Important skin changes in skin Blood and lymph

Question 1

Pathognomic characteristic of Measles

Answer 1

Koplik spots on the buccal mucosa are pathognomic

also see a maculopapular rash for 3-4 days after the onset of prodrome

Fever cough coryza and conjunctivitis

Question 2

Characteristics of Parovirus

Answer 2

Erythema Infectiosum in children or fifth disease is characterized by

• Slapped cheek appearance
• circumoral pallor
• maculopapular rash on the trunk and limbs

Question 3

what is the most common cause of myocarditis in childhood

Answer 3

Parovirus

Question 4

what other diseases does of parovirus B19 infection mimic

Answer 4

autoimmune states such as lupus, systemic sclerosis

antiphospholipid syndrome or vasculitis

Question 5

What is Ehrlichiosis

Answer 5

a rickettsial infection common in missouri

fever chills headache malasie, myalgia, nausea, vomittin, anorexia, photophobia

abdominal pain miicking appendicitis, conjunctival injection, paatal petechiae, edema of dorsal hands, calf pain

Neuroogical: altered menta lstatus, cranial or peripheral motor nerve paralysis, sudden deafness

Question 6

when does the erythematous macules appear on an erhrichiliosis patient?

Answer 6

5 days after onset of systemmic symptoms

Question 7

what is the rash that is present in lymes disease

Answer 7

Erythema migrans

Question 8

Stage 1 of Lymes disease

Answer 8

Early localized infection
Bulls eye lesion
viral like illness, mayalgias arthalgias headache fatigue and may have a fever

Question 9

Sage 2 of lymes disease

Answer 9

weeks to months later

Bacteremia with erythema migrans
-secondary skin lesions

myopericarditis with atrial or ventricular arrhythmias and heart block
maybe neurological symptoms
conjunctivitis

Question 10

Stage 3 of lymes diseae

Answer 10

late persistznt infection
months to years
-Musculoskeletal manifestations
-monarticular or oligioarticular arthritis of the knee or other large weight bearing joints 
Chronic arthritis

Question 11

can vesicle formation appear in Lymes disease

Answer 11

yes but does noot follow a dermatomal pattern like shingles

Question 12

What virus is associated with Infecious Mononucleosis and what test is positive to determine it?

Answer 12

EBV

Positive heteropjile agglutination test (monospot)

Question 13

Complications of Infectious Mononucleosis

Answer 13

Hepatitis, myocarditis, encephalitis, airway obstruction from adentitis, hemolytic anemia, thrombocytopenia

Question 14

What causes Syphillis

Answer 14

Treponema Pallidum

Question 15

What occurs in the first stage of Syphillis

Answer 15

Early stage

• Primary lesion, is chancre and regional lymphadenopathy
• second lesion is the skin and membranous membranes, bone or CNS and liver

Question 16

what consists of the late stages of syphillis

Answer 16

Benign lessions involving the skin bones and viscera
-cardiovascular disease principally aortitis
CNS and ocular syndromes

Question 17

what are some of the secondary lesions in syphillis

Answer 17

Condylomata lata

mucous patches on the hands and feet

Question 18

what does a Coxsackievirus infection lead to?

Answer 18

Hand foot and mouth disease

or

Herpangina

Question 19

Clinical findings of Hand foot and mouth disease

Answer 19

Stomatitis
Vesicular eruption rash on hands and feet
Nail dystrophies and onychomadesis

vesicles will quickly erode and form yellow to gray oval or football shaped erosions on th palms and feet

Question 20

Clinical findings of Herpangina

Answer 20

SUdden onsent fevers
headaches
Myalgias
Petechiae or papules on thes soft palate that ulcerated in about 3 days and then heal

Question 21

what can the strains of Staphyloccocal toxins produce what impoortant entities

Answer 21

• Scalded skin syndrome in children or bullious impetigo in adults
• Necrotizing pneumonia in children
• Toxic shock syndrome
• Entrotoxin in food poisioning

Question 22

Characteristics of TSS

Answer 22

Abrupt onset of fever, vpmitting and watery diarrhea

• diffuse macular erythematous rash and non prulent cinjunctiviis are common
• morbilliform, scarlatiniform or even pustular rash

Question 23

how is Scarlet Fever caused?

Answer 23

Group A Strep (pyogenes

Question 24

what is the most common cause of tonsillopharyngitis in children and adults

Answer 24

Grp A strep

Question 25

Characteristics of Scarlet Fever

Answer 25

Generalized punctuate red prominent on neck in axillae roin skin folds circumoral pallor Strawberry tongue Exudative Tonsillitis Group A beta hemolytic streptococcu in cultures from throat ANti streptolysin O titer ruse

Question 26

what di Erythema Multiforme look like and wht are most cases with these releated to?

Answer 26

Target lesions predominatly on the face and extremities Most cases are related to Herpes simplex virus and Mycoplasma Pneumoniae

Question 27

Defining characteristics of Varicella

Answer 27

aka CHicken pox - Rash that stays on face and trunk - Progress sequentially from rose colored macules to papules vesicles pustules and crusts - Lesions in all stages are present at the same time will go in to latent phase pf hiding in sensory andautonomic neurons and host immunity to VZV

Question 28

What is the cause of Gonococcemia and what is its classic triad and charcteristics

Answer 28

Bacterial infection by neisseria gonorrhoeae, a gram negative aerobic coccus shaped bacterium that is diplocci Common STD Classic Triad: - Dermatitis' - Migratory Polyarthritis - Tenosynovitis SKin findings consist of small to medium macules or most typically hemorrhagic vesicopustules on an erythmatous base loocated on palms and soles -slin lesions deveolp necrotic centers and led to a gun metal gray

Question 29

what causes Meningococcemia and how sdoes it present?

Answer 29

Neisseria Meningitidis Disseminated Meningococcal: - Meningitis alone - Acute meinigococcemia with or withoit meningitis - Chronic Meningococcemia

Question 30

What occurs in severe cases of Meningoccemia?

Answer 30

Necrosis and underlying tissue may necessitate amputation

Question 31

what does Acute Meningococcemia with disseminated intravascular coagulation may produce?

Answer 31

Purpura Fulminans

Question 32

What is the Pentad of TTP

Answer 32

Thrombotic THrombocytopenia Purpura - Microandiopathic Hemolytic anemia - Thrombocytopenia - Neurologic symptoms - Fever - Renal Failure

Question 33

How is TTP normally initiated?

Answer 33

Often an additional inflammatory trigger such as infection surgery pancreatitis or pregnacnt us required to initiate clinical TTP

Question 34

What to think when the purpura is palpable?

Answer 34

Vasculitis: - SLE - Sjorgens - Henoch Scholeins - Rheumatoid Arthritis Infection - Meningococcemia - Gonoccemia - RMSF - Endocarditis

Question 35

What to think when the purpura is not palpable?

Answer 35

Autoimmune - Idiopathic thrombocytopenia purpura - Thrombotic Thrombocytopenic purpura - Disseminated intravascular Coagulation - Other thrombocytopenia or platelet dysfunction - Clotting factor defect

Question 36

What is the most common form of cutaneous cancer? and how does it present

Answer 36

Basal cell carcinoma of the skin - Pearly palpable erythematous patch - waxy pearly apperance with telangiectatic vessels - Umbillicated bleeding

Question 37

How does squamous cell carcinoma present

Answer 37

Ulcer or warty nodule that is usually keratinized

Question 38

Risk factors of Melanoma

Answer 38

``` History of sunburns and heavy sun exposure Blue or green eyes Blonde or red hair Fair complexion >100 typical Nevi or any atypical Nevi Prior history or family history p16 mutation ```