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SBL Test 1 > CIS: Skin changes in blood and lymph > Flashcards

CIS: Skin changes in blood and lymph Flashcards

1
Q

What are causes of a Diffuse Maculopapular Rash?

A
  1. Measles
  2. Rubella
  3. Erythema Infectiosum
  4. Infectious mononucleosis
  5. Lyme disease
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2
Q

Describe Measles

A
  1. Exposure: day 1
  2. 7-18 days later: prodrome in an unvaccinated patient (fever, cough, coryza, conjunctivis)
  3. 3-4 days after prodrome: brick red maculopapular rash “morbiliform rash” that begins on the face and proceeds “downward and outward” => palms and soles LAST. Lasts 3-5 days
    1. Koplik spots on buccal mucosa = pathognomonic
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3
Q

What is pathognomic for measles

A

Koplik spots = but only occur

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4
Q

What are complications of measles?

A
  1. Pneumonia
  2. Post-measles encephalitis
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5
Q

How is the presentation of Rubella different from Measles?

A

“3 day measles”

Short prodrome and rash only lasts 2-3 days.

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6
Q

What is fifth disease and who does it occur in?

A
  • Fifth disease => erythema infectionisum => due to parvovirus B19
    • Produces a slapped cheek appearance
    • White around mouth (circumoral pallor)
    • Lacy, maculopapular rash on TRUNK and LIMBS
    • Itchy palms and soles
    • Little fever
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7
Q

What is the presentation of erythema infectiosum?

A
  1. Child + red “slapped cheek appearce”
  2. White around mouth “circumoral pallor”
  3. Lacy maculopapular rash on the trunk and limbs
  4. Pruritis in palms and soles
  5. Rarely fever
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8
Q

Parvovirus is one the most common causes of _____ in children.

What else can it cause?

A

Myocarditis

=> aplastic crisis and pure RBC aplasia

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9
Q

How does parvovirus affect middle aged people (especially women)?

A

Mimics SLE and RA => looks like an inflammatory arthritis

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10
Q

What lesion does Lymes Disease produce?

A

Erythema migrans: flat or slightly raised expanding lesion where tick bit => progresses to a bulls-eye lesion (becomes pale in the middle)

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11
Q

What are the stages of Lymes Disease?

Where is it MC?

A

NE, Mid-Atlantic, Upper Midwest, Pacific coast

  1. Stage 1 (early localized infection): Erythema migrans “bulls eye lesion” + myalgias + HA/fatigue
  2. Stage 2: Early disseminated infections (weeks - months later)
    1. Bacteremia
    2. Secondary lesions (similar to 1st but smaller)
  3. Stage 3: Late persistant infections (months - years): MSK infections => monoarticular, oligoarticular arthritis of knee or weight bearing joints
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12
Q

How is the maculopapular rash + vesicle formation seen in Lymes different than shingles?

A

Does NOT follow a dermatomal distrubution

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13
Q

Infectious mononucleosis if the MC manifestation of EBV.

  1. How is it transmitted?
  2. What is the incubation period?
  3. MC at what ages?
A
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14
Q

Infectious mononucleosis if the MC manifestation of EBV.

  1. How is it transmitted?
  2. What is the incubation period?
  3. MC at what ages?
A
  1. Saliva
  2. 30-50 days
  3. 12-19 YO
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15
Q

Other symptoms of infectious mononucleosis

Diagnose how?

A
  1. Fever + malaise
  2. Exudative sore throat: pharyngitis, uvular edema, tonsilittis, gingivitis
  3. Posterior cervical lymphandenopathy

Dx = (+) heterophile aggluttination test (monospot)

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16
Q

What are common illnesses that manifest with manifest with peripheral skin eruptions?

A
  1. Meningococcemia
  2. Rocky Mountain Spotted Fever
  3. Secondary syphilis
  4. Hand/Foot/Mouth disease
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17
Q

Rocky Moutain Spotted Fever

  1. MC caused by
  2. When does it occur
  3. Complication?
A
  1. Rickettsia rickettssi, a parasite of tick, caused by ticks
  2. Late spring - summer
  3. If untreated= 70% chance of mortality
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18
Q

Descibe the rash and presentattion of RMSF

A
  1. Cough + pneumonitis
  2. Rash = begins as a faint macule that progresses to large maculopapules/petchiae; begins on wrist and ankles (can involve palms and soles) => spreads to arms, legs and trunk
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19
Q

What causes Syphilis?

A

Treponema pallidum, a spirochete, via sexual contact

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20
Q

2 major clinical stages of syphilis

A

1. Early (infectious stage)

2. Late syphilis

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21
Q

What is this?

A
  • Primary chancre of the tongue + penis seen in early( infectious) stage of syphilis
  • Seen with regional lymphadenopathy
22
Q

What are the 2 clinical stages of syphilis and what lesions do you find?

A

1. Early (infectious) stage = chancres + regional lymphadenapathy

2. Late syphilis = benign gumma lesions on skin, bones and viscera

23
Q

What do you see in Secondary Syphilus?

A
  1. Diffuse maculopapular pustular rash (can be on palms and soles)
  2. Condylomata lata
  3. Mucous patches: painless, silvery ulcers on the mucous membranes + surrounding erythema
24
Q

Describe this lesion and what causes it

A
  1. Hand-foot-mouth disease due to Coxsackievirus A6 or enterovirus infection
  2. Lesion:
    1. ​Football- vesicular rash on palms and soles, surrounded by a red halo
      1. ​also on butt and external genitalia
25
Q

Hallmark of HFMD = football vesicular rash on the palms and soles of feet.

What other findings do we see?

A
  1. Stomatitis
  2. Nail dystrophies + onychomadesis (nail shedding)
  3. Oral erosions of tongue buccal mucosa
26
Q

What are 3 complications of Coxsackievirus?

A
  1. Epidemia pleurodynia: pleuritis chest pain
  2. Aseptic meningitis
  3. Acute pericarditis
27
Q

Causes of Desquamative Skin Changes

A
  1. Toxic Shock Syndrome
  2. Scarlet Fever
  3. Erythema Multiforme
28
Q

Strains of Staph. can produce toxins that cause what?

A
  1. Scalded skin syndrome (esp in children) or bullous impetigo (in adults)
  2. Necrotizing pneumotitis = children
  3. Toxic shock syndrome
  4. Enterotoxin food poisinging
29
Q

Most cases (≥ 90%) of TSS were initially reported in who?

A

Women of childbearing age, especially common within 5 days of the onset of a menstrual period in women who have used tampon

30
Q

Describe Toxic shock syndrme

A
  1. Abrupt onset of Fever/V/D (watery)
  2. Diffuse maculopapular (morbilliform) rash = desquamation (esp in palms and soles) is typical
  3. NON-PURELENT CONJUNCTIVITIS
31
Q

Scarlet Fever is characterized by what?

Due to?

A

Group A Strep Pyogenes

  1. Exudative pharyngitis (sore throat): strawberry tongue, exudative tonsillitis
  2. Fever
  3. Scarlet rash: bright red rash MC on neck, axilla, groin, skin folds. Desquamation occurs on hands + feet
32
Q

What do you see on labs in scarlet fever?

A
  1. Group A beta-hemolytic strep on culture
  2. Anti-streptolysin O titer rise
33
Q

what is this

A

Erythema Multiforme “target lesion” MC due to Herpes Simplex (HSV) and Mycoplasma pneumonia

  • Skin and mucus membranes: on face and extremities
  • MC in male kids and yound adults
34
Q

Describe the onset of Erythema Multiforme

A
  1. No prodome. If sx ==> URI
  2. REVIEW the past 3 weeks to ID cause: HSV, respiratory symptoms, or influenza illness
35
Q

Erythema Multiforme majus that are NON-cutaneous occur where and often due to ________

A

Mucosal lesions MCC by M. pneumoniae, most often in oral cavity: Lips, hard palate is spared.

36
Q

What causes Vesicular and Bullous lesions

A

1. Varicella

2. Pemphigus

37
Q

What is this?

A

Varicella chicken pox

  • Highly contagious rash that begins on face/scalp => trunks (SPARES extremities)
  • Scattered
  • Progresses from: rose colored macules => papules, vesicles, pustules + crusts
  • Lesions seen at all different stages
    *
38
Q

What is this

A

Varicella chicken pox: remember they becomes papules, vesicles, pustules and crust

39
Q

what is this?

what makes these lesions worse

A
  • Pemphigus vulgaris: PRURITIC + PAINFUL fragile large bulla that have a tendency to spread at periphery
  • UV radiation
40
Q

What causes Petechial and Purpuric Lesions

A
  1. Gonococcemia
  2. Meningococcemia
  3. Thrombotic thrombocytopenic purpura
41
Q

bullous pemphigus have a ____ origin

A

AI

42
Q

What is gonoccemia?

A

Disseminated gonococcal infection (spread from primary sites => other parts of body via blood stream)

43
Q

Classic triad of gonoccemia

A
  1. Dermatitis (small - medium sized macules or vesicopustules with red base on PALMS and SOLES. May develop a necrotic center and hemorrage, forming a “gun metal grey lesion”. if on palms and soles => tender. if not, painless)
  2. Migratory polyarthritis
  3. Tenosynovitis
44
Q

what is this?

A
45
Q

what is this?

A

Acute meniingococemia with DIC => pupura fulminans: retiform purpura + necrosis of skin that can cause gangrene of digits and distal extremeities => may need amputation

46
Q

Pentad of TTP

A
  1. MIHA
  2. Thrombocytopenia
  3. Neurologic symptoms
  4. Fever
  5. Renal failure
47
Q

TTP is MC at what age and MC in who?

A

40YO

Blacks

48
Q

what is this

A

purpura

49
Q

BCC is MC where?

A
  1. Back
  2. Chest
  3. Lower legs

Bleeds

50
Q

SCC presents as what?

A
  1. Red, warty nodule that can ulcerate (nonhealing)
  2. Keratinization.
  3. Common on hand
51
Q

What is the most sensitive at predicting the metastatic potentia of a melnoma?

A

COLOR

  1. Black = necrotic
  2. Blue = deeper
  3. White = ischemia, fibrosis, deeper invasion

SBL Test 1 (15 decks)

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