Paeds infections

Question 1

What does a mumps infection present like? What virus causes it?

Answer 1

causes parotid swelling + orchitis. Paramyxovirus

Question 2

What does diptheria present like?

Answer 2

grey slough covering tonsils. Gram positive anaerobe

Question 3

How does polio present?

Answer 3

disorder of anterior horn cells, affecting lower motor neurones

Question 4

S+S infectious mononucleosis

Answer 4

Malaise
Anorexia 
Low grade fever 
Tonsillitis/ pharyngitis 
Lymphadenopathy 
Spleno + hepatomegaly 
Maculopapular rash

Question 5

Blood test results for infectious mononucleosis

Answer 5

Increased mononuclear cells
Atypical lymphocytes
Thrombocytopenia
Heterophile antibodies

Question 6

Management of infectious mononucleosis

Answer 6

Supportive

DO NOT GIVE AMOXICILLIN

Question 7

Pathology of Kawasaki’s disease

Answer 7

Systemic vasculitis

Question 8

S+S of Kawasakis

Answer 8

Fever >5 days 
Non-purulent bilateral conjunctivitis 
Red mucous membranes 
Inflamed mouth, cracked lips 
Cervical lymphadenopathy 
Polymorphous rash 
Red palms + soles + peeling

Question 9

Complications of Kawasakis

Answer 9

Coronary artery aneurysm leading to myocardial ischaemia

Question 10

Management of Kawasakis

Answer 10

IV Immunoglobulin

Aspirin to reduce risk of thrombosis - continue until echo at 6 weeks shows no aneurysm

Question 11

Measles incubation period + organism causing

Answer 11

7-12 days

Rubeola virus

Question 12

S+S measles

Answer 12

Fever, cough, runny nose
Koplik spots, maculopapular rash
Rash starts behind ears on day 4 then spreads to face + trunk

Question 13

Complications of measles + long term effects of this

Answer 13

Encephalitis - occurs about 8 days after onset
S+S = headache, convulsions
Long term effects: deafness, hemiplegia, learning difficulties

Pneumonia
Otitis media

Question 14

Incubation period for rubella

Answer 14

15-21 days

Question 15

Pathology of rubella

Answer 15

RNA Rubella virus spread by droplet infection

Also called German measles

Question 16

What are the complications of congenital rubella?

Answer 16

Malformations in cardiac, ocular, CNS + skeletal system

Question 17

S+S of rubella

Answer 17

Headache, conjunctivitis, runny nose, maculopapular rash on face then spreading
Lymphadenopathy

Question 18

Chicken pox incubation period + S+S

Answer 18

10-21 days (average 14)
Fever + itchy vesicular rash - mainly on trunk
Lasts 7 days

Question 19

Complications of chicken pox

Answer 19

Secondary infection
Necrotising fasciitis
Encephalitis
VZV associated cerebellitis = ataxia + cerebellar signs = resolves within a month

Question 20

Management of chicken pox

Answer 20

Fluids, paracetamol, calamine lotion

IV acyclovir if immunocompromised

Question 21

S+S conjunctivitis

Answer 21

Purulent discharge (chlamydia + gonorrhoea)
Blepharitis + dendritic ulcers (HSV) 
Red eye, discharge

Question 22

Allergic vs chemical vs viral vs bacterial conjunctivitis symptoms

Answer 22

Allergic = itchy, swelling, watery discharge
Chemical = neonatal 
Viral = sudden onset, pre-auricular lymphadenopathy, watery discharge 
Bacterial = purulent discharge

Question 23

Conjunctivitis organisms

Answer 23

Neonates = chemical (<24hrs), Neisseria gonorrhoea (<1 week), chlamydia (1-2 weeks)
Infants = H influenza, strep pneumoniae
School age = VZV, HSV, viral, allergic

Question 24

Management of conjunctivitis

Answer 24

Clean with saline
Neomycin
Gonococcal = cephalosporin
Chlamydia = erythromycin

Question 25

What symptoms do you get with TORCH infections at birth?

Answer 25

Jaundice, microcephaly, seizures, encephalitis

Question 26

What does the coxsackie virus cause?

Answer 26

Hand foot mouth

Question 27

What is hand foot syndrome?

Answer 27

Complication of sickle cell

Question 28

What do schisctocytes indicate?

Answer 28

HUS

Question 29

What are the S+S of viral encephalitis + how do you diagnose it?

Answer 29

Focal neuro signs, focal seizures, reduced level of consciousness
CSF w/ PCR