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

Viral Exanthems Etc Flashcards

(110 cards)

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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
What is known as the 3 day measles
Rubella
26
How is varicella transmitted
Aerosolzied droplets or direct contact with skin lesions | **highly contagious**
27
How do you diagnose verruca vulgaris (common warts)
Scrape off hyperkeratotic portion until you can see the thrombosed capillaries (“seeds”)
28
What body area is usually affected by condyloma acuminatum
Anorectal area | C.a. Is mucosal HPV
29
What is the etiology of varicella
Varicella zoster virus (VZV), a herpes virus
30
What do Koplik spots look like?
bluish white grains of salt on a red background (inside mouth)
31
How do you manage the pain of herpes zoster
Acute: narcotics, NSAIDS, topical anesthetic Chronic: gabapentin (neurontin), pregabalin(lyrica), tricyclic antidepressants
32
What disease has generalized lymphadenopathy and polyarthralgias
Rubella (German measles)
33
What is Verruca Vulgaris
Common warts
34
What is the common name for herpes zoster
Shingles
35
When is the worst presentation of HSV-I
Primary presentation most severe
36
What is unique about the prodrome of measles
VERY high fever 104-105*F
37
What is the cycle of roseola infantum
1. Very high fever 2. Resolves abruptly 3. Rash appears
38
How do you tell apart measles (rubeola) from German measles (rubella)?
German measles has: 1. No Koplick’s spots 2. Lower fever 3. Less intense face rash
39
What is the etiology of condyloma acuminatum?
Human papillomavirus (HPV) C.a is mucosal HPV
40
What is the etiology of rubella
Rubella virus
41
What disease is known to cause outbreaks at Disneyland
Measles
42
What is the other name for measles
Rubeola
43
What is the etiology of Erythema Infectiosum?
Parvovirus B-19
44
What disease is consistent with a LACY rash
Erythema infectiosum (Fifth disease)
45
Can you get chicken pox more than once
Yes
46
What is the etiology of herpes zoster
Varicella zoster virus (VZV) a herpes virus same one as varicella
47
What is part of the enanthem of measles
Koplik spots
48
What are the complications of rubella?
1. Encephalitis 2. Congenital rubella syndrome if pregnant mom gets it 3. Mortality
49
What is the common name for varicella
Chicken pox
50
When should you treat herpes zoster/shingles
EARLY like within 72 hours Accelerates healing, decreases pain, and may reduce the incidence of PHN
51
What is in your ddx for the active phase of shingles
Allergic contact dermatitis, poison ivy, erysipelas, bullous impetigo ~single area so it looks like it could be something they came in contact with~
52
What are the serious complications of erythema infectiosum?
1. Transient aplastic crisis (anemia) | 2. Hydrops fetalis + fetal loss if pregnant mom gets it
53
What is the etiology of molluscum contagious?
Poxvirus
54
When should you treat HSV
EARLY within 72 hours
55
Where does the lacy rash of erythema infectiosum affect?
Trunk and extremities (extensor surfaces)
56
What is Hutchinson’s sign
Shingles vesicles on nose indicating Herpes Zoster opthalmicus
57
What is the clinical presentation of condyloma acuminatum?
Cauliflower lesions around anus
58
What is the treatment for HSV
Valacyclovir (Valtrex) Famciclovir (Famvir) Acyclovir (Zovirax) Doses differ depending on if its an initial outbreak vs a recurrence
59
What is the clinical presentation of verruca vulgaris
Raised rough lesions with tiny pigmented, thrombosis capillaries (“seeds”) Common on hands and feet
60
What is the active phase of herpes zoster
When the vesicles show up
61
What is the prodrome like for erythema Infectiosum?
Low grade fever+ various flu like symptoms
62
How long is the prodrome of HFM disease
12-24 hours (short)
63
What do HSV lesions look like?
**grouped vesicles on an erythematous base**
64
How long does the area remain infectious after measles person leaves
2 hours
65
How long does shingles last
Resolves within 2-6 wks
66
When are you contagious if you have rubella?
7 days before and after rash
67
Where are the vesicles distributed for each of these: - HFM - Varicella - herpes zoster
- HFM: hand foot mouth butt - varicella: everywhere - herpes zoster: along dermatome
68
What are the complications of chronic shingles/herpes zoster
Post-herpetic neuralgia (PHN) Herpes Zoster Ophthalmicus (HZO) Retinal necrosis Nerve palsies
69
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?
Kid has Fifth disease (Erythema infectiosum) Mom at risk for hydrops fetalis
70
What is the spreading pattern of measles
Starts intensely on face, and then spreads down to toes. | Palms and soles spared.
71
What is the treatment for varicella
Symptomatic treatment Avoiding pregnant females Avoiding susceptible people until all lesions are crusted
72
What is the treatment for Roseola infantum?
Supportive treatment | Antipyretics
73
What is the progression of the rash of Rubella
Head to toe (just like measles)
74
What is the etiology of measles
Paramyxovirus
75
What is the other name for Erythema Infectiosum?
Fifth Disease
76
What is the other name for Rubella
German measles
77
What is in the ddx during the chronic phase of shingles
Neuropathy | Drug seeking
78
What disease has anemia as a complication
Fifth disease/erythema infectiosum
79
What are the complications of HFM disease
Decreased oral intake/dehydration due to very painful mouth +encephalitis, aseptic meningitis, nail loss, fetal loss
80
Where won’t you find molluscum contagiosum lesions?
Palms and soles | If you did, you should think HFM instead
81
40% of newly acquired genital herpes is due to?
HSV-I tee hee
82
Is there a vaccine for HFM disease
No, prevent with hand washing only
83
What is unique about the prodrome for Roseola infantum?
3-5 days of EXTREMELY high fever with an abrupt end. Risk of febrile seizures Patient usually feels ok otherwise
84
How do we treat measles?
Symptomatic treatment only
85
Who is most likely to get rubella?
People who traveled or immigrants | It was eliminated in 2015
86
What antiviral do you treat herpes zoster with
Famciclovir (Famvir) TID x 7d Valacyclovir (Valtrex) TID x 7d (Acyclovir ok but its QID)
87
What is post herpetic neuralgia (PHN)
Stabbing pain that can last months-years after resolution of shingles lesions
88
How is molluscum contagiosum transmitted
Direct contact with person or fomites Ex: drying 2 kids off with same towel Frequent autoinoculation
89
What are the clinical stages of varicella
1. Incubation 10-21 days 2. Prodrome 2-5 days 3. Rash
90
Where does HSV-II usually affect
Genitals | “Herpes genitalis”
91
What % of adults have HSV-I
90%
92
How do you get herpes zoster (shingles)
Reactivation of latent VZV from dorsal root ganglion due to stress/aging
93
What is the treatment for HFM disease
Symptomatic, including lidocaine gets for oral discomfort
94
What is the etiology of verruca vulgaris
Human papillomavirus (HPV)
95
How do you treat erythema infectiosum?
1. Reassurance and symptomatic treatment 2. Blood transfusions if severely anemic 3. Avoid contact with pregnant people
96
How do you treat verruca vulgaris?
USe #15 blade to shave down the callus proper to cryotherapy Other txs can be salicylic acid, duct tape, or electrodessication
97
What is involved in the prodrome of HSV
Burning, tingling, or pruritus
98
What is classic about the prodrome for herpes zoster (shingles)
Acute nerve pain on skin but there’s nothing there for 3-5 more days
99
What is the management for Rubella
Avoiding contact with pregnant women | Symptomatic treatment
100
What type of HPV forms benign warts but plays a role in oncogenesis of skin and mucosal malignancies?
Cutaneous HPV
101
Can you get shingles if you never had chicken pox
Yes varicella vaccine can cause shingles later in life
102
Where do herpes zoster lesions form
Along a dermatome
103
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?
Varicella zoster
104
Who is most likely to get condyloma acuminatum
Gay men
105
Where does HSV-I usually affect
Oral: cold sores | “Herpes labialis”
106
What are the the infectious precautions you must take when having a shingles outbreak
- 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
What does the rash of erythema Infectiosum look like?
Slapped cheek | Lacy body rash 2-3 days later
108
What is the other name for mucosal HPV?
Condylomata Acuminata
109
What are the severe complications of measles?
Pneumonia Encephalitis Subacute Sclerosing Penencephalitis (SSPE) 7-10 yrs later
110
What is unique to the varicella rash
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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