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Family Aspects( Paeds) > Rashes > Flashcards

Rashes Flashcards

1
Q

What is the causative agent for Measles ( Rubeola)

A

Paramyxovirus

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2
Q

How is Measles transmitted?

A

It is transmitted by droplets of respiratory secretions or via airborne route and is extremely contagious

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3
Q

What is the incubation period for Measles?

A

8-12 days

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4
Q

What are the clinical manifestations of Measles?

A

Thee C’s
* Cough
* Coryza
* Conjunctivitis
* Koplik spots ( grey-white, sand grain- sized spots)
* Stimson line
* High fever
* Macular rash ( petechial or haemorrhagic ( Black Measles)
* Lymphadenopathy

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5
Q

Where does the rash begin in Measles patients?

A

Head ( often the hair line)

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6
Q

What is the spread of the Measle Rash on the skin?

A

Cephalad - to - Caudal

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7
Q

What is the laboratory studies used to diagnose Measles?

A

Serologic testing for IgM antibodies that appear 1-2 days of the rash.

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8
Q

What are the possible differentials for Measles?

A
  • Rubella
  • Roseola
  • Enteroviral or Adenoviral infection
  • Infectious mononucleosis
  • Toxoplasmosis
  • Meningiococcemia
  • Scarlet fever
  • Rickettsial disease
  • Kawasaki disease
  • Serum - sickness
  • Drug rash
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9
Q

What is the Routine Treatment for Measles?

A
  • Adequate hydration
  • Antipyretics
  • High- dose Vitamin A ( for 2 days )
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10
Q

What are some complications that can occur due to Measles?

A
  • Otitis Media ( Most common)
  • Interstitial (measles) Pneumonia
  • Giant cell ( Hecht pneumonia) - immunocompromised patients
  • Myocarditis
  • Mesenteric lymphadenitis
  • Encephalomyelitis
  • Early encephalitis
  • Subacute Sclerosing Panencephalitis ( SSPE)
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11
Q

When is the MMR vaccine given ?

A

12 months & 18 months

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12
Q

What is another name for Rubella?

A

German Measles or 3- day measles

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13
Q

When is the onset of Rash for Measles?

A

14 days after infection ( 7-21)

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14
Q

What is the family of viruses that the German measles belongs to?

A

Togavirus

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15
Q

What is the incubation for Postnatal rubella?

A

16-18 days ( range 14-21)

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16
Q

What are the clinical manifestations of Rubella?

A
  • Lymphadenopathy ( Retroauricular, Post cervical , Posterior Occipital)
  • Erythematous ,maculopapular , discrete rash
  • Forchheimer spots ( Rose - coloured spots on the soft palate)
  • Mild pharyngitis
  • Conjunctivitis
  • Anorexia
  • Headache
  • Malaise
  • Low-grade fever
  • Polyarthritis ( Usually on hands)
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17
Q

What is the laboratory diagnosis for Rubella?

A

Serology testing for IgM antibodies.

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18
Q

What are the differentials for Rubella?

A
  • Measles
  • Roseola
  • Enterovirus
  • Mononucleosis
  • Toxoplasmosis
  • Scarlet fever
  • Rickettsial disease
  • Kawasaki disease
  • Serum sickness
  • Drug rash
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19
Q

Which disease is known as the Sixth disease?

A

Roseola Infantum ( Exanthem subitem )

’ sub = six’

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20
Q

What is the causative agent for Roseola?

A

Human Herpesvirus Type 6 & 7 ( HHV 6 & 7)

” Rose has herpes”

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21
Q

What are the clinical manifestations of Roseola?

A
  • High fever
  • Maculopapular , rose- coloured rash ( lasts 1-3 days)
  • Upper respiratory symptoms ( nasal congestion, erythematous tympanic membranes , cough ( may occur)
  • Febrile seizures
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22
Q

How can Roseola be diagnosed?

A

PCR in the cerebrospinal fluid

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23
Q

What is the treatment for Roseola?

A

Adequate hydration
Antipyeretics

24
Q

What are complications of Roseola?

A
  • Encephalitis
  • Virus- Hemophagocytosis syndrome
25
Q

Which rash is called the Fifth disease?

A

Erythema Infectiosum

26
Q

What is the causative agent for Erythema Infectiosum?

A

Human Parvovirus ( B19)

27
Q

Fill in the blanks. “ Parvovirus B19 can cause __________ & __________ after infection during Pregnancy.”

A

Fetal anaemia & Hydrops Fetalis

28
Q

What is the cell receptor for Parvovirus B19 ?

A

Erythrocyte P antigen

29
Q

How is Erythema infectiosum transmitted?

A

By respiratory secretions & Blood product transfusions

30
Q

What is the Incubation period for Erythema Infectiosum?

A

4-14 days

31
Q

What are the Clinical Manifestations for t Parvovirus B19 infections?

A
  • Fever
  • Malaise
  • Myalgia
  • Headache
  • Rash
32
Q

When does the rash appear in the Parvovirus B-19 infections?

A

7-10 days after infection

33
Q

What are the Clinical Manifestations for Erythema Infectiosum?

A
  • Low grade or no fever
  • Pharyngitis
  • Mild conjunctivitis
  • Myalgia ( adults)
  • Rash ( may be Pruritic and DOES NOT desquamate)
  • Arthralgias
  • Arthritis
  • Headache
  • Pharyngitis
  • Coryza
  • GIT upset
34
Q

What are the three stages in which the Fifth disease rashes appear?

A
  1. Initial stage- “ Slapped-Cheek “ rash.
  2. Second stage- Erythematous symmetric, maculopapular, truncal rash appearing 1-4 days later.
  3. Lacy, reticulated rash last (2-40 days - mean 11 days).
35
Q

What are the Haematological abnormalities that can occur with Parvovirus infections?

A
  • Reticulocytopenia lasting 7-10 days
  • Mild anaemia
  • Thrombocytopenia
  • Lymphopenia
  • Neutropenia
36
Q

How can one detect Parvovirus B19 infection on Laboratory studies?

A
  • PCR
  • Electron Microscopy of Erythroid Precursors in bone marrow
37
Q

What are the differentials for Fifth Disease?

A

Measles
Rubella
Scarlet Fever
Enteroviral or Adenoviral infection
IM
Kawasaki disease
SLE
Serum sickness
Drug reactions

38
Q

What is the treatment for Erythema Infectiosum?

A
  • Blood Transfusions
  • IV Immunoglobulin for immunocompromised.
39
Q

What is the causative agent for Chicken Pox ?

A

Varicella - Zoster virus

40
Q

What is the clinical manifestation of a reactivated latent infection of Endogenous Varicella Zoster Virus ( VZV)?

A

Zoster ( Shingles)

41
Q

What is the incubation period for Varicella?

A

14-16 days

42
Q

What are the Clinical Manifesttaions of Varicella ?

A
  • Fever
  • Malaise
  • Anorexia
  • Rash ( small red papules that progress to nonumbilicated, oval, tear-drop like vesicles on an erythramatous base)
  • Acute neuritis
  • Lymphadenopathy
  • Ramsay- Hunter syndrome ( facial paralysis and ear canal vesicles) ( only when CN VII is involved)
  • Corneal and intraoral lesions ( CNV involvement)
  • Ipsilateral cerebral angiitis
  • stroke

NB. The fluid progresses from clear to cloudy and the vesicles ulcerate, crust and heal.

43
Q

How can Chickenpox be laboratory diagnosed?

A

PCR of vesicular fluid
Immunofluorescence using monoclonal antibodies

44
Q

What are the differentials for Chicken Pox?

A
  • Eczema herpeticum ( Kaposi varicelliform eruption)
  • localized , vesicular eruption caused by HSV
  • Coxsackievirus A ( vesiculopustular appearance to the extremities and oropharynx)
45
Q

What are the treatment methods for those with Chicken Pox?

A
  • Non-aspirin Antipyretics
  • Cool baths
  • Careful hygiene
  • Early therapy with antivirals ( immunocompromised)
  • Acyclovir or Valacyclovir - those at risk for severe varicella ( unvaccinated persons older than 12 , chronic cutaneous disease, pulmonary diseases, those receiving short term corticosteroids or long term salicylate therapy.
46
Q

What is the most common complication of Chicken pox?

A

Secondary infection of skin lesion by Streptococci or staphylococci

47
Q

What are other complications of Chicken Pox?

A
  • Pneumonia ( uncommon in healthy children )
  • Myocarditis
  • Pericarditis
  • Orchitis
  • Hepatitis
  • Ulcerative gastritis
  • Glomerulonephritis
  • Arthritis
  • Reye syndrome
  • Post infectious encephalitis
  • Cerebellar ataxia
  • Nystagmus
  • Tremor
  • Guillian - Barre syndrome
  • Transverse myelitis
  • Cranial nerve palsies
  • Optic neuritis
  • Hypothalamic syndrome
48
Q

When is the Varicella vaccine given?

A

12 months + 6 weeks later

4-6 years

49
Q

What is the Causative agent for Scarlet Fever?

A

Group A Streptococcus ( Strep Pyogenes)

50
Q

What are the diseases that can predispose Scarlet fever?

A
  • Streptococcal pharyngitis
  • Toxic shock syndrome
  • Necrotizing fasciitis
51
Q

What is the Incubation period for Scarlet fever?

A

2-5 days.

52
Q

How is Scarlet fever transmitted?

A

Respiratory Secretions and droplet or by self- infection from nasal carriage.

53
Q

What are the Clinical manifestations of Scarlet fever?

A
  • Fever
  • Vomitting
  • Abdominal Pain
  • Sore Throat
  • Sandpaper- like diffuse rash in the neck and chest area
  • Perioral pallor spreading to flexor creases ( Pastia’s lines)
  • Exudative tonsillitis
  • Uvular oedema
  • Strawberry Tongue
  • Palatal petechiae
  • Cervical lymphadenopathy
54
Q

What are the laboratory investigations for Scarlet fever?

A

Throat swab
Culture and Growth of the organism individual
Serum : Antistreptolysin O (ASO) and anti-DNase B titres

55
Q

What is the treatment for Scarlet Fever?

A

Penicillin V for 10-14 days
Isolation for 24 hours

56
Q

What are the complications of Scarlet Fever?

A

Peritonsillar abscess
Retropharyngeal abscess
Post- Streptococcal glomerulonephritis
Rheumatic fever

57
Q
A

Family Aspects( Paeds) (5 decks)

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