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Paediatrics > Paediatric infectious diseases > Flashcards

Paediatric infectious diseases Flashcards

1
Q

What are 6 signs of sepsis in a child?

A 
Temperature >38 or <36
Inappropriate tachycardia
Poor peripheral perfusion
Altered mental state
Inappropriate tachypnoea
Hypotension
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2
Q

What are 3 signs of sepsis for a child under 5?

A

Not feeding
Vomiting repeatedly
Hasn’t had a wee or wet nappy for 12 hours

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3
Q

What are the SIRS criteria?

A 
2 or more of:
Temperature >38 or <36
WCC >15x10^9 or <5x10^9/l
Tachycardia
Tachypnoea
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4
Q

What is sepsis?

A

SIRS + suspected or proven infection

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5
Q

What is severe sepsis?

A

Sepsis + organ dysfunction

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6
Q

What is septic shock?

A

Sepsis + CVS dysfunction

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7
Q

How might mental state be altered in paediatric sepsis?

A

Sleepiness
Irritability
Lethargy
Floppiness

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8
Q

What are some risk factors for infection in infants <3 months?

A 
Premature
Maternal pyrexia
Maternal Group B Strep (GBS)
Maternal STI
Premature rupture of membranes (PROM)
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9
Q

How do you manage a septic baby?

A 
Airway
Breathing
Circulation - 20ml/kg fluid bolus
DEFG - Don't ever forget glucose - 2ml/kg 10% dextrose
Antibiotics
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10
Q

Which antibiotics might be used for a septic baby?

A

3rd gen cephalosporin like cefotaxime or ceftriaxone

Add IV amoxicillin if <1m old

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11
Q

What are some blood tests to run for a septic baby?

A 
FBC
CRP
Coagulation screen
Blood gas
Glucose
Blood culture
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12
Q

How would an FBC come back in sepsis?

A

Leukocytosis

Thrombocytopenia

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13
Q

How would a blood gas come back in sepsis?

A

Metabolic acidosis

Raised lactate

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14
Q

What could you send for culture in sepsis?

A

Blood
Urine
CSF
Stool

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15
Q

Which imaging technique could be used in sepsis?

A

CXR

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16
Q

What are the main organisms causing sepsis and meningitis in neonates?

A

Group B Strep
Escherichia coli
Listeria monocytogenes

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17
Q

What are the main causative organisms for sepsis in older infants and children?

A

Strep pneumoniae
Neisseria meningitidis
Group A strep
Staph aureus

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18
Q

What is the pathogenesis of sepsis?

A

Secretion of pro and anti-inflammatory cytokines
Activation of complement
Activation and mobilisation of leukocytes
Activation of coagulation and inhibition of fibrinolysis
Increased apoptosis

19
Q

What are some signs and symptoms of meningitis in older children?

A 
Fever
Headache
Photophobia
Neck stiffness 
Nausea & vomiting
Reduced GCS
Seizures
Focal neurological deficits
20
Q

What causes neck stiffness in meningitis of older children?

A

Nuchal rigidity

21
Q

What are some signs and symptoms of meningitis in young infants?

A 
Fever/hypothermia
Poor feeding
Vomiting
Lethargy
Irritability
Respiratory distress
Apnoea
Bulging fontanelle
22
Q

How can you test nuchal rigidity (neck stiffness)?

A

Palpable resistance to neck flexion

23
Q

What is Brudzinski’s sign?

A

Hips and knees flex on passive flexion of the neck

24
Q

What is Kernig’s sign?

A

Pain on passive extension of the knee

25
Q

What are some clinical signs of meningitis?

A

Nuchal rigidity
Brudzinski’s sign
Kernig’s sign

26
Q

What are the main bacteria causing meningitis in older children?

A

Strep pneumoniae
Neisseria meningitidis
Haemophilus influenzae b

27
Q

What is the carriage of Haem influenzae and neisseria meningitidis?

A

Nasopharyngeal

28
Q

Which aspects of the immune response can haem influenzae resist?

A

Phagocytosis

Complement mediated lysis

29
Q

How is neisseria meningitidis transmitted?

A

Respiratory secretions

30
Q

What are some risk factors for invasive meningococcal disease?

A 
Age <1 year or 15-24 years
Unimmunised
Crowded living conditions
Household or kissing contact
Cigarette smoking (active or passive)
Recent viral/Mycoplasma infection
Complement deficiency
31
Q

How does invasive meningococcal disease progress?

A

Rapidly

32
Q

What are some possible long term complications of invasive meningococcal disease?

A

Amputation
Scarring
Hearing loss
Cognitive impairment

33
Q

Which aspects of the immune response can strep pneumoniae resist?

A

Neutrophil phagocytosis

Complement mediated cell lysis

34
Q

What are some risk factors for invasive pneumococcal disease?

A 
Age <2 years
Cigarette smoking (active or passive)
Recent viral URTI
Attendance at childcare
Cochlear implant
Sickle cell disease
Asplenia
HIV infection
Nephrotic syndrome
Immunodeficiency
35
Q

What are some long term neuro complications of pneumococcal meningitis?

A 
Hydrocephalus
Neurodisability
Seizures
Hearing loss
Blindness
36
Q

Are tests results for meningitis similar?

A

Yeah pretty much the same

More signs of raised ICP in meningitis

37
Q

How does staphylococcal scalded skin syndrome present?

A 
Initial bullous lesions 
Followed by widespread desquamation
Nikolsky sign
Mild fever
Purulent conjunctivitis
38
Q

How do we manage staphylococcal scalded skin syndrome?

A

IV flucloxacillin

IV fluids

39
Q

How does scarlet fever present?

A 
Fever
Malaise
Sore throat
Strawberry tongue
Sandpaper rash
Skin peeling (desquamation)
40
Q

How is scarlet fever managed?

A

Phenoxymethylpenicillin

41
Q

What are the main causative organisms behind TSS?

A

Staph aureus

Group A Strep

42
Q

How does TSS present?

A 
Fever
Diffuse "sunburn" rash
Swollen lips
Diarrhoea
Rapid progression and multi-organ failure
43
Q

How is TSS managed?

A

Fluid resuscitation
Cultures
IV flucloxacillin + clindamycin
Avoid NSAIDs

Paediatrics (25 decks)

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