Infectious diseases

Question 1

SIRS in paeds

Answer 1

tachypnoea
tachycardia
fever or hypothermia
leucocytosis or leucocytopenia

Question 2

Paediatric sepsis =

Answer 2

SIRS + blood cultures (infection)

Question 3

paediatric severe sepsis =

Answer 3

SEPSIS + multi organ failure

Question 4

Neonates - causative organisms of sepsis

Answer 4

Group B strep
E. coli
Listeria monocytogenes

Question 5

Children - causative organisms of sepsis

Answer 5

Group A strep
meningococcus
S pneumoniae
staph aureus

Question 6

Symptoms of neonatal sepsis

Answer 6

fever or hypothermia 
cold hands/feet
prolonged cap refill 
chills/rigors 
limb pain 
vomiting and diarrhoea
skin rash 
diminished urine output

Question 7

causative organisms of neonatal meningitis

Answer 7

Same as sepsis

Question 8

causative organisms of child meningitis

Answer 8

meningococcus
S pneumoniae
H influenzae

Question 9

meningitis symptom

Answer 9

nuchal rigidity
headaches, photophobia
diminished consciousness
seizures

Question 10

Neonates - meningitis symptoms

Answer 10

irritable, lethargy, nappy pain, bulging fontanelle

Question 11

paediatric sepsis 6

Answer 11

temperature 
tachycardia 
poor peripheral perfusion 
altered mental status
tachypnoea 
hypotension

Question 12

Treating meningococcal sepsis

Answer 12

ABC, DEFG
ciclosporin (and amoxicillin if neonate)
chemoprophylaxis

Question 13

Diagnosing meningococcal sepsis

Answer 13

blood 
- FBC - leucocytosis, thrombocytopenia 
CRP, coagulation, blood gas, glucose
CSF - pleocytosis 
blood and CSF culture - PCR
urine culture 
skin biopsy culture 
CT cerebrum

Question 14

S pneumoniae transfer

Answer 14

droplets as colonises upper airway

Question 15

pneumococcal meningitis complications

Answer 15

brain damage
hearing loss
hydrocephalus

Question 16

H influenza - gram negative or positive?

Answer 16

negative

Question 17

Where is meningococcus found?

Answer 17

nasopharynx

Question 18

Virulence factors of meningococcus

Answer 18

Endotoxin - LPS

Question 19

What infections can strep and staph cause?

Answer 19

impetigo
TSS
cellulitis
septic arthritis

Question 20

streptococci antibiotic

Answer 20

penicillin

Question 21

staphylococci antibiotic

Answer 21

flucloxacillin

Question 22

Causative organism of scarlet fever

Answer 22

strep pyogenes = group A beta haemolytic strep

Question 23

Symptoms of scarlet fever

Answer 23

2-4 day incubation

malaise, fever, exanthema, strawberry tongue and squamation of hands and feet

Question 24

scarlet fever age

Answer 24

2-10 years

Question 25

Treating scarlet fever

Answer 25

penicillin for 10 days

Question 26

SSSS

Answer 26

staph aureus - <5yrs | fever, widespread redness and fluid filled blisters

Question 27

Kawasaki disease criteria

Answer 27

``` fever for atleast 5 days and 4 of - bilateral conjunctivitis mucous membranes cervical LN polymorphous rash change of extremities ```

Question 28

Kawasaki disease other signs

Answer 28

peripheral oedema and erythema | periungal desquamation

Question 29

Treating Kawasaki

Answer 29

immunoglobulins aspirin immunosuppression

Question 30

Henoch Schonlein purpura

Answer 30

vasculitis - skin, kidneys | previous viral illness

Question 31

Presentation of VZV

Answer 31

children are well papules and vesicles which crust over itching

Question 32

complications of VZV

Answer 32

secondary staph/strep | meningoencephalitis, arthritis

Question 33

Fetal varicella

Answer 33

T cell deficiencies | high fever, new lesions >day 10, inflamed lesions

Question 34

HSV 1+2

Answer 34

1 = oral and 2 = genital

Question 35

Neonatal HSV

Answer 35

birth canal/direct contact disseminated/CNS infection high mortality

Question 36

Hand, foot and mouth causative organisms

Answer 36

enteroviruses | coxsackie virus A16

Question 37

Diagnostics for vesicular rash

Answer 37

clinical smear or vesicle - ulcer base PCR - fluids, blood serology for past infection

Question 38

Gene mutation in primary immunodeficiencies

Answer 38

single gene defect

Question 39

3 types of primary immunodeficiency

Answer 39

antibody cellular innate - complement and phagocytes

Question 40

antibody deficiency

Answer 40

recurrent URTI and LRTI S pneumoniae and H influenza subclasses of Ig/absent mature B cells

Question 41

cellular deficiency

Answer 41

CMV, pneumocystis

Question 42

innate deficiency

Answer 42

staph aureus and apergillos for phagocytes | meningococcus for complement

Question 43

Recognising primary immunodeficiencies

Answer 43

``` recurrent unusual organism FH severe persistent ```

Question 44

Presenting symptoms of paediatric HIV/AIDS

Answer 44

``` recurrent common RTI's persistent oral thrush general LN CMV, PCP disseminated HSV/VZV ```

Question 45

Inheritance of chronic granulomatous disease

Answer 45

65% x linked and 35% autosomal recessive

Question 46

Complications of chronic granulomatous disease

Answer 46

sever bacterial and fungal infection - aspergillus

Question 47

Treating chronic granulomatous disease

Answer 47

haematopoietic stem cell transplant

Question 48

Diagnosing chronic granulomatous disease

Answer 48

DHR test - flow cytometry | gene mutation screen

Question 49

Candida vs aspergillus

Answer 49

candida is a commensal which goes into the blood | aspergillus is inhaled and pulmonary disease

Question 50

Those at risk of candidaemia

Answer 50

neonates with a low birth weight

Question 51

neonatal candidaemia presentation

Answer 51

sepsis syndrome 2nd/3rd week of life thrombocytopenia hyperglycaemia

Question 52

risk factors for neonatal candidaemia

Answer 52

``` extreme prematurity <28 weeks low birth weight immature immune system broad spectrum antibiotics abdominal surgery ```