Exanthems and Enanthems Flashcards
(108 cards)
1
Q
aka measles
A
rubeola
2
Q
prodrome symptoms of measles
A
*koplik spots, fever, severe cough, nasal congestion, conjunctivitis
3
Q
how does measles start/spread to
A
*begins behind the ears and then trunk then extremities
4
Q
tx for measles
A
VIT A, supportive
5
Q
hand foot mouth dz cause
A
coxaskie virus and enterovirus
6
Q
symptoms of hfmd
A
oral lesions -90%
3-7mm red macules that become pale, white, oval vesicles with a red areola.
Occur on the palms, soles, dorsal aspects of the fingers toes
7
Q
tx for hfmd
A
supportive
8
Q
scarlet fever cause
A
streptococcus toxins
9
Q
where does scarlet fever originate
A
pahrynx (strep throat) or skin
10
Q
scarlet fever PE findings
A
skin-sandpaper feel
pastias line
desquamation
throat- strawberry tongue
11
Q
tx for scarlet fever
A
amoxicillin (peds), PCN, cephs, erythromycin for PCN allergy
12
Q
rubella aka
A
german measles
13
Q
most imp consequences are to who when infected w/ rubella
A
the unborn
14
Q
rubella s/sx
A
soft palate petechiae (20%)
begins on neck/face then travels to trunk
15
Q
rubella classic triad of clinical effects
A
cardiac malformation, hearing deficits, and ocular anomalies.
16
Q
blueberry muffin, congenital cataract
A
rubella
17
Q
erythema infectiosum aka
A
fifths, parvovirus
18
Q
stages of parovirus
A
Stage 1: facial erythema (slapped cheeks)
Stage 2: Net pattern erythema
Stage 3: recurrent phase
19
Q
can fifths disease affect a preggers women
A
yes-can cross placenta
20
Q
roseala infatum presentation
A
Typically: VERY high fever, fever subsides and the rash appears
21
Q
how common if roseola
A
80% of all children by age 1, 90% by age 2 (95% in adults)
22
Q
prodrome of roseola
A
Sudden onset of high fever 102°F-104°F (39°C-40°C)
23
Q
eruptive phase of roseola
A
begins when fever ends
24
Q
tx for roseola
A
supportive
25
kawasaki disease etiology
acute multisystem vasculitis of unknown etiology (likely infectious cause)
26
main cause of morbidity for kawasaki disease
***coronary aneurysms
27
major criteria for kawaskie
MUST have FEVER for more than 5 DAYS
28
kawasakie tx
high dose ASA
IV IG
careful of reyes syndrome though
29
the viral rash
will not get definite dx
| usually diffuse rash all over body
30
major complications of measles
pneumonia****, bronchitits, otitis media, sinusitis, stomatitis, encephalitis and myocarditis (high risk of getting these)
31
what could happen 10 yrs after a measles infection
subacute sclerosing panencephalitis (SSPE)
32
can measles reactivate latent TB?
yes
33
best dx for measles
oral swab
34
what is the scarlet fever look alike rash
Arcanobacterium hemolyticum
35
what season does scarlet fever occur
late fall, early winter, early spring
36
class scarlet fever presentation
abruptly with fever and sore throat, then rash appears in 1-2 days
37
late complications of scarlet fever
include rheumatic fever and poststreptococcal glomerulonephritis
38
can include rheumatic fever and poststreptococcal glomerulonephritis be prevented with early strep tx?
no
39
complications of scarlet fever-what are they same as
strep infection
Peritonsillar abscess, cervical lymphadenitis, retropharyngeal abscess, otitis media, bronchopneumonia, meningitis, brain abscess, intracranial venous sinus thrombosis, bacteremia and septicemia
40
when season does rubella infections occur
late winter early spring
41
prodrome of rubella
fever, headache, malaise, tender lymphadenopathy (occipital, posterior auricular and cervical) and upper respiratory symptoms lasting 1 to 5 days
42
when season is fifths disease most likely to occur
spring, aged 4-10
43
progression of Erythema Infectiosum
“slapped cheek” rash develops that progresses to involve the trunk and extremities with erythematous macules, papules and patches. Eventually the truncal eruption fades to leave behind lacy, reticular pattern, occasionally itchy.
44
how is the dx of Erythema Infectiosum made
clinically
45
when are kids considered no longer contagious w/ Erythema Infectiosum
when the rash is apparent
46
describe the exanthem of roseola
pink, blanchable, macule papules that are usually not pruritic
47
tx for roseloa
self limiting but associated w/ febrile seizures
48
mumps is associated with...
a virus that causes inflammation in the parotid gland
49
is mumps serious or benign, asymptomatic/symptomatic
majority benign and asymptomatic
50
complications of mumps
```
Hearing loss
Rarely viral meningitis, encephalitis,
and pancreatitis.
Orchitis can occur in teens and young
adults. Infertility can occur in those
with orchitis.
Miscarriage can occur in women with
mumps in the first trimester.
```
51
can you get mumps even if you are vaccinated
yes - possibly due to waning immunity
52
what is varicella caused by
varicella zoster virus
53
when do ppl get varicella
90% <10 yrs
54
dew drops on rose petals
varicella
55
classic triad of varicella
rash, malaise, low grade fever
56
how does the rash present in varicella
in crops, from trunk first usually
57
how long are varicella pts contagious for
2 days before lesions erupt until they are all crusted
58
dx of varicella
clinically and confirmed by PCR
59
MC complication of varicella
secondary bacterial inf
60
tx of varicella
supportive, calamine lotion for itching
61
when do you need acyclovir for varicella
immunocompromised children and with VariZIG™ for highly susceptible individuals within 96 hours of exposure
62
what is herpes zoster caused by
reactivation of varicella zoster virus
63
how does zoster present
in a dermatomal pattern rarely crossing midline
64
tx for zoster
antiviral agents (eg, acyclovir) given early in the disease course shorten the recovery period and reduce the chance of postherpetic neuralgia
65
what is herpes zoster opthalmicus and is it an emergeny
herpes zoster of the opthalmic division of trigeminal nerve, EMERGENCY
66
what is ramsay hunt syndrome
herpes zoster oticus, is a reactivation of VZV that involves the facial nerve. Cranial nerves V, VI, VIII, and IX may also be involved.
67
where does HSV-1 and HSV-2 reactivate
HSV-1 reactivates predominantly in the trigeminal ganglia, called herpes labialis (shown)
HSV-2 reactivates in the lumbosacral ganglia, called herpes genitalis.
68
symptoms of HSV
painful ulcerating lesions
69
tx for HSV
typically self limiting BUT antivirals will shorten the course of symptoms and may help to prevent dissemination and transmission
70
herpetic whitlow
intensely painful infection of the hand caused by HSV
71
enterovirus season
usually summer months
72
GI symptoms + fever + rash
enterovirus
73
tx for enterovirus
usually self limiting
74
where is enterovirus shed and spread
via fecal oral route and shed in feces
75
hfmd is a variation of...
enterovirus
76
herpangia cause
nonpolio enteroviruses, coxsackieviruses A and B as well as echoviruses
77
presenting symptoms of herpangia
rapid onset of fever, vomiting, sore throat, and the appearance of numerous vesicular lesions in the region of the tonsillar fauces (anterior tonsillar pillars, tonsillar pillars, soft palate, uvula and posterior pharynx)
78
tx of herpangia
nonspecific, possible numbing mouth rinses
79
infectious mononucleosis presenting symptoms
lymphadenopathy* or pan-lyphadenopathy
splenomegaly in > 50% of patients
Could have ULQ pain
Characteristically prolonged, recovery takes 4 to 6 weeks, rarely 12 or more weeks
80
infectious mononucleosis is caused by
EBV
81
big thing to watch out for w/ mono
SPLENIC RUPTURE***
82
specific serology test for mono
EBV viral capsid antigen (VCA) Immunoglobulin (IgM) is the most accurate and useful tool for the diagnosis of Infectious
83
tx for mono
REST- NO PHYSICAL ACTIVITIES
| highest rate of splenic rupture is 2-3 wks
84
kawasaki caused by...
vasculitis caused by unknown etiology
85
dx of kawasaki
DO ECHO -**look for coronary aneurysms**
86
tx to prevent coronary aneurysms in kawasaki dz
aspirin and intravenous immunoglobulin, which reduces the risk for cardiac involvement to 5%.
87
steven's johnson syndrome cause...
response to triggers (infections, malignancies, medication)
| more severe version of erythema multiforme
88
difference between SJS and erythema multiforme
SJS may involve the mucous
| membranes (vs erythema multiforme that has NO muscous membrane involvement)
89
lymphangitis
inflammation of lymph channels
90
lymphangitis presentation
a red streak traveling up the arm, a raised border around the affected area, and lymphadenitis.
91
lymphangitis cause
is Streptococcus pyogenes
92
cellulitis cause
Streptococcus pyogenes and Staphylococcus aureus.
93
tx for cellulitis
activity against staphylococci and streptococci (eg, dicloxacillin, cephalexin, clindamycin, amoxicillin/clavulanate=augmentin
94
cellulitis presentation
fevers, chills, pain, swelling, tenderness, erythema, and warmth. The borders of cellulitis are NOT elevated or sharply demarcated.
95
lymphangitis vs cellulits
cellulitis- more diffuse, no elevations, no sharp demarcations
lymphangitis- streaking, elevated
96
Erysipelas
superficial bacterial skin infection that extends into the cutaneous lymphatics
97
Erysipelas cause
by group A streptococci, in many cases secondary to local skin trauma.
98
Erysipelas presentation
sharp, distinct outline, whereas cellulitis fades gradually into the surrounding skin.
99
impetigo cause
Staphylococcus aureus and group A beta-hemolytic streptococci (GABHS)
100
peak incidence of impetigo
summer and fall
101
tx for impetigo
topical mupirocin
102
H.S. purpura most serious complication
Intussusception
103
where does H.S. purpura usually present
below the waist
104
how to differentiate between idiopathic thrombocytopenic pupura and H.S purpura (lab test)
platelet count generally normal in HS
105
meningococal inf cause
Neisseria meningitides.
106
clinical presentation of miningitis
Children with meningitis are usually febrile and ill-appearing, with symptoms of lethargy, vomiting, or nuchal rigidity (doesn’t always happen)
107
complications of miningitis
Septic emboli cause arterial occlusion in the distal extremities, as shown in this infant.
The disease is fatal in 50 % of cases, if left untreated. Even with prompt treatment, the mortality rate is 5-10%
Septicemia leads to capillary leak, coagulopathy, profound acidosis, and myocardial failure
108
meninigitis tx
antibiotic treatment should be initiated without waiting for confirmatory culture testing. Initial antibiotic of choice is
Vancomycin + Ceftriaxone.
