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2020 Phase 3a (DB) > paeds infxn > Flashcards

paeds infxn Flashcards

1
Q

what causes roseola infantum?

A

HSV 6 (sometimes 7, but rarer)

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2
Q

do children with roseola infantum need to be excluded from school?

A

no

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3
Q

what are the symptoms of roseola infantum?

A 
fever
maculopapular rash
nagayama spots: papular enanthem on the uvula and soft palate
febrile convulsions
diarrhroea and cough
eyelid swelling and lymphoedema
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4
Q

how is roseola treated?

A

symptomatic treatment

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5
Q

what causes hand foot and mouth?

A

coxsackie a
enterovirus
Picornaviridae family of viruses

very contagious

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6
Q

what are the symptoms of hand foot and mouth

A

sore throat
fever
oral ulcers
followed later by vesicles on the palms and soles of the feet

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7
Q

how is hand foot mouth treated?

A

symptomatic and hydration

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8
Q

do children need to be excluded for hand foot mouth?

A

no

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9
Q

what causes scarlet fever?

A

group A haemolytic strep usually strep pyogenes

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10
Q

how is scarlet fever spread?

A

respiratory droplets

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11
Q

what are the symptoms of scarlet fever?

A 
fever
malaise
headache
nausea
sore throat
STRAWBERRY TONGUE
sandpaper (pinprick) circumollar pallour 
peeling after rash
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12
Q

how is scarlet fever diagnosed?

A

throat swab, but start treating before results

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13
Q

how is scarlet fever treated?

A

pencillin V

if allergic, azithromycin

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14
Q

do children with scarlet fever need exclusion?

A

yes, until 24 hrs after Abx

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15
Q

is scarlet fever notifiable?

A

yes. students out of school for 24hrs following starting Abx

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16
Q

what are the complications of scarlet fever?

A

otitis media
rheumatic fever
glomerulonephritis

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17
Q

what is slapped cheek also known as

A

erythema infectiosum

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18
Q

what causes slapped cheek?

A

parvovirus B19

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19
Q

how does slapped cheek present?

A

fevery illness

rose red rash on cheeks that may spread to body, sparing palms and soles

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20
Q

what does heat trigger in a person previously infected with slapped cheek?

A

recurrence of the rash

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21
Q

what is the treatment for slapped cheek?

A

supportive

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22
Q

do children with slapped cheek need to be excluded?

A

no, they are no longer infectious by time rash appears

but pregnant women should be avoided

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23
Q

which stage of pregnancy should women avoid slapped cheek?

A

first 20 weeks

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24
Q

what do pregnant women who come into contact with slapped cheek need to do?

A

let antenatal care know so that she can be checked for IgG IgM

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25
Q

what are complications of slapped cheek?

A

aplastic crises in sickle cell

pancytopaenia in immunosuppressed

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26
Q

what virus causes measles?

A

RNA paramyxovirus

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27
Q

how is measles spread?

A

droplets

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28
Q

what are the symptoms of measles?

A 
conjunctivitis 
fever
Koplik spots before rash 
rash starts behind ears then to whole body
maculopapular rash becomes confluent
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29
Q

how is measles diagnosed?

A

IgM

30
Q

how is measles managed?

A

supportive

hospitalisation of pregnant/immunocompromised

31
Q

what are the complications of measles?

A

otitis media
pneumonia
encephalitis

32
Q

is measles notifiable?

A

yes

33
Q

which virus causes chickenpox?

A

varicella zoster virus

34
Q

how is chickenpox spread?

A

respiratory route

35
Q

how does Chicken pox present?

A

fever, itchy rash on head/trunk and spreads
initially macular
then papular
then vesicular

36
Q

how is Chicken pox treated?

A

keep cool
trim nails
calamine lotion

37
Q

how long is Chicken pox infectious?

A

1-2 days before rash until the rash crusts over.

38
Q

what should you give immunocompromised patients/neonates who get Chicken pox?

A

IV acyclovir

if no rash, but exposure - Varicella zoster Ig

39
Q

what are some rate complications of chicken pox?

A

pneumonia
encephalitis
disseminated haemorrhagic chickenpox
arthritis, nephritis, pancreatitis

40
Q

how does rubella present?

A

fever
maculopapular rash
suboccipital, post-auricular LN

41
Q

what is the problem with rubella?

A

risk of pregnant contracting - congenital rubella syndrome, esp before 20 weeks

42
Q

what causes rubella?

A

rubella virus (a togavirus)

43
Q

what are the effects of congenital rubella syndrome?

A 
sensorineural deafness
congenital cataracts
congenital heart disease (e.g. patent ductus arteriosus)
growth retardation
hepatosplenomegaly
purpuric skin lesions
'salt and pepper' chorioretinitis
microphthalmia
cerebral palsy
44
Q

is rubella notifiable?

A

yes

45
Q

when should rubella vaccine be given to pregnant women who are not immune?

A

after birth

46
Q

what causes Whooping cough?

A

bordatella pertussis

47
Q

what are the symptoms of whooping cough?

A 
coryza
coughing bouts (esp nocte and after feeding)
inspiratory whoop (not always present)
central cyanosis when crying
infants may have apnoeic spells!!
48
Q

how might infant with whooping cough present?

A

apneoic spells
cough persisting
post-cough vomiting
whooping (may not always be present)

49
Q

how is whooping cough diagnosed?

A

nasal swab culture

50
Q

infants under which age with whooping cough should be admitted?

A

6 months

51
Q

what is the treatment for whooping cough?

A

macrolide - clarithromycin erythtromycin etc if cough started less than 21 days ago

52
Q

why are antibiotics given in whooping cough?

A

eradicate illness and reduce spread

Abx do not alter course of disease

53
Q

how long should children with whooping cough be kept away from school?

A

48 hours post Abx

21 days post cough onset if no abx

54
Q

what are the complications of whooping cough?

A

subconjunctival haemorrhages
pneumonia
bronchiectasis
seizures

55
Q

how are contacts for pertussis treated?

A

erythromycin prophylactic

56
Q

is pertussis notifiable?

A

yes

57
Q

what causes kawasaki disease?

A

cause: vasculitic

58
Q

what are the symptoms of kawasaki?

A
  1. high-grade fever which lasts for > 5 days
  2. conjunctival infection
  3. bright red, cracked lips
  4. strawberry tongue
  5. cervical lymphadenopathy
  6. red palms and soles of the feet which later peel
59
Q

how is kawasaki diagnosed?

A

clinical

60
Q

what is the treatment for kawasaki?

A

aspirin
IVIG
Echo to screen for coronary aneurysm

61
Q

what are the complications of kawasaki?

A

coronary aneurysm

62
Q

what bacteria cause impetigo?

A

strep pyogenes

staph aureus

63
Q

how does impetigo present?

A

golden crusty rash around the mouth

64
Q

how is impetigo treated?

A

topical fucidic acid

if systemic, oral fluclox
if allergic, erythromycin

65
Q

how long should children be out of school for impetigo?

A

until crusted

or 48 hours after abx tx

66
Q

which organism causes meningitis in neonates?

A

group b strep (prolonged labour, premature)
E. Coli
listeria

67
Q

which organisms cause meningitis in children?

A

N. Meningitidis
strep pneumoniae
haemophilus influenzae

68
Q

how is meningitis treated in children?

A

IV amoxicillin and cefotaxime (younger than 3m)
amoxicillin to cover listeria

IV cefotaxime in older than 3m

69
Q

which prophylaxis for meningitis contacts?

A

ciprofloxacin preferred over rifampicin

70
Q

what is the treatment for threadworm?

A 
oral mebendazole (antihelminitic)
for the whole household even if asymptomatic

2020 Phase 3a (DB) (20 decks)

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