune response serves to augment the severity of the infection. The child presents with severe capillary leak syndrome leading to hypotension as well as haemorrhagic manifestations

What do if monospot comes back negative but EBV still suspected

Repeat in 5-7 days If urgent diagnosis required ie immediate return to contact sports then do serology

What is the management of lymphadenitis

Mild- oral co-amoxiclav and follow up 2 days later Severe (systemically unwell- fever, vomiting)- IV co-amoxiclav and consider USS

How does lymphadenitis present

Preceded by infection like tonsillitis or URTI Then get acutely swollen lymph node which is tender and painful

Hep A presentation

Abdo pain Diarrhoea Jaundice Joint pains

When do meningococcus and pneumococcus take over as most common cause of meningitis

1 month Meningococcus the most common in all of childhood

How does viral gastroenteritis tend to present

Vomiting very common

Why is hypertonic saline used in bronchiolitis

Improve wheezing

Where is lymphadenopathy in rubella

Suboccipital Post auricular

Management of malaria

Falciparum - mild= ACT (Artemisinin Combination Therapy) - severe= IV artenusate Non-falciparum - IV chloroquinine

Dengue fever presentation

Fever Myalgia Sunburn like rash Retrorbital headache Hepatomegaly

Investigation for dengue

PCR viral antigen

Chicken pox management if immunocompromised

IV aciclovir

What can cause BCG scar to become inflammed

Kawasaki

Teenager presents with cyanosis after being born abroad

Eisenmenger syndrome

Why are preterm infants more at risk of infection

Most IgG passed in the third trimester

How long off school in mumps

5 days from onset

When give oral aciclovir in chickenpox

Under 1 month Over 14 if within 1 day of rash starting

How does varicella encephalitis present

With cerebellitis- neurological symptoms related to this

When are you non-infectious with B19

As soon as rash appears

What is novel marker of bacterial sepsis

Procalcitonin