Paeds- Derm Flashcards
what is vaccinated against at the 8 week mark?
- diptheria, tetanus, pertussis, polio, HiB, Hep B (6- in - 1)
- pneumococcal
- meningitis B
- rotavirus
- gastroenteritis
what vaccines are given at 12 weeks?
6-in-1
rotavirus
what vaccines are given at 16 weeks?
6-in-1
pneumococcal
meningitis B
what vaccines are given at 1 year?
HiB and meningitis C
pneumococcal
MMR
Meningitis B
what vaccine is given each year between 2-8 years?
influenza
what vaccines are given pre-school (around 3 years and 4 months)?
diptheria, tetanus, pertussis and polio (4 in 1)
MMR
what vaccine is given to girls aged 12-13?
HPV- 2 dose given 6-12 months apart
what vaccine is given at age 14 (and which vaccine is specific to men)?
tetanus, diptheria, polio (3 in 1)
Men- ACWY
describe the epidemiology of eczema in children
present in 15-20% of children
presents before 6 months, clears in around 50% by 5 years and 75% by 10 years
how does eczema present in:
- infants
- younger children
- older children
infants- face and trunk
younger- extensor surfaces
older- typical distribution- flexor surfaces and creases of face and neck
how is eczema managed?
- identify and avoid irritants
- emolients- in ratio with topical steroids of 10:1
- severe- we wraps and oral ciclosporin may be used
what is eczema herpeticum, and how is it managed?
severe primary infection of the skin seen more commonly in kids with atopic eczema
common infective organism- HSV
life threatening ! manage with Acyclovir
what is Stevens-Johnson Syndrome?
severe bullous form or erythema multiforme- also involving mucous membranes
how does Stevens-Johnson Syndrome initally present?
Vague upper respiratory tract symptoms 2-3 weeks after starting a drug, a rash will then present 2 days after
describe the clinical presentation of Stevens-Johnson Syndrome
Painful erythematous macules- evolve to form target lesions
severe mucosal ulceration (typically on 2 surfaces- e.g. conjunctiva, oral cavity, urethra, labia)
what drugs can cause Stevens-Johnson Syndrome?
- Sulfonamides
- anti-epileptics
- penicllins
- NSAIDs
how is Stevens-Johnson Syndrome managed clinically?
- ophthalmological assessment
- supportive therapy- protect skin
- avoid steroids- increases infection risk
do not debride skin !!
how does urticaria present clinically?
hives/ flesh coloured wheals or redness
resulting from local vasodilation and increased permeability of capillaries/ venules
itchy !
how does urticaria result into angioedema?
involvement of deeper tissues produces swelling- usually around lips and eyes
what are the 3 classes of utricaria and angioedema?
- acute
- chronic idiopathic
- physical urticarias
describe acute urticaria and angioedema
- resolves in 6 weeks
- triggers- infection, food allergy, drug reaction
- viral infection- last days
- allergen- lasts hours
describe chronic idiopathic urticaria and angioedema
intermittent for >6 weeks, usually non-allergic in origin
causes of physical urticarias
cold, delayed pressure, heat contact, solar
how are urticaria and angioedema managed?
2nd generation, non-sedating antihistamines
what is given in refractory cases of urticaria and angioedema?
omalizumab
what is anaphylaxis?
severe, life-threatening hypersensitivity
causes of anaphylaxis in children
85%- food allergy
IgE mediated reactions
insect stings, drugs, latex, exercise, inhalant allergens
how is anaphylaxis diagnosed?
Airway- swelling, hoarseness, stridor
Breathing- tachypnoea, wheeze, cyanosis SpO2 <92%
Circulation- Urticaria/ angioedema
how is anaphylaxis managed?
ABCDE
- establish airway
- high flow O2
- IV fluid- crystalloid
- early administration of adrenaline IM/ IV
- chlopheniramine- antihstamine
- hydrocortisone
- salbutamol if wheeze
monitor pulse oximetry, ECG, BP
What are the TORCH infections?
Toxoplasmosis Other (syphillis, varicella-zoster, parvovirus B19) Rubella Cytomegalovirus Herpes
In HIV, what is vertical transmission?
term used to describe mother to child transmission
