Infectious Diseases & Immunisation

Question 1

Typical rash ofchicken pox

Answer 1

Multiple crops of papules and vesicles starting on the head & trunk then spread to peripheries. Has surrounding erythema & pustules.

Occurs usually after 7d of fever

Question 2

Complications of chicken pox

Answer 2

Bacterial superinfection
CNS; cerebellitis, aseptic meningitis and generalised encephalitis

In immunocompromised pts; pneumonitis, DIC etc

Question 3

Mx of chicken pox

Answer 3

In normal immunity children; supportive

Immunocompromised; VZIG + IV aciclovir

Question 4

CF of mumps

Answer 4

Onset w/ fever, malaise, parotitis (fever stops in 3-4d)
One-sided swelling and earache whilst drinking or eating
Parotid gland swelling with duct obstruction
pancreatitis (elevated plasma amylase)

Question 5

Complications of mumps

Answer 5

Unilateral, transient hearing loss
Viral meningitis and encephalitis
Orchitis/oophoritis
Corneal ulcerations; leading to visual loss

Question 6

Congenital Rubella syndrome

Answer 6

Cataract
Microcephaly
Rash - thrombocytopenic
Hepatosplenomegaly
Heart probs; PDA, pulmonary stenosis

Question 7

Management of Impetigo

Answer 7

Don’t send child to school until the last lesion is crusted
Mild = topical mupirocin
Moderate to severe cases = flucloxacillin or co-amoxiclav
Nasal - nasal cream with mupirocin or chlorohexidine + neomycin

Question 8

Management of Staph Scalded Skin Sydrome

Answer 8

IV ABx (flucloxacillin, vacnco), morphine, fluids, high protein diet (TPN)

Question 9

Mosquito types in malaria, dengue and JE

Answer 9

Malaria = anopheles
Dengue = Aedes aegypti
JE = culex

Question 10

CF of typhoid fever

Answer 10

Doughy abdomen, systemic signs, rose-spots on the trunk (D7), soft splenomegaly, bradycardia (even with fever), jaundice, coated tongue, diarhhoea/constipation

Question 11

Complications of typhoid

Answer 11

Osteomyelitis
Meningitis
GI perforation (due to inflammation of peyer’s patches)
Hepatitis
Nephritis
Myocarditis

Question 12

Ix of typhoid

Answer 12

1st week = blood culture
2nd week = urine, blood, stool culture

SAT - standard agglutination test
Widal test for O and H antigens

Question 13

Management and prevention of typhoid

Answer 13

7-10 days of IV ABX (cefotaxime/ceftriaxone w/ macrolide), rest, hydration

Vaccination and food hygiene

Question 14

Leptospirosis; epi

Answer 14

Incubation period 7-14d via contaminated soil/water (paddy fields) that enters through damaged skin. Reservoir = rats

Question 15

Leptospirosis; CF

Answer 15

For 3-7d then resolves for 1-3d
-Fever, chills and headache
- Calf tenderness
-Haemorrhagic conjunctivitis
-Pretibial skin rash

Then fever returns w/
-uveitis and iritis
-meningitis
-hepatitis
-lymphadenitis

Question 16

Leptospirosis; complications

Answer 16

Weil’s disease; icteric leptospirosis
Kidney failure
Arrhythmias
Haemorrhagic pneumonitis (ARDS has 50% mortality)

Question 17

Leptospirosis; Ix and Rx

Answer 17

Ix = dark field mirco and AB testing, FBC, LFT, RFT, coag profile

if child <8 = PO amoxicillin
if child >= 8 = PO doxycycline
Admission for IV penicillin if very severe

Question 18

Scrub typhus aetio

Answer 18

Rickettsia orienti tsutsugamishi (Bite of ticks, Chigger mites)

Question 19

Congenital CMV CF

Answer 19

Microcephaly
Chorioretinitis
Hepatosplenomegaly
SGA
Periventricular calcifications

Question 20

Congenital toxoplasmosis CF

Answer 20

Hydrocephalus, brain calcifications, retinitis

Question 21

Group A notifiable diseases in SL (3)

Answer 21

Cholera
Plague
Yellow fever

Question 22

Group B notifiable diseases in SL (4)

Answer 22

Acute poliomyelitis/acute flaccid paralysis
Measles
Rubella
Congenital Rubella syndrome

Question 23

Common group C notifiable diseases in SL

Answer 23

Chickenpox
Dengue
Human rabies
Leptospirosis
Meningitis
Mumps
TB