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Infectious Disease > Viral Infections- Part II- Exam 2 > Flashcards

Viral Infections- Part II- Exam 2 Flashcards

1
Q

What pt population is Rubeola most common in? What is it caused by?

A

Most common in children <5

Caused by Rubeola virus

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2
Q

What is the incubation period of rubeola? How is it transmitted? How long do they need to stay away from people?

A

7-14 days after infection

spread airborne through infected droplets or when people touch the droplets on surfaces- VERY contagious

need to stay away from people for 4 days after the rash appears but contagious for 8, (4 days before rash appears and 4 days after rash)

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3
Q

Low Grade Fever (can be 104-105)
Dry Cough
Coryza (Runny nose)
Conjunctivitis
Sore throat
Koplik’s spots on the buccal mucosas
Red, blotchy skin rash
s/s may last for 2-3 days

What am I?

A

Rubeola

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4
Q

What are Koplik’s spots? What dz is it associated with?

A

Tiny white spots with bluish-white centers found inside the mouth on the inner lining of the cheek

Rubeola

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5
Q

Describe the skin rash in a pt with rubeola? What are common places for it to present?

A

Small red spots, some slightly raised, in tight clusters giving the skin a blotchy red appearance

Face (behind the ears and along the hairline) → arms and trunk → thighs, lower legs, and feet-> then it gradually recedes first from the face then thighs then feet

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6
Q

If a pt is exposed to rubeola who has not been vaccinated, what is the protocol? In what timeframe?

A

Non immunized people, including infants, may be given the measles vaccination within 72 hours of exposure to provide protection against the disease.

If measles still develops, the illness usually has milder symptoms and lasts for a shorter time

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7
Q

What is the supportive care for rubeola?

A

Increased fluid intake
Acetaminophen for fever (No ASA)
Antibiotics for complications of bacterial infection

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8
Q

What are some common rubeola complications? Which one is the most common?

A

OM- MC
Bronchitis
Pneumonia
Preg complications
Encephalitis
Thrombocytopenia

aka the pt is at risk for secondary bacterial infections

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9
Q

What is the vaccine dosing schedule for measles, mumps, rubella? (MMR)

A

1st dose: 12-15 months

2nd dose: 4-6 yrs

can give both doses at least 4 weeks apart as long as the patient is 12 months and older and no older than 12 years

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10
Q

_____ is caused by the mumps virus. What is the incubation? How is it transmitted?

A

12-15 days after infection

Airborn
Contact w/ saliva
Contaminated surfaces

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11
Q

____ is the isolation/communicable period for mumps?

A

isolation of mumps patients for 5 days after their glands begin to swell

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12
Q

Fever
Headache
Muscle aches
Tiredness
Loss of appetite
parotitis

What am I?
What is the treatment?

A

Mumps

no specific treatment, supportive care

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13
Q

What is parotitis?

A

swollen and tender salivary glands under the ears or jaw on one or both sides of the face

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14
Q

What are common mumps complications?

A

orchitis
encephalitis
oophoritis/mastitis
deafness

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15
Q

What is orchitis?

A

inflammation of one or both testicles, which can cause pain, swelling, and frequent infection

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16
Q

What is the difference between measles (rubeola) and rubella (German measles)?

A

Measles (rubeola) is more severe and more contagious than rubella

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17
Q

What is the incubation period for rubella? How is it transmitted? What is the communicable period?

A

2-3 weeks

airborne
direct contact (mucus or saliva)
bloodstream of pregnant women

10 days b4 rash and 1-2 weeks after rash dissappears

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18
Q

Mild fever
Headache
Stuffy or runny nose
Inflamed, red eyes
Symmetrical postauricular and occipital tender lymphadenopathy
A fine, pink rash that begins on the face and quickly → trunk → arms and legs, before disappearing in the same sequence
Arthralgias, especially in young women.

What am I?
How long does it last?

A

Rubella

2-3 days

sometimes s/s are difficult to notice, only 50% become symptomatic

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19
Q

What are the complications of rubella?

A

arthritis (mostly in women, fingers, wrists, knees can last up to 1 month)
OM/Encephalitis
Congenital rubella syndrome

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20
Q

_____ up to 90% of infants born to mothers who had rubella during the first 11 weeks of pregnancy develop this. What is the classic triad?

A

Congenital rubella syndrome

Microcephaly
Cataracts
Cardiac defects

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21
Q

If a patient contracts rubella while pregnant and wishes to continue with the pregnancy, she may be given _______ to fight off the infection and reduce symptoms – it does not necessarily eliminate the possibility of the baby developing congenital rubella syndrome

A

hyperimmune globulin

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22
Q

you can order ____ to confirm the dx of rubella. What is the treatment?

A

IgM antibody titers

supportive care

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23
Q

T/F: You can get the MMR vaccine while pregnant

A

FALSE! because MMR is a live attenuated vaccine

24
Q

_____ is a common childhood exanthematous illness caused by Parvovirus B19 (the only parvovirus linked directly to disease in humans)

A

Erythema Infectiosum

25
Q

What is the incubation period for Erythema Infectiosum? (5th disease) Transmission? Communicable period? What season is it most common in?

A

1-2 weeks

respiratory secretions (saliva, sputum, nasal mucus)
blood or blood products
pregnant women can pass to baby

MS in the spring

26
Q

Unlike other exanthems, patients with ______ are most contagious before they get a rash or joint pain and swelling. After the rash appears, patients are generally not contagious so it is safe to go back to school or work

A

5ths disease

27
Q

What pt population is 5th disease MC in?

A

5-7 y/o

28
Q

Fever
rhinitis
HA
fiery-red facial erythema “slapped cheeks”
lacy (reticular) macular exanthem mainly over the proximal extremities

What am I?
What is the timeline for s/s?

A

5th disease: Erythema infectiosum

First: mild fever, rhinitis, HA

1-2 weeks: slapped cheeks facial redness

1-4 days after slapped cheeks, lacy rash over proximal extremities

rash can reoccur intermittently

29
Q

______ is common in adults with 5th disease, can last 1-3 weeks (sometimes longer)

A

Polyarthropathy syndrome

30
Q

What is the dx for 5th disease?

A

Diagnosis is usually clinical based on the appearance of the “slapped cheeks” or lacy rash

A blood test can also be performed to detect IgM-specific antibodies to parvovirus B19

31
Q

What is the treatment for 5th disease? Immunocompromised pts/RBC disorders?

A

usually mild- goes away by itself

symptomatic relief

IV immune globulin for immunocompromised patients and those with RBC disorders

32
Q

What are the complications with 5th disease?

A

can suppress RBC production, causing transient aplastic crisis, chronic red cell aplasia, hydrops fetalis or congenital anemia.

even more likely in patients that already have RBC illnesses: iron-deficiency anemia, HIV, sickle cell disease, thalassemia and spherocytosis

33
Q

What is the prevention for 5th disease?

A

NO vaccine!!

after infection you have immunity that protects from parvovirus B19 infections in the future

educate on the importance of handwashing, cough etiquette etc etc

34
Q

_____ is caused by Human Herpesvirus (HHV) types 6 and 7. Also known as _____

A

Roseola infantum

6th disease

35
Q

What is the incubation for 6th disease? tranmission? What time of year is it MC?

A

5-15 days

airborne

spring and fall

36
Q

Both HHV-6 and -7 are highly prevalent in the healthy population and affect almost all children between ___ and ___ of age. What age range is RARELY seen in?

A

6 mos and 3 yrs

younger than 2 and older than 4

37
Q

High fevers lasting 3-5 days
few clinical findings observed early in the course
after loss of fever, rash appears: blanchable, rosy pink, nonpruritis macular rash on the neck and trunk
feel sick only while they have the fever, once rash appears kids tend to feel fine

What am I?
What is the treatment?
When will it usually resolve?

A

Roseola

Supportive care: fluids and Tylenol.

4-6 days

38
Q

How do you dx roseola? If _____ happens need to investigate further, it happens in ____% of cases

A

dx is clinically because the rash appears after the fever, aka the kid has already begun to recover from the virus

febrile seizure (10%), further workup may be indicated

39
Q

What are roseola complications?

A

meningitis, encephalitis, leukopenia, thrombocytopenia, hepatitis

40
Q

Like other viruses in this family, _____ can reactivate after the first infection and cause illness, but this happens primarily in people who have ????

A

HHV6 and HHV7

a weakened immune system

41
Q

What three viruses are included under varicella?

A

Chicken Pox
Varicella Zoster Virus (VZV)
Human Herpes Virus

42
Q

What is the incubation for varicella?

A

10-21 days after exposure to chickenpox or shingles

43
Q

What is the transmission for varicella? Can it be spread by a person with shingles?

A

Very contagious

Does NOT require skin-to-skin contact but can be spread by touching or breathing in the virus particles that come from chickenpox blisters

more commonly transmitted by respiratory secretions

CAN be spread by someone who has shingles to those who have never had chickenpox or been vaccinated

44
Q

What is the communicable period for varicella?

A

1-2 days before the rash appears until time all blisters have scabbed over

45
Q

Fever
Malaise
Loss of appetite
Headache
Rash: itchy, fluid-filled blisters that eventually turn into scabs
dewdrop on a rosepetal

What am I?
Where does the rash tend to show up first?
How long does the kid have to stay out of school?

A

Chicken pox: Varicella

The rash may first show up on the face and trunk → 250-500 itchy blisters

Children usually miss 10 -14 days of school or childcare, takes about 1-2 weeks for all the blisters to become scabs

46
Q

What is the lab way to dx chicken pox?

A

PCR swab of the lesion
IgM titers

47
Q

What is the supportive treatment for chicken pox? What is the rx?

A

Calamine lotion / oatmeal baths
Trim nails
Acetaminophen

Acyclovir / valacyclovir: needs to be started within 24 hours and treat for 5 days

48
Q

_____ is given for post-exposure prophylaxis for chicken pox for high risk indiviuals

A

Varicella immunoglobulin

49
Q

What is the chicken pox vaccination schedule? How effective are they?

A

CDC recommends 2 doses, once at an age of 12–15 months and again at 4–6 years. 2 doses are 98% effective in prevention

50
Q

T/F: It is possible to get chicken pox even if you have had the vaccine

A

TRUE! Some people who are vaccinated may still get the disease but it is usually more mild with fewer blisters and little or no fever

51
Q

_____ is a mild, highly contagious viral infection most commonly caused by Coxsackievirus. It is most common in ____

A

Hand, Foot, and Mouth Disease

young children

52
Q

What is the incubation for HFMD? Transmission? What seasons are MC? Communicable period?

A

3-7 days

Highly contagious
Nasal secretions, saliva, stool, blisters, resp droplets

Summer and Fall

Most contagious first week of illness, but can transmit until all blisters resolved

53
Q

Fever and lymphadenopathy
Sore throat
Malaise
Irritability in infants and toddlers
Loss of appetite
A red non-pruritic rash, often with blistering (vesicles), on the palmar and plantar skin
The vesicles are often arranged parallel to the dermatoglyphs, and may have a surrounding red halo
Painful, red, blister-like lesions on the tongue, gums, hard palate, and buccal mucosa

What am I?
What is the treatment?
When does symptoms usually resolve?

A

HFMD

supportive care:
topical oral anesthetic may help relieve the pain of mouth sores
OTC pain medications to relieve general discomfort

7-10 days

54
Q

How can you distinguish HFMD from other viral infections?

A

The age of the affected person
The pattern of signs and symptoms
The appearance of the rash or sores

55
Q

What are the complications from HFMD?

A

Dehydration: sore in the mouth/throat can be swallowing difficult/painful
Enchephalitis

56
Q
A

Infectious Disease (16 decks)

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