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?

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
What are the clinical features of measles?
Maculopapular rash Koplik spots Conjunctivitis Coryza Cough
26
Name complications of measles
Respiratory - pneumonia - 2ndary bacterial infection - OM Neurological - febrile seizures - encephalitis - SSPE Other - diarrhoea - hepatitis - appendicitis - corneal ulceration - myocarditis
27
How is chickenpox transmitted?
Respiratory droplets
28
What are the clinical features of chickenpox?
Central vesicular rash that progresses to peripheries (itchy) for 3-5d
29
What are complications of chickenpox?
Bacterial superinfection CNS - cerebellitis - encephalitis - aseptic meningitis Immunocompromised - pneumonitis - dissemination
30
Name common bacterial exanthems
Scarlet fever SSS TSS Meningococcemia Rickettsia
31
What are the linear petechial feature of scarlet fever rash called?
Pastia's line
32
What skin quality is associated with scarlet fever?
Sandpaper
33
Which toxin causes SSS?
Epidermolytic exotoxin
34
Which sign is seen in SSS?
Nikolsky
35
What are the clinical signs of TSS?
Fever Rash Desquamation Hypotension Multisystem organ involvement