Exam 3 - Pediatric Exanthems

Question 1

“THE BIG 3”

Answer 1

• rubeola (measles)
• rubella (German measles)
• varicella (chix pox)

Question 2

“the little 3”

Answer 2

• Scarlet Fever (GAS)
• erythema infectiosum (Fifth’s Dz)
• Roseola Infantum (exanthema subitum/HHV6)

Question 3

Viral Exanthems

MacPap rash

Answer 3

5 Ruby-Scarlet Roses:
5th's Dz
Rubella
Rubeola
Scarlet Fever (not a virus)
Roseola

Question 4

Viral Exanthems

Vesicular Rash

Answer 4

Cox and Pox and Herps:
Coxsaxckie handfootmouth
Chixpox VZV
Herpes HSV

Question 5

Scarlet Fever
Clin/Sx
(besides the obvious)

Answer 5

• GAS
• erythro/pyrogenic toxinb
• “sandpaper” MacPap rash in skin folds
• desquamation
• tx w/ abx

Question 6

Scarlet Fever

Complications

Answer 6

-Purulent: OM, sinusitis, throat abscess,
cervical adenitis
-Nonsuppurative: rheumatic fever,
glomerulonephritis

Question 7

Measles/Rubeola

causative agent

Answer 7

paramyxovirus

Question 8

Measles/Rubeola

transmiss/epi

Answer 8

• winter/spring
• droplet/nasopharyngeal spread
• contagious 7d prior through 2nd day of rash

Question 9

Measles/Rubeola

Clin/Sx

Answer 9

• 4 day prodrome + viremia
• fever, coryza, conjunct, cough
• “KOPLIK’S SPOT” enanthem with whitehead
• MacPap irreg rash with blue/white speck

Question 10

Measles/Rubeola

Complications

Answer 10

• pneumonia
• immun suppression, diarrhea, OM
• rare post-infectious encephalitis (SSPE)

Question 11

Measles/Rubeola

dx

Answer 11

• clinical
• leukopenia
• IgM, IgG

Question 12

Measles/Rubeola

tx

Answer 12

• Ribavirin for immunocompromised

- Vit A

Question 13

German Measles/Rubella

causative agent

Answer 13

togavirus

Question 14

German Measles/Rubella

transmiss/epi

Answer 14

• children, winter/spring
• moderate contagion, nasopharyngeal droplets
• elim’d in US, not globally
• contagious for 2 weeks after onset of rash

Question 15

German Measles/Rubella

Clin/Sx

Answer 15

• prodrome
• top-to-bottom MacPap rash, NOT CONFLUENT
• postauricular, suboccipital lymphadenopathy

Question 16

German Measles/Rubella

complications

Answer 16

• small jt arthritis (women)
• hemorrhagic complications, thrombocytopenia
• encephalitis
• congenital rubella syndrome

Question 17

German Measles/Rubella

Dx

Answer 17

-IgM

Question 18

Erythema Infectiosum (5th)
Causative Agent

Answer 18

Parvovirus B19

Question 19

Erythema Infectiosum (5th)
epi/transmiss

Answer 19

• winter/spring
• children
• resp tranmiss

Question 20

Erythema Infectiosum (5th)
clin/sx

Answer 20

-prodrome
-then a week of asx
-then… A SLAP IN THE FACE, BEEEETCH
-then sexy lacy reticular rash on the trunk and extremities
(like a Vicky’s neglige that you put on after a good slapping)

Question 21

Erythema Infectiosum (5th)
rare/adult clin/sx

Answer 21

• acute arthritis (women); self-lim’d (months)
• aplastic crisis w/ hemolytic anemia (replicates in erythro progenitors
• chronic anemia w/ immunosuppression
• 2nd semester fetal demise (don’t wear negligee’s when knocked up)

Question 22

Roseola Infantum

Casuative Agent

Answer 22

-HHV6

Question 23

Roseola Infantum

transmiss/epi

Answer 23

• most babes by 24 mo
• spring/fall
• swapping spit

Question 24

Roseola Infantum

Clin/sx

Answer 24

1) abrupt high fever (4 days)
2) fever stops, pale pink MacPap rash starts
3) atypical lymphocytes
Mono-ish in adults
Rare febrile seizures, encephalitis

Question 25

Roseola Infantum

dx

Answer 25

sero

Question 26

Roseola Infantum

tx

Answer 26

usually self-lim’d

Question 27

HandFootMouth

Causative Agent

Answer 27

Enterovirus Coxsackievirus A16

Question 28

HandFootMouth

Transmiss/Epi

Answer 28

• summer/fall, all ages

- fecal/oral

Question 29

HandFootMouth

Clin/Sx

Answer 29

• sore throat, fever
• vesicular enanthem that ulcerates
• papulovesicular rash (no pustules or scabs)
• hands, feets, butt

Question 30

Herpangina

Causative Agent

Answer 30

-Enterovirus Coxsackie A

Question 31

Herpangina

Transmiss/Epi

Answer 31

-summer, children

Question 32

Herpangina

Clin/Sx

Answer 32

• fever, sore throat

- vesicular enanthm that rapidly ulcerates (2-6 lesions)

Question 33

Other Infx’ns with Fever

Answer 33

• non-specific viral
• erythema chronica migrans (ECM)
• meningococcemia
• secondary syphillis
• Rocky Mtn Spotted Fever
• TSS
• drug eruption