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A TO REVISE - PHASE 3A > PAEDS - INFECTIONS/ALLERGY TO DO > Flashcards

PAEDS - INFECTIONS/ALLERGY TO DO Flashcards

1
Q

FEBRILE CHILD
What system is used to assess a febrile child?
What are the main components?

A
  • NICE traffic light system for <5
  • Colour (skin, lips, tongue)
  • Activity
  • Respiratory
  • Circulation + hydration
  • Other
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2
Q

FEBRILE CHILD
In terms of the NICE traffic light system, what is considered amber for…

i) colour?
ii) activity?
iii) respiratory?
iv) circulation and hydration?
v) other?

A

i) Pallor
ii) No smile, decreased activity, not responding to social cues, wakes when roused
iii) Nasal flaring, SpO2 ≤95%, crackles in chest RR>50 (6-12m) or >40 (>12m)
iv) Tachy (>160 if <1y, >150 if 1–2y, >140 if 2–5y), CRT ≥3s, dry mucous membranes, reduced urine output
v) 3-6m temp ≥39, fever ≥5d, rigors, joint swelling, non-weight bearing

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3
Q

FEBRILE CHILD
In terms of the NICE traffic light system, what is considered red for…

i) colour?
ii) activity?
iii) respiratory?
iv) circulation and hydration?
v) other?

A

i) Mottled skin
ii) No response to cues, doesn’t wake if roused, weak, high-pitched or constant cry
iii) Grunting, RR>60, mod-severe chest indrawing
iv) Reduced skin turgor, no urine output
v) <3m temp ≥38, non-blanching rash, bulging fontanelle, neck stiffness, status, focal seizures/neuro

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4
Q

FEBRILE CHILD
What are some common and uncommon causes of fever?

A
  • Common = URTI, tonsillitis, otitis media, UTI
  • Uncommon = Meningitis, epiglottitis, kawasaki disease, TB
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5
Q

FEBRILE CHILD
What is the management of a green score?

A
  • Manage at home with safety netting
  • Regular fluids, monitor child, contact if concerned
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6
Q

FEBRILE CHILD
What is safety netting?

A
  • Clear verbal ± written advice about warning signs with plan of action
  • Follow up if required
  • Liaise with other HCPs so direct access if child needs
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7
Q

FEBRILE CHILD
What is the management of an amber score?

A
  • F2F assessment with paeds or specialist for further investigation
  • ?Home with safety net
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8
Q

FEBRILE CHILD
What is the management of a red score?

A
  • Urgent referral to hospital for specialist assessment (?999)
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9
Q

CHICKEN POX
What is Ramsay Hunt syndrome?

A
  • Herpes zoster oticus > reactivation of varicella zoster virus in geniculate ganglion of CN7
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10
Q

MENINGITIS
What are the most common causes of bacterial meningitis?

A
  • Neonates = GBS or listeria monocytogenes
  • 1m–6y = N. meningitidis (gram -ve diplococci), S. pneumoniae (gram + ve cocci chain), H. influenzae
  • > 6y = meningococcus + pneumococcus, rarely TB
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11
Q

MENINGITIS
What is the difference between Kernig’s and Brudzinski signs?

A
  • Kernig = pain/unable to extend leg at knee when it’s bent
  • Brudzinski = involuntary flexion of hips/knees when neck flexed
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12
Q

MENINGITIS
You suspect a diagnosis of TB meningitis. How would a lumbar puncture confirm the diagnosis for…

i) appearance?
ii) protein?
iii) glucose?
iv) white cell count?
v) other?

A

i) Turbid/viscous
ii) +++
iii) –––
iv) + lymphocytes
v) Acid fast bacilli

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13
Q

MENINGITIS
What are some complications of meningitis?

A
  • Hearing (sensorineural) loss is key complication
  • Seizures + epilepsy, cerebral abscess, encephalitis + hydrocephalus
  • Cognitive impairment, cerebral palsy + LD
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14
Q

MENINGITIS
What is the management of bacterial meningitis?

A
  • Supportive = correct shock with fluids, oxygen if needed
  • <3m = IV cefotaxime + amoxicillin (cover listeria from ?pregnancy)
  • > 3m = IV ceftriaxone + IV dexamethasone to reduce frequency + severity of hearing loss + neuro damage (NOT before 3m)
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15
Q

MENINGITIS
What are the drawbacks with giving ciprofloxacin to a close contact?

A
  • Do not give in myasthenia gravis or previous sensitivity,
  • can cause tendinitis
  • can trigger seizures
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16
Q

MENINGITIS
What are the drawbacks with giving rifampicin to a close contact?

A
  • Affect hormonal contraception,
  • not advised in pregnancy
  • have to monitor LFTs + renal function
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17
Q

ENCEPHALITIS
What causes it?

A
  • Mostly viral – herpes viruses (HSV 1 if child or 2 if neonate from birth, VZV), enteroviruses, EBV, resp viruses
  • Non viral = any bacterial meningitis, TB, lyme disease
  • Non-infective = autoimmune antibodies against brain
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18
Q

ENCEPHALITIS
What would the CSF analysis show in encephalitis for…

i) appearance?
ii) protein?
iii) glucose?
iv) white cell count?

A

i) Clear
ii) Normal/+
iii) Normal/–
iv) + lymphocytes

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19
Q

SEPTICAEMIA
What are the causes of septicaemia?

A
  • Most common = N. meningitidis
  • Neonates = GBS or gram -ve organisms from birth canal
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20
Q

SEPTICAEMIA
How does shock present?

A
  • Tachycardia + tachypnoea
  • Cold peripheries
  • Capillary refill >2s
  • Hypotensive
  • Oliguria
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21
Q

SEPTICAEMIA
What are some risk factors?

A
  • Sickle cell disease
  • immunodeficiency
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22
Q

SCARLET FEVER
What are some complications of scarlet fever?

A
  • Otitis media (#1),
  • quinsy,
  • post-strep glomerulonephritis,
  • rheumatic fever
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23
Q

KAWASAKI DISEASE
What is the diagnostic criteria for Kawasaki disease?

A

CRASH and BURN (fever)
- Conjunctivitis
- Rash
- adenopathy (unilateral, cervical)
- strawberry tongue and red/dry cracked lips
- Hands and feet swell and later desquamate
- Fever >39 degrees for >5 days

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24
Q

KAWASAKI DISEASE
What are the side effects of IVIG in the management of Kawasaki disease?

A
  • anaphylaxis,
  • aseptic meningitis,
  • organ dysfunction
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25
Q

MEASLES
What are the investigations for measles?

A

Clinical Dx with serological (blood or saliva) testing for epidemiology

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26
Q

MEASLES
What are some important complications of measles?

A
  • Otitis media (commonest complication)
  • Pneumonia (commonest cause of death)
  • Diarrhoea
  • Febrile convulsions, encephalitis
  • Subacute sclerosing panencephalitis rare where 5-10y after primary measles > loss of neuro function, dementia + death
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27
Q

RUBELLA
What is the clinical presentation of rubella?

A
  • Mild prodrome (low-grade fever, sore throat, coryza)
  • Pink maculopapular rash starts on face then spreads down to cover whole body
  • Rash not itchy in children but is in adults
  • Suboccipital + postauricular lymphadenopathy
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28
Q

RUBELLA
What are some complications of rubella?
How can it be reduced?

A
  • Rare but > encephalitis, arthritis, myocarditis + thrombocytopenia
  • Congenital rubella syndrome > cataracts, CHD + sensorineural deafness
  • Avoid pregnant women, school exclusion 4d from rash, ensure vaccinated
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29
Q

MUMPS
What are some complications of mumps?

A
  • Viral meningitis + encephalitis
  • Orchitis (usually unilateral, may reduce sperm count + lead to infertility)
  • Pancreatitis
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30
Q

GLANDULAR FEVER
What are the investigations for glandular fever?

A
  • FBC (lymphocytosis)
  • positive Monospot test with heterophile antibodies
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31
Q

GLANDULAR FEVER
What are the complications of glandular fever?

A
  • Splenic rupture,
  • haemolytic anaemia,
  • chronic fatigue,
  • EBV associated with Burkitt’s lymphoma
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32
Q

SLAPPED CHEEK
What is slapped cheek syndrome, or erythema infectiosum?

A
  • Caused by parvovirus B19, outbreaks common during spring months
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33
Q

SLAPPED CHEEK
How is it spread?

A
  • Respiratory secretions,
  • vertical transmission
  • transfusions
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34
Q

SLAPPED CHEEK
What is the clinical presentation of slapped cheek syndrome?

A
  • Prodromal Sx = fever, malaise, headache, myalgia
  • Followed by classic rose-red rash on face week later (slapped-cheek)
  • Progresses to maculopapular, ‘lace-like’ rash on trunk + limbs
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35
Q

SLAPPED CHEEK
What is important to note in slapped cheek syndrome?

A

Infects red cell precursors in bone marrow which can cause complications

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36
Q

SLAPPED CHEEK
What are some complications of slapped cheek syndrome?

A
  • Aplastic crisis (most serious) more common in chronic haemolytic anaemias like sickle cell, thalassaemia + in immunocompromised
  • Vertical transmission can lead to foetal hydrops + death due to severe anaemia
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37
Q

IMPETIGO
What is bullous impetigo?
Who is it seen in?

A
  • Epidermolytic toxins breakdown proteins that hold skin cells together > fluid-filled vesicles (bullae)
  • Rupture + fluid exudation > classic golden/honey crusted lesions
  • More common in neonates or <2y, commonly systemically unwell
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38
Q

IMPETIGO
What are some complications of impetigo?

A
  • Risk of SSSS
  • Post-strep glomerulonephritis
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39
Q

IMPETIGO
What is the management of impetigo?

A
  • Swab vesicles, avoid sharing towels, cutlery, try not to scratch
  • Hydrogen peroxide 1% cream (or mupirocin)
  • PO flucloxacillin if severe + systemically unwell
  • School exclusion until lesions crusted + healed or 48h after Abx
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40
Q

STAPH SCALDED SKIN
What is staphylococcal scalded skin syndrome (SSSS)?

A
  • Caused by type of S. aureus that produces epidermolytic toxins that breakdown proteins that hold skin together
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41
Q

STAPH SCALDED SKIN
What is the clinical presentation of SSSS?

A
  • Starts as generalised patches of erythema on the skin, skin looks thin + wrinkled
  • Bullae formation which burst + leave very sore, erythematous skin below (like a burn/scald)
  • Nikolsky sign = gentle rubbing causes peeling
  • Systemic Sx = fever, lethargy, dehydration > sepsis
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42
Q

STAPH SCALDED SKIN
Who is it more common in?

A

Children <5y as when older they develop immunity to toxins

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43
Q

STAPH SCALDED SKIN
What is the management of SSSS?

A
  • Most need admission for IV flucloxacillin, fluid balance + analgesia
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44
Q

TOXIC SHOCK SYNDROME
What is the pathophysiology?

A
  • Toxin producing S. aureus + group A strep released from infection acts as a superantigen to cause multi-organ dysfunction
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45
Q

TOXIC SHOCK SYNDROME
What is the clinical presentation of toxic shock syndrome?

A
  • Fever ≥39
  • Hypotension (shock)
  • Diffuse erythematous rash
  • Desquamation of rash (esp. palms + soles) 1-2w after
  • Multi-organ dysfunction
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46
Q

TOXIC SHOCK SYNDROME
Give some examples of multi-organ dysfunction in toxic shock syndrome

A
  • GI = D+V
  • CNS = confusion
  • Thrombocytopenia
  • Renal failure
  • Hepatitis
  • Clotting abnormalities
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47
Q

HERPES SIMPLEX
What are the various manifestations of herpes simplex infection?

A
  • Gingivostomatitis
  • Cold sores on lip
  • Eczema herpeticum
  • Herpetic whitlows
  • Eyes = blepharitis or conjunctivitis
  • CNS = aseptic meningitis, encephalitis
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48
Q

HERPES SIMPLEX
What is gingivostomatitis?
How may it present?

A
  • Vesicular lesions on lips, gums, tongue which can lead to painful ulceration + bleeding
  • High fever, miserable child, oral intake may hurt
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49
Q

HERPES SIMPLEX
How is eczema herpeticum managed?

A

IV aciclovir as life-threatening, bacterial infection will need Abx

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50
Q

HIV
When should HIV be suspected?

A
  • Persistent lymphadenopathy
  • Hepatosplenomegaly
  • Recurrent fever
  • Parotitis
  • Serious, persistent, unusual, recurrent (SPUR) infections
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51
Q

HIV
How is HIV investigated?

A
  • <18m cannot use antibody (transplacental HIV IgG if exposed anyway)
  • 2x HIV DNA PCR blood test (double negative to exclude) for viral load
    – Within first 3m + at least 2w after completion of postnatal antiretroviral
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52
Q

HIV
How should HIV be managed?

A
  • Antiretrovirals based on viral load + CD4 count
  • Co-trimoxazole prophylaxis (PCP)
  • ?Additional vaccines but not BCG as live
  • Regular follow up, check development, psychological support
  • Safe sex education when older
53
Q

TUBERCULOSIS
What is the pathophysiology of tuberculosis (TB)?

A
  • Lung lesion + (mediastinal) lymph nodes = Ghon or primary complex
  • Primary infection > caseating granulomas followed by period of dormancy with ?reactivation (secondary TB)
  • If immune system unable to cope it disseminates > miliary TB
54
Q

TUBERCULOSIS
Where can miliary TB affect?

A
  • Pleura,
  • CNS,
  • pericardium,
  • lymph nodes,
  • GI/GU tract
55
Q

TUBERCULOSIS
What are some investigations for TB?

A
  • Mantoux ‘tuberculin’ test
  • Interferon gamma release assays
  • 3x samples of sputum MC&S = gold standard
  • CXR
56
Q

TUBERCULOSIS
When diagnosing TB, what would you see on CXR?

A
  • Patchy consolidation,
  • pleural effusions,
  • hilar lymphadenopathy
57
Q

TUBERCULOSIS
When diagnosing TB, what would you see on Mantoux test?

A
  • > 15mm suggests active TB,
  • 6-15mm ?previous exposure (may be BCG)
58
Q

TUBERCULOSIS
When diagnosing TB, what would you see on interferon gamma release assays?

A

Confirms latent TB + differentiates from BCG

59
Q

TUBERCULOSIS
When diagnosing TB, what would you see on sputum MC&S?

A

Acid fast bacilli stain red with Ziehl-Neelson stain on Lowenstein-Jenson culture medium

60
Q

TUBERCULOSIS
What are some complications of TB?

A
  • Pleural + pericardial effusions
  • Lung collapse
  • Lung consolidation
61
Q

TUBERCULOSIS
What are the side effects of rifampicin?

A

Red urine

62
Q

TUBERCULOSIS
What are the side effects of isoniazid? How can it be prevented?

A
  • Peripheral neuropathy (I’m-so-numb-azid)
  • co-prescribe pyridoxine (vit B6) after puberty as prophylaxis
63
Q

TUBERCULOSIS
What are the side effects of pyrazinamide?

A
  • Gout due to hyperuricaemia,
  • rash
64
Q

TUBERCULOSIS
What are the side effects of ethambutol?

A

Optic neuritis, reduced acuity + colour (eye-thambutol)

65
Q

TUBERCULOSIS
What is the management of latent TB?

A
  • Isoniazid (+ vit B6) for 6m
  • Isoniazid (+vit B6) + rifampicin for 3m
66
Q

VACCINATIONS
What vaccines are attenuated?

A
  • MMR, BCG, nasal flu, rotavirus + Men B
67
Q

VACCINATIONS
Which vaccines are included in the 6-in-1 injection?

A
  • diphtheria
  • tetanus
  • pertussis DTaP (whooping cough)
  • polio IPV
  • Haemophilus influenza B (HiB)
  • Hepatitis B
68
Q

VACCINATIONS
What vaccines are given at…

i) 2m?
ii) 3m?
iii) 4m?

A

i) 6-in-one, rotavirus + men B
ii) 6-in-one, rotavirus + PCV
iii) 6-in-one, men B

69
Q

VACCINATIONS
What vaccines are given at…
i) 1y?
ii) 3y + 4m?
iii) 12-13y?
iv) 14y?

A

i) Men B, PCV, Hib/Men C + MMR
ii) MMR, 4-in-one preschool booster (diptheria, tetanus, whooping cough + polio)
iii) HPV
iv) men ACWY, 3-in-1 teenage booster (diptheria, tetanus + polio)

70
Q

VACCINATIONS
When in the vaccination schedule would at risk individuals get…

i) hep B vaccine?
ii) BCG?

A

i) Neonate, 1m and 1y (as well as 2m, 3m, 4m as normal schedule)
ii) Neonate

71
Q

ALLERGY
What is an allergy?
Give examples

A
  • Hypersensitivity reaction initiated by specific immunoglobulins
  • Food allergy, eczema, allergic rhinitis, asthma, urticaria, insect sting, drugs, latex + anaphylaxis
72
Q

ALLERGY
Define hypersensitivity

A

Objectively reproducible symptoms/signs following a defined stimulus at a dose tolerated by a normal person

73
Q

ALLERGY
Define atopy

A

Personal/familial tendency to produce IgE in response to ordinary exposures to allergens (triad = eczema, asthma + rhinitis)

74
Q

ALLERGY
What are two theories of allergy and briefly explain them?

A
  • Hygiene hypothesis = high microbial exposure means less allergy
  • Skin sensitisation theory = regular exposure via food + preventing exposure via breaks in skin before food means less allergies
75
Q

ALLERGY
What is the Gell and Coombs hypersensitivity classification?

A
  • Type 1 = IgE trigger mast cells + basophils to release histamines + cytokines
  • Type 2 = IgG/M bind to cell-surface antigens which is a host cell but activates immune system as considers foreign > cytotoxic
  • Type 3 = immune complex mediated with activation of complement/IgG
  • Type 4 = T-cell mediated delayed type hypersensitivity
76
Q

ALLERGY
what is the pathophysiology of a type 1 hypersensitivity reaction?

A

IgE trigger mast cells + basophils to release histamines + cytokines

77
Q

ALLERGY
Give an example of a type 1hypersensitivity reaction

A
  • acute anaphylaxis,
  • hayfever
78
Q

ALLERGY
what is the pathophysiology of a type 2 hypersensitivity reaction?

A

IgG/M bind to cell-surface antigens which is a host cell but activates immune system as considers foreign > cytotoxic

79
Q

ALLERGY
Give an example of a type 2 hypersensitivity reaction

A
  • autoimmune disease,
  • haemolytic disease of newborn,
  • transfusion reaction
80
Q

ALLERGY
what is the pathophysiology of a type 3 hypersensitivity reaction?

A

immune complex mediated with activation of complement/IgG

81
Q

ALLERGY
Give an example of a type 3 hypersensitivity reaction

A
  • SLE,
  • RA,
  • HSP,
  • post-strep glomerulonephritis
82
Q

ALLERGY
what is the pathophysiology of a type 4 hypersensitivity reaction?

A

T-cell mediated delayed type hypersensitivity

83
Q

ALLERGY
Give an example for of a type 4 hypersensitivity reaction

A
  • TB,
  • contact dermatitis
84
Q

ALLERGIC RHINITIS
What are the different types of antihistamines that can be taken for allergic rhinitis?

A
  • Non-sedating = cetirizine, loratadine
  • Sedating = chlorphenamine (Piriton) + promethazine
  • Nasal may be good option for rapid onset Sx in response to trigger
85
Q

ANAPHYLAXIS
What investigation confirms anaphylaxis?

A
  • Serum mast cell tryptase within 6h of event = mast cell degranulation
86
Q

ANAPHYLAXIS
What is the acute management of anaphylaxis?

A
  • Airway = secure
  • Breathing = oxygen, salbutamol to help wheeze, monitor SpO2, RR
  • Circulation = IV fluid bolus with collapse, monitor BP, ECG
  • Disability = lie pt flat to improve cerebral perfusion
  • Exposure = look for flushing, urticaria + angioedema
87
Q

ANAPHYLAXIS
What medications can be given in anaphylaxis?

A
  • IM adrenaline (EpiPen if community), repeat after 5m if necessary
  • Antihistamines like chlorphenamine or cetirizine
  • Steroids like IV hydrocortisone
88
Q

IMMUNE DEFICIENCY
What are the 6 types of immune deficiency?

A
  • T-cell defects
  • B-cell defects
  • Combined B- + T-cell defects
  • Neutrophil defect
  • Leucocyte function defect
  • Complement defects
89
Q

IMMUNE DEFICIENCY
What are T-cell defects?

A
  • Severe/unusual viral + fungal infections + failure to thrive in first 2m
90
Q

IMMUNE DEFICIENCY
Give some examples of T-cell defects

A
  • DiGeorge syndrome
  • HIV
  • Duncan syndrome (X-linked lymphoproliferative disease)
  • Ataxic telangiectasia
  • Wiskott-Aldrich
91
Q

IMMUNE DEFICIENCY
What are B-cell defects?
Give some examples

A
  • Present beyond infancy as passively acquired maternal antibodies, severe bacterial infections, esp. (lower) RTIs.
  • Selective IgA deficiency (#1)
  • X-linked (Bruton) agammaglobulinaemia
  • Common variable immune deficiency
92
Q

IMMUNE DEFICIENCY
Give some examples of combined B- and T-cell disorders

A
  • Severe combined immunodeficiency = group of inherited disorders of profound defective cellular + humoral immunity
  • Hyper IgM syndrome = B cells produce IgM but prevented from IgG/A
93
Q

IMMUNE DEFICIENCY
What do neutrophil defects lead to?
Give an example

A
  • Recurrent bacterial infections
  • Chronic granulomatous disease = X-linked recessive, defect in phagocytosis as fail to produce superoxide after ingestion
94
Q

IMMUNE DEFICIENCY
What are leucocyte function defects?
Give an example

A
  • Delayed separation of umbilical cord, wound healing, chronic skin ulcers
  • Leucocyte adhesion deficiency = deficiency of neutrophil surface adhesion molecules so inability to migrate to sites of infection
95
Q

IMMUNE DEFICIENCY
What are complement defects?
Examples

A
  • Recurrent bacterial infections (meningococcal, HiB, pneumococcus), SLE-like illness
  • Hereditary angioedema (measure C4 levels)
  • Mannose-binding lectin deficiency
96
Q

IMMUNE DEFICIENCY
What are some investigations for immune deficiency?

A
  • FBC (WCC, lymphocytes, neutrophils)
  • Blood film
  • Complement
  • Immunoglobulins
97
Q

IMMUNE DEFICIENCY
What prophylaxis should be given in immune deficiency?

A
  • T-cell + neutrophil = co-trimoxazole for PCP, fluconazole for fungal
  • B-cell = azithromycin for recurrent bacterial infections
98
Q

IMMUNE DEFICIENCY
What is the management of immune deficiency?

A
  • Prompt, appropriate + longer Abx courses
  • Screen for end-organ disease (CT scan)
  • Ig replacement therapy if antibody deficient
  • Bone marrow transplantation for SCID, chronic granulomatous disease
99
Q

WHOOPING COUGH
What are some complications of pertussis?

A
  • Pneumonia
  • Convulsions
  • Bronchiectasis
100
Q

WHOOPING COUGH
What is the management of pertussis?

A
  • Notify PHE
  • Prophylaxis = vaccine (esp. infants + pregnant women) or if close contact macrolide (erythromycin)
  • PO macrolides (azithromycin, clarithromycin) 1st line if onset <21d
  • School exclusion for 48h following Abx or 21d from onset if no Abx
101
Q

WHOOPING COUGH
When should you admit a child to hospital with pertussis?

A
  • Suffering from cyanotic attacks
  • <6m
102
Q

POLIO
what is the cause?

A

poliovirus type 1

103
Q

POLIO
what is the pathophysiology?

A
  • transmitted via faecal-oral route
  • incubation period is 3-30 days + can be excreted for up to 6 weeks
  • replicates in nasopharynx + GI tract and can spread to CNS where it can affect anterior horn cells, motor neurons and the brainstem
104
Q

POLIO
what is the clinical presentation?

A

90-95% of cases are asymptomatic
fatigue
fever
nausea and vomiting
diarrhoea
sore throat
headache
photophobia

105
Q

POLIO
what are the clinical features of a more serious polio infection?

A

acute flaccid paralysis (AFP)
- initially fatigue, fever N+V
- asymmetrical lower limb weakness and flaccidity

can progress to life-threatening bulbar paralysis and respiratory compromise

106
Q

POLIO
what are the investigations?

A
  • virus culture from stool, CSF or pharynx
  • CSF analysis
  • serum antibodies to poliovirus
  • MRI of spinal cord
  • EMG of affected limb(s)
107
Q

POLIO
what is the management?

A
  • supportive care with rehydration and neurological monitoring
  • physiotherapy
  • intubation and ventilation for respiratory paralysis
108
Q

POLIO
what are the complications?

A

post-poliomyelitis syndrome (PPS) - this usually occurs years after the initial infection
- demonstrates the same features as polio infection
- treated in the same way as polio

109
Q

DIPHTHERIA
what is the cause?

A

Corynebacterium diphtheriae

110
Q

DIPHTHERIA
what is the pathophysiology?

A
  • it infects the epithelium of the skin and the mucosa of the upper resp tract
  • it forms a grey pseudomembrane
111
Q

DIPHTHERIA
what is the clinical presentation?

A
  • sore throat
  • low grade fever
  • dysphagia, dysphonia, dyspnoea and croupy cough can occur in serious illness
112
Q

DIPHTHERIA
what are the investigations?

A
  • throat + nose swabs, microscopy and culture
  • diphtheria antibodies
  • PCR
113
Q

DIPHTHERIA
what is the management?

A
  • hospitalisation, isolation
  • diphtheria anti-toxin
  • antibiotic (procaine benzylpenicillin)
114
Q

DIPHTHERIA
what is the management for close-contacts?

A

prophylactic antibiotics - erythromycin

diphtheria toxoid immunisation

115
Q

CANDIDIASIS
what is the management?

A

oral or topical anti-candidial drugs e.g. nystatin, fluconazole

116
Q

SCHOOL EXCLUSION
what are the rules for scarlet fever?

A

24hrs after commencing antibiotics

117
Q

SCHOOL EXCLUSION
what are the rules for measles?

A

4 days from onset of rash

118
Q

SCHOOL EXCLUSION
what are the rules for whooping cough?

A

2 days after commencing antibiotics (or 21days from onset of symptoms if no antibiotics)

119
Q

SCHOOL EXCLUSION
what are the rules for rubella?

A

5 days from onset of rash

120
Q

SCHOOL EXCLUSION
what are the rules for chicken pox?

A

all lesions have crusted over

121
Q

SCHOOL EXCLUSION
what are the rules for mumps?

A

5 days from onset of swollen glands

122
Q

SCHOOL EXCLUSION
what are the rules for diarrhoea and vomiting?

A

until symptoms have settled for 48hrs

123
Q

SCHOOL EXCLUSION
what are the rules for scabies?

A

until treated

124
Q

SCHOOL EXCLUSION
what are the rules for influenza?

A

until recovered

125
Q

SCHOOL EXCLUSION
what are the rules for conjunctivitis?

A

no exclusion

126
Q

SCHOOL EXCLUSION
what are the rules for hand, foot and mouth?

A

no exclusion

127
Q

SCHOOL EXCLUSION
what are the rules for infectious mononucleosis?

A

no exclusion

128
Q

SCHOOL EXCLUSION
what are the rules for headlice?

A

no exlcusion

129
Q

SCHOOL EXCLUSION
what are the rules for threadworms?

A

no exclusion

A TO REVISE - PHASE 3A (16 decks)

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