Paeds infection Flashcards
What are the 2 most common causes of viral gastroenteritis?
- Rotavirus
- Noravirus
What’s the likely causative organism of gastroenteritis that is caused by eating leftover room temperature rice and that resolves in 24hrs?
Bacillus cereus
What are other bacterial causes of gastroenteritis?
- E coli
- Campylobacter jejuni
- Salmonella
- Shigella
What is encopresis? What is it usually a sign of?
- Faecal incontinence
- Chronic constipation
When can children with Scarlett fever go to school?
24 hrs after abx
When can children with measles go to school?
4 days from onset of rash
When can children with whooping cough go to school?
48 hrs from abx
When can children with rubella go to school?
5 days from onset of rash
What other symptoms do you get with measles?
CCCK
- cough
- conjunctivitis
- coryza
- koplik’s spots
Describe a typical measles rash and how it presents
- Erythematous, macular rash with flat lesions
- Fever
- Rash starting on face
- Rash spreads to rest of body
Describe a typical Scarlett fever rash and how it presents
- A red-pink, blotchy, macular rash with rough “sandpaper” skin
- Starts on the trunk
- Spreads outwards
What are other features of Scarlett fever?
- Strawberry tongue
- Red, flushed cheeks
- Sore throat
- Cervical lymphadenopathy
What is the treatment of Scarlett fever?
Phenoxymethylpenicillin (penicillin V) for 10 days
Describe a typical rubella rash and how it presents
- A erythematous macular rash (milder than in measles)
- The rash starts on the face
- Spreads to the rest of the body.
How long does a rubella rash typically last?
3 days
How long following exposure do measles symptoms present?
10-12 days after exposure
What are the initial symptoms of measles?
Fever, coryzal symptoms and conjunctivitis
How long following fever does a measles rash present?
3-5 days
What can rubella in pregnancy lead to? What triad of symptoms is this characterised by?
- Congenital rubella syndrome
- Triad of deafness, blindness and congenital heart disease
What is the management of rubella?
Management is supportive and the condition is self limiting
What are 2 other names for parvovirus B19?
- Slapped cheek syndrome
- Erythema infectiosum
Describe a typical parvovirus B19 rash and how it presents?
- A bright red rash on both cheeks, as though they have “slapped cheeks”
- A few days later a mildly erythematous rash affecting the trunk and limbs appears that can be raised and itchy
What is the management of parvovirus B19?
The illness is self limiting and the rash and symptoms usually fade over 1 - 2 wks
What is roseola infantum caused by?
Human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7)
What is the more common cause of roseola infantum?
HHV-6
What is the typical pattern of illness in roseola infantum?
- High fever that comes on suddenly and lasts 3-5 days
- Rash when the fever settles
Describe a typical roseola infantum rash
- Mild erythematous macular rash across the arms, legs, trunk and face
- Rash is not itchy
What is hand, foot and mouth disease caused by?
Coxsackie A virus
True/false - hand, foot and mouth disease self resolves?
True
When do chicken pox lesions stop being contagious?
When they crust over
What is a serious complication of chicken pox? How might this present?
Encephalitis, ataxia
What is the management of scabies?
Treat everyone in the house with Permethrin
What is the management of meningococcal sepsis in a child <3 month?
Ceftaxime + amoxicillin
What is second line for house contacts of meningococcal disease?
Rifampicin twice a day for 2 days
LP contraindications
- Raised ICP
- Coagulation abnormalities
- Local superficial infection
- Extensive purpura
- Respiratory insufficiency
What is the management of meningococcal sepsis in a child <3 month?
Ceftaxime + amoxicillin
What is second line for house contacts of meningococcal disease?
Rifampicin twice a day for 2 days
LP contraindications
- Raised ICP
- Coagulation abnormalities
- Local superficial infection
- Extensive purpura
- Respiratory insufficiency
Give some complications of measles
- Pneumonia
- Otitis media
- Encephalitis
- Diarrhoeal illness
- Vit A deficiency -> blindness
Complication of mumps?
Orchitis
Drug of choice for bacterial tonsillitis if penicillin allergy?
Clarithromycin
What does EBV commonly cause?
Infectious mononucleosis (glandular fever)
A teenager with a sore throat takes amoxicillin. They develop an extremely itchy rash. What is the cause? What other abx can trigger this?
- Infectious mononucleosis
- Cefalosporins
What antibodies are produced in infectious mononucleosis? How long can it take for these to be produced? What 2 tests can be used to identify these?
- Heterophile antibodies
- 6 weeks
- Monospot and Paul-Bunnell tests
What is the management of infectious mononucleosis? What are 2 things you should avoid with it?
- Supportive (self limiting in 2-3 weeks)
- Alcohol and contact sports (splenic rupture)
What gland swells in mumps? Is the swelling unilateral or bilateral?
- Parotid gland
- Can be either
How do you confirm mumps?
PCR testing on a saliva swab
Give 4 complications of mumps
- Pancreatitis
- Orchitis
- Meningitis
- Sensorineural hearing loss
What are 2 less common causes of infectious mononucleosis?
CMV, HHV-6
What is the management of sepsis in an <3 month old?
- IV benzylpenicillin + gentamycin
What’s included in the 6-in-1 vaccine?
Diphtheria, tetanus, polio, pertussis, HiB, hep B
What’s included in the 4-in-1 vaccine?
Diphtheria, tetanus, polio, pertussis
What’s included in the 3-in-1 vaccine?
Diphtheria, tetanus, polio
What’s included in the 2-in-1 vaccine?
HiB, meningococcal type C
What is Scarlet fever commonly associated with?
Group A strep infection e.g. tonsillitis
What sign is pathognomonic for measles?
Koplik spots
What causes slapped cheek syndrome?
Parovirus B19
