Paeds Corrections Flashcards
What is the ‘traffic light system’ for feverish illness?
Guidlines for risk stratification of children under the age of 5 years presenting with a fever.
What 4 observations should be recorded in all febrile children?
1) Temp
2) HR
3) RR
4) CRT
If the child is <4 weeks old, how should temperature be measured?
With an electronic thermometer in the axilla
or
With an electronic/chemical dot thermometer in the axilla
or
With an infra-red tympanic thermometer.
What RR is a ‘red flag’ in febrile illness in children <5?
> 60
How should immunisation dates be adjusted for babies born prematurely?
Give as per normal timetable (i.e. all babies, including those born prematurely, should receive their first set of vaccinations at 8 weeks from birth).
Why are immunisations given as per normal timetable in premature babies?
As premature babies are at higher risk of infections and therefore need protection provided by vaccines as soon as possible.
What is roseola infantum ((also known as exanthem subitum?
A common disease of infancy caused by the human herpes virus 6 (HHV6).
Features of roseola infantum?
1) high fever: lasting a few days, followed later by a
2) maculopapular rash
3) Nagayama spots: papular enanthem on the uvula and soft palate
4) febrile convulsions occur in around 10-15%
5) diarrhoea and cough are also commonly seen
Is school exclusion required for roseola infantum?
No
If a formula-fed baby is suspected of having mild-moderate cow’s milk protein intolerance, what is the 1st line management step?
Trial of extensively hydrolysed formula
What is scarlet fever?
A reaction to erythrogenic toxins produced by Group A Strep.
How is scarlet fever spread?
Via the respiratory route by inhaling or ingesting respiratory droplets or by direct contact with nose and throat discharges, (especially during sneezing and coughing).
What is the peak age incidence for scarlet fever?
4 years
Features of scarlet fever?
1) Fever: lasts 24-48h
2) Malaise, headache, N&V
3) Sore throat
4) ‘Strawberry’ tongue
5) Rash
What texture is the rash in scarlet fever often described as having?
A rough ‘sandpaper’ texture
Where does the rash in scarlet fever typically affect?
Generally appears first on the torso and spares the palms and soles.
Describe the rash in scarlet fever
1) Fine punctate erythema (‘pinhead’).
2) Generally appears first on the torso and spares the palms and soles.
3) Children often have a flushed appearance with circumoral pallor.
4) The rash is often more obvious in the flexures.
5) It is often described as having a rough ‘sandpaper’ texture.
6) Desquamination occurs later in the course of the illness, particularly around the fingers and toes.
How is a diagnosis of scarlet fever made?
A throat swab is normally taken but Abx treatment should be commenced immediately, rather than waiting for the results.
1st line management of scarlet fever?
Oral penicillin V for 10 days (azithromycin in pencillin allergy).
When can children with scarlet fever return to school?
24h after starting Abx
Is scarlet fever a notifiable disease?
Yes
What is the most common complication of scarlet fever?
Otitis media
Give some complications of scarlet fever
1) Otitis media
2) Rheumatic fever
3) Acute glomerulonephritis
4) Invasive complications e.g. bacteraemia, meningitis, necrotising fasciitis (rare)
How soon after scarlet fever can rheumatic fever occur?
20 days after infection