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Phase 3a Medicine > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

What are the 5 main features of Kawasaki disease?

A
  • Conjunctivitis, bilateral without exudate
  • Rash, polymorphic
  • Adenopathy, unilateral cervical (>1.5cm)
  • Strawberry tongue, cracked lips, pharyngitis
  • Hands and feet, erythema then desquamation
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2
Q

What is the treatment for Kawasaki disease?

A

High does IV immunoglobulin + aspirin

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3
Q

Why is aspirin not normally given in children?

A

Risk of Reye’s syndrome - causes brain and liver damage

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4
Q

What is the most common cardiac abnormality caused by Kawasaki disease?

A

Coronary artery aneurysms

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5
Q

What organism causes measles?

A

RNA paramyxovirus

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6
Q

How long is measles infective for?

A

From prodrome till 5 days after rash starts

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7
Q

What are the features of measles prodrome?

A
  • Cough
  • Conjunctivitis
  • Coryza
  • Cranky
  • Fever
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8
Q

How would you describe a measles rash?

A

Maculopapular, starts behind ears, becomes confluent, lasts for a few days

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9
Q

Management of measles

A
  • Supportive
  • Isolation
  • Vaccination of close contacts
  • Notifiable disease
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10
Q

What is the name for the small red spots often seen on the oral mucosa in measles?

A

Koplik’s spots

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11
Q

What is the most common complication of measles?

A

Otitis media

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12
Q

What organism causes rubella?

A

RNA rubella virus

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13
Q

How long is rubella infective for?

A

5 days before and after rash appears

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14
Q

Give the 3 main signs and symptoms of rubella

A
  • Low-grade fever
  • Maculopapular rash (starts on face)
  • Suboccipital lymphadenopathy
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15
Q

What complications can rubella cause in pregnancy?

A

Foetal malformations, including:

  • deafness
  • cataracts
  • heart defects
  • intellectual disabilities
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16
Q

What organism causes mumps?

A

RNA paramyxovirus

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17
Q

How long is mumps infective for?

A

7 days before and 9 days after parotid swelling begins

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18
Q

Give the 3 main signs/symptoms of mumps

A
  • Prodromal malaise
  • Fever
  • Painful, bilateral parotid swelling
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19
Q

What is the most common complication of mumps in males?

A

Orchitis -> infertility in 25% of teens/adults

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20
Q

Management of mumps

A
  • Rest and paracetamol

- Notifiable disease

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21
Q

What organism causes roseola infantum?

A

Herpes virus 6

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22
Q

What are the signs and symptoms of roseola infantum?

A

Temperature for a few days, followed by a maculopapular rash, usually mild and self-limiting

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23
Q

How long should a child be off school for if they have roseola infantum?

A

No school exclusion

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24
Q

What is the most common complication associated with roseola infantum?

A

Febrile convulsions

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25
Q

What organism causes erythrovirus/slapped cheek?

A

Parvovirus B19

26
Q

Signs and symptoms of slapped cheek

A
  • Mild unwellness for a few days - fever, coryza

- Followed by macular erythema rash on cheeks

27
Q

How long should a child be off school for if they have slapped cheek?

A

No school exclusion - not infectious by the time rash develops

28
Q

What organism causes hand, foot and mouth disease?

A

Coxsackie virus A16 or enterovirus

29
Q

What are the main signs and symptoms of hand, foot and mouth disease

A

Child mildly unwell, vesicles on palms, soles and mouth

30
Q

Management of hand foot and mouth disease

A

Supportive, no school exclusion

31
Q

What organism causes chickenpox/shingles?

A

Varicella-Zoster virus

32
Q

Can chickenpox be caught off someone with shingles?

A

Yes

33
Q

How long is chickenpox infective for?

A

4 days before rash, until all lesions have crusted over (approx. 5 days)

34
Q

What are the main signs and symptoms of chickenpox?

A
  • Initial temperature

- Rash: macules -> papules -> vesicles -> crusting

35
Q

Management of chickenpox in a normal child

A
  • Keep cool, trim nails

- Calamine lotion

36
Q

How long should a child be off school for if they have chicken pox?

A

Until all lesions crusted

37
Q

Management of chickenpox in an immunosuppressed child

A

IVIg

38
Q

What is the most common complication of chickenpox?

A

secondary bacterial infection of lesions

39
Q

What organism most commonly causes epiglottitis?

A

Hib - now vaccinated against

40
Q

Give 3 risk factors for epiglottitis

A
  • children not vaccinated
  • male gender
  • immunosuppression
41
Q

Give 5 clinical features of epiglottitis

A
  • dyspnoea
  • dysphagia
  • drooling
  • stridor
  • dysphonia
  • high-grade fever
  • dehydration
42
Q

What position might a child be in if they have epiglottitis?

A

Tripod position

43
Q

Investigations for epiglottitis

A
  • Throat swabs
  • Blood cultures
  • FBC, CRP/ESR
  • Lateral neck x-ray
44
Q

What sign is seen on a lateral neck x-ray of a child with epiglottitis?

A

Thumb-print sign

45
Q

Management of epiglottitis

A
  • Secure airway
  • Oxygen
  • IV antibiotics - cefotaxime/ceftriaxone
  • IV steroids
  • Nil by mouth until airway improved
46
Q

What organism causes scarlet fever?

A

Strep. pyogenes

47
Q

Signs and symptoms of scarlet fever

A

Sore throat

12-48 hrs later - ‘pin-prick’ blanching rash, facial flushing with circumoral pallor, strawberry tongue

48
Q

Treatment of scarlet fever

A

Penicillin/clarithromycin 10 days

49
Q

What pathogen most commonly causes tonsillitis?

A

Group A strep. (strep pyogenes)

50
Q

What is the biggest risk factor for tonsillitis?

A

Smoking

51
Q

What are the 5 criteria of the feverPAIN score?

A
  • Fever in past 24hrs
  • Purulence (pus on tonsils)
  • Attend rapidly (within 3 days of onset)
  • severely Inflammed tonsils
  • No cough or coryza
52
Q

What does a high feverPAIN score indicate?

A

Tonsillitis likely caused by strep. infection -> antibiotics

53
Q

Management of acute tonsillitis

A
  • Analgesia - paracetamol, ibuprofen, topical difflam

- Antibiotics if bacterial - feverPAIN, Centor

54
Q

What is the criteria used to determine if tonsillectomy is appropriate?

A

The SIGN criteria, at least 7 episodes in a year

55
Q

What organism causes glandular fever?

A

Epstein-Barr virus

56
Q

How is glandular fever spread?

A

Saliva - kissing

57
Q

How long is the incubation period of glandular fever?

A

Up to 6 weeks

58
Q

Give 5 clinical features of glandular fever

A
  • Sore throat
  • Snoring
  • Swollen neck
  • Feverish
  • Headaches
  • Nausea and vomiting
  • General tiredness and aches
  • Hepatosplenomegaly
59
Q

What investigation is diagnostic for glandular fever?

A

Monospot test

60
Q

Management of glandular fever

A

Supportive

61
Q

Give 3 complications of glandular fever

A
  • Post-viral fatigue
  • GBS
  • Splenic rupture - avoid contact sport for 4-6wks

Phase 3a Medicine (4 decks)

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