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Infectious Diseases (4th year) > Fever and Rash - DONE > Flashcards

Fever and Rash - DONE Flashcards

1
Q

Macules:

A

flat lesions defined by an area of changed color (i.e. blanchable erythema)

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2
Q

Blanchable erythema is a…

A

macule

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3
Q

Papules:

A

raised, solid lesions < 5 mm in diameter

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4
Q

Plaques:

A

lesions > 5 mm in diameter with a flat, plateau-like surface

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5
Q

Nodules:

A

lesions, > 5 mm in diameter with a more rounded configuration

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6
Q

Wheals =

A
  • urticaria

- hives

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7
Q

Wheals:

A
  • papules or plaques that are pale pink and may appear annual (ring-like) as they enlarge;
  • classic (nonvasculitis) wheals are transient, lasting only 24h in any defined area
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8
Q

Vesicles size:

A

< 5 mm

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9
Q

Bullae size:

A

> 5 mm

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10
Q

Vesicles and bullae:

A

circumscribes, elevated lesions containing fluid

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11
Q

Pustules:

A

raising lesions containing purulent exudate

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12
Q

Nonpalpable purpura:

A

flat lesion that is due to bleeding into the skin.

  • If < 3 mm in diameter, the purpuric lesions are termed PETECHIAE.
  • If > 3 mm, they are termed ECCHYMOSES
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13
Q

Palpable purpura:

A

raised lesion that is due to inflammation of the vessel wall (vasculitis) with subsequent hemorrhage

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14
Q

Ulcer:

A

defect in the skin extending at least into the upper layer of the dermis

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15
Q

Eschar:

A

necrotic lesion covered with a black crust

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16
Q

Rubeola =

A

measles

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17
Q

Rubeola (measles):

A
  • Paramyxovirus
  • Discrete lesions that become confluent as rash spreads from hairline downward, usually sparing palms and soles; lasts >=3 days; Koplik’s spots
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18
Q

Rubella:

A
  • Togavirus

- spreads from hairline download, clearing as it spreads; Forschheimer spots

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19
Q

Erythema infectiosum:

A
  • Human parvovirus B19
  • Bright-red “slapped-cheeks” appearance followed by lacy reticular rash that waxes and wanes over 3 weeks; rarely, papular-purpuric “gloves-and-socks” syndrome hands and feet
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20
Q

Primary HIV infection:

A
  • HIV

- Nonspecific diffuse macules and papules; less commonly, urticarial or vesicular oral or genital ulcers

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21
Q

infectious mononucleosis

A
  • Epstein-Barr virus
  • Diffuse maculopapular eruption (5% of cases; 90% if ampicillin is given);
    urticaria, petechiae in some cases; perobital oedema (50%); palatal petechiae (25%)
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22
Q

Exanthematous drug-induced eruption:

A
  • drugs (antibiotics, anticonvulsants, diuretics, etc)

- Intensely pruritic, bright-red macules and papules, symmetric on trunk and extremities; may become confluent

23
Q

Lyme disease:

A
  • Borrelia burgdorferi
  • Papule expanding to erythematous annular lesion with central clearing (erythema migrans; average diameter, 15 cm), sometimes with concentric rings, sometimes with indurated or vesicular center; multiple secondary erythema migrans lesions in some cases
24
Q

Typhoid fever:

A
  • Salmonella typhi

- Transient, blanchable erythematous macules and papules, 2-4 mm, usually on trunk (rose spots)

25
Q

What illness gives rose spots?

A

Typhoid fever

26
Q

Dengue fever:

A
  • Dengue virus
  • Rash in 50% of cases; initially diffuse flushing; midway through illness, onset of maculopapular rash, which begins on trunk and spreads centrifugally to extremities and face; pruritus, hyperesthesia in some cases; after defervescence, petechiae on extremities in some cases
27
Q

Rat-bite fever:

A
  • Spirillum minus

- Eschar at bite site; then blotchy violaceous red-brown rash involving trunk and extremities

28
Q

Systemic lupus erythematous:

A
  • autoimmune disease
  • macular and papular erythema, often in sun-exposed areas;
    discoid lupus lesions (local atrophy, scale, pigmentary changes);
    periungual teleangiectasis; malar rash;
    vasculitis sometimes causing urticaria, palpable purpura;
    oral erosions in some cases
29
Q

Still´s disease

A
  • autoimmune disease
  • transient 2- or 5-mm erythrmatous papules appearing at height of fever on trunk, proximal extremities; lesions evanescent
30
Q

Secondary syphilis:

A
  • Treponema pallidum
  • Coincident primary chancre in 10% of cases;
    copper-colored, scaly papular eruption, diffuse but prominent on palms and soles;
    rash never vesicular in adults;
    condyloma latum, mucous patches, and alopecia in some cases
31
Q

Chikungunya fever:

A
  • Chikungunya virus

- maculopapular eruption; prominent on upper extremities and face, but can also occur on trunk and lower extremitites

32
Q

Hand-foot-and-mouth-disease:

A
  • coxsackie virus
  • tender vesicles, erosions in mouth; 0,25 cm papules on hands and feet with rim of erythema evolving into tender vesicles
33
Q

Erythema multiforme (EM)

A
  • Infection, drugs, idiopathic causes
  • Target lesions (entral erythema surounded by area of clearing and another rim of erythema) up to 2 cm; symmetric on knees, elbows, palms, soles;
    spreads centripetally;
    papular, sometimes vesicular;
    when extensive and involving mucous membrane, termed EM major.
34
Q

Bacterial endocarditis - cause:

A
  • strep

- staph

35
Q

Subacute course - Bacterial endocarditis:

A

Osler´s nodes (tender pink nodules on finger or toe pads);

Petechiae on skin and mucosa; splinter hemorrhages

36
Q

Acute course - Bacterial endocarditis:

A

Janeway lesions (painless erythematous or hemorrhagic macules, usually on palms and soles)

37
Q

Scarlet fever:

A
  • group A strep
  • Diffuse blanchable erythema begining on face and spreading to trunk and extremities; circumoral pallor;
    „sandpaper” texture to skin;
    accentuation of linear erythema in skin folds (Pastia’s lines);
    enanthem of white evolving into red „stawberry” tongue; desquamation in second week
38
Q

Kawasaki disease:

A
  • idiopathic causes
  • rash similar to scarlet fever or EM;
    fissuring on lips; strawberry tongue;
    conjunctivitis;
    edema of hands, feet;
    desquamation later in disease
39
Q

Streptococcal toxic shock syndrome:

A
  • group A strep
  • when present, rash often scarlatiniform
  • staph aureus
  • Diffuse erythema involving palms;
    pronounced erythema of mucosal surfaces;
    conjunctivitis;
    desquamation 7-10 days into illness
40
Q

Staphylococcal scalded-skin syndrome:

A
  • s.aureus, phage group II

- Diffuse tender erythema, often with bullae and desquamation; Nikolsky´s sign

41
Q

Dress =

A

Dihs

42
Q

Dress (Dihs)

A
  • Aromatic anticonvulsants;
    other drugs, including sulfonamides, minocycline
  • Maculopapular eruption (mimicking exanthematous drug rash), sometimes progressing to exfoliative erythroderma;
    profound edema, especially facial;
    pustules may occur
43
Q

Steven-Johnson syndrome (SJS), toxic epidermal necrolysis (ten)

A
  • Drugs (80% of cases;
    often allopurinol, anticonvulsants, antibiotics), infection, idiopathic
  • Erythematous and purpuric macules, sometimes targetoid, or diffuse erythema progressing to bullae, with sloughing and necrosis of entire epidermis;
    Nikolsky’s sign; involves mucosal surfaces;
    TEN (>30% epidermal necrosis) is maximal form;
    SJS involves <10% of epidermis; STS/TEN overlap involves 10-30% of epidermis
44
Q

Varicella (chickenpox):

A
  • VZV
  • Macules (2-3 mm) evolving into papules, then vesicles (sometimes umbilicated), on an erythematous base („dewdrops on a rose petal”); pustules then forming and crusting; lesions appearing in crops; may involve scalp, mouth; intensely pruritic
45
Q

Variola =

A

smallpox

46
Q

Variola (smallpox):

A
  • variola major virus
  • Red macules on tongue and palate evolving to papules and vesicles;
    skin macules evolving to papules, then vesicles over 1 week, with subsequent lesion crusting;
    lesions initially appearing on face and spreading centrifugally from trunk
47
Q

Primary herpes simplex virus (HSV- infection):

A
  • HSV
  • Erythema rapidly followed by hallmark painful GROUPED VESICLES that may evolve into pustules that ulcerate, especially on mucosal surfaces;
    lesions at site of inoculation: commonly gingivostomatitis for HSV-1 and genital lesions for HSV-2;
    recurrent disease milder (e.g., herpers labialis does not involve oral mucosa)
48
Q

Urticarial vasculitis:

A
  • Serum sickness, often due to infection (including hepatitis B viral, enteroviral, parasitic), drugs; connective tissue disease
  • Erythematous, edematous „urticaria-like” plaques, pruritic or burning; unlike urticaria; typical lesion duration > 24 h (up to 5 days) and lack of complete lesion blanching with compression due to hemorrhage
49
Q

Erythema nodosum (septal panniculitis):

A
  • Infections (e.g. streptococcal, fungal, mycobacterial, yersinial);
    drugs (e.g., sulfas, penicillins, oral contraceptives); sarcoidosis;
    idiopathic causes
  • Large, violaceous, nonulcerative, subcutaneous nodules; exquisitely tender;
    usually on lower legs but also on upper extremities.
50
Q

Acute meningococcemia:

A
  • Neisseria meningitidis
  • Initially pink maculopapular lesions evoving into petechiae rapidly becoming numerous, sometimes enlarging and becoming vesicular;
    trunk, extremities most commonly involved;
    may appear on face, hands, feet;
    may include purpura fulminans reflecting DIC
51
Q

Cutaneous small - vesselvasculitis (leukocytoclastic vasculitis)

A
  • Infections (including that caused by group A Streptococcus, viral hepatitis), drugs, idiopathic causes
  • Palpable purpuric lesions appearing in crops on legs or other dependent areas;
    may become vesicular or ulcerative
52
Q

Anthrax:

A
  • Bacillus anthracis
  • Pruritic papule enlarging and evolving into a 1-by 3-cm painless ulcer surrounded by vesicles and then developing a central eschar with edema; residual scar
53
Q

Erysipelas:

A
  • Streptococcus group A

- Infection of the superficial dermis and consists of demarcated, erythematous, edematous, warm plaques

54
Q

Herpes zoster:

A
  • reactivation of varicella zoster virus (VZV)

- bubbles on one dermatomy, may be more than one dermatomy in immune deficiency.

Infectious Diseases (4th year) (19 decks)

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