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Phase 3a conditions list flashcards > Paediatrics - infectious disease > Flashcards

Paediatrics - infectious disease Flashcards

1
Q

What criteria can be used to judge how ill a child with an infection is?

A

Nice traffic light system for the unwell child

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2
Q

What criteria are included in the traffic light system for the unwell child?

A
  • Colour
  • Activity
  • Respiratory
  • C/H circulation/ hydration
  • Other
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3
Q

What are the green, amber and red criteria for colour?

A
  • Green = normal
  • Amber = pallor (reported by carer)
  • Red = mottled/ blue/ extremely pale
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4
Q

What are the green, amber and red criteria for activity?

A
  • Green = normal
  • Amber = difficult to wake, decreased activity
  • Red = does not stay awake/ does not wake up, inconsolable
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5
Q

What are the green, amber and red criteria for respiratory?

A
  • Green = RR < 50
  • Amber = RR > 50 (if 6-12 months) or > 40 (if 12+ months), SpO2 < 95, nasal flaring
  • Red = grunting, RR > 60, severe chest indrawing
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6
Q

What are the green amber and red criteria for circulation/ hydration?

A
  • Green = moist mucous membrane, normal skin
  • Amber = tachycardia, CRT > 3 seconds, dry MM, reduced urine/ feeding
  • Red = reduced skin turgor
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7
Q

What are the amber and red criteria for ‘other’?

A
  • Amber = 5 day fever, 3-6 month > 39 degrees, rigors, swelling/ non-weight bearing joint
  • Red = <3months >38 degrees, NBP rash, status epilepticus
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8
Q

What is the management for children green on the traffic light system for unwell children?

A

Safety netting

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9
Q

What is the management for children amber on the traffic light system for unwell children?

A

Assess F2F to judge need fro admission

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10
Q

What is the management for children red on the traffic light system for unwell children?

A

Urgent admission

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11
Q

What is a risk score for sepsis in children (used to predict mortality)?

A

qSOFA:
* RR > 22
* GCS < 15
* BP < 100

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12
Q

What are some typical investigations used investigate children with infections (6)?

A
  • FBC
  • Blood culture
  • Urine culture
  • CRP
  • LP
  • CXR
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13
Q

What is Kawasaki disease?

A

Systemic medium vessel vasculitis

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14
Q

Who is typically affected by Kawasaki disease (2)?

A
  • Under 5 years
  • Asian (Japanese/ Korean)
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15
Q

What are the signs/ symptoms of Kawasaki (6)?

A
  • Persistent high fever for 5 days
  • Conjunctivitis
  • Rash - erythematous maculopapular
  • Adenopathy
  • Strawberry tongue
  • Hands + feet desquamation
    CRASH
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16
Q

What are some findings on bloods for kawasaki disease (3)?

A
  • Raised ESR
  • Raised WCC
  • Raised platelets
    raised LFTs
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17
Q

What is a significant complication of Kawasaki?

A

Coronary artery aneurysms

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18
Q

What is an important investigation to request for those with Kawasaki?

A

Echo (look for coronary artery aneurysms)

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19
Q

How is Kawasaki treated (2)?

A
  • IVIg (reduce risk of CAA)
  • Aspirin (reduce risk of thrombosis)
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20
Q

What are the 3 stages of Kawasaki disease?

A
  • Acute (most unwell with fever + rash, 1-2 weeks)
  • Subacute (desquamation, CAA, 2-4 weeks)
  • Convalescent stage (Sx settle, 2-4 weeks)
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21
Q

What is a risk when giving aspirin to children?

A

Reyes syndrome

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22
Q

What is reyes syndrome and what are the symptoms (3)?

A

Neurological disease:
* Vomiting
* Seizures/ LOC
* Personality changes

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23
Q

What are the signs/ symptoms of varicella zoster virus (4)?

A
  • Maculo-papular with vesicles (blisters) rash
  • Fever
  • Itch
  • General fatigue
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24
Q

What is the progression of the chicken pox rash?

A

Macularpapular rash –> vesicles –> pop + crust over

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25
Q

Where does the rash in chicken pox often start?

A

Chest/ face

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26
Q

What is the incubation of chicken pox?

A

3 weeks

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27
Q

When is the infectious period for chicken pox?

A

4 days before rash –> 5 days after (or when all lesions have crusted over)

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28
Q

How is chicken pox treated?

A

Supportive - can give aciclovir

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29
Q

What must not be given to those with chicken pox?

A

NSAIDs (can precipitate superinfection/ necrotising fascitis)

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30
Q

What are some complications of VZV/ chicken pox (4)?

A
  • Bacterial superinfection
  • Shingles/ Ramsey hunt
  • Encephalitis
  • Dehydration
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31
Q

What is shingles?

A

VZV (also known as herpes zoster virus) lies dormant in the sensory dorsal root ganglia and reactivate later in life (usually if immunosuppressed)

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32
Q

What is Ramsey hunt syndrome?

A

VZV lies dormant in facial nerve and causes facial drooping

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33
Q

How can Ramsey hunt and bells palsy be differentiated?

A

Otoscopy (may reveal changes to tympanic membrane in Ramsey hunt)

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34
Q

How can itching caused by chicken pox be treated?

A

Chlorphenamine (antihistamine)

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35
Q

What six diseases have traditionally caused an eruptive widespread rash (‘viral exanthema’)?

A
  • First disease = measles
  • Second disease = scarlet fever
  • Third disease = rubella
  • Fourth disease = dukes disease
  • Fifth disease = parvovirus B19
  • Sixth disease = roseola
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36
Q

What are the signs/ symptoms of measles (5)?

A
  • Maculopapular rash
  • Fever
  • Cough
  • Conjunctivits
  • Coryzal Sx
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37
Q

What is a pathognomonic feature of measles?

A

Koplik spots (found on buccal mucosa)

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38
Q

Where does a measles rash classically start?

A

On face behind the ears

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39
Q

What are some complications of measles (5)?

A
  • Otitis media
  • Dehydration
  • Pneumonia
  • Hearing/ vision loss
  • Meningitis/ encephalitis
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40
Q

What is another complication of measles that may occur several years after infection?

A

Subacute sclerosing panencephalitis

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41
Q

How can measles be treated?

A

Give MMR within 72 hours of Sx

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42
Q

How is measles diagnosed?

A

Serology testing (IgM + G) > 72 hours
PCR swab <72 h from onset

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43
Q

What causes scarlet fever?

A

Group A strep (strep pyogenes)

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44
Q

What is the underlying cause of scarlet fever?

A

Exotoxin B,C,F production (from GAS strains)

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45
Q

What does scarlet fever often start as?

A

Tonsilitis

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46
Q

What are the signs/ symptoms of scarlet fever (6)?

A
  • Rough “sandpaper” rash
  • Strawberry tongue
  • Fever
  • Sore throat
  • Lymphadenopathy
  • Lethargy
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47
Q

What age group does scarlet fever usually occur in?

A

Under 10 years

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48
Q

Where does the rash in scarlet fever typically start?

A

On chest

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49
Q

How is scarlet fever treated?

A

Phenoxymethylpenicillin (penicillin V) - 10 days

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50
Q

What are some complications of scarlet fever (3)?

A
  • Rheumatic fever
  • Post strep glomerulonephritis
  • Abscess (tonsillar)
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51
Q

How can scarlet fever be diagnosed?

A

If clinical uncertainty a throat swab can be taken

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52
Q

What are the signs/ symptoms of rubella (6)?

A
  • Erythematous macular rash
  • Lymphadenopathy (behind ears + neck)
  • Coryzal Sx
  • Fever
  • Arthritis
  • Sore throat
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53
Q

How long is the incubation period for rubella?

A

2 weeks

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54
Q

How long does the rash typically last in rubella?

A

3 days

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55
Q

How is rubella diagnosed?

A

Serology testing (IgG)

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56
Q

What must children with rubella avoid?

A

Pregnant women (very dangerous for them)

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57
Q

What are some complications of rubella (2)?

A
  • Thrombocytopenia
  • Encephalitis
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58
Q

What is dukes disease?

A

Not associated with a particular virus or bacteria, more of a historic term. It is likely a non-specific viral rash

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59
Q

What is parvovirus B19 also known as?

A

Slapped cheek syndrome

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60
Q

What are the signs/ symptoms of slapped cheek syndrome (5)?

A

Starts with:
* Fever
* Coryzal Sx
* Muscle aches
then:
* Bright red rash on cheeks
then:
* Reticular (net-like) rash spreads to trunk

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61
Q

How is slapped cheek managed?

A

Symptoms usually very mild - self limiting illness

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62
Q

Who is at particular risk of parvovirus B19?

A

Those with anaemic blood disorders e.g. SSD, thalassaemia
these patients should receive serology testing, FBC, reticulocyte count

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63
Q

When is slapped cheek infectious?

A

Prior to the rash forming

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64
Q

What are some complications of slapped cheek (2)?

A
  • Aplastic anaemia (those with pre-existing anaemias affected)
  • Encephalitis/ meningitis
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65
Q

What causes roseola?

A
  • Human herpes virus 6
  • Human herpes virus 7
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66
Q

What are the signs/ symptoms of roseola (5)?

A
  • Very high fever for 3-5 days (40 degrees)
  • Coryzal Sx
  • Sore throat
  • Lymphadenopathy
  • Rash (on arms, legs, trunk) after fever settles
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67
Q

What is a feature of the rash in roseola?

A

It is not itchy

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68
Q

What are some complications of roseola (4)?

A
  • Febrile convulsions
  • Myocarditis
  • Thrombocytopenia
  • Guillian barre
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69
Q

What age is typically affected by roseola?

A

Infants (2-3)

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70
Q

How is mumps spread?

A

Respiratory droplets through the air

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71
Q

What is the typical incubation period of mumps?

A

14-25 days

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72
Q

What are the signs/ symptoms of mumps (2)?

A
  • Initial flu like symptoms (fever, muscle aches, headache, lethargy)
  • Parotid gland swelling (parotitis)
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73
Q

What are some complications of mumps (3)?

A
  • Orchitis (testicle pain/ swelling)
  • Pancreatitis
  • Meningitis
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74
Q

How is mumps diagnosed?

A

PCR testing on saliva swab

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75
Q

What causes hand foot and mouth disease?

A

Coxsackie A virus

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76
Q

What is the typical intubation period of HFM?

A

3-5 days

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77
Q

What are the signs/ symptoms of HFM (3)?

A
  • URTI Sx
    then:
  • Mouth ulcers
  • Red blistering spots on hand + feet
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78
Q

How should HFM disease be managed?

A

Supportive management only

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79
Q

What are some complications of HFM (3)?

A
  • Dehydration
  • Bacterial superinfection
  • Encephalitis
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80
Q

What causes impetigo (2)?

A
  • Staph aureus = mc
  • Strep pyogenes
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81
Q

What is the typical presentation of impetigo?

A

Golden crusted personal lesions

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82
Q

What are the two types of impetigo?

A
  • Bullous (always staph aureus, more severe - can be systemic Sx)
  • Non-bullous
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83
Q

What is the difference between bullies and non-bullous staph aureus?

A
  • Non- bullous = less severe lesions around mouth
  • Bullous = more severe larger fluid filled blisters that subsequently burst in various locations on body
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84
Q

How is impetigo diagnosed?

A

Clinically/ send swab for MC&S

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85
Q

How is impetigo treated (3)?

A
  • Hydrogen peroxide cream 1%
  • Topical Abx e.g. fusidic acid
  • Oral flucloxacillin
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86
Q

What are some complications of impetigo (6)?

A
  • Cellulitis
  • Sepsis
  • Scarring
  • Post strep glomerulonephritis
  • Staphylococcus scalded skin syndrome
  • Scarlet fever (or staphylococcal scarlet fever
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87
Q

What is cellulitis?

A

Subcutaneous and dermal infection

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88
Q

What are signs/ symptoms of cellulitis (6)?

A
  • Erythematous
  • Warm
  • Odematous
  • Shiny
  • Tense
  • Systemic Sx/ sepsis
89
Q

What bacteria causes cellulitis (3)?

A
  • Staph aureus
  • GAS (strep pyogenes)
  • GCS (strep dysgalactiae)
90
Q

How is the severity of cellulitis determined?

A

Eron classification (1-4) depending on the extent of systemic illness

91
Q

How is cellulitis treated?

A

Oral/ IV flucloxacillin
Penicillin allergy = clarithromycin

92
Q

How is MRSA cellulitis treated?

A

Vancomycin

93
Q

What is staphylococcal scalded skin syndrome?

A

Infection by a type of staph aureus that produces epidermolytic toxins A and B that break down and damage the skin

94
Q

What does SSSS look like?

A

Generalised patches of erythema on the skin followed by the formation of bullae (fluid filled blisters)
has similar appearance to a burn

95
Q

What is a key differentiating feature between SSSS and SJS/TEN?

A

There is no mucous membrane involvement in SSSS

96
Q

What sign is positive for SSSS?

A

Nikolsky sign = skin rubbing –> skin peels

97
Q

How can diagnosis of SSSS be confirmed?

A

Biopsy of skin

98
Q

How is SSSS managed (2)?

A
  • IV fluids
  • IV Abx (fluclox)
99
Q

What are four risk factors for SSSS?

A
  • Immunocompromised
  • CKD
  • < 1 year old
  • Not breastfed
100
Q

What is necrotising fasciitis?

A

Infection of the deep soft tissue compartments (dermis, SC tissue, fascia, muscle)

101
Q

What is the most common cause of necrotising fasciitis?

A

GAS

102
Q

What are the signs/ symptoms of NF (5)?

A
  • Pain disproportionate to presentation
  • Swelling
  • Erythema (pain beyond extent of erythema)
  • “Dishwater” discharge
  • Systemic Sx
103
Q

How is NF managed (2)?

A
  • Surgical debridement
  • Broad spectrum IV Abx
104
Q

What are some risk factors for NF (3)?

A
  • Wound/ bite
  • Immunocompromise
  • Prior skin condition e.g. eczema
105
Q

What is toxic shock syndrome?

A

Systemic condition caused by release of bacterial toxins

106
Q

What bacteria cause toxic shock syndrome?

A
  • Staph aureus
  • GAS
107
Q

What are some risk factors for toxic shock syndrome (3)?

A
  • Tampon use (absorbent and leaving it in for a long time)
  • Exposed wound
  • Cellulitis
108
Q

What are the signs/ symptoms of toxic shock syndrome (5)?

A
  • Fever
  • Hypotensive
  • Desquamation
  • Diffuse erythematous macular papular rash
  • End organ damage e.g. deranged LFTs, vomiting, raised creatinine
109
Q

How is toxic shock managed (3)?

A
  • ITU admission
  • Supportive care
  • Broad Abx
110
Q

What are the two types of HSV?

A

1 and 2

111
Q

Where does HSV-1 typically affect?

A

Head - oral ulcers, encephalitis
you have 1 head

112
Q

Where does HSV 2 typically affect?

A

2 affects genitals (ulcers)
you have 2 balls

113
Q

What are some complications of HSV (3)?

A
  • Encephalitis
  • Eczema herpeticum (like lots of angry chicken pox clumped together)
  • Erythema multiforme
114
Q

What is tuberculosis?

A

Infection with mycobacterium tuberculosis
or sometimes mycobacterium bovis

115
Q

What are the stages of TB disease?

A
  1. Ghon focus = primary granuloma
  2. Ghon focus = infltrated lymph nodes
  3. Miliary (disseminated severe) or latent TB
116
Q

What are the signs/ symptoms of TB (8)?

A
  • Haemoptysis
  • Weight loss
  • Night sweats
  • Fever
  • Meningitis
  • Lymphadenopathy
  • Addisons
  • Erythema nodosum
117
Q

How is TB diagnosed?

A
  • Manoux test (judges immune response) = past infection, latent or active
  • CXR
  • Sputum MC&S
118
Q

What stain is used to diagnose TB, what colour does it turn and what is this known as?

A

Ziehl Neelsen stain turns bright red known as “acid fast”

119
Q

What type hypersensitivity is the manor test?

A

Type 4

120
Q

What may be seen on an X-ray of someone with TB (3)?

A
  • Bilateral hilar infiltration
  • Upper lobe consolidation
  • Pleural effusion
121
Q

How is latent TB treated?

A
  • Rifampicin (3 months)
  • Isoniazid (3 months)
    or isoniazid for 6 months
122
Q

How is active TB treated?

A
  • Rifampicin (6 months)
  • Isoniazid (6 months)
  • Pyrazinamide (2 months)
  • Ethambutol (2 months)
123
Q

What are the side effects of TB medications?

A
  • Rifampicin = red urine (red-am-pissing)
  • Isoniazid = peripheral neruopathy (I-so-numb-am)
  • Pyrazinamide = gout (py-ra-owwwwwwww-zin-a-mide)
  • Ethambutol = optic neuritis (ethan’s-blind)
124
Q

What vaccine can protect against TB?

A

BCG vaccine
live attenuated mycobacterium bovis

125
Q

Who is offered BCG vaccine?

A

Those at higher risk e.g. parents born in country with high levels of TB

126
Q

What causes polio?

A

Poliovirus

127
Q

What percent of polio cases are asymptomatic?

A

75%

128
Q

How is polio spread?

A

Faeco-oral transmission

129
Q

Is polio in the uk vaccination schedule?

A

Yes children are vaccinated against it as the inactivated polio vaccine

130
Q

What is a severe complication of polio?

A

Paralytic polio (less than 1%)
patients put in iron lung

131
Q

What are the signs/ symptoms of polio?

A

Fever + sore throat

132
Q

What causes diphtheria?

A

Corynebacterium diphtheriae

133
Q

What are the signs/ symptoms of diphtheria (5)?

A
  • Fever
  • Thick grey membrane covering tonsils (pseudomembrane)
  • Cervical lymphadenopathy
  • Stridor
  • Croup like symptoms
    diphtheria can actually cause croup - used to be a common cause
134
Q

What is the mechanism of infection with diphtheria?

A

Diphtheria toxin produced when c. diphtheriae infected with bacteriophage (virus that replicates inside bacteria). This toxin causes illness

135
Q

How is diphtheria diagnosed (2)?

A
  • Throat swab + culture
  • Elek test (determines virulence)
136
Q

How is diphtheria treated?

A
  • DAT (diphtheria antitoxin)
  • Erythromycin/ penicillin
137
Q

What is scabies and how does it cause infection?

A

Parasitic infection whereby they lay eggs in skin

138
Q

How long do symptoms typically take to develop?

A

8 weeks

139
Q

What are the signs/ symptoms of scabies (2)?

A
  • Itchy small red spots
  • Track/ burrow marks
140
Q

When are symptoms typically worse in scabies infestations?

A

At night, when the mites come out to play

141
Q

Where does scabies infection typically start?

A

Between the finger webs

142
Q

How is scabies diagnosed (3)?

A
  • Usually a clinical diagnosis
  • Dermoscopy
  • Ink burrow test (burrows show up when ink rubbed on skin)
143
Q

How is scabies managed (2)?

A
  • Permethrin cream to all members of household
  • Hygiene advice e.g. hoovering + washing clothes
144
Q

What is a complication of scabies?

A

Crusted scabies/ norwegian scabies

145
Q

What is an alternative treatment for crusted scabies/ difficult to treat scabies?

A

Oral ivermectin

146
Q

How can itching associated with scabies be treated?

A

Chlorphenamine

147
Q

What is the medical term for headlice?

A

Pediculus humanus capitis

148
Q

How are headlice treated?

A
  1. Wet combing
  2. Dimeticone 4%
    treatment only indicated if a live headlice found
149
Q

What infection causes small spots that look like individual chicken pox?

A

Molluscum

150
Q

What causes molluscum?

A

Molluscum contagiosum

151
Q

What type of virus is molluscum contagiosum?

A

Pox virus

152
Q

What is the presentation of molluscum?

A

Small flesh coloured umbilicated (dimple in middle) papules occurring in crops

153
Q

How is molluscum treated?

A

Does not need treatment

154
Q

Where does ringworm affect and what is it known as in these different areas?

A
  • Tinea pedis = foot
  • Tinea capitis = head
  • Tinea corporis = body
  • Tinea cruruis = groin
  • Onychomycosis = fungal nail
155
Q

How is ringworm treated?

A
  • Clotimazole = fungal cream
  • Ketonazole = fungal shampoo
  • Fluconazole = oral anti fungal
156
Q

What is tinea incognito?

A

Steroid cream is used to initially treat the fungal infection (as it is mistaken for dermatitis) so the fungus spreads and is less visible

157
Q

What species of bacteria causes lyme disease?

A

Borrelia

158
Q

What is the feature of Lyme disease?

A

Raised itchy “bulls eye” rash (erythema migrans)

159
Q

What are some complications of Lyme disease (2)?

A
  • Neuroborreliosis
  • Joint involvement
160
Q

How is Lyme disease treated?

A

Doxycycline

161
Q

What is meningitis?

A

Inflammation of the meninges

162
Q

What are the most common causes of meningitis in neonates (3)?

A
  • GBS = MC
  • Listeria
  • E. coli
163
Q

What are the most common causes of meningitis in children older than 1 month (3)?

A
  • Neisseria meningitidis
  • S. pneumoniae
  • H. influenzae (up to 6 years)
164
Q

What is the classification of Neisseria meningitidis?

A

Gram negative diplococci

165
Q

What are the signs/ symptoms of meningitis in neonates (8)?

A
  • High pitched cry
  • Fever
  • Respiratory distress
  • Poor feeding
  • Inconsolable
  • Bulging fontanelle
  • Vomiting
  • Non-blaching rash
166
Q

What are the signs/ symptoms of meningitis in older children (7)?

A
  • Headache
  • Fever
  • Neck stiffness
  • Photophobia
  • Vomiting
  • Drowsy
  • Non-blanching rash
167
Q

What are two special tests that indicate meningitis?

A
  • Kernigs test - straightening leg when bent up to chest causes spinal pain
  • Brudzinski test - lifting head/ neck when lying flat –> involuntary flexion of hip + knee
168
Q

How is bacteria meningitis managed in the community?

A

IM benzylpenicillin
if meningitis and non-blanching rash

169
Q

How is meningitis treated in hospital?

A

Ceftriaxone
blood culture and LP ideally taken before antibiotics

170
Q

How is meningitis treated in hospital of those under 3 months?

A

Cefotaxime + AMOXICILLIN (for listeria cover)

171
Q

What other medication is used to treat those with meningitis?

A

Dexamethasone (if child over 3 months)

172
Q

What antibiotic is given to close contacts of those with meningitis?

A

Ciprofloxacin

173
Q

What are the most common causes of viral meningitis (3)?

A
  • HSV (most commonly 1)
  • Enterovirus
  • VZV
174
Q

How can an LP differentiate between a viral and bacterial meningitis (4)?

A
  • Appearance (bacteria = cloudy; virus = clear)
  • Protein (raised in bacterial)
  • Glucose (low in bacterial)
  • WCC (neutrophils in bacterial; lymphocytes in viral)
175
Q

What are some complications of meningitis?

A
  • Hearing loss
  • Seizures/ epilepsy
  • Cognitive impairment
  • CP
176
Q

What are some contraindications to an LP (6)?

A
  • Meningococcal septicaemia
  • Bulging fontanelle
  • Focal neurological signs
  • Papilloedema
  • GCS < 9
  • Haemodynamically unstable
    essentially any signs of raised ICP
177
Q

What are the most common causes of encephalitis (6)?

A
  • HSV (1 in children; 2 in neonates - as 2 lives in vagina) = MC
  • VZV
  • CMV (immunodeficiency)
  • EBV
  • Enterovirus
  • MMR + polio
178
Q

What are the signs/ symptoms of encephalitis (5)?

A
  • Fever
  • Headache
  • Focal neurological Sx
  • Seizures
  • Decreased consciousness
179
Q

How is encephalitis treated (3)?

A
  • HSV or VZV = aciclovir
  • CMV = ganciclovir
  • Other causes = supportive
180
Q

What is another name for glandular fever?

A

Infectious mononucleosis

181
Q

What causes infectious mononucleosis?

A

EBV

182
Q

What are some signs/ symptoms of infectious mononucleosis (5)?

A
  • Fever
  • Sore throat
  • Lymphadenopathy
  • Tonsillar enlargement
  • Splenomegally
183
Q

What sort of antibodies are produced in response to infectious mononucleosis and what is special about them?

A

Heterophile antibodies - these are non-specific to EBV

184
Q

What are some complications of infectious mononucleosis (5)?

A
  • Splenic rupture
  • Glomerulonephritis
  • Haemolytic anaemia
  • Chronic fatigue
  • Cancers (burkitts lymphoma)
185
Q

What is important for people with infectious mononucleosis to avoid (2)?

A
  • Alcohol (EBV decreases livers ability to process alcohol)
  • Contact sport (increases risk of splenic rupture)
186
Q

What is a common fungal infection in the mouth and vagina?

A

Candida infection (thrush)

187
Q

What are the symptom of a candida infection (3)?

A
  • White patches/ discolouration
  • Vaginal discharge
  • Itching
188
Q

What age does thrush occur in the vagina and mouth?

A
  • Mouth = young babies
  • Vagina = rarely before puberty
189
Q

What are some causes of immunodeficiency in children (5)?

A
  • Inherited
  • HIV
  • Malnutrition
  • Medications
  • Cancer
190
Q

What aspects of the immune system can be affected by immunodeficiency (3)?

A
  • B-cells/ immunoglobulins
  • T-cell disorders
  • Complement disorders
191
Q

What is the most severe form of inherited immunodeficiency in children?

A

Severe combined immunodeficiency

192
Q

What are the key B-cell/ immunoglobulin inherited disorders (3)?

A
  • Selective immunoglobulin A deficiency (very common often undiagnosed)
  • X-linked agammaglobulinaemia
  • Common variable immunodeficiency
193
Q

How do X-linked agammaglobulinaemia and common variable immunodeficiency affect immunoglobulins?

A
  • X-linked agammaglobulinaemia = deficiency in all Igs
  • Common variable immunodeficiency = deficiency in IgG, IgA and sometime IgM
194
Q

What are some causes of inherited T-cell disorders (3)?

A
  • DiGeorge syndrome
  • Wiskott-Aldrich syndrome
  • Ataxic telangiectasia
195
Q

Why does DiGeorge cause a T-cell deficiency?

A

Underdeveloped thymus gland

196
Q

What are some inherited causes of compliment deficiencies (2)?

A
  • C1 esterase inhibitor deficiency (hereditary angioedema)
  • Mannose-binding lectin deficiency
197
Q

What is an important step in treating children with complement deficiencies?

A

Vaccinations - particularly against encapsulated organisms

198
Q

What medications can cause immunodeficiency (3)?

A
  • Chemotherapy
  • Steroids
  • DMARDs
199
Q

How does HIV usually present?

A
  • Initial flu like illness
  • No other Sx until immunodeficiency occurs
200
Q

What does AIDS stand for?

A

Acquired immunodeficiency syndrome

201
Q

What cells does HIV enter, destroy and replicate in?

A

CD4 (T helper cells)

202
Q

How can HIV be spread (3)?

A
  • Blood
  • Sex
  • Vertical
203
Q

What are 3 ways vertical transmission can take place?

A

Pregnancy, birth or breastfeeding

204
Q

How should babies be deliver if the mother has HIV (2)?

A
  • Vaginal if the viral load is low
  • C-section if the viral load is high
205
Q

What medication can be given to prevent vertical transmission of HIV during a c-section?

A

Zidovudine IV

206
Q

How is HIV managed (3)?

A
  • Antiretroviral
  • Vaccination (live are avoided if immunosuppression severe)
  • Treatment of opportunistic infections
207
Q

What are the principles of testing babies of HIV positive parents (3)?

A
  • Test at 3 months if at risk
  • Test again at 24 months
  • Tests can be positive for 18 months due to antibodies crossing the placenta
208
Q

What are some symptoms/ signs of immunodeficiency in children (5)?

A
  • Recurrent infections (especially LRTI)
  • Unusual infections
  • Chronic diarrhoea
  • Failure to thrive
  • Appearing well, but with a serious illness
209
Q

What infectious diseases do not need to be excluded from school (6)?

A
  • Roseola infantum
  • Infectious mononucleosis
  • Headlice
  • Threadworms
  • Hand foot and mouth
  • Slapped cheek
210
Q

What infectious disease can go back to school after 24 hours of antibiotics?

A

Scarlet fever

211
Q

What infectious disease can go back to school 2 days after antibiotics?

A

Whooping cough

212
Q

What disease can go back to school 4 days after rash onset?

A

Measles

213
Q

What disease can go back to school 5 days after rash onset?

A

Rubella

214
Q

What disease can go back to school after all lesions crusted over?

A

Chickenpox

215
Q

What disease can go back to school 5 days after onset of swollen glands?

A

Mumps

216
Q

What disease can go back to school after symptoms have settles for 48 hours?

A

Diarrhoea and vomiting

217
Q

What disease can go back to school after lesions crusted and healed or 48 hours after antibiotics?

A

Impetigo

218
Q

What disease can go back to school once treated?

A

Scabies

219
Q

What disease are noticeable to PHE (11)?

A
  • COVID-19
  • Diphtheria
  • Scarlet fever
  • Haemolytic uraemic syndrome
  • Measles
  • Meningococcal septicaemia
  • Mumps
  • Rubella
  • Invasive group A strep
  • TB
  • Whooping cough
    amongst other more rare ones

Phase 3a conditions list flashcards (29 decks)

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