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MSK/Derm > SM_267a: Viral Infections / Exanthems > Flashcards

SM_267a: Viral Infections / Exanthems Flashcards

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Dermatology Board Prep flashcards
1
Q

Herpes simplex virus is a ____ with ____

A

Herpes simplex virus is a herpesvirus with dsDNA

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2
Q

HSV presents as ____

A

HSV presents as cluster of grouped vesicles on an erythematous base

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3
Q

HSV can remain ____ and ____ periodically

A

HSV can remain dormant in local nerve ganglia and reactivate periodically

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4
Q

Describe clinical diagnosis of HSV

A

HSV

  • Grouped (clustered) vesicles on erythematous base: can be painful
  • Tingling, itching, burning on the skin (before visible vesicles) -> red papules (1 day later) -> vesicles -> crusted lesions (lasts 1-2 weeks, may be recurrent in nature)
  • UVB radiation is common trigger of orolabial HSV
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5
Q

____ is common trigger of orolabial HSV

A

UVB radiation is common trigger of orolabial HSV

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6
Q

____ are found on Tzanck smear of HSV

A

Multinucleated giant cells are found on Tzanck smear of HSV

(abnormal cell division in cells caused by HSV)

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7
Q

Eczema herpeticum is ____

A

Eczema herpeticum is disseminated HSV lesions in patient with widespread eczema (atopic dermatitis)

(sudden onset of widespread small umbilicated vesicles that turn into small round erosions in a patient with active atopic dermatitis)

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8
Q

____ caused by ____ is sudden onset of widespread small umbilicated vesicles that turn into small round erosions in a patient with active atopic dermatitis

A

Eczema herpeticum caused by HSV is sudden onset of widespread small umbilicated vesicles that turn into small round erosions in a patient with active atopic dermatitis

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9
Q

Varicella zoster virus belongs to the ____ family

A

Varicella zoster virus belongs to the herpes family

(dsDNA)

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10
Q

____ infection of VZV leads to clinical presentation known as chicken pox

A

Primary infection of VZV leads to clinical presentation known as chicken pox

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11
Q

Varicella zoster virus is transmitted by ____ or ____

A

Varicella zoster virus is transmitted by respiratory droplet or direct contact

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12
Q

Varicella zoster virus is contagious beginning _____ and lasting _____

A

Varicella zoster virus is contagious beginning 24 hours before eruption appears on skin and lasting until lesions have crusted

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13
Q

Describe clinical presentation of chicken pox

A

Chicken pox clinical presentation

  • Multiple lesions on skin at various stages: faint red macules -> vesicle -> crusted papule
  • Vesicle on an erythematous base: “dewdrop on a rose petal”
  • Multinucleated giant cells with Tzanck smear
  • Systemic complications of pneumonia and encephalitis
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14
Q

“Dewdrop on rose petal” refers to ____ caused by ____

A

“Dewdrop on rose petal” refers to chicken pox caused by Varicella Zoster Virus

(vesicle on erythematous base)

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15
Q

____ are found on Tzanck smear of chicken pox (Varicella Zoster Virus)

A

Multinucleated giant cells are found on Tzanck smear of chicken pox (Varicella Zoster Virus)

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16
Q

Chicken pox vaccine is ____

A

Chicken pox vaccine is live attenuated

(2 doses)

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17
Q

Describe effect of chicken pox on special populations

A

Chicken pox (VZV) in special populations

  • Pregnant women and neonates: maternal infection during first 20 weeks may result in syndrome of congenital malformation to fetus or spontaneous abortion
  • Immunocompromised patient: can be fatal in patients with cell-mediated immunity, varicella pneumonia / hepatitis / encephalitis
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18
Q

Shingles is _____

A

Shingles is reactivation of dormant Varicella Zoster Virus from sensory dorsal root ganglion

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19
Q

Shingles has ____ distribution of crop of vesicles and pustules on an erythematous base

A

Shingles has dermatomal distribution of crop of vesicles and pustules on an erythematous base

(unilateral)

(if disseminated look for immunosuppression - check HIV status)

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20
Q

____ are found on Tzanck smear of shingles (Varicella Zoster Virus)

A

Multinucleated giant cells are found on Tzanck smear of shingles (Varicella Zoster Virus)

21
Q

Describe clinical clues for shingles

A

Shingles clinical clues

  • Preceded by one to several days of numbness, tingling, or pain in affected area prior to onset of rash
  • Papules -> vesicles -> pustules in a background of erythema in a dermatomal distribution
22
Q

Describe complications of shingles

A

Shingles complications

  • Post-herpetic neuralgia: burning or deep aching pain or shooting pain that may persist for weeks after the skin lesions have healed
  • Ramsay Hunt syndrome: VZV infection of the geniculate ganglion (CN VII - facial nerve), involvement of external ear and/or tympanic membrane, and facial paralysis (ipsilateral)
23
Q

Ramsay Hunt syndrome is ___ infection of the ___ leading to ___ and with involvement of ___

A

Ramsay Hunt syndrome is VZV infection of the geniculate ganglion (CN VII - facial nerve) leading to ipsilateral facial paralysis and with involvement of external ear and / or tympanic membrane

24
Q

Shinges vaccine (one dose) is recommended for ___

A

Shinges vaccine (one dose) is recommended for peopled aged ≥ 60

(even if they had a bout of shingles)

25
Q

Kaposi sarcoma occurs in setting of ____, results from ____, and presents as ____

A

Kaposi sarcoma occurs in setting of AIDS / other immunosuppression, results from HHV-8, and presents as brown / dark red violaceous lesions

(lesions look vascular)

26
Q

Pityriasis rosea is a ____ rash that presents as ____

A

Pityriasis rosea is a post-viral rash that presents as a large oval patch (Herald patch) followed by oval slightly scaly patches scattered on a trunk (sometimes in Christmas tree distribution)

27
Q

Christmas tree distribution refers to ____

A

Christmas tree distribution refers to pityriasis rosea

28
Q

Pityriasis rosea differential diagnosis includes ____

A

Pityriasis rosea differential diagnosis includes secondary syphilis

(pityriasis rosea will self-resolve in 3-8 weeks)

29
Q

Molluscum contagiosum is a ____ with ____ and an ____

A

Molluscum contagiosum is a poxvirus with linear double stranded DNA and an envelope

30
Q

Molluscum contagiosum affects mainly ___, ___, and ___

A

Molluscum contagiosum affects mainly children, sexually active adults, and individuals with impaired cellular immunity

31
Q

Molluscum contagiosum is transmitted _____

A

Molluscum contagiosum is transmitted skin-to-skin

32
Q

Molluscum contagiosum presents as ____

A

Molluscum contagiosum presents as small, firm umbilicated papiules with smooth, waxy, or pearly surface

33
Q

Verruca vulgaris is caused by ____ which has ____ and ____ envelope

A

Verruca vulgaris is caused by which has circular dsDNA and no envelope

34
Q

Condyloma acuminata is caused by ____ which are _____

A

Condyloma acuminata is caused by HPV 6 and 11 which are low risk

(responsible for virtually all genital warts)

35
Q

Gardasil vaccinates against ____

A

Gardasil vaccinates against HPV types 6, 11, 16, and 18

36
Q

Describe manifestations of viral rashes that should prompt HIV testing

A

Manifestations of viral rashes that should prompt HIV testing

  • Widespread and / or giant Molluscum lesions especially involving the face
  • Disseminated herpes zoster or large ulcerated herpes zoster lesions
  • Lesions suspicious of Kaposi Sarcoma
37
Q

Parvovirus B19 has ____ and ____ envelope

A

Parvovirus B19 has linear ssDNA and no envelope

38
Q

Parvovirus B19 presents as ____

A

Parvovirus B19 presents as sudden appearance of slapped cheek

(lacy reticulate eruption on trunk and extremities)

39
Q

Hand, foot, mouth disease is a common viral illness of ____ and ____ and presents as ____, ____, ____, and ____

A

Hand, foot, mouth disease is a common viral illness of infants and children and presents as fever, ulcerovesicular stomatitis, acral erythematous vesicles, and buttock lesions

40
Q

Hand, foot, mouth disease is caused by ____ and ____

A

Hand, foot, mouth disease is caused by Coxsackie Virus A-16 and Enterovirus 71

41
Q

Describe progression of measles

A

Measles

  • After 1-7 days: coalescing papules usually start around ears and quickly spread over face
  • 2-3 days later: extends to trunk and extremities and then whole body is covered
  • High fever, malaise, conjunctivitis, and URI
  • Complications: otitis media, pneumonia, encephalitis (1%) fatal
42
Q

____ are pathognomonic for measles

A

Koplick spots are pathognomonic for measles

(appear during prodrome, are classic features of measles, 1 mm white papules on erythematous base in buccal mucosa)

43
Q

Describe diagnosis of measles

A

Diagnosis of measles

  • High fever
  • Koplick spots
  • Conjunctivitis
  • URI symptoms
  • Rash
44
Q

This is ____

A

This is pityriasis rosea

45
Q

This is ____

A

This is shingles (herpes zoster)

46
Q

This is ____

A

This is molluscum (pox virus)

(extensive molluscum should trigger HIV testing)

47
Q

This is ____

A

This is condyloma accuminata (HPV likely 6 or 11)

48
Q

This is ____

A

This is HSV-1

49
Q

This is ____

A

This is HSV-2

MSK/Derm (49 decks)

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