Mucocutaneous lesions

Question 1

Viruses that cause maculopapular rashes

Answer 1

Measles/rubeola
Rubella
Roseola/HHV-6
Fifth disease/parvovirus B19

Question 2

Viruses that cause vesicular rashes

Answer 2

Chickenpox/VZV
Hand-foot-mouth/Coxsackie
HSV-1

Question 3

Virus that attaches to CD46, PVRL4, and CD150 receptors of many cells

Answer 3

Measles

Question 4

Maculopapular rash that starts on face and spreads to extremities

Answer 4

Measles

Question 5

Presentation of measles

Answer 5

CCCP –> cough, coryza, conjunctivitis, and photophobia

High fever
Exanthema

Question 6

Exanthema

Answer 6

Rash accompanying a fever

Question 7

Complications of measles

Answer 7

-Giant cell pneumonia
-Post-infectious encephalitis
-Subacute sclerosing panencephalitis (SSPE)

Question 8

Koplik’s spot

Answer 8

Grans of salt surrounded by read halo on buccal mucosa in measles

Question 9

Lab diagnostics for measles

Answer 9

ELISA (IgM)
Immunofluorescence
RT-PCR

Question 10

ssRNA virus
Paramyxoviridae
Genus Morbillivirus

Answer 10

Measles

Question 11

ssRNA virus
Togaviridae
Genus rubivirius

Answer 11

Rubella

Question 12

Prodromal phase symptoms of rubella

Answer 12

Fever
Malaise
Mild sore throat
Coryza

Question 13

Complications of Rubella

Answer 13

Arthralgia and arthritis
Congenital rubella syndrome

Question 14

Lab diagnostics for Rubella

Answer 14

ELISA (IgM)
Immunofluorescence
RT-PCR

Question 15

Complication of Parvovirus B19 and cause

Answer 15

Aplastic crisis due to infection of erythroblast precursors in bone marrow

Question 16

Complication of Parvovirus B19 in pregnant females

Answer 16

Hydrops fetalis

Question 17

Lab diagnostics for Parvovirus B19

Answer 17

ELISA (IgM)
PCR

Question 18

dsDNA virus that multiplies in salivary gland and oropharynx

Answer 18

Roseola

Question 19

Rash that appears on trunk and neck first, then spreads to face, then to extremities

Answer 19

Roseola

Question 20

Infected cells show Cowdry type A intranuclear inclusions and form syncytia

Answer 20

VZV

Question 21

Rash begins in hairline, scalp, and behind ears, then spreads to face, torso, and limbs

Answer 21

VZV

Question 22

Serious complications in adult cases of VZV

Answer 22

Pneumonia
Encephalitis
Vigorous immune response

Question 23

Latent in dorsal root and cranial nerve ganglia

Answer 23

VZV

Question 24

Complications of herpes zoster

Answer 24

Postherpetic neuralgia
Ophthalmic zoster
Ramsey Hunt syndromes

Question 25

Pathogenesis of Ramsey Hunt syndromes

Answer 25

VZV travels down geniculate ganglion

Question 26

Symptoms of Ramsey Hunt syndromes

Answer 26

Otalgia Hemiparesis Vesicular eruption around the ear

Question 27

Characteristics of smallpox lesions

Answer 27

Synchronous Concentrated on face and distal extremities

Question 28

HSV-1 enters latency here

Answer 28

Trigeminal ganglion

Question 29

Transmission of Coxsackie virus

Answer 29

Feco-oral

Question 30

Oral and pharyngeal ulcers, and vesicular rash on palms and soles with mild fever

Answer 30

Coxsackie/Hand-foot-mouth

Question 31

Laboratory diagnostic tests for vesicular rashes

Answer 31

Tzank smear Immunofluorescence ELISA Immunohistochemistry PCR (gold standard)

Question 32

Shown on Tzank smear for vesicular rashes

Answer 32

Multinucleated giant cells/syncytium Viral inclusion bodies

Question 33

Used in acyclovir resistant vesicular viral rashes

Answer 33

Foscarnet Cidofovir

Question 34

Can be used to prevent recurrence of viral vesicular rashes

Answer 34

Valacyclovir Famciclovir

Question 35

Complication of roseola

Answer 35

Febrile seizures

Question 36

Causes of petechiae, purpura, and/or ecchymosis mucocutaneous lesions

Answer 36

Menigococcemia RMSF/Rickettsia rickettsii Dengue fever/flavivirus Leptospiroses Lyme disease/erythema chronicum migrans Hantavirus/Bunyavirus

Question 37

Rash begins on wrists/hands and ankles/feet and spreads to trunk. It starts as maculopapular and becomes petechial/purpuric

Answer 37

Rocky mountain spotted fever

Question 38

Complications of RMSF

Answer 38

Splenomegaly DIC Shock Death

Question 39

Enveloped, isosahedral with positive sense ssRNA spread by Aedes mosquito

Answer 39

Dengue fever

Question 40

Maculopapular and hemorrhagic rash, retro-orbital pain, muscle and joint pain with fever

Answer 40

Dengue fever

Question 41

Caused by Borrelia burgdorferi

Answer 41

Lyme disease

Question 42

Bulls-eye rash with fever, HA, and lymphadenopathy

Answer 42

Lyme disease

Question 43

Complications of Lyme disease

Answer 43

Meningitis Encephalitis Bell's palsy Arthralgia and arthritis

Question 44

Lab diagnostics for Lyme disease

Answer 44

ELISA Immunofluorescence Western blot PCR

Question 45

Enveloped, negative sense, segemented, ssRNA in rodent excreta

Answer 45

Hantavirus/Bunyavirus

Question 46

Complications of hantavirus

Answer 46

HPS HFRS

Question 47

Non-enveloped, circular dsDNA that replicates in basal keratinocytes

Answer 47

HPV

Question 48

Koilocytes

Answer 48

Enlarged keratinocytes with clear halos around shrunken nuclei that are characteristic of HPV infections

Question 49

Nodular to wart-like lesions that later become pearly-white umbilicated nodules with central caseous pus

Answer 49

Molluscum contagiosum virus

Question 50

Histology of molluscum bodies

Answer 50

Pink, homogenous, intracytoplasmic inclusions seen in biopsy specimens, or in the expressed caseous core of a nodule

Question 51

Mycolic acid in cell wall and acid fast bacilli

Answer 51

Mycobacterium leprae

Question 52

Transmission of leprosy

Answer 52

Inhalation and skin contact Requires prolonged contact