Viral Exanthems - Verma Flashcards
1
Q
WHat is an exanthem?
A
skin eruption caused by a state of disease
2
Q
what is an enanthem?
A
eruptive lesions on the mucous membranes
3
Q
What are the six viral 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
What is 1st disease?
A
Measles
5
Q
What virus causes measles?
A
paramyxovirus
6
Q
What is the most common viral exanthem?
A
measles
7
Q
T/F: measles has been eliminated from the US
A
true
8
Q
What are the two methods of transmission of measles?
A
direct contact or airborne
9
Q
What is the incubation period of measles?
A
7-18 days
10
Q
How soon before rash onset with measles are you infective?
A
1-2 days prior to prodrome or 4 DAYS PRIOR TO RASH
11
Q
What is the charactersitic enanthem of measle’s?
A
Koplick’s spots
12
Q
How soon before the exanthem do Koplick’s spots appear?
A
2 days before
13
Q
What are the 3 C’s associated with the measles prodrome?
A
coryza, conjunctivitis, and cough
14
Q
The measles prodrome happens (blank) days prior to Koplick’s spots and (blank) days prior to the rash
A
2-4 days before spots, 3-5 days before rash
15
Q
Where does the measles exanthem first show up on the body?
A
AROUND THE EARS as irregular macules
16
Q
Where does the measles rash go after the face? How long does it take it to get there?
A
spreads to the trunk in 24-48 hours
17
Q
HOw long does the measles rash last?
A
3-5 days
18
Q
How does the measles rash change in appearance once it gets to the trunk?
A
becomes purple-ish red papular rash
19
Q
Is the measles diagnosis clinical or lab based?
A
clinical; based on Koplick’s spots and exanthem
20
Q
What is the most rapid lab test to detect measles?
A
IgM in acute infections
21
Q
You can do a PCR of what sample type to Dx measles?
A
throat swab
22
Q
Can you culture measles in house?
A
Nope, gotta send it to the state health dept.
23
Q
When do you sue serial IgG tests to Dx measles?
A
in both the acute in convalescent sera
24
Q
A vitamin A def. in measles can lead to what serious complication?
A
blindness
25
What is the most serious complication of measles?
subacute sclerosing panencephalitis
26
Besides blindness and SSPE, what are the other complications associated with measles?
otitis media and pneumonia and regular encephalitis
27
What is one of the first diseases to reappear when vaccination rates fall?
measles
28
How many doses of MMR should Intl travelers receive?
2 doses
29
What type of vaccine is MMR?
live attenuated
30
When are the two doses of MMR given?
at 12-15mos and at 4-6 years
31
What is the measles post-exposure prophylaxis?
Vaccine within three days or Ig within 6 days followed by vaccine 5-6 months later
32
What is 3rd disease?
Rubella aka german measles
33
What virus causes rubella?
togavirus
34
What are the two methods of transmission of rubella?
direct contact or airborne
35
what is the incubation period of rubella?
14-21 days
36
With regard to the rash, how long are you infectious before and after with rubella?
5-7 days before
| 3-5 days after
37
T/F: 50% of infections with rubella are asymptomatic
true
38
What is involved in the rubella prodrome?
low grade fever
39
What are the symptoms in children of rubella?
rhinorrhea, cough, and sore throat
40
What are the symptoms of rubella in adolescents?
malaise, sore throat, nausea
41
T/F: rubella presents with an enanthem
true
42
What is the name of the enanthem that presents with rubella?
Forschheimer's spots; petechiae on the hard palate
43
Where on the body does the rubella rash begin?
on the face
44
How long does the rubella rash on the face last?
24 hours
45
T/F: the rubella rash can change appearance as quickly as within several hours
true
46
What color are the rubella rash lesions?
Pink-red
| Measles are purple-red
47
What Ig do you use to Dx an acute infx of rubella and what Ig do you use to Dx a convalescent infx of rubella?
IgM for acute
| IgG for convalescent
48
What is a complication of rubella that is seen in older pts?
arthralgias/arthritis
49
Congenital rubella syndrome is a risk if the mother is infected in the first (blank) weeks of the first trimester
six
50
Congenital rubella syndrome includes what effects to the fetus?
cataracts, microcephaly, deafness, cardiac defects, anemia, thrombocytopenia
51
What is Fifth's disease?
Erythemia infectiosum
52
What virus causes fifths disease?
human parvovirus B19
53
What population is at risk for fifth's disease?
school age kids
54
What is the incubation period of fifth's disease?
4-14 days
55
What is the infectious period of erythema infectiosum?
infectious up until the onset of the exanthem and are only contagious in the first stage
56
T/F: most infx of erythema infectiosum are asymptomatic
true
57
WHat is the prodrome to erythema infectiosum?
mild fever, sore throat, malaise
58
WHat are the prodrome symptoms of fifth's disease in adults?
flu like symptoms, arthralgias/myalgias
59
How do you Dx erythema infectiosum?
serum test for parvovirus B19 specific IgM Ab
60
What is the characteristic facial rash associated with fifth's disease?
slapped cheek
61
T/F: patients are contagious when they present with the slapped cheek rash
true
62
What rash presents on the second day of the erythema infectiosum infection?
erythematous maculopapular eruptions
63
T/F: patients presenting with an erythematous maculopapular eruption of fifth's disease are contagious
false
64
The (blank) pattern seen on the sixth day of the fifth's disease infection is pathognomonic for the infection
reticular pattern on the legs
65
how long does the reticular pattern rash of erythema infectiosum last?
9-11 days
66
Erythema infectiosum can have complications as it infects precursors to what cells?
RBCs
67
A (blank) crisis is a complication of erythema infectiosum that causes hemolytic anemia
transient aplastic crisis
68
What is the treatment for an aplastic crisis?
RBC transfusion
69
What is the severe complication to the fetus that can happen as a result of an infx of erythema infectiosum?
hydrops fetalis; severe anemia causes high output cardiac failure and death
70
Papular Purpuric Glove and Shock syndrome is attributed to what viral infection?
parvovirus B19
71
What population is at risk for the PP glove syndrome?
young adults
72
How does PP glove present?
exanthem, LAD, fever, anorexia, arthralgias
73
T/F: PP glove is self limiting over two weeks
true
74
With respect to the rash, the the PP glove viremia clear before or after?
clears after the rash
75
For the sake of fuck with this naming, what the bloody hell is 6th disease??
Roseola infantum
76
What is the fancy latin name for the exanthem seen in roseola infantum?
exanthem subitum (sudden rash)
77
What age pop is at risk for 6th disease?
6-36month olds
78
T/F: people infected with roseola infantum are persistent asymptomatic carriers FOR LIFE
true, shed into the saliva fo eva
79
What is the clinical presentation of 6th disease?
Fever above 103F for 3-4 days, abrupt appearance of rash on the trunk, and febrile seizures
80
Where does the rash begin in roseola infantum?
on the trunk
81
How do you describe the HSV lesion?
vesicles on an erythematous base
82
HSV (1/2) infects the mouth while (1/2) infects the genitlas
1 to the mouth, 2 to the butt
83
T/F: the primary HSV lesion is longer and more severe than the recurring lesions
true
84
What are the symptoms besides the rash that come with an HSV infection?
fever, LAD, and malaise
85
HSV recurrence is limited to the mucocutaneous area of the involved (blank)
nerve!
86
The prodrome for HSV includes what sensations?
tingling, burning, or pain
87
what virus causes chicken pox?
VZV
88
what is the incubation period of chicken pox?
10-21 days
89
What are the two methods of transmission of chicken pox?
respiratory droplets and vesicle fluid
90
during what time are people with chicken pox infectious?
2d before and 5d after onset of rash
91
T/F: the prodrome of chicken pox can be asymptomatic to general flu like with runny nose, sore throat, and cough
true
92
In what percent of pts with chicken pox get secondary bacterial infections?
5-10%
93
What age groups are the most at risk for complications due to chicken pox?
adults, neonates, and immunocompromised pts
94
What are the scary complications associated with chicken pox?
pneumonitis, encephalitis, and hepatitis
95
VZV vaccine can be given within (blank) hours of exposure
72; pt MUST BE IMMUNOCOMPETENT
96
VZ-Ig is given within 10 days to what types of pts?
immunocompromised
pregnant
newborns at risk for disseminated varicella infection
97
What is the Tx for chicken pox?
acyclovir
98
What presents as a rash in a single, unilatera, dermatomal pattern? Most pts are older than 50
shingle
99
What sensation comes before the actual shingles?
itching or burning
100
T/F: herpes zoster really causes a ton of problems in immunocompromised pts
true; can be reinfected multiple times
101
What is the mortality rate of small pox?
30-40%
102
what is the incubation period o small pox?
8-16 days
103
What is the prodrome for small pox?
chils, fever, backache, malaise
104
HOw does the small pox rash spread?
Starts on face and forearms, moves to trunk and then legs; CENTRIFUGAL SPREAD
105
Describe the change in the appearance of the small pox rash?
Macular to papular ot vesicles to thick walled pustules
106
what type of vaccine is used for small pox?
live attenuated
107
How do you Dx small pox?
PCR through the national laboratory network, call the fucking government
108
What drug is given to treat small pox?
Cidofovir, but it can cause renal dysfunction
109
What virus causes hand foot mouth diesease?
Coxsackie A16
110
What age range is at risk for hand foot mouth disease?
pre school aged kids
111
T/F: coxsackie A is only spread by body fluid
false; highly contagious
112
What is the incubation period of coxsackie virus A?
4-6 days
113
What is the hand foot mouth prodrome?
low grade fever, anorexia, malaise, SORE MOUTH
114
T/F: hand foot mouth presents with an enanthem and an exanthem
true
115
What virus causes herpangia?
coxsackie A
116
what is the incubation period of herpangia?
7-10 days
117
what is the prodrome of herpangia?
fever and sore throat
118
What disease is this: erythematous macules transform into vesicles then ulcerate
herpangia
119
What is the tx for herpangia?
supportive care
120
Enterovirus D68 causes (respiratory/GI) illness
respiratory, i know is weird yah
121
What causes pin pointed generalized rash?
Enterovirus D68
122
What is the mode of transmission of EV-D68?
person to person via coughing, sneezing, or touching of contaminated surfaces
123
T/F: there is no specific Tx for EV-D68
ture
124
T/F: apperance alone of a rash is sufficient for diagnosis
false
125
T/F: vaccination record is suggestive of what the pt COULD have
true
