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Medicine > Dermatology - Viral, Hansen's > Flashcards

Dermatology - Viral, Hansen's Flashcards

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1
Q

Rubella effect on fetus greatest risk during

A

First 4 weeks

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2
Q

5% of fetus exposed to rubella within 4 weeks develop

A 
Microcephaly with mental retardation
Congenital heart disease
Sensorineural deafness
Cataracts
Low birth weight
Fetal death
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3
Q

Differential diagnosis
Rubella
Most likely

A

Drug hypersensitivity rxn

Rubeola (measles)

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4
Q

Differential diagnosis
Rubella
Consider

A

Other viral infection (enterovirus, adenovirus, parvovirus, human herpes virus-6)

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5
Q

Differential diagnosis
Rubella
Rulle out always

A

Streptococcal scarlet fever

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6
Q

Rare complications of rubella

A 
Peripheral neuritis
Optic neuritis
Myocarditis
Pericarditis
Hepatitis
Orchitis
Hemolytic anemia
Encephalitis
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7
Q

Tx

Uncomplicated rubella

A

Supportive

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8
Q

Tx

Non pregnant individual

A

Rubella vaccine within 3 days of exposure

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9
Q

recommendation for neonates with rubella syndrome

A

Supportive care

Contact isolation until 12 months old or if repeated cultures are negative after 3 months age

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10
Q

Rubella vaccime administered as

A

MMR
12-15 mos
4-6 years

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11
Q

Potential adverse rxn rubella vaccine

A

Fever
Morbilliform rash
Lymphadenopahy
Arthralgia

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12
Q

Should pregnant women be immunized to rubella

A

False

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13
Q

Any woman receiving rubella vaccine should not become pregnant for

A

28 days

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14
Q

T/F

Infants of vaccinated breast feeding mother may become infected with rubella via breastmilk

A

T

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15
Q

How to detect rubella infection in fetus

A

Cordocentesis - IgM antibodies

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16
Q

Transmission measles

A

Direct or airborne contact with infectious droplets

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17
Q

Incubation measles

A

9-12 days

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18
Q

Measles

Patients contagious if

A

1-2 days before onset of sx

Up to 4 days after appearance of rash

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19
Q

Needed immunity to control Measles

A

Humoral

Cell-mediated

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20
Q

Ig involved measles

A

IgM initially then IgG

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21
Q

Controls viral replication and confers antibody protection

A

Humoral

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22
Q

Eliminates infected cells

A

Cell- mediated

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23
Q

Effect of Measles on immunity

A

Transient immunosuppression

  1. Depressed delayed hypersentitivity
  2. Depressed T cell counts
  3. Inc. Risk bacteria
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24
Q

vaccine measles effect on measles

A

Less severe sx

Prolonged incubation 14-20 days

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25
Immunosuppressed | Measles presentation
Severe disease | Can present without typical rash
26
Prodrome Measles lasts for
4 days
27
Prodrome Measles
``` Fever 40-40.5 C Malaise Coryza Cough (brassy/ barking) Conjunctivitis (palpebral, lid margin) ```
28
Catarrhal inflammation of the mucrous membrane in nose esp by cold or by hay fever
Coryza`
29
Pathognomonci enanthem of measles
Koplik spots
30
Koplik spots typically seen
Buccal mucosa, near second molars
31
Koplik spots appear
1-2 days before | Lasta 2 days after onset of rash
32
Exanthem is erythematous, non-pruritic, macules and papules that begin on forehead, behind the ears
Measles
33
Rash progression | Measles
Neck, trunk, extremities Hands feet involved Leasion coalesce (face, neck)
34
Measles | Rash peak
3 days
35
Measles Rash Disappear
4-5 days after appearance | Desquamation may occur
36
Measles | Seen in inviduals who received formalin inactivated measles then exposed to wild-type virus
Atypical measles infection
37
Not present in atypical measles
Coryza, conjunctivitis, koplik spots
38
Maculo-papular, hemorrhagic, vesicular, uritcarial | Spreads centripetally
Atypical measles
39
Atypical measles difficult to distinguish from
Rock mountain spotted fever
40
Lab abormalities meases
Monocytosis Leucopenia Thrombocytopenia
41
Pharyngeal virus shedding of measles end by
2nd day rash
42
Most common complication of measles
Otitis media Pneumonia Diarrhea Laryngotracheobronchitis
43
Most common fatal complication of measles in children | Most common complication adults
Pneumonia
44
Prodromal sx of measles mimic
Influenza-like illness
45
Tx measles
Supportive Antibiotics - secondary bacterial Ribavirin
46
Vit supplement | Measles risk fatality 1%
Vit A
47
Individuals who should receive immunoglobulin prophylaxis of measles
At risk children less than1 yr, pregnant women, unimmunized, immunocompromised prophylaxis Within 6 days of exposure Within 72 hours -will not get infection
48
Measles vaccine given after immunoglobulin to confer lasting protection when
5 months later (except pregnant, impaired immune system)
49
Common potential side effects of measles vaccine include
Fever | Transient morbilliform rash that resolve w/o tx
50
Ci measles vaccine
Moderate to severe illness Allergic to eggs or neomycin Pregnant Impaired immune systems
51
How many months off chemo or immunosupressive agent can you give measles vaccine
3 months
52
Rubella transmission
Direct | Droplet contact
53
Rubella shed virus
5-7 days before | 14 days after onset
54
Rubella infection can lead to lifelong immunity
T
55
Congenital rubella , can shed virus for up to
12 months after birth
56
Prodrome rubella
Low-grade fever, rhinitis, cough, sore throat, lymphadenopathy
57
Enanthem | Tiny red macules on soft palate and uvula
Forsheimer spots
58
Enanthem that appears in rubella but not diagnostic
Forsheimer spots
59
clustered, white lesions on the buccal mucosa (opposite the lower 1st & 2nd molars) and are pathognomonic for measles.
Koplik spots
60
Koplik spots manifest
2-3 days before measles rash appear
61
Rash progression rubella
pink to red macules and papules begin to erupt on the face, quickly progressing to involve neck, trunk, and extremities Lesions on the trunk may coalesce, whereas those on the extremities often remain more discrete.
62
exanthem occurring 14 to 17 days after exposure, is characterized by pruritic pink to red macules and papules
Rubella
63
rash usually begins to disappear in 2 to 3 days,
Rubella
64
persistent and clears the head and neck first
Measles
65
Desquamation | Meales vs rubella
Both
66
Lymphadenopathy rubella | Area
Posterior cervical Suboccipital Post-auricular LN
67
Adult, women at risk to develop this complication with rubella
Arthritis
68
Lab rubella
Leukopenia Neutropenia Increase atypical lymphocytes Abundant plasma cells
69
Weakly acid-fast, causes leprosy
Mycobacterium leprae
70
M. Leprae grows best at
30 C
71
Unique glycolipid to leprosy bacillus
PGL-1 phenolic glycolipid 1
72
Leprosy favors growing
Intracellularly | Macrophages, nerves
73
Major cause of leprosy in some regions | Found in patients in mexico
Mycobacterium lepromatosis
74
Assoc with diffuse type lepromatous leprosy
M. Lepromatosis
75
Lucio’s leprosy
M. Lepromatosis
76
Invasion of endothelial cells by leprosy bacillus
Lucio’s phenomenon

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