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AKT > Paediatric infectious disease > Flashcards

Paediatric infectious disease Flashcards

1
Q

At birth immunisation

A

BCG if risk factors (see below) - At birth the BCG vaccine should be given if the baby is deemed at risk of tuberculosis (e.g. Tuberculosis in the family in the past 6 months).

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2
Q

2 months immunisation

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B

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3
Q

3 months immunisation

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV

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4
Q

4 months immunisation

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B

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5
Q

12-13m immunsations

A

Hib/Men C
MMR
PCV
Men B

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6
Q

2- 8 years annual vaccination

A

Flu vaccine annually

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7
Q

3-4 years vaccination

A

‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
MMR

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8
Q

12-13 years vaccination

A

HPV vaccination

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9
Q

13-18 years vaccination

A

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
Men ACWY

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10
Q

IM benzypenicillin dose for Meningitis <1 year

A

300mg

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11
Q

IM benzypenicillin dose for Meningitis 1-10 years

A

600mg

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12
Q

IM benzypenicillin dose for Meningitis >10 years

A

1200mg

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13
Q

Scarlet fever causative agent

A

Group A haemolytic strep

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14
Q

Scarlet fever epi

A

children aged 2-6 peak incidence at 4 years

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15
Q

scarlet fever spread

A

resp route

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16
Q

scarlet fever presentation

A

Fever: typically for 23 to 48 hours
Malaise, headache, nausea/vomiting
Sore throat
‘strawberry tongue’
Rash

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17
Q

Scarlet fever rash type/pattern

A

• fine punctate erythema (‘pinhead’) which generally appears first on the torso and spares the palms and soles
• children often have a flushed appearance with circumoral pallor. The rash is often more obvious in the flexures
• it is often described as having arough ‘sandpaper’ texture
desquamination occurs later in the course of the illness, particularly around the fingers and toes

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18
Q

Scarlet fever diagnosis

A

a throat swab is normally taken but antibiotic treatment should be commenced immediately, rather than waiting for the results

19
Q

Scarlet fever management

A

• oral penicillin V for 10 days
• patients who have apenicillin allergy should be given azithromycin
• children can return to school 24 hours after commencing antibiotics
scarlet fever is anotifiable disease

20
Q

Scarlet fever complications

A

• otitis media: the most common complication
• rheumatic fever: typically occurs 20 days after infection
• acuteglomerulonephritis: typically occurs 10 days after infection
invasive complications (e.g. bacteraemia, meningitis, necrotizing fasciitis) are rare but may present acutely with life-threatening illness

21
Q

Roseola infantum definition

A

Roseola infantum (also known as exanthem subitum, occasionally sixth disease)

22
Q

roseola infantum cause

A

HHV6

23
Q

roseola infantum incubation period

A

5-15 days

24
Q

Roseola infantum target age range

A

6 months to 2 years

25
Q

Roseola infantum features

A

• high fever: lasting a few days,followed laterby a
• maculopapular rash
• Nagayama spots: papular enanthem on the uvula and soft palate
• febrile convulsions occur in around 10-15%
• diarrhoea and cough are also commonly seen

26
Q

roseola infantum complications

A

• Aseptic meningitis
• Hepatitis
Febrile convulsions 10-15% of cases

27
Q

roseola infantum school exclusion ?

A

Not needed

28
Q

NICE traffic light - Categories

A

Colour, activity, respiratory Circulation and hydration, Other

29
Q

NICE traffic light Colour normal features

A

Normal colour

30
Q

NICE traffic light colour: Amber findings

A

Pallor reported by parent/carer

31
Q

NICE traffic light colour: Red flag

A

• Pale/mottled/ashen/blue

32
Q

NICE traffic light: Activity Green findings

A

• Responds normally to social cues
• Content/smiles
• Stays awake or awakens quickly
• Strong normal cry/not crying

33
Q

NICE traffic light: Activity Amber findings

A

normally to social cues
• Content/smiles
• Stays awake or awakens quickly
• Strong normal cry/not crying • Not responding normally to social cues
• No smile
• Wakes only with prolonged stimulation
• Decreased activity

34
Q

NICE traffic light: Red findings

A

• No response to social cues
• Appears ill to a healthcare professional
• Does not wake or if roused does not stay awake
• Weak, high-pitched or continuous cry

35
Q

NICE traffic light: respiratory amber findings

A

• Nasal flaring
• Tachypnoea: respiratory rate
>50 breaths/minute, age 6-12 months;
>40 breaths/minute, age >12 months
• Oxygen saturation <=95% in air
• Crackles in the chest

36
Q

NICE traffic light: respiratory Red findings

A

• Grunting
• Tachypnoea: respiratory rate >60 breaths/minute
• Moderate or severe chest indrawing

37
Q

NICE traffic light Circulation and hydration Green

A

• Normal skin and eyes
• Moist mucous membranes

38
Q

NICE traffic light Circulation and hydration Amber findings

A

• Tachycardia:
>160 beats/minute, age <12 months
>150 beats/minute, age 12-24 months
>140 beats/minute, age 2-5 years
• Capillary refill time >=3 seconds
• Dry mucous membranes
• Poor feeding in infants
• Reduced urine output

39
Q

NICE traffic light Circulation and hydration Red findings

A

reduced skin turgor

40
Q

NICE traffic light other amber findings

A

• Age 3-6 months, temperature >=39ºC
• Fever for >=5 days
• Rigors
• Swelling of a limb or joint
• Non-weight bearing limb/not using an extremity

41
Q

NICE traffic light other Red findings

A

• Age <3 months, temperature >=38°C
• Non-blanching rash
• Bulging fontanelle
• Neck stiffness
• Status epilepticus
• Focal neurological signs
• Focal seizures

42
Q

NICE traffic light patient in green category - management

A

Child can be managed at home with appropriate care advice, including when to seek further help

43
Q

NICE traffic light patient in Amber category

A

provide parents with a safety net or refer to a paediatric specialist for further assessment
a safety net includes verbal or written information on warning symptoms and how further healthcare can be accessed, a follow-up appointment, liaison with other healthcare professionals, e.g. out-of-hours providers, for further follow-up

44
Q

NICE traffic light patient in Red group

A

refer urgently to a paediatric specialist

AKT (10 decks)

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