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SMS Week 4 > Clinical Virology > Flashcards

Clinical Virology Flashcards

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1
Q

What is the difference between an exanthem and an enanthem?

A

an exanthem is expressed on the cutaneous surface

an enanthem is expressed on mucosal surface

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2
Q

What does HPV cause?

A

common warts, plantar warts, genital warts, condylomata

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3
Q

How is HPV transmitted?

A

person to person by contact or through fomites

does not have any connection to a specific season

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4
Q

What is the incubation period for warts?

A

3 months to many years

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5
Q

Besides clinical inspection, how can the diagnosis of HPV be made?

A

apply acetic acid and see if it turns white

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6
Q

What is the treatment for HPV?

A

liquid N2, various acids, podophylium, last, surgical

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7
Q

What virus causes molluscum contagiosum?

A

poxvirus

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8
Q

What does mulloscum contagiosum look like?

A

discrete, papular waxy lesions that gradually develop on the surface of skin. Each will have an umbilicated appearance

usually only a few are present, but in a generalized location

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9
Q

How is molluscum contagiosum spread?

A

humans are the only known source of infection

spread by contact or through fomites

non-seasonal

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10
Q

How long is the incubaton period for moluscum contagiosum?

A

2 to 7 weeks, but as long as 6 months in some

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11
Q

What is the management of molluscum contagiosum?

A

mechanical removal of the central core which contains the virus

freeze with liquid N2, burn with acids

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12
Q

What does variola (smallpox) look like?

A

a vesiculated rash that spreads from a distal distribution to central.

people will have associated headache, fever (102-105 degrees(, extreme malaise and muscular pains preceed the rash.

THe rash will develop with same stages in local crops and become encrusted during development

THIS WILL LAST FOR 2 WEEKS

resolves with significant scarring

the hemorrhagic form is highly fatal

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13
Q

How is small pox spread?

A

direct contact with skin lesions and mucous membranes, human transmission although some animal poxviruses can be transmitted

winter and spring are the peak incidences

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14
Q

WHat is the management of smallpox?

A

strict isolation

symptomatic treatment

we previously used active immunization, but stopped giving the vaccine in the 70s because we cleared it out of the US

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15
Q

Who gets Orf virus?

A

sheep herders

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16
Q

What does Orf virus present as?

A

Starts with an erythematous papule - usually on the fingers, which vesiculates

typically just a solitary lesion

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17
Q

How is orf virus spread?

A

from working with sheep - it’s a zoonosis usually seen in spring after shearing season

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18
Q

What is the technical name for what Orf virus causes?

A

Ecthyma contagiosum

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19
Q

What is the management of Orf virus?

A

the duration is usually 30 to 40 days and resolves spontaneously with only symptomati care.

wear gloves to prevent it in the future

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20
Q

WHat virus causes chicken pox?

A

varicella zoster - a herpes virus

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21
Q

WHat is the typical clinical course for a chickenpox infection?

A
  1. general malaise with mild fever
  2. pruritic rash develops centrally on head and trunk and then spreads to periphery
  3. Rash rapidly develops from macule and papule to vesicle in 24 hours
  4. Rash clears in 10 days
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22
Q

WHat complication can occur if you give a child with chickenpox aspirin?

A

Reye syndrome

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23
Q

When is someone with chickenpox able to pass it along to others?

A

from 1-2 days before the rash starts to about when the rash begins to crust over (about 5 days)

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24
Q

How do you manage chickenpox?

A

strict isolation

do NOT use aspirin

aboid hospitalization exposure to immune incompetent individuals

vitamin A

orgal acyclovir within 24 hours maybe helpful, but not by that much

we can use active immunization now

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25
What does the clinical course look like for herpes simplex?
you get a stinging erythematous lesion at the junction of the skin and lip which proceeds to a crusted sore over a few days but lasts up to 10 to 12 days no systemic symptoms you can also get lesions of the oral cavity or genital region
26
What is a herpetic whitlow?
a herpes lesion on the finger tip seen in kids who have oral herpes infections and suck their fingers
27
How is herpes simplex transmitted?
direct contact, sexual contact, birthing contact non-seasonal but associated with stress
28
How long are people infected with herpes?
it's a latent and recurrent infection, so always
29
How can you manage herpes simplex?
drying agents acyclovir ointment locally oral or IV acyclovir, famciclovir, valacyclovir, or penciclovir
30
What is the issue with herpes passed from mother to infant during birth?
newborns will contract a very severe form which is often fatal
31
How does exanthem subitum (roseola) present clinically?
Usually in infants they develop high fever with minimal respiratory symptoms preceding the patients will not be toxic - usually still playful after 3 days the fever will break, but you get a fine maculopapular rash that develops on the neck and trunk which will last for about 2 days
32
What virus causes exanthem subitum?
herpes virus 6 and 7
33
How is roseola transmitted?
probably through nasopharyngeal droplets
34
When are patient swith roseola infectious?
during the early febrile stage - once the rash starts they're not infectious anymore
35
What is the main sequela of concern in roseola?
febrile seizure because of the high fever
36
What is the management for roseola?
antipyretics to avoid febrile seizure no isolation really needed gangiclovir?
37
Why are patients with roseola frequently misdiagnosed with a penicillin allergy?
They are given the penicillin during the fever and then when they develop the rash a few days later it is assumed it's a reaction to the penicillin
38
How does ebstein barr infection present?
often with sore throat, mild fever, enlarged lymph nodes and extreme tiredness. can have splenomegaly can get a maculopapular rash on the runk jaundice may occur in severe cases
39
What will a blood smear show in an epstein barr infection?
atypical lymphocytes
40
How is mono transmitted?
close contact and pharnygeal secretions not seasonal
41
How long is the incubation period for mono?
acutally quite long - about 30 to 50 days
42
How long is someone infectious with mono\>
can be infectious for months after symptoms clear
43
What test is used to check for mono?
a mono spot test to check for heterophile antibodies
44
How is mono managed?
symptomatic treatment avoid contact sports for the spleen possible steroids observe for jaundice
45
What drug do you NOT want to give someone with mono?
Ampicillin - it makes the rash worse
46
What disease does coxsackie virus cause?
hand, foot, and mouth disease | (if just the mouth = herpangina)
47
How does hand, foot and mouth disease present?
malaise and mild fever sore throat lesions in mouth and on extremities enanthem occurs withint one or two days after onset of symptoms and exanthem is after that lesions can ulcerate in the posterior pharynx lesions clear within a week
48
How is hand, foot, mouth spread?
nasopharyngeal droplets saliva fecal-oral **peaks in summer and early fall**
49
How does echo virus present?
flu-like process with mild fever, malaise, abdominal cramping, diarrhea and a non-specific maculopapular rash on the trunk the rash will fade over a 5-day period after the other symptoms have resolved
50
How is echo virus transmitted? When?
fecal to oral route peaks in summer and early fall
51
What disease is caused by parvovirus?
Fifths disease - erythema infectiosum
52
How does fifths disease present?
mild upper respiratory illness red, slapped cheek rash on face face rash faes and can be replaced with a lacy rash on the upper extremities the extremity rash may fade, only to return in a couple of weeks maybe joint complaints
53
How is parvovirus spread? When?
nasopharyngeal droplets and maybe via blood peaks in spring
54
When is a patient infectious with parvovivrus?
from before onset of the rash to shortly after rash appears
55
WHy are teachers particularly concerned about parvovirus?
it's a big issue for teachers who might be pregnant because it can cause significant problems if exposure in 1st trimester
56
What does paramyxovirus cause?
rubeola = measles
57
How does measles present?
In an unvaccinated individual..... upper respiratoy symptoms with rhinitis and cough followed by conjunctivitis discrete red rash that gradually becomes confluent spreading from central to distal fever oral lesions called koplik spots is totally diagnostic
58
How is paramyxovirus spread? when?
nasopharyngeal droplets and direc tcontact peaks in winter and spring (and in two to 5 year cycles)
59
When is a patient with measles infectious?
1-2 days before onset of symptoms to the 4th day after onset of rash
60
How is measles managed?
you can use immune globulin in exposed susceptibles isolation, symptomatic meds, vitamin A prevent with actieve immunization!
61
What disease does Toga virus cause?
rubella = german measles | (bastard scarlatina)
62
How does rubella present clinically?
upper respiratory symptoms malaise low grade fever fine maculopapular rash develops on upper body and spreads to lower body rash clears rapidly over 3 days Enanthem = forchheimer spots on soft palate joint pain cervical lymph nodes - particularly the suboccipital and posterior auricular nodes
63
How is toga virus spread? When?
nasopharyngeal droplets, direct contact, maybe stool and urine peaks in winter and spring; occurs in 6-9 year cycles
64
WHen is a patient with rubella infectious?
7 days before onset of rash to 5 days after onset of rash
65
How is rubella managed?
symptomatic meds isolation immun globulins in early exposure - especially in susceptible pregnant women we have active immunization against this one
66
What is the worry with rubella in pregnant women?
It can be transplacentally given to the baby they will have blueberry baby syndrome with symptoms of the CNS, cardiac, hearing, eyes and skin
67
How is dengue fever spread?
mosquito bites! not present above or below 25 degrees N or S Not seen in the winte rmonths
68
How does dengue fever present?
high grade fever suddenly lasting for 1-5 days joint pain sore throat and cough general malaise vomiting after the fever a non-descript, generalized rash develops sparing the soles and the palms. patient iwll be ill and toxic there is a fatal hemorrhagic form
69
What are somethings you shoul dinclude on yoru differential diagnosis when someone presents with a fever and rash?
pityriasis rosea scarlet fever impetigo meningococcemia
70
What is the hallmark of pityriasis rosea?
the herald patch following a dermatomal pattern
71
What will present with perioral palor, sandpapery rash on face, and red lines in skin creases?
Scarlet fever - streptococcus
72

SMS Week 4 (15 decks)

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