Exam I - Rashes

Question 1

describe rash of measles

Answer 1

maculopapular rash that begins on face and proceeds downward and outward, affecting palms and soles last

Question 2

measles:

• when does prodrome start after infection
• what is the prodrome

Answer 2

7-18 days

rash, leukopenia, fever, cough, coryza, conjuctivities

Question 3

koplik spots on buccal mucosa are pathognomonic for what dz

Answer 3

measles

Question 4

clinical presentation for rubella

when does it occur after exposure

Answer 4

2-3 days of exanthem rash, 14-17 days after exposure

enlargement of cervical, suboccipital, and postauricular glands

Question 5

what risks does rubella pose to the fetus

Answer 5

microcephaly, congenital heart dz, deafness

Question 6

describe rash of rubella

Answer 6

exanthem
- erythematous macules and papules appearing initially on face and spreading to trunk, arms, legs, in 24 hours

desquamation may follow resolution of rash

Question 7

clinical presentation of erythema infectiosum (fifth disease)

Answer 7

• “slapped cheek” appearance
• circumoral pallor (pale area around mouth)
• rash
• malaise, HA, pruritis

Question 8

describe rash of erythema infectiosum (fifth disease)

Answer 8

lacy, maculopapular, evanescent rash on trunk and limbs

Question 9

what risks does parvovirus B19 pose to the fetus

Answer 9

hydrops fetalis and fetal loss

Question 10

symptoms of parvovirus in adults

Answer 10

symmetric polyarthritis (looks like RA, SLE, sjogrens)

aplastic crisis

Question 11

symptoms of stage 1 lyme dz

Answer 11

erythema migrans (bullseye lesion) 1 week after tick bite

followed by viral-like illness (myalgias, arthralgias, headache, fatigue, might have fever)

Question 12

symptoms of stage 2 lyme dz

Answer 12

early disseminated infection (weeks to months later)

bacteremia

secondary skin lesions w/ malaise, fever, fatigue, HA, neck pain

4-10% with myopericarditis

10-15% with neurologic manifestations

Question 13

symptoms of stage 3 lyme dz

Answer 13

later persistent infection (months to years later)

MSK manifestations (arthritis)

neurologic manifestations (rare)

acrodermatitis chronicum atrophicans (rare)

Question 14

incubation period for EBV

Answer 14

30-50 days

Question 15

sx infectious mononucleosis

Answer 15

• malaise, fever, sore throat
• palatal petechiae, lymphadenopathy, splenomegaly, maculopapular rash
• bilateral upper lid edema (hoagland sign)

Question 16

hoagland sign (bilateral upper lid edema) is indicative of what dz

Answer 16

infectious mononucleosis

Question 17

incubation period and sx of rocky mountain spotted fever

Answer 17

2-14 days

fever, chills, HA, nausea, vomiting

followed by cough and pneumonitis

rash

Question 18

describe rash of rocky mountain spotted fever

Answer 18

begins as a faint macule that progresses to large maculopapules and often petechiae

begins on wrists and ankles, involves palms and soles, and spreads to arms, legs, and trunk

Question 19

describe the skin manifestations of syphilis

Answer 19

diffuse rash that may include palms and soles, macular, papular, pustular, and combinations

condyloma lata

painless, silvery ulcerations of mucous membranes w/ surrounding erythema

Question 20

describe rash of hand, foot, and mouth syndrome

Answer 20

vesicular eruption on palms and soles

lesions start as bright pink macules and papules that progress to small vesicles w/ surrounding erythema

vesicles quickly erode and form yellow to gray oval or “football shaped” erosions w/ erythematous halo

rash on palms, soles, buttocks, external genitalia

Question 21

complications of cocksackie (HFMS)

Answer 21

1) epidemic pleurodynia
2) aseptic meningitis
3) acute pericarditis

Question 22

describe skin manifestations of TSS

Answer 22

diffuse macular erythematous rash

desquamation on palms and soles during recovery

Question 23

describe rash of scarlett fever

Answer 23

puncate, red, involves hands and feet

prominent on neck, axilla, groin, skin folds

circumoral pallor (around mouth)

fine desquamation

Question 24

describe rash of erythema multiforme

Answer 24

“target” lesions predominantly on face and extremities

Question 25

clinical presentation of erythema multiforme

Answer 25

mild prodromal sx

hx of HSV

targetoid lesions

Question 26

describe how erythema multiforme affects the oral cavity

Answer 26

mostly on the lips, on both cutaneous and mucosal sides

hard palate is usually spared, as are the attached gingivae

Question 27

describe rash of varicella

Answer 27

begins on face and scalp and spreads rapidly to the trunk, relative sparing of the extremities

***progresses sequentially from rose-colored macules to papules, vesicles, pustules, and crusts

***lesions of all stages are usually present at the same time

Question 28

describe skin manifesrations of pemphigus vulgaris

Answer 28

flaccid blister that can occur anywhere on the skin, but typically not the palms or soles

blisters are fragile

Question 29

describe rash of gonoccemia

Answer 29

small to medium sized macules, or more typically hemorrhagic vesicopustules on an erythematous base located on palms and soles

lesions may have necrotic centers

“gun metal gray”

Question 30

describe rash of meningococcemia

Answer 30

rose-colored macules and papules, waxes and wanes with periodic fevers

Question 31

what vasculitides have palpable purpura

Answer 31

• SLE
• sjogren’s
• henoch-scholein
• RA

Question 32

what infectious processes have palpable purpura

Answer 32

• meningococcemia
• gonoccemia
• RMSF
• endocarditis

Question 33

what conditions have non-palpable purpura

Answer 33

• ITP
• TTP
• DIC
• clotting factor defects

Question 34

describe appearance of basal cell CA

Answer 34

pearly papule, erythematous patch, non-healing ulcer

telangiectatic vessels visible

Question 35

describe appearance of squamous cell CA

Answer 35

nonhealing ulcer or warty nodule

small, red, conical, hard nodule

Question 36

most common locations for melanoma on men and women

Answer 36

men: back
women: lower extremities, then trunk