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Peds > Exanthems and Enanthems > Flashcards

Exanthems and Enanthems Flashcards

1
Q

aka measles

A

rubeola

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2
Q

prodrome symptoms of measles

A

*koplik spots, fever, severe cough, nasal congestion, conjunctivitis

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3
Q

how does measles start/spread to

A

*begins behind the ears and then trunk then extremities

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4
Q

tx for measles

A

VIT A, supportive

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5
Q

hand foot mouth dz cause

A

coxaskie virus and enterovirus

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6
Q

symptoms of hfmd

A

oral lesions -90%
3-7mm red macules that become pale, white, oval vesicles with a red areola.
Occur on the palms, soles, dorsal aspects of the fingers toes

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7
Q

tx for hfmd

A

supportive

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8
Q

scarlet fever cause

A

streptococcus toxins

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9
Q

where does scarlet fever originate

A

pahrynx (strep throat) or skin

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10
Q

scarlet fever PE findings

A

skin-sandpaper feel
pastias line
desquamation
throat- strawberry tongue

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11
Q

tx for scarlet fever

A

amoxicillin (peds), PCN, cephs, erythromycin for PCN allergy

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12
Q

rubella aka

A

german measles

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13
Q

most imp consequences are to who when infected w/ rubella

A

the unborn

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14
Q

rubella s/sx

A

soft palate petechiae (20%)

begins on neck/face then travels to trunk

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15
Q

rubella classic triad of clinical effects

A

cardiac malformation, hearing deficits, and ocular anomalies.

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16
Q

blueberry muffin, congenital cataract

A

rubella

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17
Q

erythema infectiosum aka

A

fifths, parvovirus

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18
Q

stages of parovirus

A

Stage 1: facial erythema (slapped cheeks)
Stage 2: Net pattern erythema
Stage 3: recurrent phase

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19
Q

can fifths disease affect a preggers women

A

yes-can cross placenta

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20
Q

roseala infatum presentation

A

Typically: VERY high fever, fever subsides and the rash appears

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21
Q

how common if roseola

A

80% of all children by age 1, 90% by age 2 (95% in adults)

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22
Q

prodrome of roseola

A

Sudden onset of high fever 102°F-104°F (39°C-40°C)

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23
Q

eruptive phase of roseola

A

begins when fever ends

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24
Q

tx for roseola

A

supportive

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25
Q

kawasaki disease etiology

A

acute multisystem vasculitis of unknown etiology (likely infectious cause)

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26
Q

main cause of morbidity for kawasaki disease

A

***coronary aneurysms

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27
Q

major criteria for kawaskie

A

MUST have FEVER for more than 5 DAYS

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28
Q

kawasakie tx

A

high dose ASA
IV IG
careful of reyes syndrome though

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29
Q

the viral rash

A

will not get definite dx

usually diffuse rash all over body

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30
Q

major complications of measles

A

pneumonia**, bronchitits, otitis media, sinusitis, stomatitis, encephalitis and myocarditis (high risk of getting these)

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31
Q

what could happen 10 yrs after a measles infection

A

subacute sclerosing panencephalitis (SSPE)

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32
Q

can measles reactivate latent TB?

A

yes

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33
Q

best dx for measles

A

oral swab

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34
Q

what is the scarlet fever look alike rash

A

Arcanobacterium hemolyticum

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35
Q

what season does scarlet fever occur

A

late fall, early winter, early spring

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36
Q

class scarlet fever presentation

A

abruptly with fever and sore throat, then rash appears in 1-2 days

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37
Q

late complications of scarlet fever

A

include rheumatic fever and poststreptococcal glomerulonephritis

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38
Q

can include rheumatic fever and poststreptococcal glomerulonephritis be prevented with early strep tx?

A

no

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39
Q

complications of scarlet fever-what are they same as

A

strep infection
Peritonsillar abscess, cervical lymphadenitis, retropharyngeal abscess, otitis media, bronchopneumonia, meningitis, brain abscess, intracranial venous sinus thrombosis, bacteremia and septicemia

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40
Q

when season does rubella infections occur

A

late winter early spring

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41
Q

prodrome of rubella

A

fever, headache, malaise, tender lymphadenopathy (occipital, posterior auricular and cervical) and upper respiratory symptoms lasting 1 to 5 days

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42
Q

when season is fifths disease most likely to occur

A

spring, aged 4-10

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43
Q

progression of Erythema Infectiosum

A

“slapped cheek” rash develops that progresses to involve the trunk and extremities with erythematous macules, papules and patches. Eventually the truncal eruption fades to leave behind lacy, reticular pattern, occasionally itchy.

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44
Q

how is the dx of Erythema Infectiosum made

A

clinically

45
Q

when are kids considered no longer contagious w/ Erythema Infectiosum

A

when the rash is apparent

46
Q

describe the exanthem of roseola

A

pink, blanchable, macule papules that are usually not pruritic

47
Q

tx for roseloa

A

self limiting but associated w/ febrile seizures

48
Q

mumps is associated with…

A

a virus that causes inflammation in the parotid gland

49
Q

is mumps serious or benign, asymptomatic/symptomatic

A

majority benign and asymptomatic

50
Q

complications of mumps

A 
Hearing loss
Rarely viral meningitis, encephalitis, 
	and pancreatitis. 
Orchitis can occur in teens and young
	 adults. Infertility can occur in those 
	with orchitis. 
Miscarriage can occur in women with 
	mumps in the first trimester.
51
Q

can you get mumps even if you are vaccinated

A

yes - possibly due to waning immunity

52
Q

what is varicella caused by

A

varicella zoster virus

53
Q

when do ppl get varicella

A

90% <10 yrs

54
Q

dew drops on rose petals

A

varicella

55
Q

classic triad of varicella

A

rash, malaise, low grade fever

56
Q

how does the rash present in varicella

A

in crops, from trunk first usually

57
Q

how long are varicella pts contagious for

A

2 days before lesions erupt until they are all crusted

58
Q

dx of varicella

A

clinically and confirmed by PCR

59
Q

MC complication of varicella

A

secondary bacterial inf

60
Q

tx of varicella

A

supportive, calamine lotion for itching

61
Q

when do you need acyclovir for varicella

A

immunocompromised children and with VariZIG™ for highly susceptible individuals within 96 hours of exposure

62
Q

what is herpes zoster caused by

A

reactivation of varicella zoster virus

63
Q

how does zoster present

A

in a dermatomal pattern rarely crossing midline

64
Q

tx for zoster

A

antiviral agents (eg, acyclovir) given early in the disease course shorten the recovery period and reduce the chance of postherpetic neuralgia

65
Q

what is herpes zoster opthalmicus and is it an emergeny

A

herpes zoster of the opthalmic division of trigeminal nerve, EMERGENCY

66
Q

what is ramsay hunt syndrome

A

herpes zoster oticus, is a reactivation of VZV that involves the facial nerve. Cranial nerves V, VI, VIII, and IX may also be involved.

67
Q

where does HSV-1 and HSV-2 reactivate

A

HSV-1 reactivates predominantly in the trigeminal ganglia, called herpes labialis (shown)

HSV-2 reactivates in the lumbosacral ganglia, called herpes genitalis.

68
Q

symptoms of HSV

A

painful ulcerating lesions

69
Q

tx for HSV

A

typically self limiting BUT antivirals will shorten the course of symptoms and may help to prevent dissemination and transmission

70
Q

herpetic whitlow

A

intensely painful infection of the hand caused by HSV

71
Q

enterovirus season

A

usually summer months

72
Q

GI symptoms + fever + rash

A

enterovirus

73
Q

tx for enterovirus

A

usually self limiting

74
Q

where is enterovirus shed and spread

A

via fecal oral route and shed in feces

75
Q

hfmd is a variation of…

A

enterovirus

76
Q

herpangia cause

A

nonpolio enteroviruses, coxsackieviruses A and B as well as echoviruses

77
Q

presenting symptoms of herpangia

A

rapid onset of fever, vomiting, sore throat, and the appearance of numerous vesicular lesions in the region of the tonsillar fauces (anterior tonsillar pillars, tonsillar pillars, soft palate, uvula and posterior pharynx)

78
Q

tx of herpangia

A

nonspecific, possible numbing mouth rinses

79
Q

infectious mononucleosis presenting symptoms

A

lymphadenopathy* or pan-lyphadenopathy
splenomegaly in > 50% of patients
Could have ULQ pain
Characteristically prolonged, recovery takes 4 to 6 weeks, rarely 12 or more weeks

80
Q

infectious mononucleosis is caused by

A

EBV

81
Q

big thing to watch out for w/ mono

A

SPLENIC RUPTURE***

82
Q

specific serology test for mono

A

EBV viral capsid antigen (VCA) Immunoglobulin (IgM) is the most accurate and useful tool for the diagnosis of Infectious

83
Q

tx for mono

A

REST- NO PHYSICAL ACTIVITIES

highest rate of splenic rupture is 2-3 wks

84
Q

kawasaki caused by…

A

vasculitis caused by unknown etiology

85
Q

dx of kawasaki

A

DO ECHO -look for coronary aneurysms

86
Q

tx to prevent coronary aneurysms in kawasaki dz

A

aspirin and intravenous immunoglobulin, which reduces the risk for cardiac involvement to 5%.

87
Q

steven’s johnson syndrome cause…

A

response to triggers (infections, malignancies, medication)

more severe version of erythema multiforme

88
Q

difference between SJS and erythema multiforme

A

SJS may involve the mucous

membranes (vs erythema multiforme that has NO muscous membrane involvement)

89
Q

lymphangitis

A

inflammation of lymph channels

90
Q

lymphangitis presentation

A

a red streak traveling up the arm, a raised border around the affected area, and lymphadenitis.

91
Q

lymphangitis cause

A

is Streptococcus pyogenes

92
Q

cellulitis cause

A

Streptococcus pyogenes and Staphylococcus aureus.

93
Q

tx for cellulitis

A

activity against staphylococci and streptococci (eg, dicloxacillin, cephalexin, clindamycin, amoxicillin/clavulanate=augmentin

94
Q

cellulitis presentation

A

fevers, chills, pain, swelling, tenderness, erythema, and warmth. The borders of cellulitis are NOT elevated or sharply demarcated.

95
Q

lymphangitis vs cellulits

A

cellulitis- more diffuse, no elevations, no sharp demarcations
lymphangitis- streaking, elevated

96
Q

Erysipelas

A

superficial bacterial skin infection that extends into the cutaneous lymphatics

97
Q

Erysipelas cause

A

by group A streptococci, in many cases secondary to local skin trauma.

98
Q

Erysipelas presentation

A

sharp, distinct outline, whereas cellulitis fades gradually into the surrounding skin.

99
Q

impetigo cause

A

Staphylococcus aureus and group A beta-hemolytic streptococci (GABHS)

100
Q

peak incidence of impetigo

A

summer and fall

101
Q

tx for impetigo

A

topical mupirocin

102
Q

H.S. purpura most serious complication

A

Intussusception

103
Q

where does H.S. purpura usually present

A

below the waist

104
Q

how to differentiate between idiopathic thrombocytopenic pupura and H.S purpura (lab test)

A

platelet count generally normal in HS

105
Q

meningococal inf cause

A

Neisseria meningitides.

106
Q

clinical presentation of miningitis

A

Children with meningitis are usually febrile and ill-appearing, with symptoms of lethargy, vomiting, or nuchal rigidity (doesn’t always happen)

107
Q

complications of miningitis

A

Septic emboli cause arterial occlusion in the distal extremities, as shown in this infant.

The disease is fatal in 50 % of cases, if left untreated. Even with prompt treatment, the mortality rate is 5-10%

Septicemia leads to capillary leak, coagulopathy, profound acidosis, and myocardial failure

108
Q

meninigitis tx

A

antibiotic treatment should be initiated without waiting for confirmatory culture testing. Initial antibiotic of choice is

Vancomycin + Ceftriaxone.

Peds (5 decks)

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