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MicroPath > Neonatal and childhood infections > Flashcards

Neonatal and childhood infections Flashcards

1
Q
  1. Which infections are screened for in pregnancy?
A

HIV
Hepatitis B
Syphilis

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2
Q
  1. What does ‘TORCH’ stand for?
A 
Toxoplasmosis
Other – syphilis, HIV, hep B/C
Rubella
CMV 
HSV
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3
Q
  1. What is the source of toxoplasmosis?
A

Cat faeces

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4
Q
  1. What are the possible outcomes for neonates with congenital toxoplasmosis?
A 
Asymptomatic (60%) at birth but go on to develop long-term sequelae such as deafness, low IQ and microcephaly 
Symptomatic (40%) at birth 
•	Choroidoretinitis
•	Microcephaly/ hydrocephalus
•	Intracranial calcifications 
•	Seizures 
•	Hepatosplenomegaly/jaundice
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5
Q
  1. What is the triad of features in congenital rubella syndrome?
A

Cataracts
Congenital heart disease (PDA is most common)
Deafness

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6
Q
  1. How is herpes simplex virus transmitted to the neonate?
A

Lesions in the genital tract can transmit HSV to the neonate
It causes a blistering rash and can cause disseminated infection with liver dysfunction and meningoencephalitis

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7
Q
  1. How if Chlamydia trachomatis transmitted to the neonate and what disease does it cause in the neonate?
A

During delivery
Causes neonatal conjunctivitis or pneumonia
treated with erthyromycin

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8
Q
  1. What is the definition of ‘early-onset’ infection?
A

Infection that occurs within 48 hours of birth

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9
Q
  1. What are the three main organisms that cause early-onset infection?
A

Group B Streptococcus
E. coli
Listeria monocytogenes

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10
Q
  1. What type of bacterium is Group B Streptococcus?
A

Catalase negative, Gram-positive, Beta haemolytic coccus

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11
Q
  1. List some maternal risk factors for early-onset sepsis.
A 
Premature rupture of membranes 
Preterm labour 
Foetal distress 
Fever 
Meconium staining 
Previous history
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12
Q
  1. List some baby-related risk factors for early-onset sepsis.
A 
Birth asphyxia
Respiratory distress 
Low blood pressure 
Acidosis 
Hypoglycaemia 
Neutropaenia 
Rash 
Hepatosplenomegaly 
Jaundice
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13
Q
  1. List some investigations that may be useful in early-onset sepsis.
A 
FBC 
CRP 
Blood culture 
Deep ear swab 
LP 
Surface swabs 
CXR
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14
Q
  1. Which antibiotic combination is often used in early-onset sepsis and why?
A

Benzylpenicillin and gentamicin

Benzylpenicillin covers Group B Streptococcus whilst gentamicin covers E. coli

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15
Q
  1. What are the main causes of late-onset sepsis?
A

Coagulase negative staphylococci (e.g. S. epidermidis)
GBS
E. coli
Listeria monocytogenes
S. aureus
Enterococcus sp.
Gram-negatives (e.g. Klebsiella, Enterobacter, Pseudomonas)

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16
Q
  1. List some clinical features of late-onset sepsis.
A 
Bradycardia 
Apnoea 
Poor feeding 
Irritability 
Convulsions 
Jaundice 
Respiratory distress
17
Q
  1. List some investigations for meningitis in children.
A 
Blood cultures 
Throat swab 
LP
Rapid antigen screen
EDTA for blood PCR 
Clotted serum for serology
18
Q
  1. Why is it dangerous to perform an LP in meningococcal septicaemia?
A

They may be coagulopathic

19
Q
  1. What is the main bacterial cause of meningitis at the moment?
A

Meningitis B

20
Q
  1. What type of organism is Streptococcus pneumoniae?
A

Gram-positive diplococcus

Alpha haemolytic

21
Q
  1. What type of organism is Haemophilus influenzae?
A

Gram-negative cocco-bacilli

22
Q
  1. Which children are mainly affected by Mycoplasma pneumoniae?
A

Older children (> 4 years)

23
Q
  1. Which group of antibiotics are used to treat Mycoplasma pneumoniae?
A

Macrolides

24
Q
  1. Describe the classical presentation of Mycoplasma pneumoniae.
A 
Fever 
Headache 
Myalgia 
Pharyngitis 
Dry cough
25
Q
  1. List some extra-pulmonary manifestations of Mycoplasma pneumoniae.
A

Haemolysis – IgM antibodies to I antigen on erythrocytes, cold agglutinins
Neurological – encephalitis, aseptic meningitis, peripheral neuropathy, transverse myelitis
Polyarthralgia
Cardiac
Otitis media
Bullous myringitis (vesicles on the tympanic membrane – pathognomonic of Mycoplasma)

26
Q
  1. If a respiratory tract infection fails to respond to conventional treatment, which diagnoses should be considered?
A

Whooping cough

TB

MicroPath (10 decks)

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