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Year 4 - Paediatrics > Derm - Viral Exanthemas > Flashcards

Derm - Viral Exanthemas Flashcards

1
Q

What is an exanthem?

A

Eruptive widespread rash

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2
Q

What are the 6 viral exanthemas?

A

First disease : Measles

Second disease : Scarlet Fever

Third disease : Rubella

Fourth disease : Duke’s Disease

Fifth disease : Parvovirus B19

Sixth disease : Roseola Infantum

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3
Q

What causes measles?

A

Measles virus

Highly contagious

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4
Q

How does measles present?

A

10-12 days after exposure with fever, coryzal symptoms and conjunctivitis

Koplik spots
Greyish white spots on buccal mucosa, appears 2 days after fever

Rash starts on face behind ears, 3-5 days after fever then spreads to rest of the body

NOTIFIABLE DISEASE - PUBLIC HEALTH

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5
Q

What does the rash in measles look like?

A

Erythematous, macular rash with flat lesions

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6
Q

How long does measles take to resolve?

A

7-10 days of symptoms

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7
Q

How long should children be isolated for after symptoms resolve?

A

4 days

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8
Q

What are the complications of measles?

A

30% develop complications

Pneumonia
Diarrhoea
Dehydration
Encephalitis
Meningitis
Hearing loss
Vision loss
Death

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9
Q

What is Scarlet fever caused by?

A

Exotoxin produced by streptococcus pyogenes bacteria

Associated with group A streptococcus usually tonsilitis - not caused by a virus

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10
Q

What is scarlet fever characterised by?

A

Red-pink, blotchy, macular rash with rough sandpaper skin that starts on trunk and spreads outwards

Red, flushed cheeks

Strawberry tongue

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11
Q

What are the features of scarlet fever?

A

Strawberry tongue
Cervical lymphadenopathy

Flushed face

Red-pink, blotchy macular rash
Lethargy
Extremely rough, sandpaper skin
Throat, sore

Fever

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12
Q

How is scarlet fever treated?

A

Phenoxymethylpenicillin (Penicillin V) for 10 days

For underlying streptococcal infection

NOTIFIABLE DISEASE- PUBLIC HEALTH

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13
Q

How long should children be off school for after antibiotics?

A

24 hours after starting antibiotics

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14
Q

What other conditions are associated with group A strep infection?

A

Post-streptococcal glomerulonephritis
Acute rheumatic fever

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15
Q

What is rubella caused by?

A

Rubella virous

Highly contagious

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16
Q

How is rubella spread?

A

Respiratory droplets

Symptoms start 2 weeks after exposure

17
Q

How does rubella present?

A

Milder erythematous macular rash vs measles

Rash starts on the face and spreads to the rest of the body
Mild fever
Joint pain
Sore throat
Lymphadenopathy behind ears and back of neck

18
Q

How long does the rash last in rubella?

A

3 days

19
Q

How is rubella managed?

A

Supportive
Condition is self-limiting

NOTIFIABLE TO PUBLIC HEALTH

20
Q

How long should children be kept off school in rubella?

A

At least 5 days after the rash appears

21
Q

What are the potential complications of rubella?

A

Thrombocytopenia
Encephalitis

22
Q

Who in particular should be avoided in patients with rubella?

A

Pregnant women

23
Q

Why is rubella so dangerous in pregnancy?

A

Can cause congenital rubella syndrome

Triad of :
- Deafness
- Blindness
- Congenital heart disease

24
Q

What is Duke’s disease and is it still diagnosed?

A

AKA fourth disease

No longer diagnosed as was used to describe non-specific viral rashes

25
Q

What is Parvovirus B19 disease?

A

AKA fifth disease, slapped cheek syndrome and erythema infectiosum

Caused by Parvovirus B19 virus

26
Q

How does parvovirus B19 present?

A

Mild fever
Coryza
Muscle aches
Lethargy

After 2-5 days bright red rash on both cheeks slapped cheeks

After a few days a reticular (net-like) mild erythematous rash affects trunk and limbs, can be raised and itchy

27
Q

How is parvovirus B19 managed?

A

Self-limiting
Rash and symptoms fade over 1-2 weeks

Supportive management with plenty of fluids and simple analgesia

28
Q

When should children with parvovirus B19 be kept off school?

A

Infection prior to rash formation

After rash formation they are no longer infectious

29
Q

What are some potential complications of parvovirus B19?

A

Aplastic anaemia
Encephalitis or meningitis
Pregnancy complications- foetal death

Rarely
Hepatitis, myocarditis or nephritis

30
Q

What patients are at risk of complications of parvovirus B19?

A

Immunocompromised
Pregnant women
Sickle cell
Thalassaemia
Hereditary spherocytosis
Haemolytic anaemia

31
Q

How are patients at risk of complications of parvovirus B19 checked?

A

Serology testing to confirm diagnosis

FBC and reticulocyte count for aplastic anaemia

32
Q

What is Roseola Infantum?

A

AKA roseola or sixth disease

Caused by human herpesvirus 6 and rarely human herpesvirus 7

33
Q

What is the typical pattern of roseola infantum?

A

High fever 1-2 weeks after infection
Comes on suddenly lasting for 3-5 days and then disappears suddenly

May be coryzal symptoms, sore throat and swollen lymph nodes

When the fever settles, rash appears for 1-2 days

34
Q

How does the rash appear in roseola infantum?

A

Mild erythematous macular rash across arms, legs, trunk and face

Not itchy

35
Q

How long do children have to stay at home with roseola infantum?

A

Generally no need to be kept off nursery if well enough to attend

Full recovery within a week

36
Q

What is the main complication of roseola infantum?

A

Febrile convulsions
Due to high temperature

37
Q

What are immunocompromised patients with roseola at rare risk of?

A

Myocarditis
Thrombocytopenia
Guillain-Barre syndrome

Year 4 - Paediatrics (150 decks)

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