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Clinical Micro > Viral Exanthems > Flashcards

Viral Exanthems Flashcards

1
Q

What is a macule/macular rash?

A

<1cm, circular, flat, with red, brown, or blue discolouration

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2
Q

What is a papule/papular rash?

A

<0.5 cm, superficial, solid, elevated with varied colours

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3
Q

What is a morbilliform rash?

A

erythematous macules and papules that resemble measels

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4
Q

what is a vesicle?

A

<1cm circular collection of free fluid

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5
Q

What is a pustule?

A

Vesicle containing pus

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6
Q

What is a petechiae or petechial rash?

A

Pinpoint round sports that form as the result of bleeding

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7
Q

What in an exanthem?

A

A rash that appears abruptly and affects several areas of the skin simultaneously

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8
Q

most viral exanthems affect… and are.. (2 things)

A

Affect mainly children and are non-specific and self limiting

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9
Q

Measles virus (MeV) presents with what kind of rash?

A

Morbilliform rash

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10
Q

What is another name for measles

A

rubeola

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11
Q

What is measles an infection of?

A

the respiratory tract

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12
Q

How is measles spread? Is it very contagious or not?

A

Spread by aerosol and contact and is highly contagious

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13
Q

What is the R naught value?

A

Average number of people that one sick person will infect

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14
Q

What is the infectious period for Measles?

A

4 days before the onset of the rash and the 14 days after the rash has cleared

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15
Q

What are 4 symptoms of Measles?

A
  1. Fever
  2. The 3 C’s
  3. Koplik spots in the mouth
  4. Morbilliforme rash
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16
Q

What are the 3 C’s of measles?

A

cough, coryza, and conjunctivitis

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17
Q

What is the morbilliforme rash of measles like? where does it first appear? does it spread?

A

generalized, maculopapular, and erythematous

First appears on the face and neck
- spreads quickly to entire body

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18
Q

What are 5 potential complications resulting from an infection with measles?

A
  1. Bronchitis
  2. Pneumonia
  3. Encephalitis
  4. Death
  5. Subacute sclerosing panencephalitis (SSPE)
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19
Q

What is Subacute sclerosing panencephalitis (SSPE)?

A

a rare and progressive neurological disorder that can appear years after measles infections

people die usually within 3 years

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20
Q

What % of the population needs to be vaccinated in order to benefit from heard immunity?

A

at least 90%

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21
Q

How is serology useful in differentiating between acute disease and previous exposure?

A

high IgM levels correlate to acute disease where IgG levels correlate to immunity

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22
Q

How is molecular detection useful in the diagnosis of measles?

A

MeV is a resp. virus but will spread to other areas including the bladder

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23
Q

What kind of molecular method is used to test for measles? using what sample?

A

RT-PCR from nasopharyngeal swab, throat swab, and urine sample

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24
Q

Which is more sensitive? RT-PCR or IgM serology?

A

RT-PCR

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25
Q

Why is molecular detection more useful for measles?

A

can detect viremia before the rash appears

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26
Q

How is rubella virus (RuV) transmitted?

A

droplet and vertical transmission from nasal or throat secretions

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27
Q

Why is rubella a concern for pregnant women?

A

can result in birth defects and miscarriage as well as congenital rubella syndrome (CRS)

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28
Q

What is the usual result of a rubella infection in adults?

A

self limiting rash

29
Q

What is another name for rubella?

A

german measles

30
Q

What is the rash presentation for rubella?

A

another maculopapular, mobilliform rash on the skin

also petechial rash presentation on the uvula

31
Q

What is the infectious period like for rubella?

A

7 days before to 14 days after the rash

32
Q

What is the incubation period for rubella?

A

14 to 21 days

33
Q

When are children most contagious with rubella?

A

when the rash is erupting

34
Q

Where does the rash usually present for rubella?

A

on the torso, arms and face (as well as the uvula)

35
Q

What is congenital rubella syndrome?

A

child contracting rubella from the mother in utero

36
Q

What are the outcomes of CRS?

A 
Deafness
Cataracts in the eyes
Heart problems - patent ductus arteriosus 
Meningoencephalitis
Microcephaly 
Mental or growth retardation
Enlarged liver and spleen (hepatosplenomegaly)
Skin lesions (exanthem)
Bleeding problems
37
Q

What is the viral cause of erythema infectiosum?

A

parvovirus b19

38
Q

how is parvovirus b19 transmitted?

A

droplet and vertical transmission

39
Q

When is the infectious period for parvovirus B19

A

before the onset of the rash

40
Q

What is the prodrome of symptoms for erythema infectiosum? who is the most common in?

A

low grade fever, malaise, headache, coryza, myalgias, joint pain

more common in adults

41
Q

What is the exanthem progression for erythema infectiosum?

A

Begins with bright red “slapped” cheeks
- fades over 1-4 days

Symmetric, reticular (lace like), erythematous eruption appears on trunk and extremities
- lasts 5-9 days

42
Q

What is a potential complication for parvovirus B19 infections?

A

Aplastic crisis

- infection of RBC progenitors leads to reticulocytopenia

43
Q

What is the treatment for aplastic crisis? who is most susceptible?

A

immunosuppressed are particularly at risk

treatment is blood transfusion

44
Q

What is a result of aplastic crisis in a fetus?

A

Anemia which can cause Hydrops fetalis

- Intrauterine growth retardation, pleural/pericardial effusions, and death

45
Q

What is the main way to test for parvovirus infection/immunity?

A

serology

46
Q

What do HHV-6 and HHV-7 cause?

A

Roseola infanticum

also called exanthema subitum

47
Q

What is the transmission for HHV 6 and 7?

A

unknown, likely droplet and contact

48
Q

When are HHV 6 and 7 an issue?

A

when someone is immunocompromised - leads to significant morbidity

49
Q

What is the difference in presentation for Roseola infanticum between children and adolescents?

A

Children: maculopapular mobilliform rash
Adolescents: Papular purpuric gloves and socks syndrome. Purple or brownish-red spots

50
Q

What viruses causes hand foot and mouth disease?

A

Enteroviruses, echoviruses and coxsackie viruses

51
Q

What kind of distribution do enteroviruses have?

A

Seasonal - common in late summer and early fall

52
Q

What are the exanthem vs enanthem of HFM disease?

A

Exanthem (blister like macules and papules) and enanthem (oral lesions) resembling aphthae (“canker sores”)

53
Q

What comes first for HFM disease? the exanthem or the enanthem?

A

the enanthem (canker sore like lesions in the mouth) appears first

later presents with macules and papules on the hands and feet
- painful erythemic vesicles and erosions on

54
Q

What is done to treat HFM disease?

A

nothing, self limiting and usually resolves in a few days

55
Q

another name for HHV-3 is….

A

Varicella zoster virus (VZV)

56
Q

What is the transmission like for VZV?

A

aerosol/airborne (like measles)

57
Q

What is the infectious period for VZV?

A

1-2 days before the onset of the rash until the lesions have crusted over

58
Q

Is there a vaccine for VZV?

A

yes

59
Q

what treatments are available for VZV?

A

acyclovir or VZIG (immunoglobulin)

60
Q

What is the rash like for VZV? progression?

A

Generalized and pruritic (itchy)

Rapid progression from macules to papules to vesicules with crusting

61
Q

What is a/are some severe complication(s) of VZV in children? in adults?

A

Children:

  • Bacterial infections (skin and soft tissue)
  • CNS infections and encephalitis
  • zoster

Severe pneumonia (adults)

62
Q

What is herpes zoster?

A

Reactivation of HHV-3 later in life occurring in specific dermatomes
- very painful vesicular eruptions

63
Q

What are dermatomes?

A

areas on skin supplied by sensory nerves

64
Q

What is disseminated zoster? When does that occur?

A

zoster spanning more than more dermatome

usually if someone is immunosuppressed/compromised

65
Q

What is the most sensitive and specific method for testing of HZV?

A

PCR

66
Q

When do you use serology as a means for testing for HZV?

A

only to test for immunity

- prenatal screening

67
Q

What treatments are available for VZV? When do you give either one?

A

Antivirals (ex: acyclovir, cidofovir, foscarnet)

VZIG (immunoglobulin) - exposed neonate or susceptible adult

68
Q

What are the two vaccines for VZV? when are either of them given?

A

Varivax (“chickenpox vaccine”)
-Childhood vaccination programs
Zostavax (“shingles vaccine”)
-Reduces severity and occurrences of PHN

Clinical Micro (28 decks)

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