Specials 2 Flashcards
Causes of sensorineural deafness in children
Genetic (majority) Congenital infection Preterm Hypoxic-ischaemic encephalopathy Hyperbilirubinaemia
Postnatal:
Meningitis
Head injury
Aminoglycosides, furosemide, neurodegenerative
Causes of conductive hearing loss in children
Glue ear
Eustachian tube dysfunction (Downs, Cleft palate, Pierre Robin Sequence, Mid-facial hypoplasia)
Wax (rarely)
Usually moderate (<60dB loss)
Causes of glue ear
Recurrent ear infections.
Also adenoids
Effects of glue ear
Conductive hearing loss
Interference with normal speech development
Learning difficulties in school.
Management of otitis media with effusion
Insertion of ventilation tube (grommets) can be beneficial if there is conductive hearing loss and recurrent infections.
Adenoidectomy can offer more long-term benefits, however.
NO abx, steroids or decongestants, as neither of these have been shown to have benefit
Describe the rash in measles
Spreads downwards from behind the ears to the whole body.
Discrete, maculopapular rash which later becomes blotchy and confluent.
May desquamate in 2nd week
Signs in measles (specific)
Koplik’s spots.
White spots on buccal mucosa.
See against white background
Recognize encephalitis due to measles
8 days after onset of illness.
Headache, lethargy and irritability.
Convulsions
Coma
15% mortality
Long-term sequelae: seizures, deafness, hemiplegia, severe learning difficulties
What is parvovirus B19 disease
Erythema infectiosum
Slapped cheek syndrome
How is parvovirus transmitted
Respiratory secretions from viraemic patients
Vertical transmission from mother to fetus
Transfusion of contaminated blood products
Describe erythema infectiosum caused by parvovirus B19
Fever
Malaise
Headache
Myalgia
Followed by a characteristic rash a week later (on the face: slapped-cheek)
Progresses to maculopapular, “lace”-like rash on the trunk and limbs.
What is the most serious form of parvovirus B19 infection?
Aplastic crisis
In children with chronic haemolytic anaemias
Where there is an increased rate of red cell turnover (sickle cell, thalassaemia)
Or immunodeficient (eg. malignancy)
The effect of parvovirus on a fetus?
Transmission may lead to fetal hydrops and death due to severe anaemia.
Majority of infected will recover
Spread of rubella
Respiratory route
Frequently from a known contact
Incubation period 15-20 days
Symptoms of rubella
Possible prodrome with low fever
Maculopapular rash, initially on the face and then covers whole body
Fades in 3-5 days.
Not itchy in children (unlike adults)
Lymphadenopathy prominent. Suboccipital and postauricular nodes
Clinical differentiation from other viral infections is unreliable. Diagnosis should be confirmed serologically if there is any risk of exposure of a non-immune PREGNANT woman!!
