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CM 1B: ID/EENT > Lecture 10: Viral Exanthems > Flashcards

Lecture 10: Viral Exanthems Flashcards

1
Q

What are the 6 childhood exanthems?

A
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2
Q

Who is rubeola/measles most common in?

A

Children <5

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3
Q

What is the causative organism in rubeola?

A

Rubeola virus

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4
Q

How long is someone with rubeola contagious?

A

4 days prior to rash
4 days post rash appearance

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5
Q

What do koplik’s spots look like?

A

Tiny white spots with blue centers on buccal mucosa.

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6
Q

How does rubeola typically present?

A

-low grade fever
-dry cough
-coryza
-conjuctivitis
-sore throat
-rash
-koplik’s spots on buccal mucosa

4C’s
Cough
Coryza
Conjunctivitis
Koplik

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7
Q

What kind of rash does rubeola present with?

A

Red, blotchy skin rash
Often behind the ears and along hairline.

Usually recedes from face then extremities
Can be mistaken for scarletina.

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8
Q

What is unique about the fever of rubeola?

A

It can jump to 104-105F

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9
Q

What is the treatment for rubeola?

A

Supportive care.
AVOID ASA (Reye’s syndrome)
ABX if bacterial complications.

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10
Q

What is the MC complication of rubeola?

A

OM

2: Bronchitis
3: Pneumonia
4: Pregnancy complications
5: Encephalitis
6: Thrombocytopenia

Rubeol = 7 letters, itself + 6 complications

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11
Q

What is the vaccination schedule for rubeola?

A

12 months
4 years

Both are given in MMR form.

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12
Q

What is the causative organism for Mumps?

A

Mumps virus

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13
Q

How is mumps transmitted?

A

Airborne
Saliva
Surfaces

Mumps is ASS

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14
Q

How long is mumps contagious?

A

5 days after their glands swell.

Must isolate someone during those 5 days.

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15
Q

How does mumps present?

A
  • Fever
  • HA
  • Muscle aches
  • Tiredness
  • Loss of appetite
  • Parotitis

Parotitis is swollen and tender salivary glands under the ears or jaw on one or both sides of the face.

Like a chipmunk

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16
Q

How is mumps treated?

A

Supportive care only.

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17
Q

What are the main complications of mumps?

A
  • Orchitis
  • Encephalitis
  • Oophoritis/Mastitis
  • Deafness

Orchitis and Oophoritis are for when they reach puberty.
Mumps = 5 letters, itself + 4 complications

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18
Q

How effective is the mumps vaccine?

A

2 doses = 88%
1 dose = 78%

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19
Q

What is rubella also known as?

A

German Measles
3-day measles
3rd disease

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20
Q

What is the main concern with rubella/3rd disease?

A

Placental transmission
Long contagious period

It is not as contagious as mumps or rubeola, but it has a longer period of communicability.
Milder symptoms.

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21
Q

What are the S/S of rubella?

A
  • Mild fever and HA
  • Congestion and conjuctivitis
  • Rash (face=>arm/leg=>disappears same way)
  • SYMMETRICAL postauricular and occipital tender LAN
  • Arthralgias

Rubella has 2 Ls, so bilateral LAN

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22
Q

What can cause occipital LAN besides rubella?

A

MC: Tick bite removal.
Occipital lymph nodes are reactive.

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23
Q

How long is someone with rubella contagious?

A

10 days prior to rash
1-2 weeks post rash DISAPPEARANCE

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24
Q

What are the complications with rubella?

A
  • Arthritis (mainly women)
  • OM/encephalitis
  • Congenital rubella syndrome
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24
Q

How long is someone with rubella contagious?

A

10 days prior to rash
1-2 weeks post rash DISAPPEARANCE

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25
Q

What is the classic triad of congenital rubella syndrome?

A
  • Microcephaly
  • Cataracts
  • Cardiac defects

1/3 die before age 1.
Can also cause miscarriage or stillbirth.

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26
Q

What is given for congenital rubella syndrome? What does it do?

A

Hyperimmune globulin.

It only fights off the infection and reduces symptoms.

It DOES NOT eliminate chance of fetus developing congenital rubella syndrome.

27
Q

How do we diagnose rubella?

A

Clinically.

IgM titers for confirmation if needed.

28
Q

How do we treat rubella?

A

Supportive

29
Q

Who is the main risk group for rubella?

A

Pregnant women. They should be isolated to prevent congenital rubella syndrome.

They need to get the MMR vaccine PRIOR to becoming pregnant because it is a live vaccine.

30
Q

What is the only parvovirus humans can get? What does it cause?

A

Parvovirus B19
AKA
Erythema Infectiosum
5th disease

31
Q

What is the transmission of erythema infectiosum?

A

Placental transmission
Springtime
Blood
Respiratory secretions

32
Q

How long is erythema infectiosum transmissible?

A

Only prior to the rash appearing.

33
Q

What is the typical presentation of erythema infectiosum?

A
  • Slapped cheeks.
  • Lacy macular exanthem over proximal extremities post facial rash.
  • Polyarthropathy syndrome in adults

5th disease looks like someone high-fived your face
Polyarthopathy presents as swollen and erythematous palms, knees, and joints.

34
Q

Who is erythema infectiosum most common in?

A

Children 5-7

5th disease = 5-7 years old

35
Q

How is erythema infectiosum diagnosed?

A

Clinical: slapped cheeks or lacy rash.
IgM titers if needed.

36
Q

What is unique about the rash in erythema infectiosum?

A

NO PRURITIS.

37
Q

How is erythema infectiosum treated?

A

Tylenol
IVIG for immunocompromised or RBC disorders.

38
Q

What is the main complication of erythema infectiosum?

A

People with RBC disorders.
It can lead to transient aplastic anemia, hydrops fetalis, or congenital anemia.

Patients at risk: Iron-def anemia, HIV, SCD, thalassemias, and spherocytosis.

39
Q

How is parvovirus B19 prevented?

A

No vaccine. Generally immune once you have been infected once.

40
Q

What causes Roseola infantum?

A

HHV6 and 7
AKA 6th disease

41
Q

What seasons is roseola most transmissible?

A

Fall and Spring

Falling roses spring up
Roses fall in spring

42
Q

What ages are most children infected with roseola infantum?

A

Between 6mo and 3 years.

It is rare < 2y and > 4y.

HHV6 = 6 months

43
Q

What is the typical presentation of roseola infantum?

A

High fever persisting 3-5 days.
Post fever, blanchable, rosey pink rash appears.

44
Q

What is the concern with roseola infantum fever?

A

Duration unless patient is in acute distress.

Febrile seizures most common < 3y.

45
Q

How is a child’s presentation once the rash appears in roseola infantum?

A

Usually normal. Only ill during fever.

46
Q

How is roseola infantum diagnosed?

A

Clinical.
Generally, Dx is made based on rash, but child is generally improving by then.

46
Q

What would worry a provider in regards to fever in roseola infantum besides duration?

A

Speed of onset.

Febrile seizure is likely if the fever appears rapidly, because the body cannot compensate fast enough.

46
Q

How is roseola infantum treated?

A

Supportive.

47
Q

What are the rare complications of roseola infantum?

A
  • Meningitis
  • Encephalitis
  • Leukopenia
  • Thrombocytopenia
  • Hepatitis

Roses MELT Hearts

48
Q

What causes varicella/chicken pox?

A

Varicella zoster virus (VZV)

Subtype of HHV

49
Q

How long is varicella contagious and how is it transmitted?

A

1-2 days prior to rash until all blisters scab over.
Shingles and respiratory secretions can transmit it.

50
Q

What is the hallmark sign of varicella?

A

Dewdrop on a rose petal: vesicle on an erythematous base.

51
Q

What are the systemic S/S of varicella?

A
  • Fever
  • Rash
  • Loss of appetite
  • HA
  • Malaise
52
Q

How is varicella diagnosed?

A

All stages of lesions.
PCR swabs
IgM titers

53
Q

How is varicella treated?

A

Symptomatic

Antivirals for high-risk:
Acyclovir (10x dosage within 24 hours for 5 days)
Varicella Ig

54
Q

When is the varicella vaccine administered?

A

12 months
4 years
98% prevention

Same as MMR.

55
Q

What causes HFM disease?

A

Coxsackievirus

56
Q

What seasons is HFM disease transmitted? What can you NOT get it from?

A

Summer and fall.

You cannot get it from a pet with foot and mouth disease.

57
Q

When is HFM disease contagious?

A

First week of illness until all blisters resolved.

F to M one week

58
Q

How does HFMD present?

A
  • Fever + LAN
  • Sore throat
  • Malaise
  • Irritability
  • Loss of appetite
  • Red, non-pruritic rash with blisters on palms and feet
  • Red blister-like lesions on mouth and inside mouth.

Often noted to have a halo around them.

59
Q

What is unique about the arrangement of HFMD vesicles?

A

Follows dermatoglyphs parallel with a red halo.

60
Q

How is HFMD diagnosed?

A

Clinical.
Unique in its:
* Age
* Pattern of S/S
* Rash appearance

61
Q

How is HFMD treated?

A

Magic mouthwash
Motrin/tylenol

62
Q

What are the complications of HFMD?

A
  • Dehydration (MC)
  • Encephalitis
63
Q

How is dehydration treated in infants with HFMD?

A

IVF
Pedialyte + gatorade in a syringe

Look for urination every 6-12 hours

CM 1B: ID/EENT (27 decks)

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