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All right. Uh Hello everyone. Uh My name's uh Georgia. Um and I'm here to as part of the med lecture series to go through infectious diseases and immunizations. Um So, first of all, just a little bit on who I am. Um So I'm a two at West Middlesex University Hospital and I'm currently um on pediatrics there until the first of April. And I've just put my email on there in case anyone has any questions or if anyone's on placement coming up to West mid on their pediatric block and um want a familiar face or if they need any help or support with anything. Uh or if you have any questions about foundation training, feel free to email me. Uh All right. So, um we're gonna go through a bit similar to the last lecture I did. If you, if you watch that, we're gonna go through some S PA S, we'll just do the questions first and we'll do the answers after we've done the theory. So hopefully that way it stays a bit more permanent, the answers. Um There were some responses from the last time trying to make the questions a bit harder I've tried to make them more broad rather than harder. Um But we'll see how we go and then we're going to go through a case. So it's kind of like a paces style and then we'll go through some theory and then at the end, we'll go through um immunizations and try to make that a bit fun because it's quite difficult to remember the vaccine schedule. Um It's one of those things that you either learn like the night before. Remember if the exam and forget or you have to find like a creative way to remember it. Um So these are some of the infectious diseases we're gonna go through. Hopefully, the slides are still swapping each time. Um And we'll start off with the SBS first. Um So the first case is a 60 year old boy who's presented with a three day history of fever, cough and conjunctivitis. Um He's been feeling irritable with poor feeding and on examination, you see a maculopapular rash and mum said it started on his face and then it noticed to be on his trunk, he's febrile and he's also unvaccinated. So that might help. Uh So what is the most likely diagnosis? Um Again, like in the last lecture, feel free to answer this at home in your own time and your own space or feel free to pop it in. If there, if there is a poll in the chat again, feel free to answer on that uh, whatever is most comfortable for you. I'll give you about, um, uh, 30 seconds for this one. Ok. Good. So I can see some people, um, have answers. So, always good to have a go. But again, if you don't feel comfortable having a go, just have a go at home. All right. So we'll move on and we'll go through the answers later. So, question two is a six year old boy is coming to the GP with a two day history of fever, malaise sore throat, some facial redness that started yesterday. And when you examine them, you see flushing of the cheeks and then a fine blanching, rough erythematous rash on their neck. Uh The tonsils are eryth met and they also have an erythematous nontender line creases in the elbow. Sorry, in the elbow. Question is when can they return to school? So again, I'll give you 30 seconds to have a go at that one. All right, good. So, um there's a bit of a broad range of answers there. So that's good. We can go through uh moving on to the next one. Question three. a five month old girl is brought to Ed with a fever for two days, reduced activity and feeding and on examination, she looks quite unhappy. Her respiratory rate is 49. Her heart rate is 100 and 50. She has reduced skin turgor and she looks pale. Which of the following is the most concerning feature. Ok. Good. And we'll move on to the, the final one. Um, question four. You've got a six week old baby boy being brought to the GP with poor feeding in the last 24 hours. Um, she, as in mum has noticed that he is feeling warm but hasn't noticed any cough or, or symptoms. He's due to have his immunizations next week and he's having wet and dirty nappies on examination. He has a raised temperature 38.9. He's irritable but his chest and his abdomen, examinations are normal. What is the most appropriate management here? Sorry. C is supposed to say suspected infection, treated with antibiotics and just put whatever you think feels right. Don't put what everyone else is putting, it doesn't matter if you get it wrong, no one's gonna know. All right, 10 more seconds and then we'll move on. All right. Ok. So now what we're gonna do is go through a case of a febrile child and what you would do in your cases scenario. So let's say you're outside the door and your paces scenario says on the door, you're an F one in A&E you've got a three month old baby presenting with two day history of fever, cough and coris symptoms. So you've got two minutes before you're allowed to enter. You need to be thinking, what am I gonna ask in the history? What's key that I need to ask? What examinations do I need to perform. What red flags do. I need to make sure I rule out and how am I gonna structure my management plan? You should already have that. That's high bloods imaging MDT in the back of your head. Um But what would be good is for the next minute or so, if you just quickly think of like three key things, you need to make sure you cover in history, three key examinations, you need to do three key red flags and then maybe one of each of the management scenarios before we run through each. Ok. So this is really for any child who comes in with a fever. But obviously, in this case, we're gonna talk through a three month old baby. Um, and it's quite key that they're three months because that will depend on what we do. So have a think uh and then we'll go over it. All right, I'm conscious. I don't know how much people do engage. So if we start with a history then, so we've got someone who's coming in with a fever. So, um what you need to cover for any fever, you need to know how long they've had that fever for. Exactly. When did it start? It started at five? Was that 5 a.m. five PM? How long has it been? How high that temperature has been? And the specific number you need to know