Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a > Paeds - Infectious disease > Flashcards

Paeds - Infectious disease Flashcards

1
Q

what is Kawasaki disease?

A

a type of vasculitis - predominately seen in children

leads to inflammation of the coronary arteries and medium/large vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the cause of Kawasaki disease?

A

largely unknown
infectious cause
autoimmune reation
genetic predisposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the features of Kawasaki disease?

A

CRASH and burn
C - conjunctivitis with limbus sparing
R - rash - all body parts polymorphous - then flakes (desquamation)
A - adenopathy - enlarged lymph nodes (cervical)
S -strawberry tongue + red and cracked lips
H - hands and feet swollen with rash.

high grade fever for more than 5 days which is characteristically resistant to antipyretic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is Kawasaki managed?

A

IVIG intravenous immunoglobulin
high dose aspirin (one of the few indications for the use of aspirin in children, due to the risk of Reyes syndrome aspirin is usually contraindicated in children)
Echo - to screen for coronary artery aneurysms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the complications of Kawasaki?

A

coronary artery aneurysm
ischaemia of the heart muscle
MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what would you see from blood tests of Kawasaki?

A 
anaemia 
increased WBC
more immature WBC
increased ESR and CRP 
increased liver enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the incubation period of measles?

A

10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what symptoms do you get during the prodromal period of measles and how long does it last?

what are the symptoms following the prodromal period?

A

it lasts for usually 3 days
cough
conjunctivitis
coryza

Koplik spots - spots on mucus membrane

following the prodromal period a rash occurs: starts behinds ears and then transfers to the whole body.
A desecrate maculopapular rash becoming blotch and confluent.

in the immunocompromised - a rash is often not present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the investigations of measles?

A

IgM antibodies can be detected within a few days of rash onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the management of measles?

A

mainly supportive
admission may be considered in immunosuppressed or pregnant patients
notifiable disease –> inform public health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the complications of measles

A 
pneumonia 
diarrhoea 
encephalitis (typically occurs 1-2 weeks following the onset of the illness 
otitis media 
febrile convulsions 
corneal ulceration 
myocarditis 
increased incidence of appendicitis

subacute sclerosing pan-encephalitis (very rare, may occur 5-10 years following infection of infant under 2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how is it managed if an unvaccinated child comes into contact with measles ?

A

if child is not vaccinated and comes into contact with measles then the MMR vaccine should be given within 72 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what virus is chicken pox caused by?

A

varicella zoster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how is chicken pox transmitted?

A

respiratory route
or skin to skin contact

(infectivity = 4 days before rash until 5 days after the rash first appeared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the incubation period of chicken pox?

A

10-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the clinical features of chicken pox?

A

fever initially
itchy rash starting on head trunk before spreading
initially macular then papular then vesicular
systemic upset is usually mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the management of chicken pox?

A

keep cool, trim nails
calamine lotion
school exclusion (infective until lesions are dry and crusted over - usually around 5 days after onset of the rash

in immunocompromised patients and new born consider varicella zoster immunoglobulin, if chicken pox develops then acyclovir should be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the complications of chicken pox?

A

common complication is secondary bacterial infection of the lesions - NSAIDs may increase this risk

rare complications include pneumonia, encephalitis, disseminated haemorrhage chickenpox, arthritis, nephritis and pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is rubella caused by?

A

toga virus - spread by respiratory route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the clinical features of rubella?

A

prodrome - low grade fever
rash - maculopapular, initially on the face before spreading to the whole body usually fades by the 3-5 day
lymphadenopathy: suboccipital and post auricular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the complications of rubella?

A

arthritis
thrombocytopenia
encephalitis
myocarditis

can cause severe damage to the foetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is diphtheria caused by?

A

gram positive bacterium Corynebacterium diptheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does diphtheria infection cause?

A

local disease with membrane formation affecting the nose, pharynx or larynx or systemic disease with myocarditis and neurological manifestations

immunisations has irradiated disease in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is scalded skin syndrome?

A

caused by an exfoliative staphylococcal toxin which causes separation of the epidermal skin through the granular cell layers.

a fever develops and malaise and they may have a purulent, crusting, localised infection around the eyes, nose and moth with subsequent widespread erythema and tenderness of the skin

nikolsky sign - areas of epidermis separate on rental pressure, leaving denduded areas of skin which subsequently dry and heal without scarring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how is scalded skin syndrome managed?

A

IV anti-staphylococcal antibiotic, analgesia and monitoring fluid balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is whooping cough caused by?

A

gram negative bacterium bordetella pertussis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the clinical features of whooping cough?

A

2-3 days of coryza precede the onset of:
coughing bouts - usually worse at night and after feeding, may be ended by vomiting and associated central cyanosis
insipiratory whoop - not always present - caused by force inspiration against a closed glottis
infants may have spells of apnoea
persistent coughing can cause subjconjunctival haemorrhages or even anoxia leading to syncope and seizure
symptoms may last 10-14 weeks and is more severe in infants
there is marked lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the diagnostic criteria for whooping cough?

A

if a person has an acute cough for more than 14 days or more without another apparent cause and has one or more of the following features
paroxysmal cough
inspiratory whoop
post-tussive vomiting
undiagnosed apnoeic attacks in young infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how is whooping cough diagnosed?

A

nasal swab culture to look for bordetella pertussis

PCR and serology are now increasinglt used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how is whooping cough managed?

A

under 6 months if it suspected then admit them
it is notifiable disease
an oral macrolide - e.g. clarithromycin or azithromycin

clarithromycin for infants less than 1 month
azithromycin or clarithromycin for children aged 1 month or older and non-pregnant

household contacts should be offered prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the complications of whooping cough?

A

subconjunctival haemorrhage
pneumonia
bronchiectasis
seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are the stages of whooping cough?

A

catarrhal phase is the first stage (runny nose stage - typically lasts one to two week

paroxysmal stage - duration is highly variable lasting from one to ten weeks, intense drawn out bouts of coughing during this phase. Attacks tend to be more frequent at night

convalescent phase - the third stage - this can last for week to months and a chronic cough that becomes less paroxysmal (fewer sudden outbursts of coughing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is tuberculosis caused by?

A

mycobacterium tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is primary TB?

A

a non-immune host is exposed to tuberculosis
A small lung lesion known as a Ghon focus develops 3 weeks following initial infectoin
The Ghon focus is composed of tubercle-laden macrophages.
The combination of a Ghon focus and a hilar lymph node is known as a Ghon complex.

In immunocompotent people this initially heals by fibrosis and calcification. Those who are immunocompromised may develop disseminated disease (miliary tuberculosis)

35
Q

what is secondary TB?

A

if the host becomes immunocompromised the initial infection may become reactivated
Reactivation usually occurs in the apex of the lungs and may spread locally or to more distant sites

causes of immunocompromise - HIV, immunosupressants, malnutrition

36
Q

where might extra pulmonary infection of TB occur?

A 
CNS - tuberculosis meningitis - the most serious complication 
vertabral bodies (potts disease)
cervical lymph nodes - scrofluderma
renal - WBC in urines
addisons disease
GI tract
37
Q

how do you test for TB?

A

Purified protein derivative intradermal skin test also know as tuberculin test mantoux test, TB test

this test just shows that they have been exposed to TB not whether it is latent or active

interferon gamma release assay

positive results - do xray

labs of sputum

38
Q

how do you treat latent TB?

A

isoniazid for 9 months

39
Q

how do you treat active TB?

A 
RIPE 
Rifampicin
isoniazid
pyrazinaminde
ethambutol
40
Q

what are the common causes of meningitis in neonates up to 3 months?

A

group B streptococcus (usually acquired from the mother at birth)
E.coli and other gram negative organisms
listeria monocytogenes

41
Q

what are the common causes of meningitis in children aged 1 month to six years

A 
Neisseria meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
Haemophilus influenzae
42
Q

what are the common causes of meningitis in children older than 6?

A 
Neisseria Meningitidis (meningococcus)
Streptococcus pneumoniae (pneumococcus)
43
Q

what are some viral causes of meningitis?

A

enterovirus
EBV
adenovirus
mumps

44
Q

what are the early signs of meningitis?

A 
headache
temp
cold hands and feet 
discolored skin (blotchy)
poor feeding 
irritability 
hypotonia
drowsiness
45
Q

what are late signs of meningitis?

A 
neck stiffness
kernigs sign 
photophobia 
bulging fontanelle
arched back 
siezure 
shock: increased HR, RR, cap refill and BP decrease

non blanching purpuric rash

46
Q

how is meningitis diagnosed

A 
Septic screen 
blood - coagulation screen, LFT, PCR, rap[id antigen test, blood gas 
Culture - throat swab, urine and stool
TB - mantoux test, CXR
LP
47
Q

what are the contraindications to lumbar puncture?

A 
focal neurological sigs 
papiloedema 
significant bulding of the fontanelle 
DIC
signs of cerebral herniation
48
Q

how is meningitis managed in children?

A

antibiotics
if less than 3 months - IV amoxacillin and cefotaxime
if older than 3 months - IV cefotaxime

Steroids - if less than 1 month and H.influenzae then guive dexamethosone

Fluids

Cerebral monitoring

Public health notification
prophylaxis of contacts with ciprofloxacin

49
Q

what would the characteristics of the CSF be if it was bacterial meningitis?

A

cloudy
low glucose
high protein
white cells 10-500 polymorphs

50
Q

what would the CSF show if there is viral meningitis?

A

clear/clowdy CSF
60-80% of plasma glucose
protein is normal/raised
white cells 15-1000 lymphocytes

51
Q

what is erythema infectiosum and what is it caused by?

A

slapped cheek syndrome

Parvo virus B19

52
Q

what are the clinical features of slapped cheek syndrome?

A

mild fever
rose-red rash makes the cheeks appear bright red
the rash may spread to the rest of the body but will spare the palms and soles.
rash peaks after a week and then fades

other presentations:
- asymptomatic
- pancytopaenia in immunocompromised patients
aplastic crisis e.g sickle cell diseaase

53
Q

what is the treatment for slapped cheek syndrome?

A

most children recover and need no specific treatment

54
Q

what is impetigo?

A

a superficial bacterial skin infection

it may be a primary infection or a complication of an existing skin conditiomn such as eczema, scabies or insect bites.

It is common in children in warm weather

55
Q

what is impetigo caused by?

A

staphylcoccus aureus or streptococcus pyogenes

56
Q

what are the common locations that impetigo occur?

A

anywhere on body but tend to occur on face, flexures and limbs not covered by clothing

57
Q

what are the features of impetigo?

A

golden, crusted skin lesions typically found around the moth

58
Q

what are the three types of impetigo?

A

Non-bullous/ cruted impetigo
tiny blisters that eventually burst and leave small wet patches of red skin that may weep fluid, gradually they crust over

Bullous impetigo causes larger fluid containing blisters that look clear, then cloudy. they are more likely to stay longer without bursting

Ecthyma - punched out ulcers with yellow crust and red edges

59
Q

what is the management for limited, localised impetigo?

A

first line - topical fusidic acid

second line - topical retamulin

60
Q

what is the management for extensive impetigo?

A

oral flucloxacillin
or if allergic to penacillin - erythromycin

children should be excluded from school until lesions are crusted and healed or 48 hours after commencing antibiotic treatment.

61
Q

what is scarlet fever caused by?

A

group A haemolytic streptococci

usually streptococcus pyogenes

62
Q

what is the peak incidence of scarlet fever?

A

2-6 years

peak incidence at 4 years

63
Q

what is the classical presentation of scarlet fever?

A

fever that typically lasts 24 to 48 hours
malaise, headache, nausea/vomiting
sore throat
strawberry tongue
rash - fine punctate erythema (pinhead) which generally appears first on the torso and spares the palms and soles
the rash is often described as having a rough sandpaper texture
desquamation occurs later in the course of the illness

64
Q

how is scarlet fever diagnosed?

A

throat swab

65
Q

how is scarlet fever treated?

A

oral penicillin V for 10 days

patients with penicillin allergy should be given azithromycin

scarlet fever is a notifiable disease
children can return to school 25 hours after starting antibiotics

66
Q

what are the complications of scarlet fever?

A

otitis media
rheumatic fever (usually 20 days after infection )
acute glomerularnephritis (typically 10 days after infections)
invasive complications rare but are dangerous (bacteraemia , meningitis, necrotising fasciitis)

67
Q

what is mumps caused by?

A

RBNA paramyxovirus

68
Q

how is mumps spread and what is the infective period?

A

spread by droplets
it is infective for 7 days before and 9 days after parotid swelling
it has an incubation period of 14-21 days

69
Q

what are the clinical features of mumps?

A

fever
malaise
muscular pain
parotitis (earache, pain on eating) unilateral initially then becomes bilateral in 70%

70
Q

how is mumps managed?

A

rest
paracetamol for high fever and discomfort
it is a notifiable disease

71
Q

what are the complications of mumps?

A

orchitis - uncommon in pre-pubertal males but occurs in 25-35% of post-pubertal males - typically occurs 4-5 days after parotitis
hearing loss - usually unilateral and transient
meningoencephalitis
pancreatitis

72
Q

what causes toxic shock syndrome?

A

toxin-producing staphylococcus aureus and group A streptococci

73
Q

what is toxic shock syndrome characterised by?

A

fever
hypotension
diffuse erythematous, macular rash

can also cause organ dysfunction including:
mucositis
GI - vomiting/diarrhoea
renal impairment
liver impairment
clotting abnormalities and thrombocytopenia
CNS - altered consciousness

74
Q

how is toxic shock syndrome treated?

A

areas of infection should be surgically derided
antibiotics - 3rd gen cephalosporin - ceftriaxone along side clindamycin
IVIG to neutralise circulating toxin

75
Q

what causes encephalitis ?

A

direct invasion of the cerebrum by a neurotoxic virus (HSV)

delayed brain swelling following a disordered neuroimmunological response to an antigen, usually a virus (post-infectious encephalopathy e.g. following chicken pox)
a slow virus infection such as HIV infection or subacute sclerosing pan encephalitis following measles

76
Q

how do you treat encephalitis caused by HSV?

A

high dose aciclovir

77
Q

what are the routes HIV can be passed to children?

A

mother-to-child transmission - during pregnancy, and delivery or through breast feeding.

children may also be infected by infected blood products, contaminated needle or through sexual abuse.

78
Q

how is HIV diagnosed in children?

A

in children over 18 month, HIV is diagnosed by detecting antibodies to the virus.

prior to 18 months - they will have the mothers antibodies which suggests exposure but not deffo infection
before 18months diagnosis is by HIV DNA PCR

79
Q

what are the clinical features of HIV in infants?

A

a proportion of HIV infected infants progress rapidly to symptomatic disease and onset of AIDs in the first year of life
some children remain asymptomatic for months or years

clinical presentation depends on degree of immunosuppression

mild immunosupresion: lymphadenopathy or parotitis

moderate - recurrent bacterial infection

severe - pneumocystis jiroveci pneumonia (PCP), severe FTT, encephalopathy and malignancy, although this is rare in children

80
Q

how is HIV in children treated?

A

antiretroviral therapy

prophylaxis against PCP with co-trimoxazole

immunisation

81
Q

what is hand foot and mouth disease caused by?

A

most commonly coxsackie A16 and enterovirus 71

82
Q

what are the clinical features of hand foot and mouth disease?

A

mild systemic upset - fever, sore throat
oral ulcers
followed later by vesicles on the palms and soles of feet

83
Q

how is hand foot and mouth disease managed?

A

symptomatic treatment only

do not need to be excluded from school

Phase 3a (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions