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Dermatology - Viral, Hansen's Flashcards

1
Q

Rubella effect on fetus greatest risk during

A

First 4 weeks

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2
Q

5% of fetus exposed to rubella within 4 weeks develop

A 
Microcephaly with mental retardation
Congenital heart disease
Sensorineural deafness
Cataracts
Low birth weight
Fetal death
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3
Q

Differential diagnosis
Rubella
Most likely

A

Drug hypersensitivity rxn

Rubeola (measles)

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4
Q

Differential diagnosis
Rubella
Consider

A

Other viral infection (enterovirus, adenovirus, parvovirus, human herpes virus-6)

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5
Q

Differential diagnosis
Rubella
Rulle out always

A

Streptococcal scarlet fever

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6
Q

Rare complications of rubella

A 
Peripheral neuritis
Optic neuritis
Myocarditis
Pericarditis
Hepatitis
Orchitis
Hemolytic anemia
Encephalitis
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7
Q

Tx

Uncomplicated rubella

A

Supportive

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8
Q

Tx

Non pregnant individual

A

Rubella vaccine within 3 days of exposure

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9
Q

recommendation for neonates with rubella syndrome

A

Supportive care

Contact isolation until 12 months old or if repeated cultures are negative after 3 months age

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10
Q

Rubella vaccime administered as

A

MMR
12-15 mos
4-6 years

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11
Q

Potential adverse rxn rubella vaccine

A

Fever
Morbilliform rash
Lymphadenopahy
Arthralgia

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12
Q

Should pregnant women be immunized to rubella

A

False

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13
Q

Any woman receiving rubella vaccine should not become pregnant for

A

28 days

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14
Q

T/F

Infants of vaccinated breast feeding mother may become infected with rubella via breastmilk

A

T

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15
Q

How to detect rubella infection in fetus

A

Cordocentesis - IgM antibodies

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16
Q

Transmission measles

A

Direct or airborne contact with infectious droplets

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17
Q

Incubation measles

A

9-12 days

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18
Q

Measles

Patients contagious if

A

1-2 days before onset of sx

Up to 4 days after appearance of rash

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19
Q

Needed immunity to control Measles

A

Humoral

Cell-mediated

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20
Q

Ig involved measles

A

IgM initially then IgG

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21
Q

Controls viral replication and confers antibody protection

A

Humoral

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22
Q

Eliminates infected cells

A

Cell- mediated

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23
Q

Effect of Measles on immunity

A

Transient immunosuppression

  1. Depressed delayed hypersentitivity
  2. Depressed T cell counts
  3. Inc. Risk bacteria
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24
Q

vaccine measles effect on measles

A

Less severe sx

Prolonged incubation 14-20 days

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25
Q

Immunosuppressed

Measles presentation

A

Severe disease

Can present without typical rash

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26
Q

Prodrome Measles lasts for

A

4 days

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27
Q

Prodrome Measles

A 
Fever 40-40.5 C
Malaise
Coryza
Cough (brassy/ barking)
Conjunctivitis (palpebral, lid margin)
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28
Q

Catarrhal inflammation of the mucrous membrane in nose esp by cold or by hay fever

A

Coryza`

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29
Q

Pathognomonci enanthem of measles

A

Koplik spots

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30
Q

Koplik spots typically seen

A

Buccal mucosa, near second molars

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31
Q

Koplik spots appear

A

1-2 days before

Lasta 2 days after onset of rash

32
Q

Exanthem is erythematous, non-pruritic, macules and papules that begin on forehead, behind the ears

33
Q

Rash progression

Measles

A

Neck, trunk, extremities
Hands feet involved
Leasion coalesce (face, neck)

34
Q

Measles

Rash peak

35
Q

Measles
Rash
Disappear

A

4-5 days after appearance

Desquamation may occur

36
Q

Measles

Seen in inviduals who received formalin inactivated measles then exposed to wild-type virus

A

Atypical measles infection

37
Q

Not present in atypical measles

A

Coryza, conjunctivitis, koplik spots

38
Q

Maculo-papular, hemorrhagic, vesicular, uritcarial

Spreads centripetally

A

Atypical measles

39
Q

Atypical measles difficult to distinguish from

A

Rock mountain spotted fever

40
Q

Lab abormalities meases

A

Monocytosis
Leucopenia
Thrombocytopenia

41
Q

Pharyngeal virus shedding of measles end by

A

2nd day rash

42
Q

Most common complication of measles

A

Otitis media
Pneumonia
Diarrhea
Laryngotracheobronchitis

43
Q

Most common fatal complication of measles in children

Most common complication adults

44
Q

Prodromal sx of measles mimic

A

Influenza-like illness

45
Q

Tx measles

A

Supportive
Antibiotics - secondary bacterial
Ribavirin

46
Q

Vit supplement

Measles risk fatality 1%

47
Q

Individuals who should receive immunoglobulin prophylaxis of measles

A

At risk children less than1 yr, pregnant women, unimmunized, immunocompromised prophylaxis
Within 6 days of exposure

Within 72 hours -will not get infection

48
Q

Measles vaccine given after immunoglobulin to confer lasting protection when

A

5 months later (except pregnant, impaired immune system)

49
Q

Common potential side effects of measles vaccine include

A

Fever

Transient morbilliform rash that resolve w/o tx

50
Q

Ci measles vaccine

A

Moderate to severe illness
Allergic to eggs or neomycin
Pregnant
Impaired immune systems

51
Q

How many months off chemo or immunosupressive agent can you give measles vaccine

52
Q

Rubella transmission

A

Direct

Droplet contact

53
Q

Rubella shed virus

A

5-7 days before

14 days after onset

54
Q

Rubella infection can lead to lifelong immunity

55
Q

Congenital rubella , can shed virus for up to

A

12 months after birth

56
Q

Prodrome rubella

A

Low-grade fever, rhinitis, cough, sore throat, lymphadenopathy

57
Q

Enanthem

Tiny red macules on soft palate and uvula

A

Forsheimer spots

58
Q

Enanthem that appears in rubella but not diagnostic

A

Forsheimer spots

59
Q

clustered, white lesions on the buccal mucosa (opposite the lower 1st & 2nd molars) and are pathognomonic for measles.

A

Koplik spots

60
Q

Koplik spots manifest

A

2-3 days before measles rash appear

61
Q

Rash progression rubella

A

pink to red macules and papules begin to erupt on the face, quickly progressing to involve neck, trunk, and extremities

Lesions on the trunk may coalesce, whereas those on the extremities often remain more discrete.

62
Q

exanthem occurring 14 to 17 days after exposure, is characterized by pruritic pink to red macules and papules

63
Q

rash usually begins to disappear in 2 to 3 days,

64
Q

persistent and clears the head and neck first

65
Q

Desquamation

Meales vs rubella

66
Q

Lymphadenopathy rubella

Area

A

Posterior cervical
Suboccipital
Post-auricular LN

67
Q

Adult, women at risk to develop this complication with rubella

68
Q

Lab rubella

A

Leukopenia
Neutropenia
Increase atypical lymphocytes
Abundant plasma cells

69
Q

Weakly acid-fast, causes leprosy

A

Mycobacterium leprae

70
Q

M. Leprae grows best at

71
Q

Unique glycolipid to leprosy bacillus

A

PGL-1 phenolic glycolipid 1

72
Q

Leprosy favors growing

A

Intracellularly

Macrophages, nerves

73
Q

Major cause of leprosy in some regions

Found in patients in mexico

A

Mycobacterium lepromatosis

74
Q

Assoc with diffuse type lepromatous leprosy

A

M. Lepromatosis

75
Q

Lucio’s leprosy

A

M. Lepromatosis

76
Q

Invasion of endothelial cells by leprosy bacillus

A

Lucio’s phenomenon

Medicine (29 decks)

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