Viral Exanthems-Verma Flashcards
1
Q
(blank) is a skin eruption occuring as a symptom of a general diseas.
A
Exanthem
2
Q
(blank) are eruptive lesions on the mucous membranes
A
Enanthem
3
Q
What are common classical childhood exanthems?
A
I. Measles (Rubeola)
II. Scarlet Fever (Scarlatina)
III. Rubella (German Measles)
IV. Filatow-Dukes Disease
V. Erythema Infectiosum
VI. Roseola Infantum
4
Q
Paramyxovirus causes (blank)
A
measles
5
Q
Who are at risk for measles?
A
school-age children who escaped vaccination-spread by direct or airborne droplets
IN LATE winter/spring
6
Q
What is the incubation period for measles?
A
7-18 days
7
Q
What is the infectious period for measles?
A
1-2 days prior to prodrom to 4 days after rash onset.
8
Q
T or F
measles is highly contagious
A
T
9
Q
What is this:
risk of mortality in developig countries
greater than 99% decrease in incidence due to vaccination
A
measles
10
Q
What is this stage in measles:
fever, coryza, conjunctivitis, cough (3C) occurs 2-4 days prior to Koplik’s spots and 3-5 days prior to exanthem
A
Prodrome
11
Q
What are the three C’s of the prodrome phase of measles?
A
Coryza, conjunctivitis, cough
12
Q
When does the prodrom phase occur in measles?
A
2-4 days prior to kopliks spots and 3-5 days prior to exanthem
13
Q
Where does the measles exanthem begin?
A
begins on face around ears as irregular macules
14
Q
In meases exanthem, lesions spread to trunk in (blank) hours. What happens after that time?
A
24- 48 hours
become more papular (purplish-red) and lasts 3-5 days
15
Q
What are some complications associted with measles?
A
Otitis media (7-9%) Pneumonia (1-6%) Encephalitis (fatal in 10-15%) Blindness Subacute Sclerosing Panencephalitis (SSPE)
16
Q
Why do you get blindness in measles?
A
due to poor nutrition (Vit A def) and measles infection
17
Q
How do you transmit measles?
A
by direct or airborne droplets
18
Q
How do you clinically identify measles?
A
kopliks spots or exanthem
19
Q
What are the lab ways you can diagnose measles?
A
- IgM in acute serum-most rapid
- PCR of throat swab
- Viral cultures through health department
- Serial IgG (acute and convalescent sera)
20
Q
What is one of the first diseases to reappear when vaccine rates fall?
How do you fix this?
A
measles
Intl Travelers should get 2 doses MMR
21
Q
How do you treat measles?
A
- supportive treatment
- Vit A in malnourished children
- prevention
- post exposure prophylaxis
22
Q
When you give the live attenuated virus for measles when should you give it?
A
at 12 to 15 months with second dose at 4-6 years
23
Q
When should you give post-exposure prophylaxis?
A
vaccine within 3 days (preferred) or immune globulin within 6 days followed by vaccine 5-6 months later
24
Q
What is another name for “1st disease”?
A
measles
25
What is another name for "3rd disease"?
rubella
26
What class of virus does Rubella belong to?
togavirus
27
What is another name for rubella?
german measles
28
Who are at risk for getting rubella?
unvaccinated adolescents
29
What season do you get rubella?
Late winter/early spring
30
How do you get rubella?
Direct contact and droplets
31
What is the incubation period for rubella?
14-21 days
32
What is the infectious period for rubella?
5-7 days prior to rash to 3-5 days after rash onset
33
You can get asymptomatic infection of rubella in up to (blank) percent of patients.
50%
34
In the prodrome phase of rubella do you have a fever?
low grade fever
35
How does rubella present in children?
rhinorrhea cough and sore throat
36
How does rubella present in adolescents and adults?
malaise, sore throat, nausea, anorexia, painful occipital LAD
37
What is the enanthem associated with rubella?
forsheheimer's spots (petechiae on hard palate)
38
How does rubella exanthem present?
starts on the face and fades from face within 24 hours (ie appearance changes rapidly in few hours.
Pink-red lesions
39
What color are the lesions of measles?
| color of rubella?
purplish red
| pink-red
40
What diagnostic testsdo you use for rubella exanthem?
IgM in acute serum or serial IgG in acute and convalescent sera
41
What are the complications associated with rubella?
(generally benign disease)
- Arthralgias/arthritis in older patients
- peripheral neuritis, encephalitis
- congenital rubella syndrome
42
when does congenital rubella syndrome become a very real issue?
30-50% risk if infected in the first 6 weeks of 1st trimester of pregnancy
43
What are the symptoms of congenital rubella syndrome?
cataracts, microcephaly, deafness, cardiac defects, anemia, thrombocytopenia
44
What is the "fifth disease"?
erythema infectiosum
45
What causes erythema infectiosum?
human parvovirus B19
46
What season is erythema infectiousum most prominent?
all seasons (very sporadic)
47
What is the incubation period of erythema infectiosum?
4-14 days
48
What is the infectious period of erythema infectiosum?
up until the onset of the exanthem, only contagious in the first stage
49
Over (blank) percent of infections of erythema infectiosum are asymptomatic
50
50
What is the prodrom phase of erythema infectiosum like?
mild fever (15-30%), sore throat, malaise
51
What are the clinca features of erythema infectiosum like in adults?
flu-like symptoms, arthralgias/arthritis (potentially chronic, more common in women)
52
How do you detect erythema infectiosum?
detection of serum parvovirus B19-specific IgM antibody is the preferred diagnostic test
53
What is the first stage (1st day) of erythema infectiousum (fifth disease)?
"slapped cheek"
| contagious during this stage
54
What is the 2nd stage of erythema infectiousum (fifth disease)?
erythematous maculopapular eruption
55
What is the third stage of erythema infectiosums (fifth disease) 6th day?
```
reticular pattern (pathognomonic)
lasts 9-11 days
```
56
What are complications of fifth disease?
-viral infection
-transient aplastic crisis (hemolytic, anemia)
hydrops fetalis
57
WHat is hydrops fetalis?
severe anemia causing high output cardiac failure with fetal death rate of 1-5%
58
In whom do you see papular pupuric Glove and sock syndrome?
young adults during the spring and summer
59
What are the symptoms of papular purpuric glove and sock syndrome?
exanthem, LAD, fever, anorexia, arthralgias
60
How long does papular purpuric glove and sock syndrome last?
7-14 days (self limiting)
61
When does the viremia of papular purpuric glove and sock syndrome clear?
after rash
62
What is 6th disease?
roseola infantum
63
What is the cardinal sign of roseola infantum?
rosy rash- exanthem subitum
64
Who are at risk for getting roseola infantum?
6-36 mons (peak age 6-7 months)
65
Wha tis the season for roseola infantum?
sporadic
66
What is the incubation period for roseola infantum
9 days
67
What is the infectious period for roseola infantum?
virus is intermittently shed into saliva throughout life; asymptomatic persistent infection
68
What are the clinical features of Roseola?
high fever (103)
for 3-4 days
abrupt appearance of rash, begins on trunk
febrile seizures
69
Why do you febrile seizures in roseola?
due to rapid rate of fever progression or localized infection of meninges or host factors
70
What is this:
| vesicles on an erythematous base?
herpes simplex
71
(blank) enters host through abraded skin or intact mucous membranes
Herpes simplex
72
HSV I causes (blank) and HSV 2 causes (blank)
oral lesions
| genital lesions
73
What is this:
| painful, recurring vesicular eruptions
Herpes simplex
74
T or F the primary eruption is longer and more severe than recurrences of herpes simplex
T
75
What is the primary infection like in herpes simplex?
fever, LAD, malaise
76
Recurrence of herpes simplex virus is limited to (blank) are of involved nerve
mucocutaneous
77
In herpes simplex you get (blank) tingling, burning, or pain
prodromal
78
Chicken pox: varicella is part of what family?
herpseviridae
79
Who is at risk for chicken pox?
young children, non-immune
80
What season is chicken pox around?
sporadic
81
WHat is the incubation period of chicken pox?
10-21 days
82
How do you transmit chicken pox?
via resp. droplets and vesicle fluid
83
When is the infectious period of chicken pox?
2d before to 5d after onset of rash
84
What is the prodrom phase of chicken pox like?
ranges from asymptomatic to fever, malaise, cough, coryza, sore throat.
85
What is the pruritis like in chicken pox?
variable from mild to severe
86
What are some complications associated with chicken pox?
Secondary bacterial infections
otitis media
Higher risk for adults, neonates, immunocomp (pneumonitis, encephalitis, hepatitis)
87
how do you give the varicella vaccine prophylactically?
within 72 hours of exposure for immunocompetent patients
OR
Varicella zoster IG within 10 days
88
Who do you give the varicella zoster Ig to?
immunocompromised pnts
pregnant women
newborns at risk for disseminated varicella infection
89
How do you treat chicken pox?
acyclovir and prodrugs
90
What is this:
rash in a single, unilateral dermatonal distribution.
Majority of patients are more than 50 years of age.
Pre-eruptive itching or burning.
shingles
91
(blank) is a major problem in immunocompromised patients-reactivation may occur multiple times with sever complications
Herpes zoster
92
What is the mortality rate of small pox-variola?
30-40%
93
What is the incubation period for small pox?
8-16 days
94
What is the prodrome phase of small pox like?
chills, fever, backache, malaise
95
Explain the exanthem in small pox?
starts on face/forearms then to trunk and finally legs
96
Small pox starts off macular to papular to vesicles to thick walled (blank)
pustules
97
How do you treat small pox?
anti-viral cidofovir (SE is renal dysfunction)
98
What kind of virus is hand food mouth disease?
enterovirus
99
What causes hand foot mouth disease?
coxsackie A16
100
Who is at risk for hand foot mouth disease?
pre school aged children and it is highly contagious
101
What is the incubation period for hand foot mouth disease
4-6 days
102
What is the prodrome phase for Hand foot mouth disease like?
1-2 days prior to rash onset
| -low grade fever, anorexia, malaise, sore mouth
103
What causes herpangina?
coxsackie A virus
104
Who is at risk for herpangina?
young children
105
What is the incubation period of herpangina?
7-10 days
106
What is the prodrome phase of herpangina?
fever, sore throat
107
In herpangina (blank) macules transform into vesicles which then (blank)
erythematous
| ulcerate
108
How do you treat herpangina?
supportive care
109
What is this:
causes mild to severe respiratory illness
may also cause pin pointed generalized rash.
Enterovirus D68
110
How does Ev-D68 spread?
from person to person when an infected person coughs, sneezes, or touches contaminated surfaces
111
What is the treatment for EV-D68?
no specific treatment-supportive therapy
112
What is this:
| Erythematous macules and papules begin on the face and spread cephalocaudally and centrifugally, Koplik spots.
Measles (rubeola)
113
What is this:
| Pruritic, pink to red macules and papules which begin on the face and spread to neck, trunk and extremities over 24hrs.
Rubella (german measles)
114
What is this:
Begins with bright red cheeks and as the facial rash fades over 1-4 days, a symmetric, erythematous, reticular eruption appears on the trunk and extremities.
Erythema infectiosum
115
What is this:
| Pink macules and papules surrounded by white halos. Begins on trunk, spreads to neck and proximal extremities.
Roseola infantum
| exanthem subitum
