Viral Skin Infections II

Question 1

What are the symptoms of smallpox?

Answer 1

Abrupt onset of high fever

Malaise, headache, muscle pain

Lesions - mouth, skin

Question 2

What are the characteristics of skin lesions caused by smallpox?

Answer 2

Face and extremities

Common on palms of hands and soles of feet

Synchronous evolution of lesions

Question 3

What virus causes smallpox?

Answer 3

Variola virus

Question 4

What are the characteristics of variola virus?

Answer 4

Poxviridae
large dsDNA
Replicates in cytoplasm
Uses many of its own enzymes for viral replication
Strictly human virus

Question 5

How is smallpox transmitted?

Answer 5

Contact with virus in lesions
Fomites
Spread through air - rare

Question 6

What were the skin lesions of smallpox like?

Answer 6

Hemorrhagic and flat forms of smallpox

Question 7

What are the complications of smallpox? x4

Answer 7

1. Bacterial infection of skin lesions
2. Arthritis
3. Respiratory tract infections
4. Encephalitis

Question 8

How do we prevent variola virus?

Answer 8

Live strain of a vaccinia virus

Question 9

What reaction did some people get from the smallpox vaccine?

Answer 9

Eczema vaccinatum

Question 10

What is the spread of smallpox and chickenpox?

Answer 10

Smallpox - centrifugal

Chickenpox - centripetal

Question 11

How do we protect from postexposure prophylaxis with smallpox?

Answer 11

Vaccinate within 3 days of exposure prevent disease outcome

Vaccination at 4-7 days of exposure gives partial protection or lessening of disease

Question 12

What are 6 classic childhood exanthems?

Answer 12

1. Measles
2. Scarlet Fever
3. German measles
4. Atypical Scarlet Fever
5. Erythema Infectiosum
6. Roseola

Question 13

What is the progression of Measles symptoms?

Answer 13

First prodrome that starts 2-4 days before rash

Fever peaks at 103-105

Cough, Coryza, Conjunctivitis

Koplik’s spots

Question 14

What is the rash of measles like?

Answer 14

Maculopapular
Beginning at hairline
Spreading downward

Question 15

What are the characteristics of measles virus?

Answer 15

Paramyxovirus
ssRNA
Enveloped
Syncytia formation
One antigenic type

Question 16

How is measles transmitted?

Answer 16

Respiratory

Shed in nasopharynx from prodrome to 3-4 days following onset of rash

Highly contagious - infectious in air for up to 2 hr

Question 17

How do you diagnose measles?

Answer 17

Koplik spots
rash lasting more than 3 days
immunization history

Question 18

What are Koplik spots?

Answer 18

key with measles

grains of sand surrounded by an erythematous halo

Question 19

What are the complications of measles? x6

Answer 19

1. Diarrhea
2. Otitis Media
3. Pneumonia
4. Encephalitis
5. Seizures
6. Death

Question 20

How do we prevent measles virus?

Answer 20

Limit contact with those who lack resistance

Passive immunoprophylaxis for exposed, susceptible contacts

Report

Question 21

What are characteristics of measles virus vaccine?

Answer 21

live attenuated
Subcutaneous injection
MMR
MMRV

Question 22

What are the measles vaccine dosing schedule?

Answer 22

Children - 1st dose 12-15 mo, 2nd dose 4-6 years

Adults - 1 dose for those born after 1957, 2nd dose for travelers, healthcare workers, post high school students

Question 23

What are the rashes of German measles like?

Answer 23

Maculopapular rash, appearing first on face and spreading downward

Fainter than measles

Does not coalesce

Question 24

What are other symptoms of German measles besides rash?

Answer 24

Prodrome of low grade fever, lymphadenopathy, and URT symptoms

Question 25

German measles is sometimes associated with ______ and ______

Answer 25

Arthralgia Arthritis

Question 26

What virus causes German measles?

Answer 26

Rubella virus

Question 27

__________ leads to deafness, cataracts, congenital glaucoma, congenital heart disease, pigmentary retinopathy.

Answer 27

Congenital Rubella Syndrome

Question 28

What are the characteristics of rubella virus?

Answer 28

Matonaviridae Enveloped RNA

Question 29

How is rubella virus transmitted?

Answer 29

respiratory route - replicates in nasopharynx and regional lymph nodes

Question 30

What is the time from infection to rash for rubella?

Answer 30

2 weeks

Question 31

How do you diagnose rubella virus?

Answer 31

Direct culture of virus serology

Question 32

What are the characteristics of rubella virus vaccine?

Answer 32

live attenuated vaccine Combined with mumps and measles (MMR) or MMRV Prevents congenital rubella syndrome

Question 33

________ also called slapped cheek syndrome Presents with fever, rash on cheeks.

Answer 33

Fifth Disease Erythema Infectiosum

Question 34

What virus causes Fifth Disease?

Answer 34

B19 Parvovirus

Question 35

What are the characteristics of B19 Parvovirus?

Answer 35

Parvoviridae ssDNA Grows exclusively in mitotically active cells - hematopoietic cells in bone marrow Utilize host enzymes for genome transcription and replication

Question 36

How does the rash of Fifth Disease spread?

Answer 36

Rash begin on cheeks and then spreads to other parts of body in lacelike pattern

Question 37

Infection with B19 Parvovirus causes ______ in patients with chronic anemia (sick cell anemia)

Answer 37

Aplastic crisis

Question 38

Infection with B19 Parvovirus in adults causes ______ and often without rash

Answer 38

arthralgia arthritis

Question 39

What are the complications that can occur to the fetus with B19 Parvovirus infection during pregnancy?

Answer 39

Anemia Congestive heart failure Hydrops fetalis

Question 40

What are the symptoms of Roseola Infantum?

Answer 40

High fever around 4 days Maculopapular rash follows the fever resolution

Question 41

What are the characteristics of the virus HHV-6?

Answer 41

Herpesviridae dsDNA enveloped Replicated in T-cells, B-cells, oral pharynx Latent in T cells

Question 42

What are the characteristics of HHV-7?

Answer 42

Herpesviridae CD4+ T cells Present in saliva of adults Infection occurs later than infection with HHV-6