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SBL Exam 1 & 2 > Skin changes in skin, blood and lymph > Flashcards

Skin changes in skin, blood and lymph Flashcards

1
Q

What is erythema infectiosum also called?

A

Fifth disease

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2
Q

Physical presentation of erythema infectiosum?

A

Slapped cheek appearance, circumoral pallor, evanescent rash (rash that appears with fever) on trunk and limbs. Little fever

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3
Q

What is one of the most common causes of myocarditis?

A

Parvovirus

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4
Q

How does parvovirus present in middle-aged persons?

A

Limited symmetric polyarthritis that mimics systemic lupus and RA, which may be in some cases be a type II mixed cryoglobulinemia develops.

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5
Q

Symptoms of parvovirus B19 infection can mimic?

A

Those of autoimmune states.

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6
Q

Are arthralgias common in children with parvovirus?

A

No

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7
Q

What happens in pregnant women with parvovirus?

A

Premature labor, hydrops fetalis and fetal loss are reported sequelae.

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8
Q

How does Lyme disease present?

In which part of the United States is it commonly found?

A

Erythema migrans: A flat or slightly raised red lesion that expands with central clearing.
Headache or stiff neck
Arthralgia/myalgias/Arthritis
Common in Pacific NE USA

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9
Q

Arthritis in Lyme disease is often?

A

Chronic and recurrent

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10
Q

Stage 1 of lyme disease. When does it occur, where, progression?

A

Erythema migrans - 1-week after bite.
Common in areas of tight clothing (groin, axilla)
Expands over several days
Progresses with central clearing (bull’s eye)

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11
Q

What else happens in stage 1 of Lyme disease?

A

Viral-like illness: Myalgia, HA, fatigue, +/- fever

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12
Q

How does stage 2 of Lyme disease present?

A

Malaise, fatigue, neck pain.
Myopericarditis with atrial/ventricular arrhythmias and heart block.
Neuro manifestations (Bells Palsy)
Conjunctivitis, keratitis

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13
Q

When and how does stage 3 of Lyme disease present?

A

Late to persistent infection (months- years later)
MSK manifestations: mono/oligoarthritis of the knee or other large weight bearning joint.
Others: neuro manifestation (encephalopathy) and acrodermatitis chronicum atrophicans (both rare)

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14
Q

Difference between Lyme disease and shingles?

A

Lyme does not follow dermatomes like shingles.

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15
Q

How is EBV largely transmitted?

A

Saliva. Sometimes genital secretions.

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16
Q

In which population has EBV (infectious mono) remained high?

A

Age 12-19

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17
Q

How does infectious mono present?

A

Malaise, fever, (exudative) sore throat/pharyngitis
Palatal petechiae, lymphadenopathy, splenomegaly and occasional maculopapular rash
Transient bilateral upper lid edema
Conjunctival hemorrhage

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18
Q

Histological presentation of infectious mono?

A

Atypical lymphocytes

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19
Q

Positive test or mono?

A

Mono spot (heterophile agglutination test)

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20
Q

Complications of mono?

A

Hepatitis, myocarditis, neuropathy etc

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21
Q

In which 4 diseases do peripheral skins eruptions occur?

A

Meningococcemia
Rocky Mountain spotted fever
Secondary syphilis
Hand-Foot-mouth disease

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22
Q

What organism is rocky mountain fever caused by?

A

Rickettsia rickettsii (a parasite of ticks)

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23
Q

Where and When (time) does Rocky Mountain fever typically occur.
Incubation period?
Mortality in untreated patients?

A

North/South Carolina, Tennessee, Oklahoma, and Arkansas.
Late spring and summer.
Incubation - 2-14 days
High mortality in untreated pts.

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24
Q

Symptoms of rocky fever?

A

Fever, chills, HA, N/V.
Cough and pneumonitis occur early in the disease
Rash: faint macule -> petechiae. Begins on wrist/ankles, spreads upwards (arms/legs) and towards center of the body.
May px with splenomegaly, hepatomegaly, jaundice, myocarditis.

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25
Stages in syphilis are separated by?
Symptom-free latent period.
26
How does the early infectious stage of syphilis present?
Chancre and regional lymphadenopathy
27
How does the late stage of syphilis present?
A gummatous lesion in skin, bones or viscera. Cardiovascular disease (esp aortitis) CNS and ocular syndromes
28
How does secondary syphilis present?
Diffuse rash, condylomata lata and mucous patches (painless salivary ulceration of mucous membrane with surrounding erythema. Generalized lymphadenopathy Constitutional sx: fever, malaise, arthralgias
29
What two diseases is the Coxsackievirus responsible for?
Hand -foot-mouth disease and Herpangina
30
How does hand-foot-mouth disease present clinically?
Stomatitis (sore/inflammation of the mouth) Vesicular rash on hands and feet Nail dystrophies and onychomadesis (nail shedding)
31
How does Herpangina present clinically?
Sudden onset fever HA Myalgias Petechies or papules on the soft palate that ulcerate in 3 days then heal.
32
What is the hallmark of HFMd?
The development of a vesicular eruption on the palms and soles.
33
How do the lesions in HFMd progress?
bright pink macules -> small vesicles -> erosion of vesicles surrounded by an erythematous halo. Some may develop similar oral erosions that involve the tongue, buccal mucosa, hard palate.
34
Complications of coxsackie virus?
Epidemic pleurodynia (pleuritic chest pain & systemic symptoms) Aseptic meningitis, Acute pericarditis.
35
Diseases that present with desquamative skin changes?
Toxic Shock Syndrome Scarlet fever Erythema multiforme
36
Strains of staphylococci may produce toxins that cause four important entities. What are they?
Scalded skin syndrome (children). Bullous impetigo (adults) Necrotizing pneumonitis (children) Toxic Shock syndrome Enterotoxin food poisoning
37
How does TSS present clinically?
Abrupt onset of fever, vomiting and watery diarrhea. Diffuse macular erythematous rash Nonpurulent conjunctivitis Desquamation of palms and soles during recovery
38
How is scarlet fever characterized?
Exudative pharyngitis, fever & scarlatiniform rash
39
How does scarlet fever present clinically?
Prodrome: 1/2 -2 days of malaise Rash: Generalized, red, prominent on neck & skin folds Circumoral pallor Desquamation of hands & feets Others: Strawberry tongue, exudative tonsillitis
40
How is erythema multiforme characterized?
Target lesions on the face and extremities. | Male children & young adults
41
Most cases of erythema multiforme are related to?
Infections (herpes simplex and Mycoplasma pneumoniae)
42
Is prodrome typically present in erythema multiforme?
No. If they are, they are usually mild and suggestion of a URI.
43
In many cases of erythema multiforme, pay special attention to?
The previous occurrence of disease
44
Erythema multiforme Majus form can typically present differently. How?
Mucosal lesions mostly in the oral cavity | Hard palate is typically spared
45
How does Erythema multiforme Majus present in children?
In children- lip and oral mucosal are severely affected by M. Pneumoniae.
46
Which disease present with vesicular and bullous lesions?
Varicella and pemphigus
47
How does varicella present clinically?
Rash that begins on the face and scalp > trunk. Relatively spares the extremities
48
How are the lesions organized in varicella?
Scattered (reflecting viremic spread to the skin) Rose-colored macules -> papules -> vesicles -> pustules ->crusts Lesions in all stages are usually present at the same time.
49
Which population does varicella mostly affect?
immunocompromised of any age
50
What does varicella lead to?
Lifelong latent VZD infection of sensory and autonomic neurons.
51
How does pemphigus Vulgaris present?
Blisters that typically appear on normal-looking skin (not typically hands and soles) Fragile so -> large erosions from broken blisters
52
Which skin conditions present with petechial and purpuric lesions?
Gonococcemia Meningococcemia TTP
53
In which cells can N. meningitides be visualized?
Polymorphonuclear leukocytes
54
What is the classic triad of gonoccemia?
Dermatitis Migratory polyarthritis Tenosynovitis
55
How does dermatitis present in gonoccemia?
small to medium-sized macule or hemorrhagic vesicopustules on an erythematous base located on palms and soles.
56
The word "gunmetal grey" describes what?
The concurrence of hemorrhage and necrosis that occurs in cutaneous lesions of gonoccemia.
57
How does the rash of acute meningococcemia present?
Petechial rash most common in extremities. | In severe cases: necrosis of skin and underlying tissue
58
How does the rash of chronic meningococcemia present?
Rose-colored macules and papules. The rash may wax and wane with fevers.
59
What is the pentad of TTP?
``` Microangiopathic autoimmune hemolytic anemia Thrombocytopenia Neuro symptoms Fever Renal failure ```
60
In which population would you commonly see TTP?
Blacks
61
What type of purpura would you see in TTP?
Non-palpable purpura. Also seen with other thrombocytopenic purpura & platelet defects
62
Palpable purpura can be seen in which conditions?
Vasculitis due to autoimmune disease and blood infection (meningococcemia).
63
How does basal cell carcinoma present?
Pearly papule, erythematous patch (esp >6mm) or nonhealing ulcers sun-exposed areas (face, trunk, lower legs).
64
A patient with basal cell carcinoma will also often present with a history of?
Bleeding
65
How does squamous cell carcinoma of the skin present?
Non-healing ulcer or warty nodule. Small, red conical, hard nodules that occasionally ulcerate.
66
The most common location for melanoma? Men? Women/
Men: back Women: Lower extremities followed by trunk
67
What feature of ABCDE (melanoma screening) caries the greatest sensitivity and specificity at predicting the metastatic potential of a lesion
Color

SBL Exam 1 & 2 (3 decks)

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