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Finals > Paediatric ID > Flashcards

Paediatric ID Flashcards

1
Q

Management of bacterial meningitis in a child <3 mnths

A

IV cefotaxime plus IV amoxicillin

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2
Q

Management of bacterial meningitis in a child >3mnths

A

IV Ceftriaxone

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3
Q

What is also given for management of bacterial meningitis in children >3mnths ?

A
  • Dexamethasone 4x daily for 4 days
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4
Q

What is the most common cause of encephalitis in children ?

A
  • Viral : HSV-1 from cold sores
  • In neonates : HSV-2 from genital herpes
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5
Q

Give 6 features of encephalitis

A
  • Altered consciousness
  • Altered cognition
  • Unusual behaviour
  • Acute onset of focal neurological symptoms
  • Acute onset of focal seizures
  • Fever
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6
Q

How is encephalitis investigated ?

A
  • LP : sending CSF for viral PCR
  • CT if LP CI
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7
Q

How is encephalitis manged ?

A
  • IV Aciclovir : covers HSV and VZV
  • Ganciclovir covers CMV
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8
Q

What causes infectious mononucleosis ?

A
  • EBV
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9
Q

How does IM present ?

A

TRIAD :

  • Fever
  • Sore throat
  • Lymphadenopathy
  • Fatigue
  • Tonsillar enlargement
  • Splenomegaly and in rare cases splenic rupture
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10
Q

How does IM typically present in an exam ?

A
  • Adolescent with a sore throat
  • Develops itchy rash after taking amoxicilin

(IM causes intensely itchy maculopapular rash in response to amoxacillin or cefalosporins )

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11
Q

What advice is givento someone with IM ?

A
  • Avoid playing contact sports for 4 wks after having glandular fever to reduce the risk of splenic rupture
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12
Q

How can IM be test for ?

A
  • Monospot test : +ve result = presence of heterophile antibodies
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13
Q

How does mumps present ?

A
  • Prodromal flu like symptoms
  • Parotid gland swelling (initially unilateral before becoming bilateral).
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14
Q

4 complications of mumps

A
  • Orchitis
  • Pancreatitis
  • Meningitis
  • Encephalitis
  • Sensorineural hearing loss
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15
Q

How is mumps spread and how is it diagnosed ?

A
  • Respiratory droplets
  • PCR testing on viral swab
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16
Q

What is the mode of delivery in a mother with HIV with a viral load <50 copies/ml

A

Normal vaginal delivery

17
Q

When is a CS considered in mothers with HIV ?

A

Viral load >50 copies /ml

18
Q

What is given to mothers with HIV during a CS if viral load is unknown or there are >10000 copes / ml

A

IV zidovudine

19
Q

When and what prophylactic treatment is given to a baby when the mother has HIV ?

A
  • > Low risk babies, where mums viral load is < 50 copies per ml, should be given zidovudine for 4 weeks
  • > High risk babies, where mums viral load is > 50 copies / ml, should be given zidovudine, lamivudine and nevirapine for 4 weeks
20
Q

When is breast feeding recommended in HIV +ve mother ?

A

Never

21
Q

When are babies to HIV positive parents test for HIV?

A
  • > HIV viral load test at 3 mnths. If this is negative, the child has not contracted HIV during birth and will not develop HIV unless they have further exposure
  • > HIV antibody test at 24 months. This is to assess whether they have contracted HIV since their 3 month viral load.
22
Q

what are the principles of medical care in a child with HIV ?

A
  • ART
  • Prophylactic co-trimoxazole (septrin) for children with low CD4 to protect against pneumocystis jirovecii pneumonia
23
Q

How is the risk of a baby contracting hepatitis B from a hep B +ve mother reduced ?

A
  • Hepatitis B vaccine
  • Hepatitis B immunoglobulin infusion
  • Additional Hep B vaccine at 1 and 12 mnths
24
Q

When are babies to hepatitis C +ve mothers tested ?

A

18 mnths of age

25
Q

Features of measles

A
  • Prodromal : conjunctivits, fever
  • Koplik spots of buccal mucosa before the rash : white spots
  • Rash : starts behind the ears before spreading
26
Q

Most common complication and most common cause of death following measles and complication that can occur 5-10 yrs later

A
  • Complication : measles
  • Death : pneumonia
  • 5-10 yrs later : subacute sclerosing panencephalitis
27
Q

Threadworm treatment

A
  • Oral mebendazole
  • Including all household contacts
28
Q

Chickenpox

A
  • Fever initially
  • Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
  • Systemic upset is usually mild
29
Q

Measles

A
  • Prodrome: irritable, conjunctivitis, fever
  • Koplik spots: white spots (‘grain of salt’) on buccal mucosa
  • Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
30
Q

Mumps

A
  • Fever, malaise, muscular pain
  • Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%
31
Q

Rubella

A
  • Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
  • Lymphadenopathy: suboccipital and postauricular
32
Q

Erythema infectosum

A
  • Also known as fifth disease or ‘slapped-cheek syndrome’
  • Caused by parvovirus B19
  • Lethargy, fever, headache
  • ‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces
33
Q

Scarlett fever

A
  • Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
  • Fever, malaise, tonsillitis
  • ‘Strawberry’ tongue
  • Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)
34
Q

Hand, foot and mouth disease

A
  • Caused by the coxsackie A16 virus
  • Mild systemic upset: sore throat, fever
  • Vesicles in the mouth and on the palms and soles of the feet

Finals (92 decks)

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