Infectious diseases Flashcards
How does diptheria present
Fever
Sore throat
Cough
Recent travel
Cervical lymphadenopathy- very bulky
Main complication of diptheria
Myocarditis- presents with tachycardia out of proportion or with HB
What suspect if grey exudate on tonsils
Diphteria
Organism causing diphteria
Gram positive bacterium Corynebacterium diphtheriae
What presents with bulky (bull neck) lymphadenopathy
Diphteria
Investigation for diphteria
culture of throat swab
Management of diphteria
Diphteria antitoxin
IM penicillin
Management of EBV
Bed rest and analgesia
School inclusion not necessary
Admission if dehydration or splenic rupture
Complications of EBV
Splenic rupture
Dehydration
White exudate
Palatal petechiae
Splenomegaly
Cervical lymphadenopathy
EBV
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
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
When to admit with measles
Signs of pneuomonia or encephalitis
Infant
Immunocompromised
What adjunct can be used in management of measles if under 2
Vitamin A
Ask paediatrician for advice
If suspect rubella how investigate
Ensure do not live with someone who is pregnant
Oral fluid sample for NAAT
How is rubella managed
Adequate fluid intake
Paracetamol or NSAID
Complications of mumps
Epididymo-orchitis
Pancreatitis
Meningitis
Oophrotis
Mumps presentation
Parotitis
Coryza
Mumps management
Oral fluid intake
Paracetamol
NSAID
Review in 1 week
Safety net about meningitis and epidiymo-orchitis
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
