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DTMH Block 4 > Fever and rash syndromes in children > Flashcards

Fever and rash syndromes in children Flashcards

1
Q

What is an elevated solid lesion <1cm?

A

Papule

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2
Q

What is an elevated solid lesion >1cm?

A

> 1cm nodule

> > 2cm plaque

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3
Q

What is a flat area of altered colour/texture <1cm?

A

Maculae

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4
Q

What is a flat area of altered colour/texture >1cm?

A

Patch

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5
Q

What is a fluid filled lesion <1cm?

A

Vesicle

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6
Q

What is a fluid filled lesion >1cm?

A

Bullae

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7
Q

What is a pus filled lesion <1cm?

A

Pustule

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8
Q

What is a pus filled lesion >1cm?

A

Abscess

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9
Q

What is extravasation of blood <1cm?

A

Petechiae (pinhead)
Purpura

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10
Q

What is extravasation of blood >1cm?

A

Ecchymoses
Haematoma

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11
Q

What is dermal edema <1cm?

A

Wheal

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12
Q

What is dermal edema >1cm?

A

Angioedema

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13
Q

Name types of non-infectious fever/rash syndromes

A

Allergic (immune-mediated)
Inflammatory/rheumatological
Oncological

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14
Q

Name types of allergic/immune mediated fever/rash syndromes

A

Urticaria
Erythema multiform
SJS and TEN

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15
Q

Name infectious causes of urticarial rash

A

Bacteria
- m pneumonia
- GAS
- shigella
- meningococcus
- yersinia
Viruses
- EBV
- HBV
- HIV
- enteroviruses
Other
- parasites
- insect bites

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16
Q

What is the most common infectious cause of erythema multiform?

A

HSV

17
Q

What are the features of DRESS (drug reaction with eosinophilia and systemic symptoms)?

A

Extensive skin rash
Visceral organ involvement
Lymphadenopathy
Eosinophilia
Atypical lymphocytosis

18
Q

Which antibiotics are high risk for DRESS?

A

Vancomycin
Sulfonamides
Minocycline
RIPE

19
Q

Name rheumatological causes of fever/rash syndromes

A

Juvenile idiopathic arthritis
Kawasakii
SLE
Dermatomyositis
HSP
MIS-c
Haematophagocytic lymphohistiocytosis

20
Q

What is MIS-c?

A

Multisystem inflammatory syndrome associated with covid 19

21
Q

What is the diagnostic criteria for Kawasaki?

A
  1. Fever for at least 5 days
  2. 4 of the following clinical features
    - bilateral bulbar conjunctival injection without exudate
    - erythema and lip cracking, strawberry tongue, erythema of oral and pharyngeal mucosa
  3. Cervical lymphadenopathy
  4. Maculopapular diffuse erythroderma or erythema multiform-like
  5. Erythema and edema of hands and feet +/- nail desquamation
22
Q

What is the diagnostic criteria for hemophagocytic lymphohistiocytosis?

A

5 of the following
- fever >38.5
- splenomegaly
- peripheral cytopenia
- hypertriglyceridema +/- hypofibrinogenaemia
- hemophagocytosis in BM, spleen, liver, LN
- low or absent NK cell activity
- ferritin >500ng/ml
- elevated soluble CD25
- elevated CXCL9

23
Q

Name common causes of viral exanthems

A

Measles (rubeola)
Rubella (German measles)
Roseola (exanthema subitum HHV6)
Fifth disease (erythema infectiosum parvovirus B19)
Chickenpox (VZV)
Enterovirus
EBV (mononucleosis)
Gianotti-Crosti syndrome (EBV, HBV, coxsackie)

24
Q

What is the method of transmission of measles?

A

Droplet spread

25
Q

What are the clinical features of measles?

A

Maculopapular rash
Koplik spots
Conjunctivitis
Coryza
Cough

26
Q

Name complications of measles

A

Respiratory
- pneumonia
- 2ndary bacterial infection
- OM

Neurological
- febrile seizures
- encephalitis
- SSPE

Other
- diarrhoea
- hepatitis
- appendicitis
- corneal ulceration
- myocarditis

27
Q

How is chickenpox transmitted?

A

Respiratory droplets

28
Q

What are the clinical features of chickenpox?

A

Central vesicular rash that progresses to peripheries (itchy) for 3-5d

29
Q

What are complications of chickenpox?

A

Bacterial superinfection

CNS
- cerebellitis
- encephalitis
- aseptic meningitis

Immunocompromised
- pneumonitis
- dissemination

30
Q

Name common bacterial exanthems

A

Scarlet fever
SSS
TSS
Meningococcemia
Rickettsia

31
Q

What are the linear petechial feature of scarlet fever rash called?

A

Pastia’s line

32
Q

What skin quality is associated with scarlet fever?

A

Sandpaper

33
Q

Which toxin causes SSS?

A

Epidermolytic exotoxin

34
Q

Which sign is seen in SSS?

A

Nikolsky

35
Q

What are the clinical signs of TSS?

A

Fever
Rash
Desquamation
Hypotension
Multisystem organ involvement

DTMH Block 4 (14 decks)

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