Week 1 Block 3: MIHO

Question 1

(1) DDx: In susceptible child, a febrile maculopapular rash that begins on face & spreads to trunk and extremities (2) Dx: if additional finding of postauricular LAD

Answer 1

(1) Suggestive of Rubeola (measles) or Rubella (German measles) (2) Indicates Rubella is most likely etiology

Question 2

(1) Dx: Brassy, barking cough; dyspnea; and recent history of upper respiratory infection in child (2) Most common cause of this Dx

Answer 2

(1) Suggestive of viral laryngotracheitis (croup) (2) Parainfluenza virus (a Paramyxovirus)

Question 3

Dx important respiratory infections in children & give common etiologic agents: (1) Nasal congestion & discharge, sneezing, cough, sore throat (2) Upper respiratory tract symptoms followed by hoarseness, barking cough, stridor, & respiratory distress (3) Sore throat, cervical LAD, coalescing pseudomembrane (4) Sore throat, dysphagia, drooling, & respiratory distress (5) Upper respiratory tract symptoms followed by wheezing, cough, & respiratory distress

Answer 3

(1) Nasopharyngitis (common cold) - Rhinovirus, Influenza virus, Coronavirus (2) Laryngotracheitis (croup) - Parainfluenza virus (3) Diphtheria - Corynebacterium diphtheriae (4) Epiglottitis - Haemophilus influenzae (5) Bronchiolitis - Respiratory synctial virus

Question 4

Presentation of: (1) Primary infection with HSV-1 (2) Reactivation of latent HSV infection (3) Abortive viral infection

Answer 4

(1) Fever, vesiculoulcerative gingivostomatitis, and cervical LAD most common clinical manifestations of primary infection with HSV-1 (2) Trigeminal ganglion generally results in more limited perioral blisters or “cold sores” (3) An abortive viral infection does not cause significant cytopathic effects

Question 5

Tricuspid endocarditis in IV drug users: (1) Most common cause (2) Second most common cause (3) Gross findings

Answer 5

(1) S. aureus (2) P. aeruginosa (3) These patients can develop multiple septic emboli in lungs. Pulmonary infarcts are almost always hemorrhagic due to the dual blood supply to the lungs (pulmonary and bronchial arteries).