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Block 7 Week 2 > Viral Exanthems-Verma > Flashcards

Viral Exanthems-Verma Flashcards

1
Q

(blank) is a skin eruption occuring as a symptom of a general diseas.

A

Exanthem

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2
Q

(blank) are eruptive lesions on the mucous membranes

A

Enanthem

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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
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4
Q

Paramyxovirus causes (blank)

A

measles

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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

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6
Q

What is the incubation period for measles?

A

7-18 days

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7
Q

What is the infectious period for measles?

A

1-2 days prior to prodrom to 4 days after rash onset.

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8
Q

T or F

measles is highly contagious

A

T

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9
Q

What is this:
risk of mortality in developig countries
greater than 99% decrease in incidence due to vaccination

A

measles

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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

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11
Q

What are the three C’s of the prodrome phase of measles?

A

Coryza, conjunctivitis, cough

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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

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13
Q

Where does the measles exanthem begin?

A

begins on face around ears as irregular macules

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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

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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)
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16
Q

Why do you get blindness in measles?

A

due to poor nutrition (Vit A def) and measles infection

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17
Q

How do you transmit measles?

A

by direct or airborne droplets

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18
Q

How do you clinically identify measles?

A

kopliks spots or exanthem

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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)
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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

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21
Q

How do you treat measles?

A
  • supportive treatment
  • Vit A in malnourished children
  • prevention
  • post exposure prophylaxis
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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

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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

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24
Q

What is another name for “1st disease”?

A

measles

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25
Q

What is another name for “3rd disease”?

A

rubella

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26
Q

What class of virus does Rubella belong to?

A

togavirus

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27
Q

What is another name for rubella?

A

german measles

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28
Q

Who are at risk for getting rubella?

A

unvaccinated adolescents

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29
Q

What season do you get rubella?

A

Late winter/early spring

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30
Q

How do you get rubella?

A

Direct contact and droplets

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31
Q

What is the incubation period for rubella?

A

14-21 days

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32
Q

What is the infectious period for rubella?

A

5-7 days prior to rash to 3-5 days after rash onset

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33
Q

You can get asymptomatic infection of rubella in up to (blank) percent of patients.

A

50%

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34
Q

In the prodrome phase of rubella do you have a fever?

A

low grade fever

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35
Q

How does rubella present in children?

A

rhinorrhea cough and sore throat

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36
Q

How does rubella present in adolescents and adults?

A

malaise, sore throat, nausea, anorexia, painful occipital LAD

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37
Q

What is the enanthem associated with rubella?

A

forsheheimer’s spots (petechiae on hard palate)

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38
Q

How does rubella exanthem present?

A

starts on the face and fades from face within 24 hours (ie appearance changes rapidly in few hours.
Pink-red lesions

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39
Q

What color are the lesions of measles?

color of rubella?

A

purplish red

pink-red

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40
Q

What diagnostic testsdo you use for rubella exanthem?

A

IgM in acute serum or serial IgG in acute and convalescent sera

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41
Q

What are the complications associated with rubella?

A

(generally benign disease)

  • Arthralgias/arthritis in older patients
  • peripheral neuritis, encephalitis
  • congenital rubella syndrome
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42
Q

when does congenital rubella syndrome become a very real issue?

A

30-50% risk if infected in the first 6 weeks of 1st trimester of pregnancy

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43
Q

What are the symptoms of congenital rubella syndrome?

A

cataracts, microcephaly, deafness, cardiac defects, anemia, thrombocytopenia

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44
Q

What is the “fifth disease”?

A

erythema infectiosum

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45
Q

What causes erythema infectiosum?

A

human parvovirus B19

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46
Q

What season is erythema infectiousum most prominent?

A

all seasons (very sporadic)

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47
Q

What is the incubation period of erythema infectiosum?

A

4-14 days

48
Q

What is the infectious period of erythema infectiosum?

A

up until the onset of the exanthem, only contagious in the first stage

49
Q

Over (blank) percent of infections of erythema infectiosum are asymptomatic

A

50

50
Q

What is the prodrom phase of erythema infectiosum like?

A

mild fever (15-30%), sore throat, malaise

51
Q

What are the clinca features of erythema infectiosum like in adults?

A

flu-like symptoms, arthralgias/arthritis (potentially chronic, more common in women)

52
Q

How do you detect erythema infectiosum?

A

detection of serum parvovirus B19-specific IgM antibody is the preferred diagnostic test

53
Q

What is the first stage (1st day) of erythema infectiousum (fifth disease)?

A

“slapped cheek”

contagious during this stage

54
Q

What is the 2nd stage of erythema infectiousum (fifth disease)?

A

erythematous maculopapular eruption

55
Q

What is the third stage of erythema infectiosums (fifth disease) 6th day?

A 
reticular pattern (pathognomonic)
lasts 9-11 days
56
Q

What are complications of fifth disease?

A

-viral infection
-transient aplastic crisis (hemolytic, anemia)
hydrops fetalis

57
Q

WHat is hydrops fetalis?

A

severe anemia causing high output cardiac failure with fetal death rate of 1-5%

58
Q

In whom do you see papular pupuric Glove and sock syndrome?

A

young adults during the spring and summer

59
Q

What are the symptoms of papular purpuric glove and sock syndrome?

A

exanthem, LAD, fever, anorexia, arthralgias

60
Q

How long does papular purpuric glove and sock syndrome last?

A

7-14 days (self limiting)

61
Q

When does the viremia of papular purpuric glove and sock syndrome clear?

A

after rash

62
Q

What is 6th disease?

A

roseola infantum

63
Q

What is the cardinal sign of roseola infantum?

A

rosy rash- exanthem subitum

64
Q

Who are at risk for getting roseola infantum?

A

6-36 mons (peak age 6-7 months)

65
Q

Wha tis the season for roseola infantum?

A

sporadic

66
Q

What is the incubation period for roseola infantum

A

9 days

67
Q

What is the infectious period for roseola infantum?

A

virus is intermittently shed into saliva throughout life; asymptomatic persistent infection

68
Q

What are the clinical features of Roseola?

A

high fever (103)
for 3-4 days
abrupt appearance of rash, begins on trunk
febrile seizures

69
Q

Why do you febrile seizures in roseola?

A

due to rapid rate of fever progression or localized infection of meninges or host factors

70
Q

What is this:

vesicles on an erythematous base?

A

herpes simplex

71
Q

(blank) enters host through abraded skin or intact mucous membranes

A

Herpes simplex

72
Q

HSV I causes (blank) and HSV 2 causes (blank)

A

oral lesions

genital lesions

73
Q

What is this:

painful, recurring vesicular eruptions

A

Herpes simplex

74
Q

T or F the primary eruption is longer and more severe than recurrences of herpes simplex

A

T

75
Q

What is the primary infection like in herpes simplex?

A

fever, LAD, malaise

76
Q

Recurrence of herpes simplex virus is limited to (blank) are of involved nerve

A

mucocutaneous

77
Q

In herpes simplex you get (blank) tingling, burning, or pain

A

prodromal

78
Q

Chicken pox: varicella is part of what family?

A

herpseviridae

79
Q

Who is at risk for chicken pox?

A

young children, non-immune

80
Q

What season is chicken pox around?

A

sporadic

81
Q

WHat is the incubation period of chicken pox?

A

10-21 days

82
Q

How do you transmit chicken pox?

A

via resp. droplets and vesicle fluid

83
Q

When is the infectious period of chicken pox?

A

2d before to 5d after onset of rash

84
Q

What is the prodrom phase of chicken pox like?

A

ranges from asymptomatic to fever, malaise, cough, coryza, sore throat.

85
Q

What is the pruritis like in chicken pox?

A

variable from mild to severe

86
Q

What are some complications associated with chicken pox?

A

Secondary bacterial infections
otitis media
Higher risk for adults, neonates, immunocomp (pneumonitis, encephalitis, hepatitis)

87
Q

how do you give the varicella vaccine prophylactically?

A

within 72 hours of exposure for immunocompetent patients
OR
Varicella zoster IG within 10 days

88
Q

Who do you give the varicella zoster Ig to?

A

immunocompromised pnts
pregnant women
newborns at risk for disseminated varicella infection

89
Q

How do you treat chicken pox?

A

acyclovir and prodrugs

90
Q

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.

A

shingles

91
Q

(blank) is a major problem in immunocompromised patients-reactivation may occur multiple times with sever complications

A

Herpes zoster

92
Q

What is the mortality rate of small pox-variola?

A

30-40%

93
Q

What is the incubation period for small pox?

A

8-16 days

94
Q

What is the prodrome phase of small pox like?

A

chills, fever, backache, malaise

95
Q

Explain the exanthem in small pox?

A

starts on face/forearms then to trunk and finally legs

96
Q

Small pox starts off macular to papular to vesicles to thick walled (blank)

A

pustules

97
Q

How do you treat small pox?

A

anti-viral cidofovir (SE is renal dysfunction)

98
Q

What kind of virus is hand food mouth disease?

A

enterovirus

99
Q

What causes hand foot mouth disease?

A

coxsackie A16

100
Q

Who is at risk for hand foot mouth disease?

A

pre school aged children and it is highly contagious

101
Q

What is the incubation period for hand foot mouth disease

A

4-6 days

102
Q

What is the prodrome phase for Hand foot mouth disease like?

A

1-2 days prior to rash onset

-low grade fever, anorexia, malaise, sore mouth

103
Q

What causes herpangina?

A

coxsackie A virus

104
Q

Who is at risk for herpangina?

A

young children

105
Q

What is the incubation period of herpangina?

A

7-10 days

106
Q

What is the prodrome phase of herpangina?

A

fever, sore throat

107
Q

In herpangina (blank) macules transform into vesicles which then (blank)

A

erythematous

ulcerate

108
Q

How do you treat herpangina?

A

supportive care

109
Q

What is this:
causes mild to severe respiratory illness
may also cause pin pointed generalized rash.

A

Enterovirus D68

110
Q

How does Ev-D68 spread?

A

from person to person when an infected person coughs, sneezes, or touches contaminated surfaces

111
Q

What is the treatment for EV-D68?

A

no specific treatment-supportive therapy

112
Q

What is this:

Erythematous macules and papules begin on the face and spread cephalocaudally and centrifugally, Koplik spots.

A

Measles (rubeola)

113
Q

What is this:

Pruritic, pink to red macules and papules which begin on the face and spread to neck, trunk and extremities over 24hrs.

A

Rubella (german measles)

114
Q

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.

A

Erythema infectiosum

115
Q

What is this:

Pink macules and papules surrounded by white halos. Begins on trunk, spreads to neck and proximal extremities.

A

Roseola infantum

exanthem subitum

Block 7 Week 2 (10 decks)

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