Viruses & The Skin Flashcards

1
Q

What are exanthems

A

widespread rash & systemic symptoms

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2
Q

What erythematous exanthems tend to start on the face

A

• MEASLES
• Rubella
• Erythema infectiosum

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3
Q

What erythematous exanthems tend to start on the trunk

A

• ROSEOLA
• Scarlet fever
• Unilateral laterothoracic exanthem

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4
Q

Name 2 Papulo-vesicular exanthems

A

• Chickenpox (syn. varicella)
• Gianotti-Crosti syndrome

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5
Q

What erythematous exanthems tend to effect the extremities

A

Hand, foot & mouth disease

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6
Q

What is an enanthem

A

Rash on the mucosal membrane

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7
Q

What is the incubation period of an infection

A

Incubation period is the time from being infected & showing symptoms

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8
Q

When is the infectious period of an infection

A

Depends on the infectious agent

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9
Q

What causes measles & how is it transmitted

A

Measles virus (part of paramyxovirus family)
Respiratory droplets

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10
Q

What is the incubation period of measles

A

8-12 days

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11
Q

Measles clinical features

A
  • High fever (above 40 degrees)
  • Cough
  • Coryza
  • Conjunctivitis
  • Koplik spots
  • Maculopapular rash, beginning on head before spreading
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12
Q

Describe koplik spots & the measles rash

A

Koplik spots - small grey discolourations of the mucosal membranes in the mouth, appearing 1-3 days after symptoms begin during the prodrome phase of infection

Measles rash - Maculopapular rash, beginning on head, spreading to trunk & extremities

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13
Q

Measles treatment

A

Preventative vaccination
Supportive treatment

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14
Q

Measles investigations

A

1st: measles-specific IgM and IgG serology (ELISA), most sensitive 3-14 days after onset of the rash

2nd: measles RNA detection by PCR, best for swabs taken 1-3 days after rash onset

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15
Q

Measles complications

A

Conditions caused by disruption of epithelial surfaces & immunosuppression e.g. otitis media, febrile seizures etc

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16
Q

What type of vaccine is measles & what does this mean clinically

A

Live vaccine
& so avoided in immunodeficient/suppressed individuals

17
Q

What causes erythema infectiosum & what is it aka

A

Aka Slapped cheek disease/ fifth disease
Is caused by human parvovirus B19 (HPV B19)

18
Q

Describe the rash of erythema infectiosum & state associated symptoms

A

Reticular lacy pattern sparing palms & soles
Red ‘slapped’ cheeks
Malaise & fever

19
Q

What indicates that a child’s chicken pox is infectious

A

Chicken pox is infectious until ALL lesions have crusted over

20
Q

What infectious agent causes chicken pox

A

Varicella zoster

21
Q

What happens when varicella zoster is reactivated

A

Virus reactivates in the dermatome it was dormant & causes shingles

22
Q

What is herpes zoster opticus

A

occurs when a shingles outbreak affects the facial nerve near one of your ears

23
Q

Varicella zoster virus investigations

A

PCR of vesicle fluid/pus

24
Q

Varicella zoster virus treatment (chicken pox & shingles)

A

Anti viral e.g. acyclovir may be prescribed depending on severity, patient age & complications

25
How is rubella similar but different to measles in clinical presentation
Similarity - Erythema exanthem/ maculopapular rash - Rash starts at head & spreads to trunk/ extremities Differences - Rash is typically less red & lasts a shorter durations - Different systemic symptoms, - Rubella typically associated with cervical lymphadenopathy
26
What live vaccines are currently available in the UK
Live influenza vaccine MMR vaccine Rotavirus vaccine Shingles vaccine BCG vaccine Oral typhoid vaccine Varicella vaccine Yellow fever vaccine
27
What is the clinical relevance of the human papilloma virus
It has a vaccine It can cause a range of cancers
28
What are the two strains of herpes simplex virus
HSV1 & HSV2
29
Herpes simplex virus clinical features
- Severe gingivostomatitis - Cold sores - Painful genital ulceration
30
Herpes simplex virus treatment
- Gingivostomatitis: oral aciclovir, chlorhexidine mouthwash - Cold sores: topical aciclovir - Genital herpes: oral aciclovir
31
How does acyclovir work in HSV
Acyclovir reacts with multiple cellular kinases This forms acyclovir triphosphate This gets incorporated into HSV DNA & causes DNA chain termination
32
What type of skin rash occurs in HSV
Localised vesicular rash
33
What other family of viruses can present with a rash similar to measles & rubella
Echovirus
34
What causes infectious mononucleosis
EBV
35
What is infectious mononucleosis aka
Glandular fever
36
Infectious mononucleosis clinical features
Diffused maculopapular eruption & urticaria Lymphocytosis & lymphadenopathy Splenomegaly etc Palatal petechial, periorbital oedema