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Block 7 Week 2 Colt > Viral Exanthems - Verma > Flashcards

Viral Exanthems - Verma Flashcards

1
Q

WHat is an exanthem?

A

skin eruption caused by a state of disease

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2
Q

what is an enanthem?

A

eruptive lesions on the mucous membranes

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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
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4
Q

What is 1st disease?

A

Measles

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5
Q

What virus causes measles?

A

paramyxovirus

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6
Q

What is the most common viral exanthem?

A

measles

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7
Q

T/F: measles has been eliminated from the US

A

true

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8
Q

What are the two methods of transmission of measles?

A

direct contact or airborne

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9
Q

What is the incubation period of measles?

A

7-18 days

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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

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11
Q

What is the charactersitic enanthem of measle’s?

A

Koplick’s spots

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12
Q

How soon before the exanthem do Koplick’s spots appear?

A

2 days before

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13
Q

What are the 3 C’s associated with the measles prodrome?

A

coryza, conjunctivitis, and cough

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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

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15
Q

Where does the measles exanthem first show up on the body?

A

AROUND THE EARS as irregular macules

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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

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17
Q

HOw long does the measles rash last?

A

3-5 days

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18
Q

How does the measles rash change in appearance once it gets to the trunk?

A

becomes purple-ish red papular rash

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19
Q

Is the measles diagnosis clinical or lab based?

A

clinical; based on Koplick’s spots and exanthem

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20
Q

What is the most rapid lab test to detect measles?

A

IgM in acute infections

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21
Q

You can do a PCR of what sample type to Dx measles?

A

throat swab

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22
Q

Can you culture measles in house?

A

Nope, gotta send it to the state health dept.

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23
Q

When do you sue serial IgG tests to Dx measles?

A

in both the acute in convalescent sera

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24
Q

A vitamin A def. in measles can lead to what serious complication?

A

blindness

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25
Q

What is the most serious complication of measles?

A

subacute sclerosing panencephalitis

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26
Q

Besides blindness and SSPE, what are the other complications associated with measles?

A

otitis media and pneumonia and regular encephalitis

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27
Q

What is one of the first diseases to reappear when vaccination rates fall?

A

measles

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28
Q

How many doses of MMR should Intl travelers receive?

A

2 doses

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29
Q

What type of vaccine is MMR?

A

live attenuated

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30
Q

When are the two doses of MMR given?

A

at 12-15mos and at 4-6 years

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31
Q

What is the measles post-exposure prophylaxis?

A

Vaccine within three days or Ig within 6 days followed by vaccine 5-6 months later

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32
Q

What is 3rd disease?

A

Rubella aka german measles

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33
Q

What virus causes rubella?

A

togavirus

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34
Q

What are the two methods of transmission of rubella?

A

direct contact or airborne

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35
Q

what is the incubation period of rubella?

A

14-21 days

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36
Q

With regard to the rash, how long are you infectious before and after with rubella?

A

5-7 days before

3-5 days after

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37
Q

T/F: 50% of infections with rubella are asymptomatic

A

true

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38
Q

What is involved in the rubella prodrome?

A

low grade fever

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39
Q

What are the symptoms in children of rubella?

A

rhinorrhea, cough, and sore throat

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40
Q

What are the symptoms of rubella in adolescents?

A

malaise, sore throat, nausea

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41
Q

T/F: rubella presents with an enanthem

A

true

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42
Q

What is the name of the enanthem that presents with rubella?

A

Forschheimer’s spots; petechiae on the hard palate

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43
Q

Where on the body does the rubella rash begin?

A

on the face

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44
Q

How long does the rubella rash on the face last?

A

24 hours

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45
Q

T/F: the rubella rash can change appearance as quickly as within several hours

A

true

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46
Q

What color are the rubella rash lesions?

A

Pink-red

Measles are purple-red

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47
Q

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?

A

IgM for acute

IgG for convalescent

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48
Q

What is a complication of rubella that is seen in older pts?

A

arthralgias/arthritis

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49
Q

Congenital rubella syndrome is a risk if the mother is infected in the first (blank) weeks of the first trimester

A

six

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50
Q

Congenital rubella syndrome includes what effects to the fetus?

A

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

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51
Q

What is Fifth’s disease?

A

Erythemia infectiosum

52
Q

What virus causes fifths disease?

A

human parvovirus B19

53
Q

What population is at risk for fifth’s disease?

A

school age kids

54
Q

What is the incubation period of fifth’s disease?

A

4-14 days

55
Q

What is the infectious period of erythema infectiosum?

A

infectious up until the onset of the exanthem and are only contagious in the first stage

56
Q

T/F: most infx of erythema infectiosum are asymptomatic

A

true

57
Q

WHat is the prodrome to erythema infectiosum?

A

mild fever, sore throat, malaise

58
Q

WHat are the prodrome symptoms of fifth’s disease in adults?

A

flu like symptoms, arthralgias/myalgias

59
Q

How do you Dx erythema infectiosum?

A

serum test for parvovirus B19 specific IgM Ab

60
Q

What is the characteristic facial rash associated with fifth’s disease?

A

slapped cheek

61
Q

T/F: patients are contagious when they present with the slapped cheek rash

A

true

62
Q

What rash presents on the second day of the erythema infectiosum infection?

A

erythematous maculopapular eruptions

63
Q

T/F: patients presenting with an erythematous maculopapular eruption of fifth’s disease are contagious

A

false

64
Q

The (blank) pattern seen on the sixth day of the fifth’s disease infection is pathognomonic for the infection

A

reticular pattern on the legs

65
Q

how long does the reticular pattern rash of erythema infectiosum last?

A

9-11 days

66
Q

Erythema infectiosum can have complications as it infects precursors to what cells?

A

RBCs

67
Q

A (blank) crisis is a complication of erythema infectiosum that causes hemolytic anemia

A

transient aplastic crisis

68
Q

What is the treatment for an aplastic crisis?

A

RBC transfusion

69
Q

What is the severe complication to the fetus that can happen as a result of an infx of erythema infectiosum?

A

hydrops fetalis; severe anemia causes high output cardiac failure and death

70
Q

Papular Purpuric Glove and Shock syndrome is attributed to what viral infection?

A

parvovirus B19

71
Q

What population is at risk for the PP glove syndrome?

A

young adults

72
Q

How does PP glove present?

A

exanthem, LAD, fever, anorexia, arthralgias

73
Q

T/F: PP glove is self limiting over two weeks

A

true

74
Q

With respect to the rash, the the PP glove viremia clear before or after?

A

clears after the rash

75
Q

For the sake of fuck with this naming, what the bloody hell is 6th disease??

A

Roseola infantum

76
Q

What is the fancy latin name for the exanthem seen in roseola infantum?

A

exanthem subitum (sudden rash)

77
Q

What age pop is at risk for 6th disease?

A

6-36month olds

78
Q

T/F: people infected with roseola infantum are persistent asymptomatic carriers FOR LIFE

A

true, shed into the saliva fo eva

79
Q

What is the clinical presentation of 6th disease?

A

Fever above 103F for 3-4 days, abrupt appearance of rash on the trunk, and febrile seizures

80
Q

Where does the rash begin in roseola infantum?

A

on the trunk

81
Q

How do you describe the HSV lesion?

A

vesicles on an erythematous base

82
Q

HSV (1/2) infects the mouth while (1/2) infects the genitlas

A

1 to the mouth, 2 to the butt

83
Q

T/F: the primary HSV lesion is longer and more severe than the recurring lesions

A

true

84
Q

What are the symptoms besides the rash that come with an HSV infection?

A

fever, LAD, and malaise

85
Q

HSV recurrence is limited to the mucocutaneous area of the involved (blank)

A

nerve!

86
Q

The prodrome for HSV includes what sensations?

A

tingling, burning, or pain

87
Q

what virus causes chicken pox?

A

VZV

88
Q

what is the incubation period of chicken pox?

A

10-21 days

89
Q

What are the two methods of transmission of chicken pox?

A

respiratory droplets and vesicle fluid

90
Q

during what time are people with chicken pox infectious?

A

2d before and 5d after onset of rash

91
Q

T/F: the prodrome of chicken pox can be asymptomatic to general flu like with runny nose, sore throat, and cough

A

true

92
Q

In what percent of pts with chicken pox get secondary bacterial infections?

A

5-10%

93
Q

What age groups are the most at risk for complications due to chicken pox?

A

adults, neonates, and immunocompromised pts

94
Q

What are the scary complications associated with chicken pox?

A

pneumonitis, encephalitis, and hepatitis

95
Q

VZV vaccine can be given within (blank) hours of exposure

A

72; pt MUST BE IMMUNOCOMPETENT

96
Q

VZ-Ig is given within 10 days to what types of pts?

A

immunocompromised
pregnant
newborns at risk for disseminated varicella infection

97
Q

What is the Tx for chicken pox?

A

acyclovir

98
Q

What presents as a rash in a single, unilatera, dermatomal pattern? Most pts are older than 50

A

shingle

99
Q

What sensation comes before the actual shingles?

A

itching or burning

100
Q

T/F: herpes zoster really causes a ton of problems in immunocompromised pts

A

true; can be reinfected multiple times

101
Q

What is the mortality rate of small pox?

A

30-40%

102
Q

what is the incubation period o small pox?

A

8-16 days

103
Q

What is the prodrome for small pox?

A

chils, fever, backache, malaise

104
Q

HOw does the small pox rash spread?

A

Starts on face and forearms, moves to trunk and then legs; CENTRIFUGAL SPREAD

105
Q

Describe the change in the appearance of the small pox rash?

A

Macular to papular ot vesicles to thick walled pustules

106
Q

what type of vaccine is used for small pox?

A

live attenuated

107
Q

How do you Dx small pox?

A

PCR through the national laboratory network, call the fucking government

108
Q

What drug is given to treat small pox?

A

Cidofovir, but it can cause renal dysfunction

109
Q

What virus causes hand foot mouth diesease?

A

Coxsackie A16

110
Q

What age range is at risk for hand foot mouth disease?

A

pre school aged kids

111
Q

T/F: coxsackie A is only spread by body fluid

A

false; highly contagious

112
Q

What is the incubation period of coxsackie virus A?

A

4-6 days

113
Q

What is the hand foot mouth prodrome?

A

low grade fever, anorexia, malaise, SORE MOUTH

114
Q

T/F: hand foot mouth presents with an enanthem and an exanthem

A

true

115
Q

What virus causes herpangia?

A

coxsackie A

116
Q

what is the incubation period of herpangia?

A

7-10 days

117
Q

what is the prodrome of herpangia?

A

fever and sore throat

118
Q

What disease is this: erythematous macules transform into vesicles then ulcerate

A

herpangia

119
Q

What is the tx for herpangia?

A

supportive care

120
Q

Enterovirus D68 causes (respiratory/GI) illness

A

respiratory, i know is weird yah

121
Q

What causes pin pointed generalized rash?

A

Enterovirus D68

122
Q

What is the mode of transmission of EV-D68?

A

person to person via coughing, sneezing, or touching of contaminated surfaces

123
Q

T/F: there is no specific Tx for EV-D68

A

ture

124
Q

T/F: apperance alone of a rash is sufficient for diagnosis

A

false

125
Q

T/F: vaccination record is suggestive of what the pt COULD have

A

true

Block 7 Week 2 Colt (4 decks)

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