Week 6: Rashes in Infectious Disease Flashcards

1
Q

Learning Objectives

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2
Q

What is a macule?

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3
Q

What is a papule?

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4
Q

Macule vs Papule

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5
Q

What is a nodule?

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6
Q

What is a Plaque?

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7
Q

Nodule vs plaque

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8
Q

What is a pustule?

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9
Q

What is a vesicle/Bulla?

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10
Q

Pustule vs vesicle/Bulla

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11
Q

What are hives?

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12
Q

What is angioedema?

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13
Q

Hives vs angioedema

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14
Q

What are scales?

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15
Q

What is crust?

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16
Q

Scales vs crust

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17
Q

What is an erosion?

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18
Q

What is an ulcer?

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19
Q

What is a fissure?

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20
Q

Erosion vs ulcer vs fissure

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21
Q

What is a cyst?

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22
Q

What is a burrow

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23
Q

Cyst vs burrow

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24
Q

What is petechiae?

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25
Q

What is purpura?

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26
Q

Petechiae vs purpura

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27
Q

Question

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28
Q

Measles clinical presentation

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  • Fever
  • The 3 C’s:
    • Cough
    • Coryza
    • Conjunctivitis
  • Koplik spots 1-2 days prior to rash
  • The rash starts on the face and spreads down
  • Rash is NOT pruritic
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29
Q

Complications of Measels

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Rare complications are

  • Secon dary bacterial infection
  • Encephalitis
  • Subacute sclerosing panencephalitis
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30
Q

Measels overview

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31
Q

Rubella AKA

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German Measles

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32
Q

Rubella clinical manifestations

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  • Nonspecific
  • Low grade fever
  • 50% asymptomatic
  • The rash starts on the face and moves down to the trunk
    • It IS pink, NOT red like Measels
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33
Q

Rubella complications

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  • Congenital Rubella (highest risk first 4 months of pregnancy)
    • hearing-loss
    • mental retardation
    • Cardiovascular defects
    • ocular defects
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34
Q

Rubella overview

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35
Q

Reseola AKA

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HHV-6 or HHV-7

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36
Q

Roseola Clinical Manifestations

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  • Upper respiratory symptoms
  • High fever for 5-7 days
  • 90% case in children <2 y/o
  • The rash starts when fever breaks
    • spreads from neck/trunk to face and extremities
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37
Q

Roseola complications

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  • Occasionally high fever will trigger febrile seizures
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38
Q

Roseola overview

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39
Q

Hand-foot-mouth Disease AKA

A

Coxsackievirus

40
Q

Hand-foot-mouth Disease clinical manifestations

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  • Fever
  • Sore-throat
  • Malaise
  • Painful sores develop in the mouth (Herpangina)
  • similar lesions on the hands and feet
  • Some appear lie blisters that break and ulcerate
41
Q

Complications of Hand-foot-mouth Disease

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  • Fingernail/Toenail loss (Temporary)
  • Aseptic meningitis
  • Encephalitis
42
Q

Hand-foot-mouth Disease overview

A
43
Q

Fifth Disease AKA

A

Parvovirus B19

44
Q

Fifth Disease Clinical manifestations

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  • Flu-like symptoms for 3 days
  • Rash
    • “slapped-cheek” with erythematous macular or papular lesions
    • “Lacy” rash on trunk and extremities
45
Q

Fifth Disease complications

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  • Arthralgias
  • Aplastic crisis
  • Fetal hydrops
46
Q

Fifth Disease overview

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47
Q

Scarlet Fever Clinical manifestations

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  • Very sore-red-throat
  • High fever
  • Headache
  • NV
  • Strawberry tongue
  • Rash
    • Begins neck, underarms and groin and then spreads
    • Red rash with sandpaper feel
    • Skin may desquamate
    • Pastia’s lines
48
Q

Complications of Scarlet Fever

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  • Rheumatic fever
  • Poststreptococcal glomerulonephritis
49
Q

Scarlet Fever AKA

A

Group A Strep

50
Q

Scarlet Fever overview

A
51
Q

Penicillin Skin Rash

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  • Occurs hours or sometimes days after exposure to penicillin
  • Skin rash can be macular, papular or hives
  • Associated itching, swelling, possible wheezing or anaphylaxis
  • Can be diagnosed via skin testing
  • Desensitization available
52
Q

Question

A
53
Q

Chicken Pox AKA

A

Varicella or VZV

54
Q

Chicken pox clinical manifestations

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  • Mild fever
  • malaise 1-2 days prior to the rash
  • Rash
    • Starts on the head/chest/back and then generalizes
    • macules to papules to vesicles to crust
    • varying stages of lesions
55
Q

Complications of Chicken pox

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  • Secondary bacterial infections of skin
  • Pneumonia in adults
  • Rarely encephalitis or cerebellar ataxia
56
Q

Chicken pox overview

A
57
Q

Shingles AKA

A

Herpes Zoster

58
Q

Shingles Clinical manifestations

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  • Pain
  • Itching
  • Tingling of skin dermatome
  • Rarely systemic symptoms like
    • fever
    • malaise
    • headache
  • Rash
    • Unilateral dermatome
    • Blisters (vesciles) to crusts in varying stages
59
Q

Shingles complications

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  • Postherpetic neuralgia
  • Ocular movement (fifth cranial nerve)
  • Bacterial superinfection
  • Disseminated zoster
60
Q

Shingles overview

A
61
Q

Herpes Zoster AKA

A

Shingles

62
Q

Herpes AKA

A
  • HSV-1

or

  • HSV-2
63
Q

Herpes clinical manifestations

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  • 1st infection has associated fever, achiness, headache, lymphadenopathy
  • Recurrent outbreaks with tingling or pain in skin
  • Rash
    • Vesicles that open to painful ulcers that heal 2-4 weeks
64
Q

Herpes complications

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  • Aseptic meningitis
  • Encephalitis
  • Blindness
  • Disseminated infection if immunocompromised
65
Q

Molluscum contagiosum clinical manifestations

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  • Rash
    • 2-5 mm painless
    • flesh colored, pearly papules with a central umbilication
    • Resolves in 6-12 months to 4 years
66
Q

Molluscum contagiosum complications

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  • Scarring if manipulated
  • Bacterial superinfection
67
Q

Molluscum contagiosum overview

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68
Q

Question

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69
Q

What is Erysipelas?

A

Bacterial skin infection of the upper dermis

70
Q

Erysipelas clinical manifestations

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  • Very erythematous, indurated plaque with a sharply demarcated border
  • Typically associated with Group A Streptococcus (Though other bacteria are also implicated)
  • Previously associated with the face but now more commonly on legs
71
Q

What is cellulitis?

A
  • A non-necrotizing inflammation of skin and subcutaneous tissues from acute infection
  • Typically from a break in the skin
72
Q

Cellulitis clinical manifestations

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Symptoms of

  • erythema
  • swelling
  • pain
  • warmth
73
Q

Cellulitis pathogens

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Staph aureus (including MRSA) and streptococcus are most common

74
Q

Cellulitis complications

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If left untreated, may progress to deeper infection or bloodstream infection

75
Q

Cellulitis overview

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76
Q

What is Necrotizing fasciitis?

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Infection that spreas along fascial planes, causing tissue necrosis

77
Q

Necrotizing fasciitis pathogen

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Typically Group A Streptococcus but also Staph aureus, Clostridium species or polymicrobial species

78
Q

Necrotizing fasciitis clinical manifestations

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  • Patients have intense pain compared to the appearance of the skin
  • They are also quite ill with fever, tachycardia
  • Skin eventually develops blisters, clear fluid drainage and crepitus
79
Q

Necrotizing fasciitis Treatment

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  • Surgical for extensive debridement
  • Antibiotics are usually broad spectrum initially plus clindamycin to disrupt toxin production
80
Q

Necrotizing fasciitis overview

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81
Q

Furuncle, Carbuncle, Abscess overview

A
82
Q

What is a Furuncle?

A

Deep folliculitis typically caused by S. aureus

83
Q

What is a carbuncle?

A

Cluster of furuncles connected to each other under the skin

84
Q

What is an abcess?

A

Collection of pus causing swelling and inflammation (Often deeper than a furuncle or carbuncle

85
Q

Furuncle, Carbuncle, Abscess Treatment

A

Drainage +/- antibiotics

86
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Question

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87
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88
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89
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90
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91
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92
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93
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94
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95
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96
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Question

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