Important skin changes in skin Blood and lymph Flashcards
Pathognomic characteristic of Measles
Koplik spots on the buccal mucosa are pathognomic
also see a maculopapular rash for 3-4 days after the onset of prodrome
Fever cough coryza and conjunctivitis
Characteristics of Parovirus
Erythema Infectiosum in children or fifth disease is characterized by
- Slapped cheek appearance
- circumoral pallor
- maculopapular rash on the trunk and limbs
what is the most common cause of myocarditis in childhood
Parovirus
what other diseases does of parovirus B19 infection mimic
autoimmune states such as lupus, systemic sclerosis
antiphospholipid syndrome or vasculitis
What is Ehrlichiosis
a rickettsial infection common in missouri
fever chills headache malasie, myalgia, nausea, vomittin, anorexia, photophobia
abdominal pain miicking appendicitis, conjunctival injection, paatal petechiae, edema of dorsal hands, calf pain
Neuroogical: altered menta lstatus, cranial or peripheral motor nerve paralysis, sudden deafness
when does the erythematous macules appear on an erhrichiliosis patient?
5 days after onset of systemmic symptoms
what is the rash that is present in lymes disease
Erythema migrans
Stage 1 of Lymes disease
Early localized infection
Bulls eye lesion
viral like illness, mayalgias arthalgias headache fatigue and may have a fever
Sage 2 of lymes disease
weeks to months later
Bacteremia with erythema migrans
-secondary skin lesions
myopericarditis with atrial or ventricular arrhythmias and heart block
maybe neurological symptoms
conjunctivitis
Stage 3 of lymes diseae
late persistznt infection months to years -Musculoskeletal manifestations -monarticular or oligioarticular arthritis of the knee or other large weight bearing joints Chronic arthritis
can vesicle formation appear in Lymes disease
yes but does noot follow a dermatomal pattern like shingles
What virus is associated with Infecious Mononucleosis and what test is positive to determine it?
EBV
Positive heteropjile agglutination test (monospot)
Complications of Infectious Mononucleosis
Hepatitis, myocarditis, encephalitis, airway obstruction from adentitis, hemolytic anemia, thrombocytopenia
What causes Syphillis
Treponema Pallidum
What occurs in the first stage of Syphillis
Early stage
- Primary lesion, is chancre and regional lymphadenopathy
- second lesion is the skin and membranous membranes, bone or CNS and liver
what consists of the late stages of syphillis
Benign lessions involving the skin bones and viscera
-cardiovascular disease principally aortitis
CNS and ocular syndromes
what are some of the secondary lesions in syphillis
Condylomata lata
mucous patches on the hands and feet
what does a Coxsackievirus infection lead to?
Hand foot and mouth disease
or
Herpangina
Clinical findings of Hand foot and mouth disease
Stomatitis
Vesicular eruption rash on hands and feet
Nail dystrophies and onychomadesis
vesicles will quickly erode and form yellow to gray oval or football shaped erosions on th palms and feet
Clinical findings of Herpangina
SUdden onsent fevers
headaches
Myalgias
Petechiae or papules on thes soft palate that ulcerated in about 3 days and then heal
what can the strains of Staphyloccocal toxins produce what impoortant entities
- Scalded skin syndrome in children or bullious impetigo in adults
- Necrotizing pneumonia in children
- Toxic shock syndrome
- Entrotoxin in food poisioning
Characteristics of TSS
Abrupt onset of fever, vpmitting and watery diarrhea
- diffuse macular erythematous rash and non prulent cinjunctiviis are common
- morbilliform, scarlatiniform or even pustular rash
how is Scarlet Fever caused?
Group A Strep (pyogenes
what is the most common cause of tonsillopharyngitis in children and adults
Grp A strep
Characteristics of Scarlet Fever
Generalized punctuate red prominent on neck in axillae roin skin folds
circumoral pallor
Strawberry tongue
Exudative Tonsillitis
Group A beta hemolytic streptococcu in cultures from throat
ANti streptolysin O titer ruse
what di Erythema Multiforme look like and wht are most cases with these releated to?
Target lesions predominatly on the face and extremities
Most cases are related to Herpes simplex virus and Mycoplasma Pneumoniae
Defining characteristics of Varicella
aka CHicken pox
- Rash that stays on face and trunk
- Progress sequentially from rose colored macules to papules vesicles pustules and crusts
- Lesions in all stages are present at the same time
will go in to latent phase pf hiding in sensory andautonomic neurons and host immunity to VZV
What is the cause of Gonococcemia and what is its classic triad and charcteristics
Bacterial infection by neisseria gonorrhoeae, a gram negative aerobic coccus shaped bacterium that is diplocci
Common STD
Classic Triad:
- Dermatitis’
- Migratory Polyarthritis
- Tenosynovitis
SKin findings consist of small to medium macules or most typically hemorrhagic vesicopustules on an erythmatous base loocated on palms and soles
-slin lesions deveolp necrotic centers and led to a gun metal gray
what causes Meningococcemia and how sdoes it present?
Neisseria Meningitidis
Disseminated Meningococcal:
- Meningitis alone
- Acute meinigococcemia with or withoit meningitis
- Chronic Meningococcemia
What occurs in severe cases of Meningoccemia?
Necrosis and underlying tissue may necessitate amputation
what does Acute Meningococcemia with disseminated intravascular coagulation may produce?
Purpura Fulminans
What is the Pentad of TTP
Thrombotic THrombocytopenia Purpura
- Microandiopathic Hemolytic anemia
- Thrombocytopenia
- Neurologic symptoms
- Fever
- Renal Failure
How is TTP normally initiated?
Often an additional inflammatory trigger such as infection surgery pancreatitis or pregnacnt us required to initiate clinical TTP
What to think when the purpura is palpable?
Vasculitis:
- SLE
- Sjorgens
- Henoch Scholeins
- Rheumatoid Arthritis
Infection
- Meningococcemia
- Gonoccemia
- RMSF
- Endocarditis
What to think when the purpura is not palpable?
Autoimmune
- Idiopathic thrombocytopenia purpura
- Thrombotic Thrombocytopenic purpura
- Disseminated intravascular Coagulation
- Other thrombocytopenia or platelet dysfunction
- Clotting factor defect
What is the most common form of cutaneous cancer? and how does it present
Basal cell carcinoma of the skin
- Pearly palpable erythematous patch
- waxy pearly apperance with telangiectatic vessels
- Umbillicated bleeding
How does squamous cell carcinoma present
Ulcer or warty nodule that is usually keratinized
Risk factors of Melanoma
History of sunburns and heavy sun exposure Blue or green eyes Blonde or red hair Fair complexion >100 typical Nevi or any atypical Nevi Prior history or family history p16 mutation
