Schoenwald - Monkeypox

Question 1

what type of virus is monkeypox

Answer 1

orthopoxvirus

Question 2

how is monkeypox spread

Answer 2

close/direct contact w.:

lesions

bodily fluids

respiratory secretions

objects w. spores

animal/animal products

vertical → mother to fetus

Question 3

early sx of monkeypox are similar to __, but milder

and include (7)

Answer 3

small pox

fever, HA, muscle aches, backache, LAD, chills, exhaustion

Question 4

1-3 days after the appearance of __,

__ sx occur (2)

Answer 4

fever

rash, lesions

Question 5

what stages do monkeypox lesions progress thru over 2-3 weeks

Answer 5

macules

papules

vesicles/pustules

scabs

can also be umbilicated

Question 6

what distinguishes monkeypox prodrome from smallpox

Answer 6

LAD

Question 7

ddx for monkeypox rash

Answer 7

syphilis

herpes

varicella

molluscum contagiosum

smallpox

Question 8

chicken pox starts __

and spreads __

Answer 8

centrally

outwards

Question 9

what is this

Answer 9

molluscum contagiousum

Question 10

what is this

Answer 10

HSV

Question 11

what is this

Answer 11

syphilis

Question 12

key characteristics for identifying monkeypox lesions

Answer 12

well circumscribed

deep seeded

often umbilicated

same size and stage on single body site

lesions on palms/toes

painful → crust → itchy

Question 13

2 key characteristics of monkeypox prodrome

Answer 13

fever prior to rash

LAD

Question 14

describe disseminated rash in monkeypox

Answer 14

centrifulgal → more on face/extremities than central

Question 15

3 stages of monkeypox illness

Answer 15

incubation → 5-21 days

prodrome → 1-3 days

rash → 2-3 weeks

Question 16

which stages of monkeypox is pt contagious

Answer 16

prodrome

rash

Question 17

pt w. monkeypox is contagious until

Answer 17

all scabs have fallen off

AND

fresh layer of intact skin has formed underneat

Question 18

enathem thru scab stage

Answer 18

enathem

macules

papules

vesicles

pustules

scabs

Question 19

CDC definition of monkeypox

Answer 19

new characteristic rash

PLUS:

contact w. person w. similar rash and confirmed/probably monkeypox

close or intimate contact w. monkeypox

traveled outside US w. confirmed cases

contact w. dead or live wild animal or exotic African species or used a product from such animal

Question 20

CDC definition includes MSM who

Answer 20

meet partners thru online website, app, or social event

Question 21

dx test for monkeypox

Answer 21

PCR of lesion material

should use mask and shield

Question 22

t/f: pt must isolate at home until monkeypox case is confirmed/ruled out

Answer 22

T!

Question 23

how long must pt w. confirmed monkeypox isolate

Answer 23

until all scabs fall off

Question 24

t/f: most cases of monkeypox are mild/self limiting

Answer 24

T!

Question 25

complications of severe monkeypox

Answer 25

hemorrhagic dz

confluent lesions

sepsis

encephalitis

PNA

Question 26

pops at high risk of severe dz

Answer 26

immunocompromised (including solid organ transplant)

peds < 8 yo

pregnant/breastfeeding

hx atopic dermatitis, eczema, burns etc (derm conditions)

one or more complications from lesions: gastroenteritis, dehydration, bronchopna, concurrent infxn

comorbidities

Question 27

t/f: there is no specific tx for monkeypox

Answer 27

T!

Question 28

antivirals to try for monkeypox

Answer 28

tecovirimat

cidofivir

vaccinia immune globulin

Question 29

what virus is cidofivir approved for

Answer 29

CMV

Question 30

post exposure prophylaxis for monkeypox in CO

Answer 30

jynneos vaccine

Question 31

is jynneos used for tx of monkeypox

Answer 31

nope - just PEP

Question 32

who gets PEP

Answer 32

close contacts after consult w. health dept