PAEDIATRICS > Infectious diseases > Flashcards

Infectious diseases Flashcards

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1
Q

Macules

A

Red/Pink discrete flat areas which blanch on pressure

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2
Q

Papules

A

Solid raised hemispherical lesions, usually tiny, blanch on pressure

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3
Q

Rubella

A

macular rash

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4
Q

Measles

A

Maculopapular rash

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5
Q

Purpuric, petechia

A

non blanching red/purple spots, tested with a glass

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6
Q

some conditions that are purpuric or petechial

A
  • meningococcal
  • HSP
  • Enterovirus
  • Thrombocytopenia
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7
Q

vesicles

A

raised hemispehrical lesions, <0.5cm diameter, contain clear fluid

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8
Q

infections with vesicles

A
  • Chicken pox
  • shingles
  • Hand, foot and mouth disease
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9
Q

Pustules/ bullae

A

raised hemispherical lesions >0.5cm diameter, contain clear or purulent fluid

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10
Q

Infections with pustules/ bullae

A
  • impetigo
  • scalded skin syndrome
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11
Q

Desquamation

A

dry and flaky loss of surface epithelium, often in peripheries

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12
Q

Infections with desquamation

A
  • post- scarlet fever
  • kawasaki
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13
Q

measles is caused by

A

the measles virus

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14
Q

measles

incubation period

A

around 2 weeks

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15
Q

measles

mode of spread

A

droplet spread, highly infectious during viral shedding

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16
Q

measles

pathognomic feature

A

koplik spots

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17
Q

measles

Clinical features

A
  • cough
  • conjunctivitis, coryza
  • koplik spots
  • Maculpapular Rash
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18
Q

measles

Koplik spots

A

white spots on the buccal mucosa seen against a red background

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19
Q

measles

Rash seen

A

maculopapular rash starting from behind the ears to the whole body. May desquamate in the second week

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20
Q

measles

Respi complications

A
  • Pneumonia
  • Secondary bacterial infection and otitis media
  • Tracheitis
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21
Q

measles

Neuro complications

A
  • Febrile convulsions
  • EEG abnormalities
  • Encephalitis
  • SSPE
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22
Q

measles

SSPE

A

late and rare manifestation by around 7 years. loss of neuro function and 100% death rate

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23
Q

measles

complications

A
  • Respi
  • Neuro
  • Diarrhea
  • Hepatitis
  • Appendicitis
  • Corneal ulceration
  • Myocarditis
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24
Q

measles

Mx

A
  • Symptomatic Rx
  • Isolate the child
  • Ribavirin for immunocompromised
  • Vitamin A to boost immunity
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25
# measles Prevention
MMR vaccine- given at 9 months and 3 years
26
# Chicken pox MO
Varicella zoster
27
# Chicken pox Incubation period
around 2 weeks
28
# Chicken pox Spread
by respiratory droplets. until the last lesion has crusted, child is infectious
29
# Chicken pox Clinical features
Vesicular rash starting on the head and trunk and progress to peripheries
30
# Chicken pox Rash
starts as papules, vesicles with sorrounding erythema and pustules for upto one week.
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# Chicken pox Why do children present with difficulty eating
lesions may appear on the palate
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# Chicken pox Does it leave scars
no unless they are scratched
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# Chicken pox lesions appear beyond 10 days
suggests defective cellular immunity
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# Chicken pox Complications
* bacterial superinfection * CNS- cerebellitis, generalised encephalitis, aspetic meningitis * Immunocompromised- Penumonitis, hemorrhagic lesions, DIC, progressive and disseminated infections
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# Chicken pox Rx
* immunocopromised- IV acyclovir * high- risk immunocompromised following contact- HZV Ig vaccine (VZIG) * Normal immunity- no Rx
36
# Chicken Pox Prevention
Immunization against chickenpox
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# Mumps Incubation period
15-24 days
38
# Mumps MO
Measles virus
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# Mumps spread by
aerosolized droplets
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# Mumps clinical features
* Fever, malaise, parotitis * Parotitis starts U/L but spreads B/L in the next week * Earache, pain on eating and drinking (acidic, salty)
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# Mumps Parotitis
Usually starts U/L and then spread B/L over the next few days
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# Mumps how long does the fever last
around 3-4 days
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# Mumps pancreatic involvement
Serum amylase is high
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# Mumps how long does the infectivity last
upto a week
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# Mumps complications
* transient and U/L hearing loss * viral meningitis, encephalitis * Orchitis- uncommon * Myocarditis
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# Mumps risk of subfertility
Mumps complicated with B/L orchitis
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# Mumps Prevention
MMR vaccine SL remedy- ali hakka
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# Rubella MO
Rubella virus
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# Rubella incubation period
15-20 days
50
# Rubella Spread
Respiratory
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# Rubella Clinical features
* Prodrome- mild fever * maculopapular rash * Lymphadenopathy
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# Rubella Rash
Maculopapular rash starting from the face and spreading centrifugally to the whole body
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# Rubella Lymphadenopathy locations
* Suboccipital * Postauricular
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# Rubella Complications
* Arthritis * Encephalitis * Thrombocytopenia * Myocarditis- rare
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# Rubella Prevention
MMR vaccine
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# Impetigo MO
Staphylococcal Streptococcal
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# Impetigo most common in
children with pre- existing skin disease
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# Impetigo lesions location
* Face * Neck * Hands
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# Impetigo rash
1. begins as erythematous macules 2. become vesicles/ pustules/ bullae 3. rupture 4. honey- colored crusted lesions
60
# Impetigo Infection spread
autoinculation
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# Impetigo Rx
* Mild cases- topical ABx (Mupirocin) * Severe- flucloxa, co-amoxiclav * Isolate the child * Nasal cream of mupirocin, chlorhexidine
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# SSSS Pathophysiology
exfoliative toxin of staph seperates the epidermal skin from the dermis
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# SSSS affected age groups
Infants, young children
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# SSSS Clinical features
* fever, malaise * purulent, crusting, localized infection around the eyes, nose, mouth * widespread erythema and tenderness of skin * subtle pressure cause epidermis to peel off, leaving denuded skin * denuded areas dry and heal without scarring
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# SSSS Mx
* iv ABx- flucloxa, vancomycin * iv morphine * fluid balance- NS * Losing protein- high protein diet (NG tube, TPN)
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# HIV Spread
* mother- to child transmission- during PG, at delivery, through breastfeeding * infected blood products- abuse, contaminated needles
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# HIV Sx of mild HIV
* lymphadenopathy * parotitis
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# HIV Sx of moderate HIV
* Recurrent bacterial infections * candidiasis * chronic diarrhea * lymphocytic interstitial pneumonitis (LIP)
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# HIV Sx of severe HIV
* opportunistic infections- pneumocystis carinii pneumonia * severe failure to thrive * encephalopathy * malignancy
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# HIV * Dx of <18 months * >18 months
* <18 months- HIV DNA PCR * >18 months- HIV Ab
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# HIV How to know the infant is not infected anymore
Two negative PCR within first 3 months of life at least two weeks after the completion of postnatal antiretroviral therapy
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# HIV confirmatory test that the infant is free of HIV
loss of transplacental maternal HIV Ab from the infant's circulation after 18 months of age
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# HIV screening Dx
all infants born to HIV infected mothers needs to be tested whether they are symptomatic or not
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# HIV Rx
* ART- combo of 3-4 drugs * Prophylaxis against Pneumocystis jiroveci carinii pneumonia- Co- trimoxazole * MDT approach
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# HIV immunization
* no live vaccines- BCG not given
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# HIV MDT consists of
* Pediatrician * venerologist * Psychiatrist * social workers
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# HIV prevention
* antenatal ART * offer LSCS * avoid breastfeeding
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# Malaria MO
* Plasmodium vivax * Plasmodium falciparum * Pl ovale * Pl malariae
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# Malaria incubation period
7- 10 days
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# Malaria spread
Female anopheles mosquito
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# Malaria Sx
* high- grade cyclical fever * diarrhea, vomiting * flu- like Sx * Jaundice * Anemia, thrombocytopenia * Chills, rigors
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Hepatosplenomegaly High- grade fever chills and rigors Recent travel Hx to Africa
Malaria!
81
# Malaria complications
* severe anemia * hepatic, liver failure * renal failure * cerebral malaria
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# Malaria Dx
* thick film- +/- to malaria * thin film- the causative species
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# Malaria Rx
* Quinine * Artemether * Artesunate
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# Malaria Rx for Pl vivax malaria
* Chloroquine * Primaquine
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# Malaria Cerebral edema risk is highest
Pl falciparum
86
# Malaria Malaria MO that are mostly seen in SL
* Pl falciparum * Pl vivax
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# Malaria Immediate Dx test
RAT
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# Malaria Prevention
* prophylaxis- primaquien before traveling to high risk areas * mosquito nets, repellants * cleaning breeding areas
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# Malaria Best drug for the hepatic form of Pl vivax
Primaquine
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# Malaria ADRS of Quinine
hypoglycemia
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# Malaria ADRS for Primaquine, Chloroquine
G6PD deficiency. Not given during PG
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# Typhoid MO
Salmonella typhi Salmonella paratyphi
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# Typhoid Incubation period
7-14 days
94
# Typhoid spread
Feco- oral route
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# Typhoid Salmonella is G+ or G-?
G- flagellated
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# Typhoid Clinical features
* Worsening fever, headache, cough, abd pain, anorexia, malaise, myalgia * GI Sx- Starts with constipation upto diarrhea * mild to mod soft splenomegaly, bradycardia, rose- colored spots on the trunk
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# Typhoid Complications
* GI perforation - Peritonitis * Myocarditis * Hepatitis * Nephritis * Meningitis * Osteomyelitis
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# Typhoid Dx
* 1st week- Blood culture * 2nd week- urine and stool culture * after first week BM culture can be done * Standard agglutination test (SAT)- after one week. H Ag and O Ag
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# Typhoid SAT which antigen is most specific of typhoid
O Ag
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# Typhoid Rx
iv 3rd Gen cephalosporin + azithromycin - cefotaxime +clarithromycin (7-10 days)
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# Typhoid Prevention
* Practicing safe food hygiene methods * vaccination against typhoid (3 yearly)
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# Typhoid Typhoid vaccine is included in the EPI or not
not included
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Constipation, fever turning into abd pain, diarrhea Hx of food intake from outside Rose spots Relative bradycardia
Typhoid
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# Typhoid Carriers
MO lodge in the gall bladder and cholecystectomy should be offered
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# Typhoid Typical Abdomen
Doughy abdomen
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# Typhoid Drug used in the past but not given anymore
Chloramphenicol - aplastic anemia
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# Typhoid Why is ciprofloxacin not given to children
cause cartilage, growth problems
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# Typhoid 3rd Gen cephalosporins cover
Both G+ and G- but mostly G- coverage
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# Leptospirosis MO
Leptospira
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# Leptospirosis Incubation period
7-14 days
111
# Leptospirosis Spread
Via contaminated soil or water mainly muddy water, paddy fields. Bacteria infect domestic and wild animals and are excreted in animal urine to soil or water
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# Leptospirosis Clinical features during the first week
* fever, chills * headache * muscle soreness in the calves * redness of the eyes- conjunctivitis, conjunctival suffusions * Abd pain, nausea, vomiting * skin rash over the shins ( pretibial)
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# Leptospirosis how long does the fever last
around a week and it settles for 1-3 days and again returns with additional Sx * Uveitis, iritis * Meningitis * Hepatitis * Lymphadenitis
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# Leptospirosis Dx
* IgG, IgM in blood samples * Culture of leptospira- body fluids or tissue * Dark field microscopy
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# Leptospirosis Ix
* FBC * LFT * RFT * Coagulation studies
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# Leptospirosis Complications
* Hepatitis, Jaundice * Bleeding * Kidney failure * Irregular heart rhythm * Hemorrhagic pneumonitis * Meningitis
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# Leptospirosis Hepatitis and Jaundice
Weil's disease
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# Leptospirosis Rx- prophylaxis
* <8 y/o- PO amoxicillin * >8y/o- doxycycline
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# Leptospirosis Rx
* iv penicillin
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# Leptospirosis why is doxycycline not given to children <8 years
cause teeth abnormalities- teeth staining
121
# Leptospirosis Prevention
* Personal hygiene- protective boots * Avoid muddy waters * Vaccination of pets
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# Scrub typhus MO
Rickettsia (Orientia tsutsugamishi)
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# Scrub typhus Incubation period
5-20 days
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# Scrub typhus Spread
* Bite of an infected mite larvae or chigger * Transmitted to humans and rodents by the mites * Children goes to jungles, tree areas with no shirts
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# Scrub typhus Sx
* Chigger bites * Headache * Fever * Shaking chills * Conjunctivitis * Lymphadenopathy * Spotted rash on trunk * splenomegaly * Hepatomegaly
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# Scrub typhus chigger bite
Painless, localized itch, an eschar seen on the groin, axilla, genitalia, neck
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# Scrub typhus Eschar
Resembles cigarette burn marks
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# Scrub typhus complications
* CNS, pulmonary, cardiac involvement * Renal failure * Shock * DIC
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# Scrub typhus Dx
* Early lymphopenia * Late lymphocytosis * Decreased CD4:CD8 ratio * Thrombocytopenia * Increased AST, ALT * Hypoalbuminemia * IgM, IgG elevated
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# Scrub typhus Rx
* >8y/o- Doxycycline * <8y/o- Azithromycin
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# Scrub typhus Prevention
* Vector control * Protective clothing
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# Congenital Rubella Sx
* LBW * Microcephaly * Cataracts * PDA * Pulm Stenosis * Hepatosplenomegaly * Thrombocytopenia * Rash
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# CMV Sx
* LBW * Microcephaly * Chorioretinitis * Brain calcification * Hepatosplenomegaly
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# CMV Dx
Urine sample for CMV
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# CMV Mx
* Anti- viral * Acyclovir
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# Toxoplasmosis Sx
* Hydrocephalus * Diffuse calcification in basal ganglia * Eye abnormalities
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# Toxoplasmosis Vector
Domestic pets
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# Toxoplasmosis Mx
Anti- parasitic drugs
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# Congenital infection Signs
* Baby too small <2.5kg * PG mom has fever+ rash * SGA baby * Microcephaly * Abnormal eyes- cataracts * PDA * Bleeding manifestations * Hepatosplenomegaly
140
# Congenital infections TORCH
* toxoplasmosis * Rubella * CMV * Hepatitis, HIV, Herpes
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