Rashes

Question 1

Complications of Measles

Answer 1

Pneumonia - bacterial superinfection
Herpes Simplex gingivostomatitis

Immunosuppression 
Am acute encephalitis 
Diarrhoea 
Otitis media 
Corneal ulceration 
LTB - croup 
Encephalopathy 
SSPE

Question 2

Complications of Herpes Simplex Virus

Answer 2

Meningo-encephalitis
conjunctivitis
recurrent fever blisters
disseminated disease in immunocompromised

Eczema herpeticum - atopic children
infection of eczematous skin - systemic reaction with fever - superinfection with HSV (wrestlers)

Question 3

Impetigo

Answer 3

staphylococci and streptococci
round confluent blisters
rupture and form cysts - honey crusted lesions
topical antibiotics (polymyxin B or bacitracin)
if severe - systemic antibiotics (erythromycin and cloxacilln)

Question 4

Meningococcal disease

Answer 4

petechial or purpuric rash
fever
typical: URTI, fever, haemorrhagic rash, circulatory collapse, purpura, shock
MENINGITIS - hydrocephalus, CN palsies, subdural effusion/empyema, cerebral oedema, cortical vein thrombosis, cerebral infarction, hearing loss

Question 5

Laboratory investigations for meningococcal disease

Answer 5

gold standard - culture (blood, CSF, petechiae)
rapid diagnosis - gram stain
antigen detection - CSF, urine, serum
PCR - useful partially treated meningitis

Question 6

Treatment meningococcal meningitis

Answer 6

empiric
ceftriaxone, cefotaxime, penicillin
in penicillin allergy - chloramphenicol
no conclusive advantage use of steroids - only in Waterhouse Fredric’s - bleeding of adrenal glands
Eradicate carrier state if treated with penicillin - done with Rifampicin
SE - teratogenic, decrease reliability contraceptives, colours secretions, and contact lenses
Ceftriaxone
Azithromycin

Question 7

Side effects of Ciprofloxacin

Answer 7

tendinitis and tendon rupture
cardiac arrhythmia - QT prolongation
may damage growing cartilage
CNS effects: confusion, insomnia, headache, dizziness anxiety

Question 8

Kawasaki disease - diagnostic criteria

Answer 8

5 day fever 
and 
4 of 5 
- Conjunctivitis 
- Rash - polymorphous 
- Adenopathy - cervical and usually unilateral 
- Skin - oral mucosa/lips/ are red OR lips are peeling/crusting - Strawberry tongue 
- Hands - oedema or erythema hands/feet 

also get coronary artery aneurysms