4.10 Dermatology Paediatric Rashes

Front 1

What is the differential diagnosis for a

purpuric rash?

Back 1

1. Infective
- Meningococcaemia
2. Post infective
- Streptococcus
3. ITP ( Idiopathic Thrombocytopenic purpura)
4. HSP ( Henoch Schonlein Purpura)
5. Vasculitis ( PAN ; Wegener's ; Malignancy )
6. Drugs ( NSAIDS ; Diuretics ; ACEI ; Sulfonamides)

Front 2

Which of the following is incorrect regarding

paediatric rashes?
A. Koplick's spots is pathognmonic for Measles.
B. Strawberry tongue is characteristic of Scarlet fever.
C. Both Erythema Infectiosum and Scarlet fever have perioral rash sparing.
D. Subacute Sclerosing Panencephalitis is a

complication of Rubella.

Back 2

D. Measles

Front 3

Which of the following is incorrect regarding the aetiology of rashes?
A. Erythema Infectiosum = Parvovirus B19
B. Measles = RNA virus
C. Scarlet fever = HHV-6
D. Rubella = RNA virus

Back 3

C. Scarlet fever = GABHS (strep)

Roseola Infantum = HHV 6

(Human herpes virus )

Front 4

List the highly contagious rashes.

Back 4

1. Erythema Infectiosum (parvovirus B19)
2. Impetigo ( GABHS)
3. Hand , Foot and Mouth (Coxsackie A virus)
4. Varicella and Zoster.
5. Herpetic Gingivo stomatitis ( HSV )
6. Scarlet fever (GABHS)
7. Measles
8. Rubella
9. Meningococcus (Neisseria Meningitidis)

Front 5

In regards to ITP, which is incorrect ?
A. It usually occurs acutely in Children, 1-2 weeks after a viral URTI.
B. The rash can be petechial or purpuric or

ecchymotic.
C. It is usually managed with platelet

transfusion.
D. The rash is usually non-palpable.

Back 5

C.

1. Steroids
2. Immunosuppressive drugs
3. IV IG
4. Platelet transfusion for life threatening

bleeding OR platelet count < 10,000.

Front 6

Which is incorrect regarding HSP ?

A. The usual age range is 3 -12 years
B. It is an IgA mediated post infective small

vessel vasculitis.
C. Intussusception is a complication in 2% of

cases.
D. The main complication is GIT haemorrhage.

Back 6

D. Renal

- Glomerulonephritis
- ESRF in 1%

Front 7

In regards to TTP, which is incorrect ?
A. It is due to an endothelial surface enzyme deficiency , secondary to drugs and pregnancy.
B. It is closely related to HUS, and only occurs in Children.
C. Neurological abnormalities are a significant complication, including seizures and coma.
D. Plasma exchange and FFP are treatment options.

Back 7

B. Age range 10-60

Can occur at any age

Front 8

Which of the following is incorrect regarding Measles?
A. The morbilliform rash commences on the trunk
B. RNA virus
C. = fever + cough + coryza + conjunctivitis
D. Oral mucosa Koplick's spots are

pathognomonic

Back 8

A. Begins on the forehead and behind ears- spreading to face/neck/torso/extremities.

Front 9

Which of the following is incorrect regarding Scarlet Fever?
A. The diffuse rash is "sand paper like"
B. There is facial flushing with no perioral

sparing.
C. Pastia's Lines are pathognomonic
D. Strawberry tongue is pathognomonic.

Back 9

B. Typically has peri-oral sparing

Front 10

Which of the following is incorrect regarding Kawasaki's Disease?
A. It is also known as "mucocutaneous lymph node syndrome"
B. It's peak incidence is age 5 years
C. It is an acute self-lmiting vasculitis.
D. Treatment involves IV Immunoglobulin and high dose aspirin

Back 10

B. Peak incidence 1-2 years

Front 11

Which is incorrect regarding the complications of Kawasaki disease?
A. Gallbladder hydrops
B. Coronary artery aneurysms in 15-25 % of

untreated.
C. Arthritis
D. Pneumonia

Back 11

D. Not listed in most texts.

Front 12

Which is incorrect regarding the comparison

between Measles and Kawasaki disease?
A. They both have exudative conjunctivitis
B. Their rashes are quite distinctly different.
C. Both can be treated with IV IG.
D. Myocarditis is a complication of both.

Back 12

A. Kawasaki has non-exudative conjunctivitis

Front 13

Which of the following links is incorrect?

A. Strawberry tongue - Scarlet Fever
B. Koplick's spots - measles
C. Pastia's Lines - Erythema Infectiosum
D. SSPE - Measles

Back 13

C. Pastia's lines = Scarlet fever

Erythema Infectiosum = Slapped Cheek

Front 14

Which of the following links is incorrect?
A. Rash with peri-oral sparing

= Erythema Infectiosum
B. Rash with peri-oral sparing = Scarlet Fever
C. Sand-paper like rash = Scarlet Fever
D. Morbilliform rash = Rubella

Back 14

D. Morbilliform rash = measles

Rubella rash = pruritic maculopapular

widespread

Front 15

Which of the following link is incorrect ?
A. Parvovirus B 19 = Roseola Infantum
B. Group A Beta Haemolytic Strep ( GABHS) = Scarlet fever
C. Human Herpes Virus 6 = Roseola Infantum
D. Rubella = RNA virus

Back 15

A Parvovirus B19 = Erythema Infectiosum = Slapped Cheek

Front 16

Which of the following links is correct?
A. Hand, Foot and Mouth = HSV
B. Impetigo = GABHS
C. Varicella = HSV
D. Herpetic Gingivo-stomatitis = RNA virus

Back 16

B. Impetigo :

Streptococcus pyogenes (GABHS)
Staph aureus

A = Coxsackie A virus
C = Varicella Zoster Virus (VSV)
D = Herpes Simplex virus (HSV)

Front 17

Which of the following is incorrect regarding the Highly contagious rashes ?
A. Glomerulonephritis can be a complication of Impetigo
B. Pneumonia can be complication of Hand, Foot and Mouth.
C. The oral lesions of herpetic gingivo-stomatitis are usually situated in the posterior oral cavity
D. Both impetigo and Hand,Foot and Mouth can occur in the Toddler's to School-age group.

Back 17

C. Anterior 2/3 of oral cavity

Front 18

Which of the following is incorrect regarding ITP?
A. It is usually a post-viral thrombocytopenia
B. It only has petechial-type rashes
C. Platelets are transfused if bleeding is

life-threatening.
D. Steroids and IVIG are treatment options.

Back 18

B. petechial AND purpuric AND ecchymotic

Front 19

Which of the following is incorrect regarding ITP?
A. The main complications occur in the CNS and GIT.
B. Petechiae + splenomegaly +

thrombocytopenia is pathognomonic
C. The rash is palpable.
D. The rash is either spontaneous, or after minor trauma.

Back 19

C. Non palpable rash = ITP

Front 20

In regards to Thrombotic, thrombocytopenic purpura (TTP) , which of the following is

incorrect?
A. It can occur at any age, but typically is in age older than 10 years.
B. it is closely related to HUS
C. CNS complications occur in 30%, with altered conscious state, seizures and coma.
D. Plasma exchange and FFP are treatment options.

Back 20

C. High CNS complications : 75%

Front 21

Which of the following is not a common

laboratory finding in TTP?
A. Haemolytic anaemia - microangiopathic.
B. Coombs Test positive
C. Elevated Bilirubin and LDH
D. Thrombocytopenia with normal coagulation studies.

Back 21

B. TTP = Coombs negative

Front 22

Which is not a treatment option in TTP?

A. IV Immunoglobulin (IV IG)
B. Plasma exchange
C. FFP
D. Steroids / immunosuppressives

Back 22

A.