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Clin Med Exam 1 (Lauren) > Viral Exanthems Etc > Flashcards

Viral Exanthems Etc Flashcards

1
Q

What are the 3 C’s of measles

A

Cough

Coryza

Conjunctivitis

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2
Q

Where do vesicles appear in Hand Foot and Mouth disease?

A

Hands, feet, mouth, and BUTTOCKS***

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3
Q

How do you diagnose varicella

A

Visualize lesions in all 3 stages at the same time

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4
Q

What are the two kinds of HPV?

A

Mucosal

Cutaneous

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5
Q

When do Koplik spots appear

A

48 hours before rash

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6
Q

What is in your ddx for the prodrome of herpes zoster

A

Migraine, cardiac/pleural disease, acute abdomen, vertebral disease
~many misdiagnoses during prodrome of shingles~

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7
Q

What are the clinical stages of measles

A
  1. Incubation
  2. Prodrome
  3. 3 C’s
  4. Enanthem
  5. Exanthem
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8
Q

What is a differential diagnosis for condyloma acuminata

A

Anal SCC

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9
Q

How is measles spread

A

Cough
Sneeze
Close breathing

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10
Q

What disease has fatal complications after 7-10 years

A

Measles

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11
Q

What is the key to diagnosing measles?

A

Clinical presentation

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12
Q

What % of US population has HSV-II

A

15-20%

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13
Q

How is HFM disease transmitted

A

Oral ingestion of virus

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14
Q

What is the etiology of hand foot and mouth disease

A

Coxsackie A16 Virus

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15
Q

What is the treatment for molluscum contagiosum?

A

Home treatment with podophyllotoxin cream (NOT OK for pregnancy)

(Otherwise it clears up on its own in 6-12 months)

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16
Q

When can a kid with varicella go back to school?

A

After all the lesions are crusted

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17
Q

How do we prevent rubella

A

MMR vaccine (not while pregnant though)

Draw rubella titers at first prenatal visit

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18
Q

What is the etiology of Roseola Infantum?

A

Herpes virus 6 (HHV-6)

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19
Q

What is herpes zoster ophthalmicus (HZO)

A

A vision-threatening activation of trigeminal nerve ganglion due to shingles

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20
Q

How do you prevent herpes zoster

A

Shingrix vaccination

Approved for 50yo+

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21
Q

What do molluscum contagiosum lesions look like?

A

UMBILICATED, flesh colored, pearly papules

Anywhere but palms and soles

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22
Q

What is congenital rubella syndrome

A

Baby looks like a BLUEBERRY MUFFIN

Hearing loss
Mental retardation
Heart & eye problems
Death

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23
Q

How is HSV spread

A

Direct contact with active lesions, even though pt may be asymptomatic

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24
Q

What is the pattern of spreading for roseola infantum?

A

Starts at neck/trunk

Moves to face/extremities

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25
Q

What is known as the 3 day measles

A

Rubella

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26
Q

How is varicella transmitted

A

Aerosolzied droplets or direct contact with skin lesions

highly contagious

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27
Q

How do you diagnose verruca vulgaris (common warts)

A

Scrape off hyperkeratotic portion until you can see the thrombosed capillaries (“seeds”)

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28
Q

What body area is usually affected by condyloma acuminatum

A

Anorectal area

C.a. Is mucosal HPV

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29
Q

What is the etiology of varicella

A

Varicella zoster virus (VZV), a herpes virus

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30
Q

What do Koplik spots look like?

A

bluish white grains of salt on a red background (inside mouth)

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31
Q

How do you manage the pain of herpes zoster

A

Acute: narcotics, NSAIDS, topical anesthetic

Chronic: gabapentin (neurontin), pregabalin(lyrica), tricyclic antidepressants

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32
Q

What disease has generalized lymphadenopathy and polyarthralgias

A

Rubella (German measles)

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33
Q

What is Verruca Vulgaris

A

Common warts

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34
Q

What is the common name for herpes zoster

A

Shingles

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35
Q

When is the worst presentation of HSV-I

A

Primary presentation most severe

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36
Q

What is unique about the prodrome of measles

A

VERY high fever 104-105*F

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37
Q

What is the cycle of roseola infantum

A
  1. Very high fever
  2. Resolves abruptly
  3. Rash appears
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38
Q

How do you tell apart measles (rubeola) from German measles (rubella)?

A

German measles has:
1. No Koplick’s spots

  1. Lower fever
  2. Less intense face rash
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39
Q

What is the etiology of condyloma acuminatum?

A

Human papillomavirus (HPV)

C.a is mucosal HPV

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40
Q

What is the etiology of rubella

A

Rubella virus

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41
Q

What disease is known to cause outbreaks at Disneyland

A

Measles

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42
Q

What is the other name for measles

A

Rubeola

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43
Q

What is the etiology of Erythema Infectiosum?

A

Parvovirus B-19

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44
Q

What disease is consistent with a LACY rash

A

Erythema infectiosum (Fifth disease)

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45
Q

Can you get chicken pox more than once

A

Yes

46
Q

What is the etiology of herpes zoster

A

Varicella zoster virus (VZV) a herpes virus

same one as varicella

47
Q

What is part of the enanthem of measles

A

Koplik spots

48
Q

What are the complications of rubella?

A
  1. Encephalitis
  2. Congenital rubella syndrome if pregnant mom gets it
  3. Mortality
49
Q

What is the common name for varicella

A

Chicken pox

50
Q

When should you treat herpes zoster/shingles

A

EARLY like within 72 hours

Accelerates healing, decreases pain, and may reduce the incidence of PHN

51
Q

What is in your ddx for the active phase of shingles

A

Allergic contact dermatitis, poison ivy, erysipelas, bullous impetigo
~single area so it looks like it could be something they came in contact with~

52
Q

What are the serious complications of erythema infectiosum?

A
  1. Transient aplastic crisis (anemia)

2. Hydrops fetalis + fetal loss if pregnant mom gets it

53
Q

What is the etiology of molluscum contagious?

A

Poxvirus

54
Q

When should you treat HSV

A

EARLY within 72 hours

55
Q

Where does the lacy rash of erythema infectiosum affect?

A

Trunk and extremities (extensor surfaces)

56
Q

What is Hutchinson’s sign

A

Shingles vesicles on nose indicating Herpes Zoster opthalmicus

57
Q

What is the clinical presentation of condyloma acuminatum?

A

Cauliflower lesions around anus

58
Q

What is the treatment for HSV

A

Valacyclovir (Valtrex)
Famciclovir (Famvir)
Acyclovir (Zovirax)

Doses differ depending on if its an initial outbreak vs a recurrence

59
Q

What is the clinical presentation of verruca vulgaris

A

Raised rough lesions with tiny pigmented, thrombosis capillaries (“seeds”)

Common on hands and feet

60
Q

What is the active phase of herpes zoster

A

When the vesicles show up

61
Q

What is the prodrome like for erythema Infectiosum?

A

Low grade fever+ various flu like symptoms

62
Q

How long is the prodrome of HFM disease

A

12-24 hours (short)

63
Q

What do HSV lesions look like?

A

grouped vesicles on an erythematous base

64
Q

How long does the area remain infectious after measles person leaves

A

2 hours

65
Q

How long does shingles last

A

Resolves within 2-6 wks

66
Q

When are you contagious if you have rubella?

A

7 days before and after rash

67
Q

Where are the vesicles distributed for each of these:

  • HFM
  • Varicella
  • herpes zoster
A
  • HFM: hand foot mouth butt
  • varicella: everywhere
  • herpes zoster: along dermatome
68
Q

What are the complications of chronic shingles/herpes zoster

A

Post-herpetic neuralgia (PHN)

Herpes Zoster Ophthalmicus (HZO)

Retinal necrosis

Nerve palsies

69
Q

A 7 year old presents with an eryhtematous rash on cheeks and lower extremities. It’s not itching and he doesn’t feel ill. What does kid have and what is his pregnant mom at risk for?

A

Kid has Fifth disease (Erythema infectiosum)

Mom at risk for hydrops fetalis

70
Q

What is the spreading pattern of measles

A

Starts intensely on face, and then spreads down to toes.

Palms and soles spared.

71
Q

What is the treatment for varicella

A

Symptomatic treatment

Avoiding pregnant females

Avoiding susceptible people until all lesions are crusted

72
Q

What is the treatment for Roseola infantum?

A

Supportive treatment

Antipyretics

73
Q

What is the progression of the rash of Rubella

A

Head to toe (just like measles)

74
Q

What is the etiology of measles

A

Paramyxovirus

75
Q

What is the other name for Erythema Infectiosum?

A

Fifth Disease

76
Q

What is the other name for Rubella

A

German measles

77
Q

What is in the ddx during the chronic phase of shingles

A

Neuropathy

Drug seeking

78
Q

What disease has anemia as a complication

A

Fifth disease/erythema infectiosum

79
Q

What are the complications of HFM disease

A

Decreased oral intake/dehydration due to very painful mouth

+encephalitis, aseptic meningitis, nail loss, fetal loss

80
Q

Where won’t you find molluscum contagiosum lesions?

A

Palms and soles

If you did, you should think HFM instead

81
Q

40% of newly acquired genital herpes is due to?

A

HSV-I tee hee

82
Q

Is there a vaccine for HFM disease

A

No, prevent with hand washing only

83
Q

What is unique about the prodrome for Roseola infantum?

A

3-5 days of EXTREMELY high fever with an abrupt end.

Risk of febrile seizures

Patient usually feels ok otherwise

84
Q

How do we treat measles?

A

Symptomatic treatment only

85
Q

Who is most likely to get rubella?

A

People who traveled or immigrants

It was eliminated in 2015

86
Q

What antiviral do you treat herpes zoster with

A

Famciclovir (Famvir) TID x 7d
Valacyclovir (Valtrex) TID x 7d

(Acyclovir ok but its QID)

87
Q

What is post herpetic neuralgia (PHN)

A

Stabbing pain that can last months-years after resolution of shingles lesions

88
Q

How is molluscum contagiosum transmitted

A

Direct contact with person or fomites
Ex: drying 2 kids off with same towel

Frequent autoinoculation

89
Q

What are the clinical stages of varicella

A
  1. Incubation 10-21 days
  2. Prodrome 2-5 days
  3. Rash
90
Q

Where does HSV-II usually affect

A

Genitals

“Herpes genitalis”

91
Q

What % of adults have HSV-I

A

90%

92
Q

How do you get herpes zoster (shingles)

A

Reactivation of latent VZV from dorsal root ganglion due to stress/aging

93
Q

What is the treatment for HFM disease

A

Symptomatic, including lidocaine gets for oral discomfort

94
Q

What is the etiology of verruca vulgaris

A

Human papillomavirus (HPV)

95
Q

How do you treat erythema infectiosum?

A
  1. Reassurance and symptomatic treatment
  2. Blood transfusions if severely anemic
  3. Avoid contact with pregnant people
96
Q

How do you treat verruca vulgaris?

A

USe #15 blade to shave down the callus proper to cryotherapy

Other txs can be salicylic acid, duct tape, or electrodessication

97
Q

What is involved in the prodrome of HSV

A

Burning, tingling, or pruritus

98
Q

What is classic about the prodrome for herpes zoster (shingles)

A

Acute nerve pain on skin but there’s nothing there for 3-5 more days

99
Q

What is the management for Rubella

A

Avoiding contact with pregnant women

Symptomatic treatment

100
Q

What type of HPV forms benign warts but plays a role in oncogenesis of skin and mucosal malignancies?

A

Cutaneous HPV

101
Q

Can you get shingles if you never had chicken pox

A

Yes varicella vaccine can cause shingles later in life

102
Q

Where do herpes zoster lesions form

A

Along a dermatome

103
Q

11 yr old presents with itchy rash after a fever foe r 3 days. Started on trunk and then went to extremities and face. It began as flat papules and is progressing to blisters. What is the diagnosis?

A

Varicella zoster

104
Q

Who is most likely to get condyloma acuminatum

A

Gay men

105
Q

Where does HSV-I usually affect

A

Oral: cold sores

“Herpes labialis”

106
Q

What are the the infectious precautions you must take when having a shingles outbreak

A
  • can transmit varicella to seronegative people via contact with lesions
  • avoid pregnant women, infants, and immunocompromised ppl
  • use caution until primary crusts have healed
107
Q

What does the rash of erythema Infectiosum look like?

A

Slapped cheek

Lacy body rash 2-3 days later

108
Q

What is the other name for mucosal HPV?

A

Condylomata Acuminata

109
Q

What are the severe complications of measles?

A

Pneumonia

Encephalitis

Subacute Sclerosing Penencephalitis (SSPE) 7-10 yrs later

110
Q

What is unique to the varicella rash

A

The vesicles occur at different stages over 4 days and are crusted over after 6 days

Clin Med Exam 1 (Lauren) (5 decks)

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