L78

Question 1

What is exanthem?

Answer 1

Rash on skin

Vs. enanthem = rash on mucous membrane

Question 2

Big 5 childhood diseases that cause rash

Answer 2

Measles 
Strep pyogenes 
Rubella
Parvo - erythema infectiosum
Roseola (HHV 6)

Question 3

Symptoms of measles

Answer 3

3 Cs + K
Conjunctivitis 
Cough
Coryza = running nose
Koplic spots = enanthem rash in the mouth w/ grey middle

Question 4

Describe the measles rash: appearance, timing

Answer 4

= Rubeola 
Develops after Koplic spots
Starts on face
Progresses centrally
Moves to periphery & toes

Question 5

Geographic tip offs for measles

Answer 5

California

Switzerland

Question 6

Measles incubation

Answer 6

1 up to 2 wks
Day 10 - fever
Day 14 - rash
Infectious before symptoms start during this incubation period

Question 7

Measles transmission

Answer 7

Air-born

Kids in school

Question 8

Diagnose measles

Answer 8

1. Clinical

2. Serum testing - IgM/G - watch out for false +/-

Question 9

What tissue does measles infect?

Answer 9

Respiratory epithelium –> LN

Question 10

Which immune system is important for measles resolution?

Answer 10

Cellular

Question 11

Measles genome

Answer 11

(-) ssRNA
Enveloped
Labile

Question 12

What cell types does measles infect during primary viremia?

Answer 12

T cells! Same time once penetrated resp epi
Causes temp immune suppression that is definitely noticeable
- Pna

Question 13

What CNS disease might result from measles? When might this present?

Answer 13

Encephalitis

Acute or sub-acute years later!

Question 14

What nutrition deficiency would make measles worse?

Answer 14

Vit A def

Question 15

When do you give the measles vaccine?

Answer 15

9mo-1 year

Live, attenuated vaccine - therefore babies who have mom’s Abs might not have right response

Question 16

Mumps symptoms

Answer 16

Swollen neck!!
Parotid gland
1 sided - may spread bilateral

Question 17

Mumps genome

Answer 17

(-) ss RNA
Capsid w/ 
- Hemagglutinin (H)
- Neuraminidase (N)
- Fusion protein (F)
Lipid bilayer from host cells

Question 18

Mumps pathogenesis - where does infection start and move

Answer 18

Start @ URT epi
to LN
Viremia -> glandular tissue (scrotum)

Question 19

Which branch of immunity controls mumps infection?

Answer 19

Cellular

Question 20

Mumps transmission

Answer 20

Resp drops
Saliva
Fomites

Question 21

Mumps incubation

Answer 21

2-3 wks

Longer than measles

Question 22

When is mumps contagious?

Answer 22

2 days before jaw swelling –> 5 days after

Question 23

Which CNS disease is associated with mumps?

Answer 23

Aseptic meningitis

Question 24

Mumps complications

Answer 24

Encephalitis
Deafness
Infertility

Question 25

Mumps vaccine. Who don't you give this to?

Answer 25

Live, attenuated As MMR/V DONT give to PREGNANT

Question 26

Rubella symptoms

Answer 26

Head --> toes : disappears as it progresses - Correlates w/ appearance of Abs Cervical swollen LN Arthritis - esp adults

Question 27

Rubella genome

Answer 27

+ ssRNA

Question 28

Rubella pathogenesis

Answer 28

URT epi LNs Viremia

Question 29

What is the role of Abs vs cell immunity for rubella?

Answer 29

Ab: limit spread Cell: elim infection

Question 30

Rubella incubation & infectious period

Answer 30

2-3 wk incubation | Infectious: prodome --> 2 wks post rash

Question 31

What is congenital rubella syndrome?

Answer 31

``` In BABIES :( Cataracts Heart disease Deafness "Blue berry muffin rash" ```

Question 32

Why do we vaccinate vs rubella?

Answer 32

To cover women who might become pregnant to prevent congenital rubella syndrome

Question 33

Parvovirus symptoms - correlation to infectiousness

Answer 33

1. Fever due to viremia = infectious | 2. Slap check rash = erythema infectiousum

Question 34

Parvovirus genome

Answer 34

ss DNA

Question 35

What cells does parvo replicate in?

Answer 35

Erythroid precursors | Fetal capillary endothelium in placenta

Question 36

Parvo patho

Answer 36

Replicates @ RT | Viremia --> bone marrow

Question 37

Secondary diseases that might result from parvo

Answer 37

Arthritis Anemia - duh, infecting blood precursors! Non-immune fetal hydrops !! Myocarditis