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CDM I > Monkeypox > Flashcards

Monkeypox Flashcards

1
Q

What is Monkeypox?

A

Rare disease caused by the Monkeypox virus

Orthopoxvirus

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2
Q

First human case?

A

1970 in DRC

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3
Q

How is Monkeypox spread?

A
  1. Close/Direct contact with:
    lesions, bodily fluids, or resp secretions
  2. Spread from an infected animal or animal products
  3. Vertical transmission from mother to fetus
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4
Q

T/F: Monkeypox can be spread by OBJECTS that have had contact with lesion crusts or body fluids-current outbreak

A

TRUEE

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5
Q

How to clasify the sx?

A

Similar to but milder than symptoms of smallpox

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6
Q

Monkeypox Sx being with:

A 
Fever
Headache
Muscle aches
Backache	
Lymphadenopathy 
Chills
Exhaustion
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7
Q

How to distinguish Monkeypox from Smallpox?

A

LAD

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8
Q

What sx develop w/in 1-3 days after appearance of fever?

A

Rash

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9
Q

Lesions progress through the following stages over 2-3 weeks:

A

Macules
Papules
Vesicles pustules
Scabs

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10
Q

Can the lesions be umbilicated?

A

yes

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11
Q

DDx:

A
  • Molluscum contagiosum
  • Syphilis
  • VZV
  • Smallpox
  • Chickenpox
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12
Q

T/F: Smallpox is an agent of bioterrorism

A

True

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13
Q

Chickenpox

A
  • Starts inward and grows out.

- Body wide

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14
Q

Smallpox

A
  • Papule to pustule to vesicle

- Can be umbilicated

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15
Q

T/F: hard to determine clinical diff b/w monkeypox & smallpox?

A

True

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16
Q

Has smallpox been erradicated?

A

Yes

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17
Q

Key Characteristics of ID Monkeypox

Lesions are:

A

Lesions well circumscribed, deep seated, and often umbilicated
Lesions are relatively the same size and stage on a single body site
Lesions on palms and soles
Lesions are painful until crust appears when they become itchy

18
Q

Key Characteristics of ID Monkeypox

___ prior to ____

A

Fever prior to rash

19
Q

Key Characteristics of ID Monkeypox

Disseminated rash is ______

A

Disseminated rash is centrifugal (more lesions on face and extremities)

20
Q

Key Characteristics of ID Monkeypox

Differentiator from Smallpox

A

Lymphadenopathy

21
Q

Incubation of Monkeypox
Sx?
Contagious?

A

average 7-14 days, Range 5-21 days
Asymptomatic during this time
Not contagious

22
Q

Enanthem vs Exanthem

A

Exanthem: “breaking out,”
used to describe cutaneous eruptions that arise abruptly and on several skin surfaces at once.
Enanthem: refers to mucous membrane (tongue & mouth) involvement

23
Q

Prodrome phase
Characterized by:
time?
Contagious?

A

Prodrome of fever after the incubation phase
1-3 days
contagious

24
Q

Onset of the rash phase
Characterized by
Time?
Contagious?

A

Enanthem (mouth & tongue) then macules then papules then vesicles then pustule then scab
Lasts 2-3 weeks
Contagious until all scab have fallen off AND a fresh layer of intact skin has formed underneath

25
Q

Unroofing a lesion: how is transmission spread?

A
  • Respiratory spread

- By scab

26
Q

Testing

A

PCR test of lesion material available through State Health Department/CDC

27
Q

When is pt no loger contagious?

A

when scab falls off and new layer of skin grown

28
Q

T/F: Monkeypox can cause hemorrhagic PNA

A

True

29
Q

Severe dizeases caused by Monkeypox that need hospitalization?

A

confluent lesions, sepsis, encephalitis,

30
Q

Pt education

A

Isolation at home is necessary until case is confirmed

If case confirmed, isolate until no longer contagious ie scabs fall off

31
Q

T/F: Most cases are relatively mild and self limiting

A

True

32
Q

Pts at high risk for severe dz?

A
  • Immunocompromise (HIV/AIDS, leukemia, lymphoma, generalized malignancy, solid organ transplant, tx w/ alkylating agents, antimetabolites, radiation, TNF inhibitors, high-dose corticosteroids, hematopoietic stem cell transplant <24mo)
  • Patients <8yo
  • Pregnant or breastfeeding
  • AD
  • Pt w/ eczema, burns, impetigo, VZV, infection,HSV, severe acne, severe diaper dermatitis with extensive areas of denuded skin, psoriasis, or Darier disease [keratosis follicularis])
  • Pts w/ secondary bacterial skin infection; gastroenteritis with severe N/V/D or dehydration; bronchopneumonia; concurrent disease or other comorbidities
33
Q 
Is there a Monkeypox specific treatment?
What drug class can we use?
A

No specific treatment

BUT antivirals developed for smallpox may be beneficial:

Tecovirimat
Cidofovir (FDA approved for CMV)
Vaccinia Immune Globulin

34
Q

Prophylaxis recommendations:

A
  • Avoid skin to skin close contact if lesions present
  • If respiratory symptoms present, those in contact should mask (N95)
  • Avoid contact with objects that may have come into contact with monkeypox
35
Q

contact with objects that may have come into contact with monkeypox

A

Bedding/linens
Towels
Sex gear and toys

36
Q

Monkeypox PEP

A

Jynneos vaccine

37
Q

Is Jynneos vaccine available in colorado?

A

Yes

38
Q

Is monkeypox an extremely contagious dz?

A

Yes

39
Q

Shoudl we wear an N95 for Monkeypox?

A

yes

40
Q

Who should get Monkeypox PEP?

A

Close contacts

after consultation with the State Health Dept

CDM I (9 decks)

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