Paediatric ID 2 Flashcards
What is the infective period for measles?
5 days either side of the rash
What are the causes of macular star/neuroretinitis?
- Toxoplasmosis
- Syphillis
- Lyme
- Cat scratch (Bartonella)
Which serological finding in patients with hepatitis B
indicates active viral replication?
HbeAg
What is the seafood-associated diarrhoea?
Vibrio - supportive management only
What organism has intrinsic aminoglycoside resistance?
Salmonella
What does the aedes aegypti mosquito transmit?
- Dengue
- Zika
- Chikungunya
- Yellow fever
How many rotavirus strains are present in Rotarix?
One
In SSSS where is the cleavage plane in the skin?
- superficially in the stratum granulosum layer of the skin
- biopsy will show cleaveage in granular layer with no inflammatory cell infiltrate
Which serotype of parechovirus causes the most serious infections?
- parechovirus serotype 3
- hot red angry baby
How do macrolides work?
Bind to 50s ribosomal unit to inhibit protein synthesis
How do antifungals work?
• Polyenes (e.g. amphotericin B)
•Azoles (e.g. fluconazole, vori)
•Echinocandins (e.g. caspofungin)
- POlyenes POke holes in cell membranes
- AzOLes interfere with cell membrane function by inhibiting sterOL synthesis
- EchINocandins INhibit cell wall synthesis
What do we use aztreonam for?
Gram negatives that aren’t ESBL
Aminoglycoside efficacy is dependent on…?
C max/Mic
B-lactam efficacy is dependent on…?
T>MIC
Vancomycin efficacy is dependent on…?
AUC/MIC
What does the anopheles mosquito transmit?
Malaria
What is leishmaniasis transmitted by?
Sandflies
What is Lyme disease transmitted by?
- Ixodes ticks
- USA
- If you tick check and remove within 24hrs, you shouldn’t get Lyme
How does HUS happen with STEC?
ENDOtoxin binding to renal vessel epithelium
What are exotoxins?
- potent protein toxins secreted by any type of bacteria,
The most common clinical manifestation of atypical cat-scratch disease is:
Parinaud Oculoglandular Syndrome (unilateral granulomatous follicular conjunctivitis associated with ipsilateral regional lymphadenopathy)
If you have persistent diarrhoea in CVID think…
Giardiasis
H. pylori is often resistant to…
- macrolides - clarithromycin
Cleaved lymphocytes on a blood film with lymphocytosis may mean:
Pertussis!
Which type of influenza exhibits antigenic shift?
A
How long does natural immunity to influenza last?
4 years
Which subtype of influenza is more likely to cause myalgias?
B
Which diseases are associated with cold haemoglobinuria/Donath-Landsteiner antibodies?
- Measles vaccination/MMR (the viruses)
- Mycoplasma pneumoniae
- Haemophilus influenzae and various other viruses
- Syphilis, especially congenital and tertiary syphilis
Where does brucellosis come from?
Livestock (goat, cattle, sheep, pig) and dogs, occasionally seals
Which antibiotic is most likely to give you lupus?
Minocycline
What is the cutpoint for LTBI on a mantoux?
≥10mm if 5-14yo+/-BCG, prev BCG <5yo
≥5mm if <5yo, immunosuppressed, close contact with Tb
What are the pertinent side effects of typical Tb treatment?
- Rifampicin: orange body secretions, hepatitis 1%, leukopenia/thrombocytopenia, rash
- Isoniazid: peripheral neuritis, hepatitis
- Ethambutol: retrobulbar neuritis
- Pyrazinamide: joint pain, itch
What are the pertinent side effects of zidovudine?
- Zidovudine is a NRTI
- Nausea/vomiting
- Myopathy
- Anaemia/granulocytopaenias (e.g. neutropaenia, low basophils/eosinophils)
Which antibiotics give you fixed drug eruptions?
- Sulfonamides most likely - but can get with others e.g. doxy
- round/oval, dusky erythematous macules 6-48 hours after administration.
- characteristically recurs at the same site with each subsequent exposure to the same drug
- May be bullous
- May be painful/itchy/burning and get fevers
What antibiotics make you have seizures?
- Imipenem (+other carbapenems)
- Neurotoxicity 1st-4th generation cephalosporins e.g encephalopathy to non-convulsive status epilepticus, higher risk if renal impairment.
- Non-convulsive status epilepticus has been reported frequently with cefepime, also you die more if you’re neutropaenic and on cefepime (no cause found)
Which antibiotic has been associated with idiopathic intracranial hypertension?
- Doxycycline
What cells are the PRIMARY driver of nodule formation in a positive tuberculin skin test reaction?
- Macrophages
What do you treat hydatid disease with?
- echinococcosis - albendazole