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Paediatric rotation > Paediatric infectious diseases > Flashcards

Paediatric infectious diseases Flashcards

1
Q

What type of infection is measles?

A

Respiratory viral infection

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2
Q

What pathogen causes measles?

A

a virus of the family Paramyxoviridae, genus morbillivirus

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3
Q

What type of virus is measles?

A

Single-stranded, RNA virus

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4
Q

How is measles spread?

A

respiratory droplets from coughing, sneezing etc.

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5
Q

What is the incubation period for measles?

A

10 days

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6
Q

What are the typical features of the prodromal phase (2-4 days) of measles?

A

A fever of 39°C or more without antipyretics, decreases after the rash develops
Cough
Conjunctivitis
Coryza
Diarrhoea

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7
Q

What type of spots do you get in the mouth in measles?

A

Koplik’s spots

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8
Q

What typ eof rash do you get in measles?

A

Erythematous, maculopapular rash: beginning on the face and behind the ears and it spreads downwards

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9
Q

What are DDx for measles?

A

Rubella, Parvovirus B19, Herpes virus type 6, streptococcal infection, Kawasaki disease, EBV, early meningococcal disease.

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10
Q

What are the complications of measles in pregnancy?

A

Miscarriage or stillbirth
Premature birth
Low birthweight

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11
Q

What are the complications of measles?

A

otitis media, pneumonia, encephalitis, subacute sclerosing panencephalitis and blindness.

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12
Q

Which pathogen causes chicken pox?

A

varicella zoster virus (VZV)

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13
Q

What type of rash do you get in chicken pox?

A

widespread, erythematous, raised, vesicular (fluid filled), blistering lesions. usually starts on the trunk or face

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14
Q

What symptoms do you get in chicken pox apart from a rash?

A

Fever is often the first symptom
Itch
General fatigue and malaise

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15
Q

What are the complications of chicken pox?

A

Bacterial superinfection
Dehydration
Conjunctival lesions
Pneumonia
Encephalitis (presenting as ataxia)

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16
Q

Where can chicken pox lie dormant in the body after infection?

A

sensory dorsal root ganglion cells

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17
Q

What can reactivated chicken pox cause in later life?

A

shingles or Ramsay Hunt syndrome.

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18
Q

What is given to pregnant women who have not had chicken pox?

A

varicella zoster immunoglobulins

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19
Q

What drug can be given to those with chicken pox who are immunocompromised, adults, neonates or those at risk of complication.

A

Aciclovir

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20
Q

What can itching caused by chicken pox be treated with?

A

calamine lotion and chlorphenamine (antihistamine)

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21
Q

What type of infection is impetigo?

A

superficial bacterial skin infection

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22
Q

What pathogen causes impetigo?

A

staphylococcus aureus (sometimes streptococcus pyogenes)

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23
Q

Is impetigo contagious?

A

Yes

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24
Q

What are the two different types of impetigo?

A

Bullous and non-bullous

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25
Q

Where does non-bullous impetigo generally occur

A

Round the mouth or nose

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26
Q

What is characteristic of non-bullous impetigo?

A

Golden crust round the mouth or nose and patient is generally well

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27
Q

What can be used to treat loaclised, non-bullous imopetigo?

A

Antiseptic cream is 1st line but Topical fusidic acid can be used

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28
Q

What is used to treat more widespread or severe impetigo?

A

Flucloxacillin

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29
Q

What is the antibiotic of choice for stapylococcal infections?

A

Flucloxacillin

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30
Q

Which bacteria is always the cause of bullous impetigo?

A

Staphylococcus aureus

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31
Q

Which typ eof impetigo is more common in neonates and children under 2?

A

Bullous impetigo

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32
Q

What is more severe bullous impetigo called when lesions are widespread?

A

Staphylococcus scalded skin syndrome

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33
Q

In which type of impetigo is there more likely to be systemic symptoms?

A

Bullous impetigo

34
Q

What are the complications of impetigo?

A

Cellulitis if the infection gets deeper in the skin
Sepsis
Scarring
Post streptococcal glomerulonephritis
Staphylococcus scalded skin syndrome
Scarlet fever

35
Q

What is kawasaki disease also known as?

A

mucocutaneous lymph node syndrome

36
Q

What kind of vasculitis is kawasaki disease?

A

Medium-sized vessel vasculitis

37
Q

Who does kawasaki disease typically affect?

A

Young children under 5 years old

38
Q

Which ethnicity is kawasaki disease more common in?

A

Asian children, particularly Japanese and Korean children

39
Q

Which gender is kawasaki disease more common in?

A

Boys

40
Q

What is a key complication of kawasaki disease?

A

coronary artery aneurysm.

41
Q

How long does a fever last to make you think it could be kawasaki disease?

A

at least 5 days

42
Q

What are the key skin findings of kawasaki disease?

A

widespread erythematous maculopapular rash and desquamation (skin peeling) on the palms and soles

43
Q

What are the features of kawasaki excluding skin findings and fever?

A

Strawberry tongue (red tongue with large papillae)
Cracked lips
Cervical lymphadenopathy
Bilateral conjunctivitis

44
Q

What investigations will be useful for diagnosing kawasaki disease?

A

Full blood count can show anaemia, leukocytosis and thrombocytosis
Liver function tests can show hypoalbuminemia and elevated liver enzymes
Inflammatory markers (particularly ESR) are raised
Urinalysis can show raised white blood cells without infection
Echocardiogram can demonstrate coronary artery pathology

45
Q

What happens in the acute phase of kawasaki disease?

A

The child is most unwell with the fever, rash and lymphadenopathy. This lasts 1 – 2 weeks.

46
Q

What happens in the subacute phase of kawasaki disease?

A

The acute symptoms settle, the desquamation and arthralgia occur and there is a risk of coronary artery aneurysms forming. This lasts 2 – 4 weeks.

47
Q

What happens in the convalescent phase of kawasaki disease?

A

The remaining symptoms settle, the blood tests slowly return to normal and the coronary aneurysms may regress. This last 2 – 4 weeks.

48
Q

What are two first line medical treatments given to patients with Kawasaki disease?

A

High dose aspirin to reduce the risk of thrombosis
IV immunoglobulins to reduce the risk of coronary artery aneurysms

49
Q

Why is aspirin usually contraindicated in kawasaki disease?

A

due to Reye’s syndrome

50
Q

What does encephalitis mean?

A

inflammation of the brain

51
Q

What does encephalitis mean?

A

inflammation of the brain

52
Q

What is the non-infective cause of encephalitis?

A

Autoimmune

53
Q

What is the most common cause of encephalitis?

A

Viral

54
Q

What is the most common viral cause of encephalitis?

A

herpes simplex virus (HSV)

55
Q

What is the most common HSV in children to cause encephalitis?

A

HSV-1 from cold sores

56
Q

What is the most common HSV in neonates?

A

HSV-2 from genital herpes

57
Q

What are the other viral causes of encephalitis apart from HSV?

A

varicella zoster virus (VZV), cytomegalovirus, EBV, polio, mumps, rubella and measles

58
Q

What is VZV associated with?

A

chickenpox, cytomegalovirus

59
Q

What is cytomegalovirus associated with?

A

Immunodeficiency

60
Q

What is EBV associated?

A

infectious mononucleosis, enterovirus, adenovirus and influenza virus

61
Q

What is the presentation of encephalitis?

A

Altered consciousness
Altered cognition
Unusual behaviour
Acute onset of focal neurological symptoms
Acute onset of focal seizures
Fever

62
Q

What investigations are done for encephalitis?

A

Lumbar puncture, sending cerebrospinal fluid for viral PCR testing
CT scan if a lumbar puncture is contraindicated
MRI scan after the lumbar puncture to visualise the brain in detail
EEG recording can be helpful in mild or ambiguous symptoms but is not always routinely required
Swabs of other areas can help establish the causative organism, such as throat and vesicle swabs
HIV testing is recommended in all patients with encephalitis

63
Q

What is used to treat HSV and VZV?

A

Aciclovir

64
Q

What is used to treat cytomegalovirus?

A

Ganciclovir

65
Q

What are the complications of encephalitis?

A

Lasting fatigue and prolonged recovery
Change in personality or mood
Changes to memory and cognition
Learning disability
Headaches
Chronic pain
Movement disorders
Sensory disturbance
Seizures
Hormonal imbalance

66
Q

Give some examples of inactivated vaccines.

A

Polio
Flu vaccine
Hepatits A
Rabies

67
Q

What are subunit and conjugate vaccines?

A

only contain parts of the organism used to stimulate an immune response- cannot cause infection and safe for immunocompromised patients

68
Q

Give some examples of subunit and conjugate vaccines

A

Pneumococcus
Meningococcus
Hepatitis B
Pertussis
Haemophilus influenza type B
Human papillomavirus
Shingles

69
Q

Give some examples of live, attenuated vaccines

A

Measles, mups and rubella vaccine
BCG (TB)
Chickenpox
Nasal influenza
Rotavirus

70
Q

Give some examples of toxin vaccines

A

Diptheria and tetanus

71
Q

What vaccines do children have at 8 weeks?

A

6 in 1 vaccines (diptheria, tetanus, pertussis, polio, haemophilus influenzae type B (Hib) and hep B)
Meningiococcal type B
Rotavirus (oral)

72
Q

What vaccines do children have at 12 weeks?

A

6 in 1 vaccine again
Pneumococcal
Rotavirus again

73
Q

What vaccines do children have at 16 weeks?

A

3rd 6 in 1 vaccine
Meningococcal type B 2nd

74
Q

What vaccines do children have at 1 year?

A

2 in 1 (haemophilus influenza type B and meningococcal type C)
Pneumococcal 2nd
MMR vaccine
Meningococcal type B 3rd

75
Q

What vaccines do children have yearly from age 2-8?

A

influenza vaccine

76
Q

What vaccines do children have at 3 years and 4 months?

A

4 in 1 (diptheria, tetanus, pertussis and polio)
MMR vaccine 2nd

77
Q

What vaccine do children have at 12-13 years?

A

Human papillomavirus vaccine (2 doses 6 to 24 months apart)

78
Q

What vaccine do children have at 14 years?

A

3 in 1 (tetanus, diptheria and polio)
Meningococcal groups A,C,W and Y

79
Q

Which strains of HPV cause genital warts?

A

6 and 11

80
Q

Which strains of HPV cause cervical cancer?

A

16 and 18

81
Q
A

Paediatric rotation (14 decks)

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