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Block 7 Week 2 > Verma: Viral Exanthems > Flashcards

Verma: Viral Exanthems Flashcards

1
Q

A skin eruption occurring as a symptom of a general disease.

A

exanthem

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2
Q

Eruptive lesions on the mucous membranes.

A

enanthem

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3
Q

This is the most common viral exanthem; 1st disease; it was eliminated in the US in 2000

A

measles

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4
Q

How is measles acquired?

A

direct or airborne droplets

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5
Q

How long is the measles incubation period? How long is the infectious period?

A

7-18 days

1-2 days prior to prodrome, 4 days after rash onset

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6
Q

Is measles contagious?

A

YES, highly contagious!

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7
Q

What occurs during the prodrome phase in measles? When does the prodrome phase occur?

A

fever, coryza, conjunctivitis, cough (3 Cs); occurs 2-4 days before Koplik spots and 3-5 days before exanthem (rash)

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8
Q

How does the measles exanthem begin? Then what happens to the lesion?

A

around the ears as irregular macules; lesions spread to trunk in 24-48 hours, become more papular (purplish/red) and last 3-5 days

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9
Q

How can you diagnose measles?

A 
Koplik spots, exanthem (rash)
IgM in acute serum *most rapid detection
PCR of throat swab looking for paramyxovirus
Viral cultures
Serial IgG
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10
Q

List some measles complications

A

otitis media
pneumonia
encephalitis
blindness due to Vit A deficiency

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11
Q

This is one of the first diseases to reappear when vaccine rates fall

A

measles

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12
Q

What should international travelers be given to avoid measles?

A

2 doses MMR

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13
Q

How to treat measles?

A

supportive treatment
Vit A in malnourished children
Live attenuated vaccine *prevention
Post-exposure prophylaxis with vaccine w/i 3 days or Ig within 6 days with vaccine 5-6 months later

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14
Q

Togavirus; “German measles;” 3rd disease

A

Rubella

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15
Q

How is rubella spread?

A

direct contact and droplets

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16
Q

How long is the incubation period in rubella? How long is the infectious period?

A

14-21 days; 5-7 days before rash onset, 3-5 days after rash

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17
Q

What does rubella present like clinically?

A

asymptomatic infection in up to 50% or low grade fever

children: rhinorrhea, cough, sore throat

adolescents/adults: malaise, sore throat, nausea, anorexia

enanthem

Forschheimer’s spots: petechiae on hard palate

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18
Q

What are Forschheimer’s spots?

A

petechiae on the hard palate

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19
Q

How does the rash in rubella start? What is one notable feature of the rash? How is it different from the measles rash?

A

starts on the face and then fades from face w/i 24 hours;
notable feature: appearance rapidly changes in 24 hours;
pink-red lesions in rubella, instead of purplish-red lesions in measles

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20
Q

What is the diagnostic testing for rubella?

A

IgM or IgG in serum

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21
Q

What are some complications of rubella?

A

arthralgias/arthritis in older pts
peripheral neuritis, encephalitis
congenital rubella syndrome: cataracts, microencephaly, deafness, cadiac defects, anemia, low platelets

22
Q

When is a fetus at risk of becoming infected with rubella?

A

30-50% risk if mother is infected during the first 6 weeks of the pregnancy **early in first trimester

23
Q

What causes fifth disease, or erythema infectiosum?

A

human parvovirus B19

24
Q

How long is the incubation period for fifth disease? How long is this disease contagious?

A

4-14 days; only contagious in the first stage

25
Q

Over 50% of fifth disease infections are (blank)

A

asymptomatic

26
Q

How do you diagnose fifth disease?

A

detection of serum parvovirus B19-specific IgM antibody

27
Q

What happens on day #1 in patients with fifth disease? What is unique about this stage of the disease?

A

slapped cheek appearance; it is contagious during this first stage

28
Q

What happens on day #2 in patients with fifth disease (2nd stage)? What happens on day #6 (3rd stage)?

A

erythematous maculopapular eruption; reticular pattern of rash which lasts 9-11 days

29
Q

What cells does the parvovirus B19 infect? So what are some complications?

A

erythrocytic precursors; can cause hemolysis and anemia, may need RBC transfusion, may cause hydrops fetalis (severe anemia leading to cardiac failure)

30
Q 
2nd syndrome ascribed to Parvovirus B19
Spring/Summer
Young Adults
Exanthem, LAD, fever, anorexia, arthralgias
Self-limited over 7-14 days
Viremia clears after rash
A

Papular purpuric glove and sock syndrome

31
Q

What is Roseola infantum also called? What viruses cause this disease?

A

6th disease; Human herpes virus 6 and 7

32
Q

What is unique about the infectious period of roseola infantum?

A

the virus is intermittently shed into the saliva throughout life, causing an asymptomatic persistent infection

33
Q

How does roseola present clinically?

A

high fever for 3-4 days
followed by abrupt appearance of rash, which begins on the trunk and spreads to extremities

  • *otherwise well-appearing child
  • *febrile seizures may occur
34
Q

How is herpes simplex transmitted?

A

through abraded skin or intact mucous membranes

35
Q

What are the symptoms of herpes simplex infection?

A

painful, recurring vesicular eruptions that are worse primarily than they are when they recur;
fever, LAD, and malaise w primary infection;
prodromal tingling, burning or pain

36
Q

Two ways in which varicella zoster (chicken pox) is spread?

A

respiratory droplets

vesicle fluid

37
Q

Symptoms of the prodrome phase of chicken pox?

A

asymptomatic to fever, malaise, cough, coryza, sore throat

**coryza: inflammation of mucous membranes of the nose

38
Q

One complication associated with chicken pox?

A

secondary bacterial infection

**occurs 5-10% of the time

39
Q

What would you give an immunocompotent patient if they were exposed to varicella zoster?

A

varicella vaccine prophylaxis w/i 72hrs

40
Q

Treatment for herpes viruses, including chicken pox?

A

acyclovir

41
Q

What age are the majority of shingles patients? What is one complication with immunocompromised patients?

A

> 50yo; reactivation of the virus may occur multiple times

42
Q

Describe the progression of small box

A

prodrome phase: chills, fever, backache, malaise

exanthem starts on face/forearms and spreads to trunk and legs last (centrifugal - from distal to core)

macular vesicles –> papular vesicles –> thick walled pustules

43
Q

What drug WAS used for small pox?

**it has been eradicated globally

A

anti-viral cidofovir

44
Q

Enteroviruses, like coxsackie A16 cause this disease…

A

hand-foot-and-mouth disease

45
Q

What symptoms does hand-foot-and-mouth disease cause? Is it contagious?

A

highly contagious; low-grade fever, anorexia, malaise, sore mouth, rash

46
Q

So what would be the difference b/w enantham and exanthem?

A

enantham is in the mucous membranes, while exanthem is in the skin

47
Q

What virus causes herpangina? What is it?

A

Coxsackie A virus; painful mouth ulcers preceded by fever and sore throat

48
Q

What does enterovirus D68 cause?

A

severe respiratory illness

pin pointed generalized rash

49
Q

How does enterovirus D68 spread?

A

from person to person through coughs, sneezes, or contaminated surfaces

50
Q

Pink macules and papules surrounded by white halos. Begins on trunk, spreads to neck and proximal extremities.

A

roseola infantum (exanthem subitum)

Block 7 Week 2 (9 decks)

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