26 May Peds Viral Exanthems

Question 1

What is the slapped cheek disease?

Answer 1

Erythema infectiosum or 5th disease

Question 2

What disease is caused by parvovirus B19?

Answer 2

Erythema infectiosum or 5th disease

Question 3

How are the fever and rash timed in erythema infectiosum?

Answer 3

Fever and rash at same time

Question 4

Child presents with red cheeks that started at same time as fever onset. Dx? Primary/serious concerns with this disease?

Answer 4

Erythema infectiosum or 5th disease with slapped cheek rash.
Serious complications are:
Aplastic crisis in sickle cell anemia
Hydrops fetalis if fetus infected in utero. Thus, pregnant women should be isolated from kids infected with this.

Question 5

What disease is benign but very common in kids but can lead to hydrops fetalis and aplastic crisis?

Answer 5

Erythema infectiosum caused by parvovirus B19

Question 6

What is the causative agent for measles?

Answer 6

Paramyxovirus

Question 7

What is other name for rubeola?

Answer 7

Measles

Question 8

What is another name for german measles?

Answer 8

Rubella

Question 9

How does the rash in measles begin and progress?

Answer 9

Begins in the head/face and progresses down to the trunk and extremities and clears in the same fashion

Question 10

What are the prodrome sx for measles?

Answer 10

4 C's
Cough
Coryza
Conjunctivitis
Koplick spots

Question 11

What is the long-term potential complication of measles?

Answer 11

Subacute sclerosing panencephalitis

Question 12

Who gets measles?

Answer 12

People who are not vaccinated. Remember this as a clue in questions looking for a patient that for some reason has not received normal and complete medical care or has some other reason to not be vaccinated.
Condition appears several years after apparent recovery from the virus. Affects males more than females. Leads to a progressive disease that can eventually lead to death.

Question 13

What virus can cause subacute sclerosing panencephalitis?

Answer 13

Paramyxovirus (cause of measles)

Question 14

How are rubeola and rubella the same and different?

Answer 14

Rubella (German Measles) appears similar to Rubeola (Measles) with a face rash and fever with rash that then spreads to trunk and extremities.
Different in the prodrome: measles has the 4 C’s including Koplick spots in the mouth and German measles (Rubella) has generalized tender lymphadenopathy

Question 15

Kid presents with a rash on the face and then a subsequent fever and spread of the rash to the trunk and extremities. On exam, tender LAD is found. Dx?

Answer 15

Rubella (German Measles) caused by Rubella virus

Question 16

What is the causative agent is Roseola, and what is the characteristic presenting Sx?

Answer 16

HHV-6

High-spiking fever

Question 17

Patient presents with history of a fever of 104.5 that seemed to clear and then a rash developed on the trunk which later spread to the face and extremities. Likely Dx? Possible complications and required interventions?

Answer 17

Roseola
Fever then rash
Rash after fever breaks
Rash starts on trunk and spreads to extremities
High spiking fever
Tx overall is supportive, but high fever can lead to febrile seizures which can be aborted with benzos if lasting more than 5 minutes and can be prevented with acetaminophen

Question 18

What disease is caused by HHV-6?

Answer 18

Roseola

Question 19

Patient presents with a diffuse rash and denies having a fever. Rash described as being pruritic, maculopapular with scattered vesicular lesions on an erythematous base. On exam, some lesions have crusted over whereas others are at different stages. Likely Dx? Causative agent?

Answer 19

Chicken Pox caused by Varicella virus

Question 20

How does someone get shingles?

Answer 20

Previous infection with varicella with virus that remains dormant in dorsal root ganglion until someone becomes immunocompromized which happens most commonly in people over 60y. People who were vaccinated with varicella but never had chicken pox will not get shingles.

Question 21

14 y male presents with swollen cheeks and tender testicles. Dx? Tx? Bad complication?

Answer 21

Mumps

Caused by mumps virus, Tx is supportive, due to orchitis, patients can become infertile.

Question 22

Which of these diseases have a fever and a rash at the same time?

Answer 22

Erythema Infectiosum
Measles
Rubella

Question 23

Which of these diseases has a fever and then a rash?

Answer 23

Roseola

Question 24

Which of these diseases has a rash without a fever?

Answer 24

Varicella

Question 25

Which of these diseases has a rash that is isolated to the face?

Answer 25

Erythema Infectiosum

Question 26

Which of these diseases has a rash that starts on the face and progresses cepholcaudally?

Answer 26

Measles and Rubella

Question 27

Which of these diseases has a rash that starts on the trunk and then spreads outward?

Answer 27

Roseola

Question 28

Which of these diseases has a diffuse rash with lesions at different stages?

Answer 28

Chicken pox

Question 29

Which of these diseases can cause post herpetic neuralgia?

Answer 29

Shingles