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Foundations of Practise > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

What is the most prevalent malarial species in sub-Saharan Africa

A

Plasmodium falciparum

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2
Q

What are the gold standard investigations if concerned about malaria

A

Thick and thin blood film, however if a child is unwell a rapid dipstick antigen test would be the quickest way to establish a diagnosis

If the first blood film is negative at least 2 further should be done in the next 48 hours

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3
Q

What results may you see on blood tests ina child with malaria

A
  • thrombocytopenia and anaemia (Leukocytosis)
  • G6PD activity
  • Abnormal LFTs
  • hyponatraemia and raised Cr
  • Hypoglycaemia (severe)
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4
Q

Symptoms of malaria

A 
Fever, often recurring
Chills
Rigors
Headache
Cough
Myalgia
Gastrointestinal upset
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5
Q

Signs of malaria

A 
Fever
Splenomegaly
Hepatomegaly
Jaundice
\+/- abdominal tenderness
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6
Q

Differential diagnoses of Malaria

A 
Typhoid
Hepatitis
Dengue fever
Influenza
HIV
Meningitis/encephalitis
Viral haemorrhagic fevers
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7
Q

drug of choice for the treatment of all non-falciparum malaria

A

Chloroquine

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8
Q

What are the red flag symptoms of skin/lipstongue

A

pale
mottled
ashen
blue

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9
Q

What are the red flag resp symptoms

A

grunting
tachypnoea
RR >60
Moderate/severe chest indrawing

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10
Q

What are the red flag symptoms relating to activity in children

A

no response to social cies
Appears ill to HCP
Unrousable/drowsey
weak/high pitched or continuous crying

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11
Q

What is group B strep

A

common bacterium (bug) which is carried in the vagina and rectum in 2–4 in 20–40% woman

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12
Q

What is considered early onset group B strep infection

A

symptoms in the first 0-7 days

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13
Q

What is considered late onset group B infection

A

8-90 days

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14
Q

What are the symptoms of late onset group B strep

A
  • irritable/high pitched/ whimpering cry
  • Blank, staring or trance-like expression;
  • Floppy, may dislike being handled,
  • Tense or bulging fontanelle
  • Turns away from bright light;
  • Involuntary stiff body or jerking movements
  • Pale, blotchy skin.
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15
Q

What is the management of Group B strep in infants

A

3-4 weeks systemic penicillin,

+/- clindamycin or vanc

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16
Q

Signs and symptoms of meningococcal disease

A

Non-blanching rash with >1

  • Ill looking cgld
  • purpura - lesions >2mm
  • Cap refil >3s
  • Neck stiffness
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17
Q

Signs and symptoms of bacterial meningitis

A

Neck stiffness
Bulging fontanelle
Deceased level of conciousness
Convulsive status epilepticus

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18
Q

Signs and symptoms of herpes simplex encephalitis

A

Focal neurological signs
Focal seizres
Decreased level of conciousness

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19
Q

Signs and symptoms of pneumonia

A 
tachypnoea
crackles
nasal flaring
chest indrawing
cyanosis
Sats <95%
20
Q

Signs and symptoms of UTI

A 
Vomiting
Poor feeding
Lethargy
Irritability
Abdo pain/tenderness
LUTs
21
Q

Signs and symptoms of septic arthritis

A

swelling of limb or joint
Not using an extremity
Non weight bearing

22
Q

Signs and symptoms of kawasaki disease

A

Fever >5 days and 4 of:

  • Bilateral conjunctivitis
  • Change in mucous membranes
  • Change in extremities
  • cervical lymphadenopathy
  • polymorphos rash
23
Q

What bacteria can cause purpura (non blanching rash >2mm)

A

meningococcus
Listeria
Pneumococcus

24
Q

What is the pre-hospital management of suspected bacterial meningitis in patients with a purpuric rash

A

intramuscular or intravenous benzylpenicillin

25
Q

In children <3 months, what is the antibiotic guidance for suspected meningitis

A

cefotaxime
Amoxicillin or ampicillan
Vanc - If out of the country or lots of Abx

26
Q

Which infants should not be given ceftriaxone (cefataxime instead)

A

premature
babies with jaundice
acidosis
low albumin

27
Q

In children >3 months what is the antibiotics guidance for suspected bacterial meningitis

A

ceftriaxone

28
Q

Treat bacterial meningitis due to L monocytogenes with

A
  • IV amoxicillin or ampicillin for 21 days in total,

- gentamicin for at least the first 7 days.

29
Q

Treat bacterial meningitis due to Group B streptococcus

A

IV cefotaxime for at least 14 days

30
Q

Who should be given corticosteroids in suspected or confirmed bacterial meningitis

A
  • frankly purulent CSF
  • CSF WBC count greater than 1000/microlitre
  • raised CSF WBC count with protein concentration greater than 1 g/litre
  • bacteria on Gram stain.
31
Q

What corticosteroid should be given in patients with suspected of confirmed bacterial meningitis

A

0.15 mg/kg to a maximum dose of 10 mg, four times daily for 4 days

32
Q

Who should not be given corticosteroids in suspected or confirmed bacterial meningitis

A
  • <3 months
  • If antibitiocs were started over 12 hours ago
  • if infant is shocked that is not responsive to vasopressors
33
Q

What follow up should be given in all children with bacteral meningitis

A
  • paediatrician w/i 6 weeks

- audiometry ASAP or within 4 weeks of being fit

34
Q

What is the empirical antibiotic of choice for sepsis (not bacterial) in neonates

A
  • benzylpenicillan + gent
  • If gram negative suspcted add in cefotaxime
  • Once gram neg confirmed, stop benzylpenicillan
35
Q

If you are giving a second dose of gent, when is it usually administed in neonates

A

After 36 hours

36
Q

What dose of fluid bolus should you give ina shocked child

A

20ml/kg stat

37
Q

When are children allowed to return to school following chickenpox

A

all lesions have crusted over

no new crops occurring

38
Q

What pathogen usually causes scarlett fever

A

Group A streptococcus (streptococcus pyogenes)

39
Q

What are the symptoms of scarlett fever

A
  • Sore throat
  • fever
  • sandpaper rash - starts on neck, chest and scapular
  • red/strawberry tongue
  • flushed face
  • desquamation of skin may appear
40
Q

What is the incubation period of scarlett fever

A

1-7

41
Q

IS scarlett fever notifiable

A

yes

42
Q

What features may you find in the mouth with scarlet fever

A
  • exudate
  • cervical lymphadenopathy
  • haemorrhagic spots on palette
43
Q

What is the management of scarlett fever

A
  • penicillin or azithromycin (pen allergic)
  • fluids
  • analgesia
44
Q

Why do we avoid aspirin in children under 16

A

Increase risk of reyes syndrome

45
Q

When can a child return to school after diagnosis with scarlet fever

A

Can return after 24 hours of antibiotics

46
Q

What are the rare side effects of scarlet fever

A
  • rheumatic fever

- AKI - post-streptococcal glomerulonephritis

Foundations of Practise (20 decks)

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