Chapter 163- Exanthematous Viral Diseases

Question 1

Pathognomonic for measles

Answer 1

Koplik spots

Question 2

Severe complications of measles (2)

Answer 2

Pneumonia

Postmeasles encephalomyelitis

Question 3

Reduce morbidity and mortality of measles

Answer 3

Vitamin A

Question 4

Infectious droplets have been reported to remain airborne for up to ___

Answer 4

2 hours

Question 5

Small, bright red macules that have 1-2 mm blue white speck within buccal mucosa near the second molars

Answer 5

Koplik spots

Question 6

Koplik spots occur ___ hours prior to the onset of rash and only last ___ hours

Answer 6

48

12-72

Question 7

The hands and feet are involved in measles.

True or False

Answer 7

True

Question 8

Positive on the first day of the rash, remains positive for at least 30 days

Answer 8

IgM

Question 9

Measles is contagious ___ days prior to the onset of the rash until ___ days after onset of rash

Answer 9

5 days; 4 days

Question 10

WHO recommends that Vitamin A should be adminstered to all children with measles regardless of their country of residence.
True or False

Answer 10

True

Question 11

Vitamin A should be administered ___ IU per day on ___ consecutive days and a reduced risk of measles mortality in children younger than ___ years old

Answer 11

100,000
2 days
2 years old

Question 12

Individuals at risk for complications are (4)

Answer 12

Younger than 1 year old
Pregnant
Unimmunized
Immunocompromised

Question 13

Measles immunoglobulin should be given

Answer 13

0.5ml/kg IM

400mg/kg IV

Question 14

MMR vaccine should be given

Answer 14

12 mos
12- 15 mos
4-6 years old

Question 15

Approximately ___% of US-born populations older than age ___ is susceptible to rubella

Answer 15

10

5

Question 16

Infants may have more severe and persistent prodromal symptoms that make distinction from rubeola difficult.
True or False

Answer 16

False, older adults

Question 17

Tiny red macules in soft palate and uvula of rubella

Answer 17

Forchheimer spots

Question 18

Lymphadenopathy is most severe in (3) and noted __ days before rash

Answer 18

Posterior cervical
Suboccipital
Postauricular lymph nodes
7

Question 19

___% of women develops arthritis of small and large joints with rubella infection

Answer 19

70

Question 20

___% of infants exposed ti rubella within the first ___ weeks of gestation develop serious sequela

Answer 20

85%

12 weeks

Question 21

1-3% of infants with congenital rubella excrete virus in the first month of life.
True or False

Answer 21

False, majority

Question 22

Rarely, rubella may lead to encephalitis with mortality rate of

Answer 22

50%

Question 23

In nonpregnant, rubella vaccine may be administered within ___ of exposure

Answer 23

3 days

Question 24

Contact isolation is recommended for infants with congenital rubella until they are at least ___ mos old or repeated cultures are negative after ___ mos of age

Answer 24

12 mos old

3 mos of age

Question 25

Febrile seizures may occur in children ____ when receiving first MMR vaccine

Answer 25

1-2 years old

Question 26

Any woman receiving rubella vaccine should not be pregnant for ___ days

Answer 26

28

Question 27

Infants may be infected with rubella via breastmilk | True or False

Answer 27

True

Question 28

Previous infection with B19 confers lifelong immunity | True or False

Answer 28

True

Question 29

B19 is usually found in respiratory secretions or serum hence are infectious even after the onset of rash. True or False

Answer 29

False, not found, before the rash

Question 30

The secondary attack among household contacts is approximately

Answer 30

50%

Question 31

Receptor of parvovirus responsible for infection

Answer 31

Blood group P antigen

Question 32

Most common clinical picture of parvovirus B19 in children

Answer 32

Fifth disease

Question 33

___% of children develop arthralgia or arthritis

Answer 33

10%

Question 34

Major feature of rash of erythema infectiosum in children

Answer 34

Pruritus

Question 35

Primary manifestation of B19 in adults

Answer 35

Acute arthropathy

Question 36

Syndrome of pruritic erythema and edema of hands and feet with petechia, fever, and oral erosions

Answer 36

Papular purpuric gloves and socks syndrome

Question 37

IgM can be identified by 7th day of illness and lasts for years. True or False

Answer 37

False, IgG

Question 38

Test of choice in an immunocompromised patient and to confirm fetal infection

Answer 38

PCR

Question 39

Chronic anemia of B19 is treated with

Answer 39

Gamma globulin

Question 40

Most common cause of transient aplastic crisis in patients with chronic hemolytic anemia

Answer 40

Parvovirus B19

Question 41

In aplastic crisis, Hgb may fall below

Answer 41

4ug/dl

Question 42

Most common intrauterune infection with B19

Answer 42

Nonimmune fetal hydrops

Question 43

Approximately __% of women of childbearing age are immune to parvovirus infection because of prior infection

Answer 43

50

Question 44

Treatment for transient aplastic crisis

Answer 44

Oxygen therapy | Blood transfusion

Question 45

Infectious mononucleosis is vcaracterized by triad of (3)

Answer 45

Fever Lymphadenopathy Pharyngitis

Question 46

Morbiliform exanthem with primary infection of EBV is due to

Answer 46

Ampicillin | Amoxicillin

Question 47

In Us, ___% are of 6 to 8 year olds are seropositive for EBV; __% by 18-19 years olds

Answer 47

50% | 89%

Question 48

Risk factors for early seropositivity of EBV

Answer 48

Lower household income Parental education level Uninsured status Mexican American or Black

Question 49

EBV infects B lymphocytes bia binding of EBV gp 350 with __ on surface of B cells

Answer 49

CD21

Question 50

Inherited immunodeficiencies particularly associated with impaired immune responses to EBV infection

Answer 50

X linked lymphoproliferative disease | GATA2 deficiency

Question 51

MC manifestation of EBV infection in adolescents and adults

Answer 51

Infectious mononucleosis

Question 52

Complications of EBV (5)

Answer 52

``` Airway obstruction AHA/thrombocytopenia Neutropenia Myocarditis Hepatitis ```

Question 53

Splenomegaly occurs in ___% of patients and resolves by 4th-6th week of illness

Answer 53

50

Question 54

EBv infection during pregnancy is teratogenic | True or False

Answer 54

False, not teratogenic

Question 55

Painful multiple ulcers with red-purple ragged edges on medial or outer surface of labia minora that resolves in 2-6 weeks

Answer 55

Lipschutz ulcers

Question 56

Hallmarks of ENK/T (nasal type extranodal NK/T cell lymphoma)

Answer 56

NK cell phenotype CD2,CD56 (+) Angioinvasion Necrosis

Question 57

Ulcerated midfacial tumor common among males around 50 years of age leading to nasal obstruction, facial swelling, sinusitis, destruction of underlying sinuses and palate

Answer 57

Nasal type extranodal NK/T cell lymphoma

Question 58

Difference of HVLL disease from hydroa vacciniforme (5)

Answer 58

``` Systemic symptoms Extensive facial edema Ulceration Scarring Lesions are on photoprotected sites ```

Question 59

___ deficiency has been implicated in HVLL

Answer 59

GATA2 deficiency

Question 60

Angioinvasive proliferation of EBV infected cells with reactive polyclonal T cells population

Answer 60

Lymphomatoid granulomatosis

Question 61

Suggestive features of primary EBV infection

Answer 61

Splenomegaly Posterior cervical lymphadenopathy Lymphocytosis with predominance of atypical lymphocytes

Question 62

Used to confirm an EBV infection (2)

Answer 62

Heterophile antibody | EBV- specific antibody

Question 63

Used to confirm infectious mononucleosis in adolescents and adults due to its high specificity and rapid turnaround time

Answer 63

Monospot test

Question 64

Monospot test is most sensitive for children younger than 4 years old. True or False

Answer 64

False, not

Question 65

IgM VCA (+) and IgG EBNA (+) means an acute infection

Answer 65

(-) IgG EBNA

Question 66

Marker for impending post transplantation lymphoproliferative disease

Answer 66

EBV serum PCR

Question 67

Anti-R antibodies occur during recent infection and resolve with recovery. True or False

Answer 67

False, anti-D

Question 68

Used to reduce duration if fever or pharyngeal symptoms in infectious mononucleosis

Answer 68

Systemic corticosteroids