rash

Question 1

differentials for rash in a child

Question 2

Child with fever + conjunctivitis + irritable.
Maculopapular rash - started behind ears before spreading and becoming blotchy and confluent

Answer 2

measles

Question 3

rash in measles

Answer 3

Maculopapular rash - started behind ears before spreading and becoming blotchy and confluent

Question 4

child wit fever + conjunctivitis + white spots on buccal mucosa

Answer 4

measles

Question 5

child with fever + conjunctivitis + desquamating rash + strawberry tongue

Answer 5

kawasaki

Question 6

child wit fever, fine punctuate erythematous rash with sandpaper like texture, strawberry tongue

Answer 6

Scarlet fever

Question 7

maculopapular rash appears 48 hours after high fever = ?

Answer 7

roseola infantum

Question 8

Child: sore throat + low grade fever
Vesicles in the mouth and on the palms and soles of the feet

Answer 8

Hand foot and mouth disease

Question 9

cx of kawasaki disease

Answer 9

Coronary artery anuerysm

Question 10

What rash does mycoplasma pneumoniae cause

Answer 10

erythema multiforme
erythema nodosum

Question 11

causative organism in toxic shock syndrome

Answer 11

staph auerus

Question 12

features of congenital rubella

Answer 12

sensorineural deafness
congenital cataracts
congenital heart disease (e.g. patent ductus arteriosus)
growth retardation
hepatosplenomegaly
purpuric skin lesions
‘salt and pepper’ chorioretinitis
microphthalmia
cerebral palsy

Question 13

features of eczema herpeticum

Answer 13

Hx of atopic eczema
Sudden eruption of painful, edematos vesicles and pustules
Systemically unwell + fever

Question 14

Dry cough + atypical chest signs + autoimmune hemolytic anaemia + erythema multiforme

Answer 14

mycoplasma pneumoniae

Question 15

clin f of erythema multiforme

Answer 15

Ault with erythematous lesions on the hands that spread to the torso following a herpes simplex infection

Question 16

MCC cx of measles

Answer 16

encephalitis

Question 17

what association does HSP havae

Answer 17

IgA nephropathy

Question 18

rash in scarlet fever

Answer 18

fine, erythematous ‘sandpaper’ rash more prominent in flexural areas

Question 19

Mng chickenpox

Answer 19

Supportive: keep fingernails short, puritis with antihistamine, relieve discomfort with paracetamol and avoid NSAIDS

Aciclovir if high risk, adult

Question 20

When would antivirals be indicated in mgn chickenpox

Answer 20

Immunocompetent children who are at increased risk of severe chickenpox, including extensive cutaneous lesions and complications (eg pneumonitis, encephalitis, hepatitis). This includes children:

with significant pre-existing skin disease (eg eczema)
with chronic lung disease
using inhaled or oral corticosteroids
older than 12 years who have not been vaccinated for chickenpox.

Question 21

Isolated fever in well patient in first 24 hours following surgery?

Answer 21

Think physiological reaction to operation

Question 22

scarlet fever age

Answer 22

2-6yo

Question 23

rash features scarlet fever

Answer 23

fine punctuate erythematous spares perioral
sanpaper like texture
flexural areas- begins at torso

Question 24

associated features scarlet fever

Answer 24

strawberry tongue
fever
tonsillitis
malasie

Question 25

scarlet fever mng

Answer 25

Throat swab Penicillin V for 10days Notifiable school commencement after 24hours starting abx

Question 26

characteristic rash for juveniliie idiopathic arthritis

Answer 26

salmon pink rash

Question 27

features of ITP in children

Answer 27

Features bruising petechial or purpuric rash bleeding is less common and typically presents as epistaxis or gingival bleeding ITP in children is typically more acute than in adults and may follow an infection or vaccination.

Question 28

pathphys ITP

Answer 28

Immune (or idiopathic) thrombocytopenic purpura (ITP) is an immune-mediated reduction in the platelet count. Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex. It is an example of a type II hypersensitivity reaction.

Question 29

Mng ITP in children

Answer 29

usually, no treatment is required ITP resolves in around 80% of children with 6 months, with or without treatment advice to avoid activities that may result in trauma (e.g. team sports) other options may be indicated if the platelet count is very low (e.g. < 10 * 109/L) or there is significant bleeding. Options include: oral/IV corticosteroid IV immunoglobulins platelet transfusions can be used in an emergency (e.g. active bleeding) but are only a temporary measure as they are soon destroyed by the circulating antibodies

Question 30

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd003.jpg

Answer 30

erythema multiforme

Question 31

conditions associated with kobner

Answer 31

psoriasis vitiligo warts lichen planus lichen sclerosus molluscum contagiosum

Question 32

mng of roseola infanatum

Answer 32

supportive

Question 33

Features of roseola infanatum

Answer 33

high fever 48 hours prior - maculopapular rash: torso -> limbs

Question 34

rash description in chickenpox

Answer 34

itchy rash: starting at head/trunk then spreading Macular-> papular-> vesicular

Question 35

mumps features

Answer 35

Fever, malaise, muscular pain Parotitis ('earache', 'pain on eating'): unilateral initially then becomes bilateral in 70%

Question 36

Rash rubella

Answer 36

Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day

Question 37

Rubella associated features

Answer 37

Lymphadenopathy: suboccipital and postauricular

Question 38

rash in erythema infectiosum

Answer 38

slapped cheek bilateral-> prox arms and extensor surfaces

Question 39

Associated features in erythema infectiosum

Answer 39

lethargy, fever, HA

Question 40

HFM cause

Answer 40

Coxsackie A16