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Paediatrics cabinetchip > Paediatric infection > Flashcards

Paediatric infection Flashcards

1
Q

incubation period of measles

A

7-14 days

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2
Q

define SSPE

A

subacute scerlosing panencephalitis

-type of encephalitis occurs after measles infections
-at least 2 to 10 years for symptoms to develop after MEASLES infections

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3
Q

infectivity period of measles

A

1-2 days before syx to 4 days afteer appearnace of rash

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4
Q

prodrome of measles 4

A

prodrome (3-5 days)
-fever, coryza, cough, conjunctivitis and Kopliks spots (small red/white dots on inside of cheeks)

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5
Q

features of measles after prodrome 3

A

then maculopapular rash starts behind the eyes, migrates to face and trunk then to limbs
-also cervical lymphadenopathy
-high fever

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6
Q

complications of measles 8

A

otitis media

lympadenitis

interstilal pneumonitis

secondary bacterial brnachopneumonia

myocarditis

post-infectious demyelening encephalomyelitis

SSPE

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7
Q

treatment for measles

A

supportive

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8
Q

prevention for measles

A

MMR vaccine

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9
Q

incubation period of chicken pox (Varicella Zoster)

A

14-21 days

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10
Q

infectivity period of chicken pox (Varicella Zoster)

A

2 days before until 5 days post rash

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11
Q

prodrome of chicken pox (Varicella Zoster) 4

A

48hrs of fever, malaise, headahce and abdo pain

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12
Q

clinical features of chicken pox (varicella zoster) after prodrome 1

A

followed by:
-itchy crops of erythematous macules, evolve into papules then vesicles containing serous fluid
*-different stages of vesciles present simultaneously

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13
Q

where do chicken pox (Varicella Zoster) usually start

A

on trunk then spread to limbs

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14
Q

complicatinos of chicken pox (Varicella Zoster) 9

A

secondary bacterial infection

pneumonia

encephalitis

progressive dissemeniated variclella

cerebellar ataxia

thrombocytopenia

purpura fulminans

post infectious encephalitis

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15
Q

which secondary bacterial infections are common in chicken pox (Varicella Zoster) 2

A

group A streoptococcus

S. aureus

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16
Q

treatment for chicken pox (Varicella Zoster) 2

A

supportive,

aciclovir in high risk patients

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17
Q

prevention for chicken pox (Varicella Zoster) 2

A

vaccination for high risk patients

post exposure prophylaxis w varicella zoster immunoglobulin (IVIG) for severe disease
-especially if immunocompormised

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18
Q

incubcation periods of mumps

A

14-21 days

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19
Q

infectivity period of mumps

A

1-2days prior to parotid swelling
9 days after

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20
Q

prodrome of mumps 3

A

prodrome- mumps, anorexia, headache

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21
Q

clinical features of mumps after prodrome 2

A

followed by painful uni/bilateral salivary ± submandibular gland swelling

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22
Q

complications of mumps 9

A

menignoencephalitis

deafness

orchitis

epididymitis

pancreatits

nephritis

myocarditis

arthitis

thrydoiditis

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23
Q

treatment for mumps 1

A

supportive

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24
Q

prevention of mumps 1

A

MMR vaccine

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25
Q

incubation of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)

A

4-14 days

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26
Q

infectivity period of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)

A

not infectious once rash appears

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27
Q

prodrome of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 2

A

low grade fever

general malaise

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28
Q

features of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) after prodrome 4

A

few days of maculopapular spots on cheeks
-coalesce to give slapped cheeks appearance

fine rash extends to trank & limbs

fades w central cleaning giving a lacy appearance

assocaited:
-arthralgia
-arthitis

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29
Q

complciations of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19)

A

aplastic crisis in chornic haemolytic disease eg sickle cell disease, thalassaemia and immunocompormised

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30
Q

treatment for erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 1

A

supportive

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31
Q

prevention of erythema infectiosum / slapped cheeck/ fifths disease (Parovirus B19) 1

A

none

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32
Q

incubation period of rubella

A

14-21 days

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33
Q

infectivity period of rubella

A

1-2 days before to 7 days after the rash appears

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34
Q

prodrome of rubella 2

A

coryza

tender cervical lymphadenopathy

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35
Q

clinical features of rubella after prodrome 3

A

fine maculopapular rash
-starts on face from where it fades as it spreads down the drunk

arthralgia

palatal petechiae

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36
Q

complicaitons of rubella 3

A

encephalitis

thrombocytopenia

congenital rubella syndrome (most feotal dameg if esposed in 1st 10 weks of pregnancy)

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37
Q

treatment of rubella 1

A

supportive

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38
Q

prevention of rubella 1

A

MMR

39
Q

incubation of roseola infantum/ sixth disease (human herpes virus 6)

A

7-14 days

40
Q

infectivty period of roseola infantum/ sixth disease (human herpes virus 6)

A

until fever subsides

41
Q

prodrome of roseola infantum/ sixth disease (human herpes virus 6) 2

A

sudden onset high fever

milkd coryza

no other physical findings

42
Q

clinical features of roseola infantum/ sixth disease (human herpes virus 6) after prodrome 2

A

day 3-4 fever resolves
-maculopapular rash appears on trunk/ limbs and lasts for 1-2days

43
Q

complications of roseola infantum/ sixth disease (human herpes virus 6) 2

A

febrile convulstions- one of the commonest causes of febrile convulsions in 6-18 mnth olds
-usually on first day of illness

encephalitis

44
Q

treatment for roseola infantum/ sixth disease (human herpes virus 6) 1

A

supportive

45
Q

prevention for roseola infantum/ sixth disease (human herpes virus 6) 1

A

none

46
Q

incubation period of pertussis

A

7-14 days

47
Q

infectiveity period of pertussis

A

whilst coughing

risk of transmision greated in catarrhal phase

48
Q

phases of pertussis 3

A

*-in chronological order
catarrhal phase

paroysmal phase

convalescent stage

49
Q

features of catarrhal phase of pertussis

A

lwo grade fever

coryza

conjunctivtis 1-2 weeks

50
Q

features of paroxysmal phase of pertussis 4

A

*-follows catarrhal phase

paroxysm of severe cough withor without whoop

post-tussive vomiting

cyannosis

apnoea

can last for 2-8 weeks

51
Q

features of convalescent phase of pertussis 1

A

cough subsides over weeks to months

52
Q

complications of pertussis 3

A

apneoa

secondary bacterial pneumonia

weight loss secondary to feeding dificulties and post-tussive vomiting

53
Q

severe complciations of pertussis 8

A

subsewuent bornchietisis

otitis media

seizures

encephalopahty

subocnjunctival, subarachnoid or intraventitrrilcuar haemorrhage

umbilial or inguinal hernia

rupture of diaphragm

54
Q

diagnosis of pertussis 3

A

pernasal swab for PCR testing

culture

lymphocytosis

55
Q

treatment of pertussis 2

A

supportive
-low threshold for admission if neonates

macroslides

56
Q

benefits of using macroslides in pertussis infection 3

A

modify course of early disease

later reduce infectivitivty

and reduce secondrary bacterial complciatiosn

57
Q

preveniton of pertussis

A

vaccination

58
Q

most common cuases of bacterial meningitis in uk children 2 (3 others)

A

Neisseria meningitdis (mainly B)- 60-70% of cases
-incidence decreasing with routine vaccinatin

streptococcus pneumonia around 30%

H. Infunzae, TB and group B strep the rest

59
Q

common cause of viral meningitis 1

A

enterovirus

60
Q

common cuase of menigoencephalitis 1

A

herpes simplex

61
Q

neonates cause of meningitis 1

A

50-60% of cases are due to Group B strep (colonisation of the birth canal)

62
Q

other causes of noenates meningitis 2

A

listeria monocytogenes (eg mother eating unpasteurieiszed cheese during pregnancy)

gram-neg organmis s like E.coli

63
Q

presenation of meningitisin children 10

A

*-bacterial meningitis MEDICAL EMERGENCY

fever

headache

vomiting

neck stiffness

photophobia

lethargy

decreased level of consciousness

seizures

postive kernigns and brudzinski tests

64
Q

define kernings test

A

hip flexed-> extended knee= pain

65
Q

define brudzinkis sign

A

neck flexed-> hip & knee flex

66
Q

presenation of infants with meningitis 7

A

unexplained fever

lethargy

high pitched/ iritable cry that cannot be soothed by parents

poor feeding

apnoeic or cyanotic attacks

posturing

seizures

67
Q

advanced sign of meningitis in infants

A

bulging fontanelle
-sign of rasied ICP

*-can be masked by dehydration

68
Q

diagnosis of meningitis 1

A

lumbar puncture

69
Q

contraindications to a lumbar puncture 4

A

cardiovascular compormise

signs of raised ICP (risk of cerebral herniation)

abnormla clotting studies/ low platelets (risk of subdural or epidural haematoma)

skin infection at lumbar puncture site (risk of introducing infectoin)

70
Q

signs of raised ICP 8

A

GCS<9 or drop of 3 or more

relative bradycardia and hypertension

focal neuro signs

abnormal posute/posturing

unequal

dilated or poorly repsonsive pupils

papilloedema

abnormal dolls eyes mvoemeonts

71
Q

CSF analysis in meningitis
-White cell count cut off for children and neonates

A

children >5cells /mcl

neonates >20 cells/mcl

72
Q

type of WCC seen in CSF of bacterial meningitis

A

polymorphs

73
Q

type of WCC seen in CSF of viral mengitis after 24 hours

A

lymphocytes

74
Q

protein and glucose in CSF of bacterial/TB meningitis

A

elevated protein >0.4g/L

decreased glucose <0.6 CSF:blood ratio

75
Q

important point on gram staining for bacterial mengitis

A

60% of bacterial meningitis are negavtive for staining

-DO A CULTURE

76
Q

CSF investigations for TB meningitis 2

A

ZN/auramine stain

mycobacterial culture

77
Q

when to do PCR of CSF for what type sof meningitis 6

A

pneumococcus

meningococcus

HiB

HSC

VZV

enterovirus

78
Q

emperical treatment for suscpected bacterial meningitis :
<6wks

6wks-3mnths

> 3mnth

A

<6wks- cefotaxime, amox, gent

6wks-3mnths- cefotaxime

> 3mnths- cefotaxime and dexamethasone

79
Q

when should dexamethazone be used in menigitits, what age and why

A

if no petechiae or purpuric lesions

child over 3 months

reduces risk of deafness from Hib meningitis

80
Q

definitve treawtment for N. meningitiidis meningitis 2

A

7 days IV cefotaxime/ceftriaxone

81
Q

definitive treatment for S. pneumoniae meningitis 2

A

14 days IV cefotaxime/ceftriaxone

82
Q

if somneone has confirmed meningitis who should also be informed and what sohuld occur

A

refer to public health

contact tracing for chemoprophylaxis

83
Q

complications of meningitis 7

A

hydrocephalus

deafness- routine hearing tests after meningitis in children

neuromotor disordeers

seizures

visual disorders

speech/ language disordrs

learning difficulties and behaviorual problems ‘

84
Q

what is released in meningococcal sepsis (1) and what do they do (4)

A

endotoxins from cell wall cuase activation of proinflammaotry cytokines leading to:

-capillary leak
-coagulopathy
-myocardial depression
-metabolic derangement (low K, Ca, Mg & Ph)

85
Q

presentation of meningococcal sepsis 2

A

fever

petechial/purpuric rash (may be erytheamtous at onset)

*-can rapdily deteriotate and lead to severe sepsis and septic shock

86
Q

presenation of septic shcok 6

A

breahting difficulties

tachycardia
hypotension

cool extremities

leg pain

CRT>2s

decreaed GCS

87
Q

managemnet of meningococcal sepsis 5

A

high flow O2 15l via facemask w reservoir bag

signs of shcok IV fluid bolus
-20ml/kg 0.9% saline
-repeat
-if more than two= DW PICU/anaestjeitc team for ventilation/intubation/inotropic support

IV cefotaxime (50mg/kg)

correct metabolic derangement

treat coagulopathy

88
Q

what causes acute epiglottitis

A

Haemophilus influenzae type B
-rare but serious

*use to be children mainly affected but since immunisation now more adults

89
Q

features of acute epiglottitis 5

A

rapid onset

high temp

stridor

drooling of saliva

TRIPOD POSITION
- paitent finds it easier to breath if they are leaning forward and extending their neck in a seated posiotin

90
Q

diagnosis of acute epiglottitis 2

A

direct visulisation
-ONLY BY SENIOR STAFF
-risk of acute airway obstruction

x-ray aswell

91
Q

xray findings in acute epiglottitis 1

*why is xray helpful here

A

lateral view- show swelling of epiglottis - ‘thumb sign’

*Xray also helpful to assess for foreign body

92
Q

xray findings in croup

A

posterior-anterior view show subglottic narrowing
-‘steeple sign’

93
Q

management of acute epiglottitis 4

A

immediate senior involmemet

-endotracheal intubation may be necessary to protect teh airway

Oxyrgen

IV ABx (cefotaxime)

93
Q

management of acute epiglottitis 4

A

immediate senior involmemet

-endotracheal intubation may be necessary to protect teh airway

Oxyrgen

IV ABx

Paediatrics cabinetchip (80 decks)

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