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AUC MS2 > Exanthems Micro > Flashcards

Exanthems Micro Flashcards

1
Q

The major types of exanthems AKA rashes/skin eruptions (6)

A 
Macular
Maculopapular
Vesicular/bullae
Pustular
Petechial
Purpura
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2
Q

Type of exanthem: flat, discolored, blanchins spot(s)

A

Macule

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3
Q

Type of exanthem: fluid filled sac in epidermis

A

Vesicle, bullae if over 0.5cm

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4
Q

Type of exanthem: elevated, pus filled sac

A

Pustule

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5
Q

Type of exanthem: red/brown hemorrhagic spots without blanching

A

Petichia

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6
Q

Coalescence of small petechia

A

Purpura

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7
Q

Type of exanthem: raised with discoloration and blanching (papular spots)

A

Maculopapular rash

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8
Q

Medical term for blanching of the skin

A

Schultz-Charleton Phenomenon

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9
Q

Bacterial cause(s) of exanthems

A

Streptococcus pyogenes

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10
Q

Viral cause(s) of exanthems

A 
Coxsackie Virus
Parvovirus B19
Rubeola (Measles) Virus
Rubella Virus
Varicella-Zoster Virus
Variola/Vaccinia Virus
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11
Q

Cause(s) of maculopapular exanthems

A 
Streptococcus pyogenes
Rubeola virus
Rubella virus
HHV 6
Parvo B19 virus
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12
Q

Cause(s) of vesicular exanthems

A

Varicella-Zoster
Coxsackie A
Pox Virus
-Smallpox

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13
Q

Diagnose: Rash starts on upper chest then spreads to extremities, Schultz-Charleton Phenomenon, Pastia’s Lines,
sandpaper feel, strawberry tongue, fever, possible nausea/vomiting.
Begins several days after onset of Strep pharyngitis or in rare cases surgically/trauma associated Strep infections

A

Scarlet Fever/ Scarlatina

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14
Q

The maculopapular scarlet fever rash is caused by production of erythrogenic toxins which trigger a ____ type hypersensitivity

A

Delayed

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15
Q

To obtain the erythrogenic toxin, S. pyogenes must be lysogenized by a phage carrying the ___ gene

A

Spe

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16
Q

The name for a rash discoloration that is darker in skin folds

A

Pastia’s lines

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17
Q

The rash of scarlet fever starts ____ and spreads___

A

On the upper chest

Towards the extremities

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18
Q

The disease involving a rough maculopapular rash, fever, and swollen papillae of the tongue caused by Strep. pyogenes (GAS) is called:

A

Scarlet Fever/ Scarlatina

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19
Q

The sandpaper feel of Scarlet fever is due to:

A

Sweat glands becoming occluded

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20
Q

Gram positive coccus, catalase negative, beta hemolytic on Blood agar (BAP); Lancefield group A

A

Streptococcus pyogenes (GAS)

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21
Q

Erythrogenic toxins of Strep. pyogenes act as ______ and are pyrogenic (produce fever)
Their Spe gene is located on a _____, and triggers a delayed hypersensitivity reaction.

A

Superantigens

Lysogenized phage

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22
Q

Diagnose: Maculopapular rash starts on face and spreads to trunk including palms and soles of feet. Tendency to become confluent.

Fever of 101F (38.3 C) or above, cough, coryza (cold like), and conjunctivitis with photophobia (the 3 C’s)
Kopliks spots on buccal mucosa and throat.

Incubation period: 7-18 days
Infectious ~5 days before and 4 days after eruption of rash
Last about a week

A

Measles

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23
Q

Small bluish-white to grey spots on erythematous base, associated with ____

A

Kopliks spots

Measles

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24
Q

Time frame of measles

A

Incubation period: 7-18 days
Infectious ~5 days before and 4 days after eruption of rash
Last about a week

25
Q

Measles infectious agent

A

Paramyxoviridae: Rubeola Virus

26
Q

The rash of measles seems to be associated with ____ (cell type) targeting infected ______ (cell type) in small blood vessels

A

CTLs

Endothelial cells

27
Q

Viral cytopathology of Rubeola results in _____ formation

A

Syncitia

28
Q

General characteristics of Rubeola Virus (Measles)

A

Neg sense ssRNA, enveloped virus
H (hemagglutinin) spike
F (fusion) spike facilitates uptake of virus by host cells, causes syncitia formation

29
Q

Reservoir, Transmission, and risk groups for Rubeola Virus (Measles)

A

Human

Respiratory droplets

Unvaccinated

30
Q

Describe prevention of measles

A

Vaccine: live attenuated – part of MMR (12-15 mo + 5-6 yr)
Passive immunization: for at risk patients during an outbreak; that is those less than 1 year old or those with impaired cellular immunity.

31
Q

Measles/Rubeola Sequelae/Complications

A

Secondary bacterial infections;
Pneumonia;
Meningitis/encephalitis
Subacute Sclerosing Panencephalitis (SSPE)

32
Q

How long after measles infection does a patient develop Subacute Sclerosing Panencephalitis (SSPE)?

A

1-10 years

33
Q

Risk factor(s) for acquiriing SSPE after measles infection

A

Acquiring primary measles at an early age (under 2 years) AND defective forms of the virus

34
Q 
Diagnose:  Maculopapular rash that starts on face to moves to trunk, less intensely red than Rubeola.
Low Fever (usually only on first day), may have myalgia/arthralgia,
Rare mild coryza and conjunctivitis 
Resembles mild case of Rubeola, can be asymptomatic or subclinical
A

Rubella
German Measles
Three Day Measles

35
Q

The rash from rubella is associated with _____ and may cause ______.

A

Immune complex formation

Polyarthralgia

36
Q

Time frame of Rubella Virus infection

A

Incubation period 7-14 days
Last about 3 days
Most contagious when rash is erupting BUT virus shed from 7 days before until 4 days after onset of rash

37
Q

It is important to note that Rubella can undergo ________ transmission

A

Transplacental

38
Q

The Rubella Virus acts as a teratogen during the _____ trimester resulting in congenital defects

A

First

39
Q

The primary targets of Rubella Virus in the fetus are:

A

Heart: patent/primary ductus arteriosus, other defects
Eyes: cataracts, glacoma, blindness
CNS: mental retardation, deafness

40
Q

Can an infant with Congenital Rubella Syndrome act as a reservoir after birth?

A

Yes, for months

41
Q

4 general characteristics of Rubella Virus

A

ss pos sense linear RNA, Enveloped
H glycoprotein spike (peplomer)
NO F peplomer

42
Q

Describe prevention of Rubella Virus

A

Vaccinate: Live, attenuated vaccine - MMR

43
Q

Diagnose:
First: Fever, Coryza, Headache, mild GI distress, myalgia, then Classic bilateral “slapped-cheek syndrome” maculopapular
rash appears, with circumoral pallor. Eruption of lacy, reticulate maculopapular body rash appearing on trunk, limbs, soles of the feet.
Polyarthragias in adults.

Drop in hematocrit (some with acute anemia)

A

Erythema Infectiosum (Fifth Disease)

44
Q

RARE transplacental infection (stillbirth and miscarriage) due to transplacental infections (non immune) like Fifth disease.

A

Hydrops fetalis

45
Q

Aplastic crisis may occur in patient with underlying anemias such as sickle cell anemia when ______ drops in Fifth Disease. May require transfusion for survival

A

Hematocrit

46
Q

Abrupt cessation of erythropoiesis characterized by reticolocytopenia, absent erythroid precursors in the bone marrow, and worsening of existing anemia. Occurs in patients with underlying hemolytic disorders.

A

Transient aplastic crisis

47
Q

Drop in hematocrit seen in Fifth Disease could lead to what disorders in an anemic person (2)

A

Aplastic crisis,

Fatal Hemolytic Anemia (pts with previous aplastic crisis)

48
Q

Time course of Erythema Infectiosum (Fifth Disease)

A

IP 2-5 Days

Lasts less than a week usually

49
Q

The inectious agent causing Erythema Infectiosum (Fifth Disease) is

A

Parvoviridae: ParvoB19 Virus

50
Q

The maculopapular rash seen in Fifth Disease is due to

A

Immune complex depostition

51
Q

Viral cytopatholgy of ParvoB19 results in inactivation of ____ (cell type) which may result in a drop in the hematocrit.

A

Erythroid precursor cells

52
Q

General characteristics of Parvoviridae: ParvoB19 Virus

A

naked ss linear DNA (+ or - sense)

Requires that the host cell be undergoing DNA replication – Tropism for Erythroid precursor cells

53
Q

What antigen gives ParvoB19 its tropism for erythroid precursor cells?

A

P/globoside antigen

54
Q

Reservoir, transmission, and risk groups for ParvoB19

A

Humans

Resp. droplet, transplacental, fecal-oral, blood

Fetus, anemics

55
Q

2 features used to diagnose ParvoB19 in addition to serology and clinical presentation are:

A

Drop in hematocrit

+/- giant pronormoblasts in blood smears

56
Q

Diagnose:
Three to five day history of HIGH FEVER, occasionally mild upper respiratory symptoms.
Fever ends then rose-colored macular to maculopapular rash on trunk, could be absent in the face and legs.
In some infants, disease may be fever without rash
Infantile Fever: Felt to be a major contributor to seizures in infants

Time Course – not clear due to delay in diagnosis

A

Exanthem Subitum (Roseola)

57
Q

Cause of Exanthem Subitum (Roseola)

A

Herpesviridae: Human Herpes Virus 6 (HHV-6)

58
Q

3 general characteristics of Herpesviridae: Human Herpes Virus 6 (HHV-6)

A

ds linear DNA
Enveloped
Replicates in T cells, B cells, oropharyngeal epithelium

AUC MS2 (2 decks)

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