Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

y6 uro & id > Viral Exanthema > Flashcards

Viral Exanthema Flashcards

1
Q

What are the causes of viral exanthema

A

Herpes simplex virus
Parvovirus B19 (slapped cheek/fifth disease)
Hand, foot, and mouth disease
Varicella zoster
Measles
Rubella
Molluscum contagiosum
Roseola infantum (HHV-6)
(Infectious mononucleosis)
(Zika virus
Dengues virus
West Nile virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is erythema multiforme and what is the most common causes

A

Type IV hypersensitivity reaction presenting with skin rash

  • Herpes simplex virus
  • Mycoplasma pneumoniae
  • Medications
  • Autoimmune disease
  • Sarcoidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features of erythema multiforme

A

Target-like lesions
- Starts as a red maculae and develops into target lesions 24h later
- 1-3cm
- Arises abruptly in successive crops over 3-5 days
- Upper > lower limbs
- May progress to bullae

EM Major: Haemorrhagic crusting of lips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the management for erythema multiforme

A

Usually self-limiting - no treatment needed

HSV → Aciclovir

Pruritis → Antihistamines and corticosteroids

If drug is causative → withdraw

Severe → admit + IV hydration + skin care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the cause of slapped cheek syndrome and what are the risk factors

A

Parvovirus B19, usually in outbreaks among school-aged children

RF: haemoglobinopathies, immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the signs and symptoms of parvovirus B19 infection

A

Prodrome for 2-3 days: fever, coryza, headache, N&V
(Latent for 7-10 days)

Rash:
- Malar rash with circumoral pallor (perioral sparing)
- Very hot to touch
- Followed by a lace-like rash on the trunk and extremities

Aplastic crisis – occurs in children with chronic haemolytic anaemia (sickle cell) or immunodeficient
Fetal disease – maternal transmission – leads to fetal hydrops, death due to severe anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What investigations should be done for suspected parvovirus B19

A

Clinical diagnosis

Can confirm with blood tests:
- Parvovirus serology (IgG, IgM)
- Parvovirus RT-PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management for Parvovirus B19

A

Supportive (self-limiting) - the rash usually peaks after a week and then fades
- Re-assure
- Emollients
- Ice-cold flannel to relieve discomfort/burning cheeks

NO school exclusion required
Safety net: anaemia, lethargy, pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is hand, foot, and mouth disease and what is the cause

A

Acute viral infection caused by enteroviruses

Enteroviruses: most commonly coxsackievirus A16
Otherwise enterovirus A71 (severe)
Highly infectious - several close contacts may be affected (outbreak)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs and symptoms of Hand, foot, and mouth disease

A

Macular, maculopapular or vesicular exanthema on hands, feet, buttocks, legs, arms
Oral vesicles that rupture to form ulcers on the tongue and buccal mucosa (enanthem): Peel off within a week, Grey in colour
Fever
Sore throat
Loss of appetite
Malaise
Mild diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the investigations and management for hand, foot, and mouth disease

A

Clinical diagnosis
(If any travel to South East Asia, Canada or America consider throat swab and EDTA serology for typing as causes more severe illness)

Supportive
(resolves within 7 days)
- Analgesia
- Difflam spray
- Hand hygiene

No school exclusion required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is molluscum contagiosum caused by and what are the risk factors for infection

A

Caused by Poxvirus

Predominantly affects children

Risk Factors:
- Close contact with infected individual (children)
- Sexual contact with an infected individual
- HIV infection
- Tropical climate
- Swimming
- Atopic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs and symptoms of molluscum contagiosum

A

Flesh-coloured, pearly, dome-shaped papules on the skin
- Painless, pruritic
- 2-5mm
- Central umbilication/dell and shiny surface
- Occurs in crops
- >50 lesions suggests immunosuppression
Surrounding erythema
Atopic dermatitis
Pruritus, difficulty sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations and management is indicated for molluscum contagiosum

A

Clinical diagnosis
If widespread → consider HIV testing
Haematoxylin and eosin staining (Henderson-Patterson bodies)

Self resolving - no treatment indicated
Lasts 18 months
Warn that they become red/visible inflamed before improving
Lesions are facial/in sensitive or obvious areas/ bullying involved → refer to Derm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why might infectious mononucleosis cause a rash

A

Treatment with penicillin while infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes roseola infantum, how is it transmitted and what age group does it affect

A

Human Herpesvirus 6 (HHV-6)
Incubation period of 5-15 days, highly infectious
6 months - 2years

17
Q

What are the signs and symptoms of roseola infantum

A

Prodrome: High fever and malaise (3-4 days)
Generalised macular (small pink spots) rash (appears as the fever wanes)
- Starts on neck/body and spread to arms, lasting
- 1-2 days, non-itchy, blanching
Sore throat
Lymphadenopathy
Coryzal symptoms
D&V
Nagayama spots (spots on the uvula and soft palate)

(Many have a febrile illness and never develop a rash; commonly misdiagnosed as measles/rubella - Febrile convulsions in 10-15%)

18
Q

What investigations should be done for roseola infantum

A

HHV6/7 serology (IgG and IgM)
Measles & rubella serology (similar presentation)

19
Q

What is the management for roseola infantum

A

Supportive (virus; fluids, analgesia, rest)
Will clear in ~1 week
No need to stay off school
Safety net the complications – high fever (febrile convulsions 10-15%)

20
Q

Aetiology and risk factors for rubella

A

RNA virus in the togaviridae family

RF:
Incomplete immunisation with no evidence of previous infection
History of exposure to contacts with rubella
Travel to an area endemic for rubella e.g. Africa, South-East Asia

21
Q

Symptoms of rubella

A

Asymptomatic in 50% of people

prodrome of fever (<39), headache, malaise, nausea, URTI, and non-purulent conjunctivitis

Rash (50-80%)
- Starts on the face and neck before spreading down the body and becoming generalised
- Pink/light red in colour
- Maculopapular
- Transient, usually present for 3-5 present
Lumps on the neck (lymphadenopathy)
Pain and stiffness of joints, especially fingers, wrists, and knees (arthritis or arthralgia)

22
Q

What investigations should be done for rubella

A

Bedside: Oral fluid sample/throat swab for viral culture and urine culture (positive)

Bloods: Rubella-specific IgM serum antibody for capture ELISA: Positive (acute)
FBC - normal, may show thrombocytopenia

23
Q

Management for rubella

A
  1. NOTIFY LOCAL HPT
  2. Re-assure: mild, self-limiting condition that resolves within a week
  3. Supportive:
    - Adequate fluids
    - Paracetamol or ibuprofen (NOT aspirin)
    - Isolate for at least 5 days after initial development of rash
    - Avoid contact with pregnant women
  4. Safety net: confusion, bleeding

+ follow up (over the phone sufficient)

y6 uro & id (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions