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Phase 2 PEDs > Cutaneous Exanthems > Flashcards

Cutaneous Exanthems Flashcards

1
Q

Rubeola is AKA?

A

Measles

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2
Q

Rubella is AKA?

A

German measles

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3
Q

Roseola is AKA?

A 
6th disease (fever before rash)
Exanthem subitum
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4
Q

5th Dz is AKA?

A

Erythema infectiosum

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5
Q

Varicella is AKA?

A

Chicken pox

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6
Q

6 different cutaneous exanthems?

A 
Rubeola
Rubella
Roseola
5th Dz 
Varicella
Hand/foot/mouth disease
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7
Q

Rubeola etiology/epidemiology?

A

Highly contagious
RNA paramyxovirus
URI and regional lymph nodes
Systemic spread

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8
Q

Rubeola incubation time?

A

8-14d

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9
Q

Rubeola is infectious when?

A

5d before RASH and 4 days after

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10
Q

Rubeola is transmitted via?

A

Respiratory secretions,
Blood,
Urine

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11
Q

Rare in young infants <1yr due to?

A

Maternal antibodies

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12
Q

Rubeola presents as?

A

Rash-exanthem
High fever 104-105
Classic S/S ( Cough, Coryza, Conjunctivitis)
Koplik spots (lower molars - gray-white spots)
Cervical/Mesenteric LAD
Splenomegaly

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13
Q

Rubeola Rash-exanthem begins when/where/how?

A

2-5d after fever
On head > most of body over 24hrs
(rash fades same way - Rash extent = severity)

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14
Q

Rubeola Rash appearance?

A

Macular rash - petechial or hemorrhagic

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15
Q

Infants w/ Rubeola w/ have what presentation also?

A

AOM, Pneumonia, Diarrhea

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16
Q

WBC level of rubeola pt is?

A

Leukopenia

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17
Q

Dx of rubeola?

A

Clinical

PCR or IgM ABs

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18
Q

PEDs MC complication of measles is?

A

AOM

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19
Q

TXT of rubeola?

A

Supportive - fluids/APAP
Vit A for 2days
TXT complications

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20
Q

Rubeola Prevention?

A

Vaccine (MMR)

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21
Q

Rubeola prophylaxis available? If so when?

A

Measles vaccine w/in 72hr of exposure

Immunoglobin w/in 6d of exposure

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22
Q

Rubella etiology/epidemiology?

A

Togavirus - Single strand RNA

Unvaccinated populations in spring

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23
Q

Maternal antibodies protect infant for how long against Rubella?

A

6mo

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24
Q

Rubella incubation period?

A

14-21d

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25
Q

Rubella transmitted via?

A

Direct contact or droplets from nasopharyngeal secretions

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26
Q

Rubella pahtophys?

A

Invades respiratory epithelium >

Virus spreads through blood

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27
Q

Rubella most infectious when?

A

2d before RASH 5-7 after

- virus will be present 7d before RASH 14d after

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28
Q

Rubella presents as?

A 
Rash
Low fever, HA
LAD - post auricular/cervical/occipital
Mild sore throat, Conjunctivitis
Anorexia, malaise, Polyarthritis (hands)
Forschheimer spots
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29
Q

Rubella Rash-exanthem begins when/where/how?

A

Begins on face and spreads to the body that lasts 3 days.

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30
Q

Rubella rash appearance?

A

Red, maculopapular, discrete rash

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31
Q

Forschheimer spots are?

A

Rose-colored spots on palate indicting Rubella

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32
Q

Complications of Rubella typically occur when/where/what?

A

In-utero

  • Blueberry muffin baby
  • Deaf, Cataracts, CHD
  • Sheds virus in NP secretion up to >12mo after birth
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33
Q

PVT of Rubella include?

A

Vaccine

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34
Q

Erythema infectiosum (5th) etiology/epidemiology?

A

Parvovirus B19 (single strand DNA)
High affinity for RBC stem cells
Spring time epidemics

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35
Q

Erythema infectiosum transmitted via?

A

Respiratory secretions

Blood products during transfusions

36
Q

Erythema infectiosum pathophys?

A

Invades RBC progenitors and divides >
Cell death of RBC progenitors >
Erythroid aplasia

37
Q

Erythema infectiosum during pregnancy complication to baby?

A

Fetal anemia or hydrops fetalis

38
Q

Erythema infectiosum ass/w SCA, spherocytosis, thalassemia will cause?

A

Hemolytic anemias + 5th dz = Aplastic crisis

39
Q

Erythema infectiosum incubation?

A

4-14d (rare 21d)

40
Q

Erythema infectiosum presents as?

A

Mild nonspecific illness - fever, malaise, myalgia, HA
Rash
(Adolescent may have pharyngitis, coryza, GI upset.)

41
Q

Erythema infectiosum rash process?

A
  1. Slapped cheek w/ circumoral pallor around mouth
  2. Red, Symmetric, maculopapular truncal rash (1-4d)
  3. Rash fades > lacy/reticular lasting 2-40d and is pruritic, no desquamination.
42
Q

Erythema infectiosum rash stage 3 reoccurs if?

A

Exercise, bath, rubbing, stress

43
Q

Dx of Erythema infectiosum occurs?

A

Clinically
IgM ABs
PCR

44
Q

TXT of Erythema infectiosum?

A

Supportive - fluids/APAP

IV IG for - x-imm or severe anemia/chronic infection

45
Q

Erythema infectiosum greatest risk is to?

A

Pregnant women

46
Q

Exanthem subitem 6th dz (rose) etiology/epidemiology?

A

HHV 6 and 7

LRG double strand DNA

47
Q

Maternal antibodies protect child from Exanthem subitem for how long?

48
Q

Exanthem subitem presents as?

A 
Rash
Sudden onset High fever lasting 3-5d
URI S/S - congestion, Red TMs, cough
GI symptoms
33% febrile seizures
49
Q

Rash lasts how long?

50
Q

Dx of Exanthem subitem?

A

Clinical

Sudden high fever 3-5d followed by rash then defervescence

51
Q

Hand, foot, mouth dz is due to

A

Coxsackie A virus via A2M transmission

52
Q

Hand, foot, mouth dz incubation?

53
Q

Hand, foot, mouth dz presents w/

A 
Rash
Mouth pain
Sore throat
Refuse to eat/drink > anorexia
\+- fever, fussy, abd pain, N/V/D
54
Q

Hand, foot, mouth dz rash presents as?

A

Oral ulcers
Vesiculopustular rash on hands/feet (+- diaper/thigh)
- palms/soles too

55
Q

When can Hand, foot, mouth dz pts go back to school?

A

2-3d after fever resolves

56
Q

TXT of Hand, foot, mouth dz?

A

Supportive

57
Q

Hand, foot, mouth dz can last how long?

58
Q

Hand, foot, mouth dz is infectious how long?

A

Sheds 6w - 3mo after infection

59
Q

Varicella etiology and epidemiology?

A

Varicella-zoster virus (Double strand icosahedral DNA)
Primary infection = Chickenpox (Varicella)
2ndy infection = Shingles (Zoster) - latent
Highly infectious
Late/winter spring

60
Q

Varicella is infectious until?

A

2 days before RASH onset 7 days after onset

61
Q

Varicella is contagious until?

A

All lesions are crusted

62
Q

Peak age range of Varicella?

A

10-14yo - vaccinated

63
Q

Varicella transmits via?

A

Direct contact, droplet, airborne into conjunctivae or respiratory tract

64
Q

Varicella incubation is?

65
Q

Varicella presents as?

A

Prodrome (Fever, malaise, anorexia) - 1 day before rash

66
Q

Varicella rash spreads how?

A

Begins on trunk and spreads to head, face, extremities

W/ all lesion stages present

67
Q

Varicella rash characteristics?

A

Pruritic - +- in mucosa membranes
SML red papules - non-umbilicated, oval, teardrop vesicles on red base.
Fluid progresses clear to cloudy

68
Q

Varicella rash progression?

A

Small red papules >

Vesicles ulcerate, crust, heal

69
Q

Cycle of varicella New Lesion crops occurs how often?

70
Q

Varicella TXT?

A

Symptomatic - (antipyretics, cool bath, hygiene)

NO Rx unless severe

71
Q

Severe Varicella may be TXT w/?

A

Acyclovir or Valacyclovir

72
Q

Varicella complications?

A

MC = 2ndy infection of skin lesions (staph/strep)
Pneumonia
Reye syndrome
Neuro/Cardiac/Arthritis etc.

73
Q

Neonatal Varicella is?

A

Mothers w/ varicella (not shingles) can pass to infant.

74
Q

When does neonatal Varicella occur?

A

5d before to 2d after delivery

75
Q

How to TXT neonatal Varicella?

A

VZIG (Varicella-zoster IG)

76
Q

Varicella and Zoster are not SL diseases T/F?

77
Q

Varicella OR Zoster leads to more scarring?

A

Zoster (deeper in tissue)

78
Q

When should PEDs return to school if they have Zoster?

A

After ALL vesicles crusted

79
Q

Admitted PED w/ Varicella requires what?

A

Negative pressure room to PVT transmission

80
Q

Varicella vaccinations req?

A

Live attenuated virus (x2 doses)

81
Q

Varicella prophylaxis?

A

VZIG w/in 96h

82
Q

V-Zoster is what?

A

Recurrence of latent VZV

83
Q

V-Zoster presents as?

A

Unilateral Dermatomal distro Rash (trunk)
- Regional LAD
- Acute neuritis (pain/TTP)
Fever/Malaise

84
Q

V-Zoster rash appearance?

A

Group of lesions for 1-7d > crusts

85
Q

What nerve branch can be involved w/ V-Zoster?

A

CN V - Corneal/intraoral lesions

CN VII - Facial paralysis/ear canal vesicles

86
Q

CN VII V-Zoster is AKA?

A

Ramsay Hunt syndrome

87
Q

Complication of V-Zoster w/ pain persisting longer than 1 month is called?

A

Post-herpetic neuralgia

Phase 2 PEDs (23 decks)

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