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Paediatrics > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What are the components of SIRS?

A

Fever or hypothermia

Tachycardia

Tachypnoea

Leucocytosis or leucocytopeania

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2
Q

What is the definition of severe sepsis?

A

Sepsis + multi-organ failure

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3
Q

Which organs are commonly affected by severe sepsis?

A

Lungs

Kidneys

Brain

Blood

Liver

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4
Q

What is septic shock?

A

Sepsis + hypotension or hyperlactatemia

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5
Q

In which group of children is sepsis more common?

A

Preterm

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6
Q

What is the most likely organism causing sepsis in neonates (<1 month)?

A

Group B streptococci

E.coli

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7
Q

What is the most likely organism causing sepsis in children?

A

Strep pneumoniae

Meningococci

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8
Q

What are the pathophysiological processes that occur in sepsis?

A

1 - Microvascular occlusion

2 - Vascular instability

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9
Q

What are the symptoms of sepsis in paediatric patients?

A
  • Fever or hypothermia
  • Cold hands/feet
  • Prolonged cap refill time
  • Chills & rigors
  • Vomiting
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10
Q

What are the pathogens that are most likely to cause meningitis in neonates (<1 month)?

A

Group B strep

E.coli

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11
Q

What are the pathogens that are most likely to cause meningitis in children?

A
  • Strep pneumoniae
  • Meningococci
  • Haemophilius Influenzae B
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12
Q

What are the symptoms of meningitis in children?

A

Nuchal rigidity (unable to flex neck forwards)

Headaches

Photophobia

Reduced consciousness

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13
Q

What are the symptoms of meningitis in neonates?

A
  • Lethargy
  • Irritability
  • Bulging fontanelle
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14
Q

What are the 6 components of the sepsis 6 recognition tool?

A

1 - Temperature (<36 or >38)

2 - Tachycardia

3 - Tachypnoea

4 - Poor peripheral perfusion & cap refill time > 2 secs

5 - Altered mental status (sleepy, irritable, lethargy, floppy)

6 - Hypotension

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15
Q

How should meningitis +- sepsis patients initially be supported?

A

A - Airway

B - Breathing

C - Circulation

DEFG - Don’t ever forget glucose

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16
Q

How should meningitis +- sepsis patients be treated?

A
  • Antibiotics
  • Cephalosporins
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17
Q

How can meningitis and sepsis be diagnosed?

A

FBC

CRP (high)

Coagulation factors (low)

Blood gas (metabolic acidosis)

Blood glucose (hypoglycaemic)

CSF (raised protein levels)

Urine culture

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18
Q

How is strep pneumoniae transmitted?

A

Droplets

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19
Q

Where in the body can pneumococcal disease spread to and what diseases does it occur when in these locations?

A

Lungs - Pneumonia

Middle ear - Otitis media

Blood - Septicaemia

Sinuses - Sinusitis

Meninges - Meningitis

Joints - Osteomyelitis

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20
Q

What are some of the complications that can arise from meningitis?

A

Brain damage

Hearing loss

Hydrocephalus

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21
Q

In what age group is meningococcal disease most likely to occur?

A

< 1 years old

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22
Q

What is the endotoxin associated with meningococcal disease?

A

Lipooligosaccharie

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23
Q

For which meningitis bacterias are there vaccines available?

A

Haemophilus Influenzae B

Pneuomococcal infections

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24
Q

What type of bacteria are streptococci and staphylococci?

A

Gram + ve cocci

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25
Q

Out of staphylococci and streptococci, which one is resistant to penicillin?

A

Staphylococci

26
Q

With which antibiotic should stahpylococci bacteria be treated with?

A

Flucloxacilin

27
Q

With which antibiotic can streptococci bacterias be treated with?

A

Penicillin

28
Q

What is one of the commonest Streptococcal A infections in children and what bacteria causes it?

A

Scarlet fever - Strep pyogenes

29
Q

What is the characteristic feature of scarlet fever?

A

Strwaberry tongue

Skin like sand paper

30
Q

How is scarlet fever treated?

A

Penicillin for 10 days

31
Q

Who gets scarlet fever?

A

Mean age is 4 years old

32
Q

What are the common skin infections from staphylococcal and streptococcal infections?

A

Impetigo

SSSS - Staphylococcus scalded skin syndrome

33
Q

Which bacteria cause impetigo?

A

Staph aureus

Strep pyogenes

34
Q

Which bacteria causes SSSS?

A

Exotoxins of staph aureus

35
Q

What is the classical sign of impetigo?

A

Golden crusted on top lip

36
Q

What are the clinical symptoms of Kawasaki disease?

A

Fever for at least 5 days AND 4 out of these 5:

1 - Bilateral conjunctival injection

2 - Changes in mucous membranes

3 - Cervical lymphadenopathy

4 - Polymorphous rash

5 - Changes of the extremities

37
Q

What is Kawasaki disease?

A

Vasculitis of medium-sized arteries

38
Q

How is Kawasaki disease treated?

A

The main purpose of kawasaki diseas treatment is to prevent coronary artery vasculitis

This is achieved by using:

  • Immunoglobulins
  • Aspirin
39
Q

What is Henoch-Schonlein purpura and how does it differ from a meningococcal rash?

A

Vasculitis where the child not systemically unwell

40
Q

What viruses are associated with maculopapular rashes?

A

Measles

Rubella

Enterovirus

CMV

41
Q

What viruses are characterised by vesicles and bullae?

A

Varicella-zoster

Herpes simplex

Enterovirus

42
Q

What viruses can cause petechiae and purpura?

A

Rubella

Enterovirus

CMV

43
Q

Vesicles on the palm of the hand and foot are characteristic of which virus?

A

Enterovirus

44
Q

Vesicles on tongue are found in which virus?

A

Herpes simplex virus

45
Q

Which virus causes chickenpox and shingles?

A

Varicella-zoster

46
Q

What is a key feature of chicken pox?

A

They are systemically well

47
Q

Which antiviral drug can be used to treat chickenpox and shingles?

A

Aciclovir

48
Q

What are the characteristic features of HSV in children?

A

Stomatitis

Recurrent cold sores

49
Q

What are some of the complications of HSV in neonates?

A

Sepsis

Meningoencephalitis

Jaundice

50
Q

What is the difference between primary and secondary immunodeficiencis?

A

Primary - parts of the immune system are missing or not working properly

Secondary - all of the immune system is present and working correctly but they have acquired a disease which affects the working of the immune system

51
Q

What are common examples of secondary immunodeficiencies?

A

HIV

Immunodeficiencies caused by cancer treatment

52
Q

Which cells are defective in antibody deficiencies?

A

B-cells

53
Q

Which cells are defective in cellular immunodeficiencies?

A

T cells

54
Q

Which cells are defective in innate immune disorders?

A

Phagocytes

55
Q

What are signs that an infection in a child may be caused by an immunodeficiency?

A

Severe (requires IV antibiotics and hospitalization)

Persistent

Unusual

Recurrent

Runs in the family

56
Q

What blood test measurements should be made to diagnose an immunodeficiency?

A

IgG, IgA, IgM blood measurements

57
Q

What type of inheritance is chronic granulomatous disease?

A

X-linked autosomal recessive

58
Q

What are the characteristics of chronic granulomatous disease?

A

Recurrent life-threatening bacterial and fungal infections

59
Q

How is chronic granulomatous disease diagnosed?

A

DHR test

60
Q

What is the clinical presentation of neonatal candidaemia?

A

1 - Sepsis syndrome

2 - Occurs in 2nd/3rd week of life

3 - Thrombocytopaenia

4 - Hyperglycaemia

61
Q

What are the risk factors for contracting neonatal candidaemia?

A

Extreme prematurity

Extremely low birth weight

Immature immune system

Paediatrics (25 decks)

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