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Paediatrics > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

When are Koplik spots found?

A

Measles

24-48 hours before the exanthem

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2
Q

What are the stages of subacute sclerosing panencephalitis?

A
  1. Dementia
  2. Epilepsy and myoclonus
  3. Decerebration (increased tone, vegetative state, coma)
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3
Q

What is the treatment for scabies?

A

Permethrin

Wash all clothing and linen

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4
Q

When are renal ultrasounds indicated for UTIs?

A

Severe UTI

Recurrent febrile UTIs

Atypical UTI (i.e. non-E.coli)

Children younger than 2 with a febrile UTI

For structural abnormalities

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5
Q

Why are pregnant women vaccinated for pertussis?

A

To provide passive immunity to their children

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6
Q

What is the triad of Reye syndrome?

A
  1. Preceding viral illness
  2. Acute encephalopathy
  3. Liver failure
    * Due to aspirin use in children with a viral infection*
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7
Q

How long is a patient with scarlet fever infectious for?

A

24 hours after penicillin is given

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8
Q

How does the rash of meningococcus progress?

A

Red rash → petechiae → purpura

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9
Q

What vaccinations are given at 4 years?

A

Diptheria, tetanus, pertussis, polio

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10
Q

What is Brudzinski sign?

A

Pain and hip flexion with passive neck flexion

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11
Q

What bacteria is the most common cause of osteomyelitis?

A

Staphylococcus auerus

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12
Q

When is a child with erythema infectiosum contagious?

A

During the prodrome only

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13
Q

Which TORCH infection is associated with Hutchinson teeth, a congenital dental malformation involving notches and widely shaped central incisors?

A

Syphilis

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14
Q

What vaccinations are given at 4 months?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

Pneumococcal

Rotavirus

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15
Q

What is the pathophysiology of DIC secondary to sepsis?

A

Cytokines → hypercoagulation with hypofibrinolysis → microthrombi → impaired perfusion and tissue necrosis

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16
Q

What chemoprophylaxis is given to people who have had contact with Neisseria meningitidis?

A

Ciprofloxacin oral

OR

Ceftriaxone IM (hurts)

Contacts within the past week

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17
Q

Which TORCH infection is associated with saddle nose and a short maxilla?

A

Syphilis

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18
Q

What vaccination is given at birth?

A

Hepatitis B

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19
Q

How do meningococci stain?

A

Gram negative diplococci

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20
Q

Passive infant immunity through breast milk occurs through which immunoglobulin?

A

IgA

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21
Q

What is the most common cause of meningitis in newborns?

A

Group B Streptococcus

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22
Q

What drug can be given for RSV prevention?

A

Palivizumab

Monoclonal antibody that provides passive immunisation to RSV infection

Indications: infants at risk for severe bronchiolitis e.g. prematurity, heart or lung disease, immunocompromised states

Monthly IM administration during RSV season for the first year of life

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23
Q

What does a non-blanching rash in children suggest?

A

Meningococcal

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24
Q

What is the major complication of measles?

A

Subacute sclerosing panencephalitis

A lethal, generalised, demyelinating inflammation of the brain

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25
Q

A sandpaper rash is characteristic of which disease?

A

Scarlet fever

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26
Q

What is the treatment for Staphylococcus impetigo?

A

Flucloxacillin

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27
Q

Which TORCH infection is associated with CN VIII deafness?

A

Syphilis

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28
Q

How is meningococcus spread?

A

Secretions from the back of the nose and throat

Requires close and prolonged contact, not easily spread

Bacteria do not last long outside of the body

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29
Q

Which TORCH infections present with a blueberry muffin appearance, indicative of extramedullay haematopoesis?

A

Rubella + CMV

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30
Q

Which organism causes pertussis?

A

Bordetella pertussis

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31
Q

Is tonsillitis more commonly viral or bacterial?

A

Viral

If bacterial - S. pyogenes (Group A strep)

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32
Q

What is the most common cause of croup?

A

Parainfluenza virus (75%)

Followed by respiratory syncytial virus

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33
Q

What is the pathophysiology of Waterhouse-Friderichsen syndrome?

A

Bacterial endotoxins → coagulopathy → haemorrhagic necrosis of the adrenal gland

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34
Q

What features are suggestive of pyelonephritis in a child with bacteriuria?

A

Fever

Loin pain

Tenderness

If any of these features are present treat as pyelonephritis (common in children)

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35
Q

Gastroenteritis that occurs in an outbreak is most likely?

A

Norovirus

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36
Q

Which population is predisposed to eczema herpeticum?

A

Atopic people

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37
Q

Which TORCHes infection presents with recurrent infections and diarrhoea?

A

HIV

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38
Q

What is the triad of congenital rubella?

A
  1. Patent ductus arteriosus
  2. Cataracts
  3. Deafness
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39
Q

What causes hand, foot and mouth disease?

A

Coxsackie A

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40
Q

What vaccinations are given at 6 weeks?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

Pneumococcal

Rotavirus

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41
Q

What cause scabies?

A

Sarcoptes scabiei mite

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42
Q

Do premature infants recieve their vaccinations at chronological or corrected age?

A

Chronological

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43
Q

When are Pastia’s lines seen?

A

Scarlet fever

Most pronounced in the groin, underarm and elbow creases

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44
Q

What is the most common cause of meningitis in children and teens?

A

Neisseria meningitidis

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45
Q

Why do infants with bronchiolitis have hyperinfilation in CXR?

A

Mucous plugs act as a one way valve → air goes in but not out → air-trapping and hyperinflation

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46
Q

Viral infection followed by extension of commensals from the larynx into the trachea describes which disease?

A

Bacterial tracheitis

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47
Q

What cardiovascular defects are associated with congenital rubella?

A

Patent ductus arteriosis

Pulmonary artery hyperplasia

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48
Q

What are the three most suggestive signs of sepsis from meningococcal disease?

A
  1. Cold hands and feet
  2. Leg pain
  3. Abnormal skin colour e.g. pallor, mottling
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49
Q

What is the tetrad of HSP?

A
  1. Palpable purpura
  2. Arthritis/arthralgia
  3. GI symptoms
  4. Renal disease
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50
Q

What are the TORCH infections?

A

T - toxoplasmosis

O - others; syphilis, varicella zoster, parvovirus B19, listeriosis

R - rubella

C - cytomegalovirus

H - herpes simplex

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51
Q

How is tonsillitis treated?

A

Supportive

Antibiotics only used in groups at risk of complications of S. pyogenes infection e.g. high rates of rheumatic fever, existing heart disease

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52
Q

Which TORCH infection is associated with saber shins?

A

Syphilis

Sharp anterior bowing of the tibia

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53
Q

When is the peak incidence of bronchiolitis?

A

2-6 months of age

Primarily affects children <2

More common in winter

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54
Q

Which pathogen is most commonly involved in otitis media?

A

S. pneumoniae

Bacterial superinfection following URTI

55
Q

How is hand, foot and mouth disease treated?

A

Supportive

Hygeiene

Lesions are contagious until they dry up

56
Q

How is Kawasaki disease treated?

A

IV immunoglobulin

High dose aspirin

57
Q

Which pathogen may cause meningitis with myalgia and a petechial/purpuric rash?

A

Neisseria meningitidis

58
Q

How is a diagnosis of epiglottitis confirmed?

A

Pharyngoscopy

Cherry-red epiglottis

Not needed for a diagnosis

59
Q

What causes the induction of prostaglandins, particularly PGE2, during fever?

A

Pyogenic cytokines arriving at the anterior hypothalamus

60
Q

Why is the rash from meningococcal sepsis non-blanching?

A

Neisseria meningitidis has direct toxicity to the endothelium of blood vessels → bleeding into the skin

61
Q

What are the distinctive clinical features of a child with epiglottitis?

A

Tripoding

Drooling

Muffled voice with painful speech

Distress

62
Q

What is the classic triad of congenital toxoplasmosis?

A
  1. Chorioretinitis
  2. Hydrocephalus
  3. Intracranial calcifications
63
Q

What vaccinations are given in year 7?

A

Diptheria, tetanus, pertussis

Human papillomavirus (2 doses)

64
Q

What are the features of Kawaski disease?

A

C - conjunctivitis

R - rash

A - adenopathy

S - strawberry tongue

H - hands and feet (oedema and erythema)

and burn

65
Q

What are the 3 C’s of measles?

A

Conjunctivitis

Cough

Coryza

66
Q

What is the major complication of Kawasaki disease?

A

Coronary artery aneurysm

67
Q

When does Forchheimer sign occur?

A

Rubella

Petechiae on the soft palate and uvula during the prodromal period

68
Q

What is the most common causative agent of bacterial tracheitis?

A

Staphylococcus aureus

69
Q

Which TORCHes infection presents with hearing loss, seizures, petechial rash and blueberry muffin rash?

A

CMV

70
Q

What is the most common cause of gastroenteritis in young children?

A

Rotavirus

71
Q

How long is a child with rubella infectious for?

A

1-2 weeks before the rash appears → 5 days after

72
Q

What are 3 risk factors for bronchiolitis?

A
  1. Prematurity
  2. Congenital heart disease
  3. Congenital lung disease
  4. Immunodeficiency
73
Q

When is a child with varicella zoster contagious?

A

24 hours before the rash until all crusted

74
Q

What follow up imaging is performed if a renal ultrasound is suggestive of vesiculoureteric reflux?

A

Micturating cystourethrogram

75
Q

What vaccinations are given at 12 months?

A

Meningococcal ACWY

Pneumococcal

Measles, mumps, rubella

76
Q

What is the immediate treatment if meningococcal meningitis is suspected?

A

IV ceftriaxone/cefotaxime

77
Q

What vaccination is given in years 10-11?

A

Meningococcal ACWY

78
Q

What vaccinations are given at 18 months?

A

Diphtheria, tetanus, pertussis

Measles, mumps, rubella, varicella

Haemophilus influenzae type b

79
Q

Palivizumab is used to prevent what disease?

A

Bronchiolitis (RSV)

80
Q

What are the two most common causes of meningitis in infants (1 month - 2 years)

A
  • Streptococcus pneumoniae*
  • Neisseria meningitidis*
81
Q

Which antibiotic is used for otitis media?

A

Amoxicillin

Indications: bilateral infection, symptoms not resolving, severe illness, immunosuppression

82
Q

What is the most common cause of bronchiolitis?

A

Respiratory syncytial virus

83
Q

What is erythema marginatum?

A

Cutaneous manifestation of rheumatic fever

Centrifugally expanding pink rash with a well-defined outer border and central clearing

Non-pruritic

84
Q

What is the classic triad of meningitis?

A

Fever, headache, neck stiffness

85
Q

Which TORCH infection often presents with foetal hydrops?

A

Parvovirus

Due to aplastic anaemia

86
Q

What causes roseola?

A

Herpes virus 6

87
Q

What is the formal name for croup?

A

Laryngotracheitis

88
Q

Where does the rash of measles spread on the body>

A

Cephalocaudal

89
Q

Which TORCH infection presents with encephalitis and herpetic (vesicular) lesions?

A

HSV-2

90
Q

What causes eczema herpeticum?

A

Herpes simplex 1/2

91
Q

Where does the rash from rubella start?

A

Behind the ears

92
Q

How is acute cystitis treated?

A

Trimethoprim + sulfamethoxazole

5 days (10 days for pyelonephritis)

93
Q

Does vomiting predominate in rotavirus or norovius?

A

Norovirus

Diarrhoea is more severe in rotavirus

94
Q

What imaging finding is characteristic of croup?

A

Steeple sign (subglottic narrowing)

95
Q

What is Kernig sign?

A

Pain with leg flexion in meningitis

96
Q

Why is dexamethasone given to infants with meningitis?

A

Reduces the risk of hearing loss (Hib) and may improve mortality (pneumococcus)

Thought to reduce the overwhelming inflammatory response to administration of antibiotics - give before antibiotics

97
Q

How is eczema herpeticum treated?

A

Oral acyclovir

Dermatologic emergency

98
Q

What vaccinations are given at 6 months?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

99
Q

How is encephalitis treated?

A

Acyclovir

In case the cause is HSV - rare but devestating

100
Q

What is the characteristic x-ray sign of epiglottitis?

A

Thumbprint sign

Enlarged epiglottis with supraglottic narrowing

101
Q

What causes impetigo?

A

Staphylococcus aureus

Group A B-haemolytic Streptococcus if low SES

102
Q

How does Streptoccocus pneumoniae (pneumococci) stain?

A

Gram positive diplococci

103
Q

What causes scarlet fever?

A

TOXINS from Group A Streptococcus

104
Q

What type of immunoglobulin can cross from maternal blood into the placenta?

A

IgG

105
Q

What are the most common causes of viral meningitis?

A

Enterovirus: coxsackie and echovirus

Herpes simplex

EBV

More common in teens and young adults

Less severe than bacterial meningitis and a full recovery can be expected

106
Q

What is the most common cause of Waterhouse-Friderichsen syndrome?

A

Meningococcal meningitis

(Neisseria meningitidis)

107
Q

Why do infants with bronchiolotis have atelectasis on CXR?

A

Mucous plugs trap air in the bronchioles → air diffuses into the bloodstream → airways collapse

108
Q

How is herpetic gingivostomatitis managed?

A

Supportive management with analgesia

Acyclovir if immunocompromised

109
Q

When is dexamethasone given during the treatment of meningitis?

A

Before administration of Abx

Prevents overwhelming inflammatory response

110
Q

What immunisation is given at birth?

A

Hepatitis B

111
Q

What immunisations are given at 6 weeks?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

Pneumococcal

Rotavirus

112
Q

What immunisations are given at 4 months?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

Pneumococcal

Rotavirus

113
Q

What immunisations are given at 6 months?

A

Diptheria, tetanus, pertussis, Haemophilus influenzae type b, hepatitis B, polio

114
Q

What immunisations are given at 12 months?

A

Meningococcal ACWY

Pneumococcal

Measles, mumps, rubella

115
Q

What immunisations are given at 18 months?

A

Diptheria, tetanus, pertussis

Measles, mumps, rubella, varicella

Haemophilus influenzae type b

116
Q

What immunisations are given at 4 years?

A

Diptheria, tetanus, pertussis, polio

117
Q

What immunisations are given in year 7?

A

Diptheria, tetanus, pertussis

Human papillomavirus (2 doses)

118
Q

Give three ways by which GAS infection can be confirmed (current or recent)

A
  1. Throat culture
  2. Rapid streptococcal antigen test
  3. Antistreptolysin antibody
  4. Antideoxyribonuclease B antiboody
119
Q

What are the major criteria for rheumatic fever?

A
  1. Carditis
  2. Arthritis
  3. Chorea
  4. Erythema marginatum
  5. Subcutaneous nodules
120
Q

What are anti-deoxyribonuclease B antibodies tested for?

A

Group A strep

121
Q

Which vaccines are live-attenuated?

A

MMR

Rotavirus

Varicella

Zoster

Yellow fever

Tyhoid

Japanese encephalitis

BCG

122
Q

Does SSSS involved the mucosa?

A

NO

123
Q

How is Sydenham’s chorea treated?

A

Usually no treatment

Carbamazepine or valproic acid, if necessary

124
Q

Following acute rheumatic fever, how long is secondary prevention with benzathine penicillin continued for?

A

3-4 weekly

Minimum of 10 yearts after more recent episode or until age 21 (whichever is longer)

125
Q

Which organism often causes infection following fresh water exposure?

A

Pseudomonas aeruginosa

126
Q

What are the most common causes of ophthalmia neonatorum?

A

Conjunctivitis in the first month of life

Chlamydia or gonorrhoea

127
Q

What are the possible complications of meningitis?

A

SIADH

Cerebral oedema

Hearing loss

Waterhouse-Friderischsen syndrome

Epilepsy

Cognitive deficits, CP

128
Q

How many annual URTIs is normal for a young child?

A

8-10

129
Q

What is cat scratch disease?

A

Benign, self-limiting illness caused by Bartonella henselae, transmitted by cats

Mild constitutional symptoms, papules/vesicles, lymphadenopathy

130
Q

Which helminth causes threadworm/pinworm?

A

Enterobius vermicularis

131
Q

Which medication is in Combantrin?

(anti-helminth chocolates)

A

Pyrantel

132
Q

What is the triad of infectious mononucleosis?

A
  1. Fever
  2. Generalised non-tender lymphadenopathy
  3. Exudative pharyngitis/tonsilitis
133
Q

Which childhood vaccination is associated with febrile seizures?

A

MMR

Paediatrics (24 decks)

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