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SMS Week 4 > Clinical Virology > Flashcards

Flashcards in Clinical Virology Deck (72):
1

What is the difference between an exanthem and an enanthem?


an exanthem is expressed on the cutaneous surface

an enanthem is expressed on mucosal surface

2

What does HPV cause?


common warts, plantar warts, genital warts, condylomata

3

How is HPV transmitted?


person to person by contact or through fomites

does not have any connection to a specific season

4

What is the incubation period for warts?


3 months to many years

5

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


apply acetic acid and see if it turns white

6

What is the treatment for HPV?


liquid N2, various acids, podophylium, last, surgical

7

What virus causes molluscum contagiosum?


poxvirus

8

What does mulloscum contagiosum look like?


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

9

How is molluscum contagiosum spread?


humans are the only known source of infection

spread by contact or through fomites

non-seasonal

10

How long is the incubaton period for moluscum contagiosum?


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

11

What is the management of molluscum contagiosum?


mechanical removal of the central core which contains the virus

freeze with liquid N2, burn with acids

12

What does variola (smallpox) look like?

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

How is small pox spread?


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

winter and spring are the peak incidences

14

WHat is the management of smallpox?


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

15

Who gets Orf virus?


sheep herders

16

What does Orf virus present as?

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

typically just a solitary lesion

17

How is orf virus spread?


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

18

What is the technical name for what Orf virus causes?


Ecthyma contagiosum

19

What is the management of Orf virus?


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

 

wear gloves to prevent it in the future

20

WHat virus causes chicken pox?


varicella zoster - a herpes virus

21

WHat is the typical clinical course for a chickenpox infection?

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

22

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


Reye syndrome

23

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

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

24

How do you manage chickenpox?


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

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

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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

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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

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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

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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

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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

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71


What will present with perioral palor, sandpapery rash on face, and red lines in skin creases?


Scarlet fever - streptococcus

72