Paediatrics Infections and ENT Flashcards
What is Measles ?
Should be in incubation for 10-14 days.
Firstly, it presents with fever, conjunctivitis, coryza, and lymph nodes
Later, it develops Kolpik’s spots on the mouth and about 4th day it will appear with a maculopapular rash
what are the complications of Measles?
Bronchopneumonia
Corneal ulcer
Gastroenteritis
rarely encephalitis
What is the management for Measles ?
Paracetamol
Fluids
What to suggest if it has secondary infections from Measles ?
Secondary infection must be treated with Antibiotics-n
What is Rubella ?
Also called as german measles
incubation for 14-21 days
When does rubella appear as infectious ?
7 days before and 7 days after the rash appears
How does Rubella present with ?
Fever
Lymph nodes (sub-occipital)
Maculopapular rash lasts for 3 days
What are the complications of Rubella?
Arthritis, thrombocytopaenia & Encephalitis –rare
cause BIRTH DEFECT IN PREGNANCY
What is the management for Rubella ?
Arthritis, thrombocytopaenia & Encephalitis –rare
Wghat is the management of rubella?
Paracetamol and fluids
Which would last for
what is the risk to the baby if the mother is infected with Rubella ?
Cataract
Deafness
Cerebral Palsy
Retardation
Microcephaly
if they’re >16 weeks, the minimal risk is deafness
What is Erythema infectiosum - 5th disease ?
Slapped cheek disease
5th disease presents with ?
Fever and Rash
Facial red maculopapular rash
(slapped cheeks)
Cause of 5th disease ?
Parvovirus
What is the management of 5th disease ?
Paracetamol
Fluids
If there is a Non vesicular rash identified in pregnancy, what would you do ?
Seek for specialist advice
Test for B19 parovirus , IgE, igM
If found, therapeutic abortion is generally recommended after proven the rubella infection during the first trimester
What is Roseola infantum (sixth disease) ?
Occur in children under 2 years
How does the Roseola infantum present with ?
High fever
Sore throat
lymph nodes
maculopapular rash appears at 3rd day as fever subsides
What is the management of Roseola infantum ?
Paracetamol
Fluids
It lasts upto 7 days
How does Chicken pox appear ?
Papule ( fluid or pus)
Ulcer
Blister
How long is the incubation period for Chicken pox?
10 -21 days
but its infectious 2 days before and 5 days after rash has stopped
How does Chicken pox presents?
Fever
aches and pains
itchy
What is the formation of rash ?
It comes in over the space ( comes in a wave as it disappears and a new wave will come again) of a week where firstly it is macule, papule, vesicle, then sometimes pustule , and scabs over (crust over and then it wont be contagious)
What is the complication of chicken pox ?
Pneumonia
encephalitis
birth defects
What is the management for chickenpox?
Drink plenty of fluid, ice lollies
Paracetamol for discomfort but not ibuprofen
Cut the nails
Apply Calamine Lotion
Antihistamine for itchiness
Take a cool bath, pat but do not rub
What is Mumps ?
A contagious viral infection in children and the incubation period is 16- 21 days . It can spread through droplets and saliva spread ( cough/sneeze)
How does mums present?
Fever
Malaise
Tender parotid glands and sometimes submandibular glands
what is the complication of Mumps ?
Epididymo-orchitis
Meningitis
Pancreatitis
What is the management of Mumps ?
Paracetamol and fluids
Lats for 10 days
Kissing disease formally called as EBV-Glandular fever-infectious mononucleosis ?
Mostly occur in teenagers /young adult and they present with sore throat more than 1 week
Kissing disease is caused by ?
EBV (herpes family)
What is the incubation period for kissing disease ?
4 - 14 days
What is Glandular fever?
Glandular fever (infectious mononucleosis) is a viral infection that most often affects teenagers and young adults
What are the symptoms of Glandular fever ?
Sore throat
fever
malaise ( could go on for several months )
What are the signs of Glandular fever ?
Lymph nodes
splenomegaly
palatal petechiae
rash 20%
What is the investigation of Glandular fever ?
FBC shows atypical lymphocyte- white cell look a bit strange
Monospot/Paul Bunell test for antibodies
What is the management of Glandular fever ?
Self limiting
fluid
rest
paracetamol
salty gargles
no alcohol
What is Cradle Cap- infantile seborrheic dermatitis?
It is acute, reddened scaling of the scalp in the nappy area, face, chest, back, and limb flexures.
It usually starts <2 weeks of age
What is the appearance of infantile seborrheic dermatitis (craddle cap) ?
Coarse
Yellow scales on the scalp
spreads to other areas
What is the management of craddle cap ?
If mild, settles in few weeks but rarely after 3 months
You can massage the craddle cap area by using arachis oil, olive oil, baby oil or salicylic acid in aqueous cream into the scalp prior to using a mild shampoo.
ketoconazole 2% cream od or shampoo bd
Pharyngitis ? (gas)
Group A Streptococcal pharyngitis/tonsilitis
How does pharyngitis occur?
Very common in children
especially in winter and it presented with
Fever
Lymph nodes on the anterior neck
Absence of cough
Scarlatiniform rash especially in children
Fever PAIN Score 4/5 or the centor rules strongly suggest it
How does the Centor rules work?
Scoring 1 point for each including
Tonsillar exudate /erythema +1
NODES +1
Cough +1
Fever +1
Age 3-4 years +1
Age 15 -45 years 0
Age over 45 years -1 points
Describe Fever PAIN score?
Score 1 for each point
Feverover 38°c.
Purulence (pharyngeal/tonsillar exudate).
Attend rapidly (3 days or less)
Severelyinflamed tonsils
No cough or coryza
What is the management of Pharyngitis ?
- Delayed antibiotic prescribing strategy: fever pain score of 2/3
- Antibiotics:
Group A Strepconfirmed by rapid antigen testing, or
Fever pain scores 4 or 5
Centor score of 3 or 4
Low threshold for infants, aged, immunosuppressed
Very severe symptoms
What abx do you use for pharyngitis ?
Phenoxymethylpenicillin as the first-choice antibiotic.
What is the alternative option to manage pharyngitis if patients are allergic to penicillin ?
Clarithromycin
but give pregnant women erythromycin if they’re allergic to penicillin allergy
