Skin: 12. Martin : Exanthematous Diseases Of Childhood And Vesiculobullous Disorders

Front 1

what spreads rubeola (measles)?

Back 1

nasal system

rubbing snot on you

Front 2

What are the 3 C's and what are they associated with

Back 2

the 3 C's of measles

cough, coryza*, and conjunctivitis

coryza=runny nose

Front 3

if you see Koplik spots and high fever, what does a patient have?

Back 3

measles

Front 4

if you see a maculopapular rash from head to toe what does the patient have?

Back 4

measles

maculopapular=macules and papules: macules are small (<1cm), flat lesions (L.spot) and papules are non-vesicular, non-pustular raised lesions (L.pimple)

Front 5

how does measles spread on the body?

Back 5

cephalocaudal (head to tail)

Front 6

Neurologic complications are more common than in any other exanthematous illness

name this disease

Back 6

Measles

Front 7

when do you give the measles, mumps, and rubella (MMR) combination vaccine ?

Back 7

13 months and 4-6 years

Front 8

Measles is primarily spread by…

Surface contamination
Contact with lesions
Respiratory droplets
Poor hygiene

?

Back 8

Respiratory droplets

Front 9

if you see Nonspecific, “rose-pink” macules and papules on the trunk that was preceeded by low grade fever and rhinorrhea and malaise, what would your patient likely have?

Back 9

Rubella (German or 3 Day Measles)

Front 10

what vaccine is available for rubella?

Back 10

MMR

Front 11

what causes Erythema Infectiosum ?

Back 11

Parvovirus B19

Front 12

if you se a patient who initially presents with a low grade fever, headache, and URI symptoms and then has slapped cheek appearance with lace like rash on the extremities what do they have?

Back 12

Erythema Infectiosum (fifths)

Front 13

if a patient has erythema infectiosum, how long might it last? what is a unique feature of this?

Back 13

it can last 1 to 3 weeks and can wax and wane with different stressors (such as heat)

Front 14

What causes Roseola infantum (sixth disease)

Back 14

Caused by HHV-6 or 7—Herpesviridae family

Front 15

what is infected in roseola infantum?

Back 15

DNA virus preferentially infects activated T cells enhancing natural killer cell activity and induction of numerous cytokines.

Front 16

when is the peak incidence for roseola infantum?

Back 16

6-12 months

Front 17

what is the prodrum to roseola infantum? ***

Back 17

3 to 5 days of high fever (101-106°)

Front 18

you have a child who has a very high fever for 4 days that suddenly disappears and a new finding of a rash is noted. What does the child have?

Back 18

roseola infantum

Front 19

how does the rash seen in roseola appear/spread?

Back 19

starts on trunk and spreads to the limbs

Front 20

child presents with erythematous, blanchable* macules and papules on an infant who had high fever for 3 days preceding the skin eruption

what do they have?

Back 20

Roseola infantum

Front 21

The typical rash of Roseola infantum is preceded by:

Rhinorrhea and cough
Nothing—there is no prodrome
High fever
Cough, coryza, and conjunctivitis

Back 21

High fever

Front 22

what spreads chicken pox, and what is the incubaiton period?

Back 22

Spread by respiratory droplets or direct contact with lesions—incubation period of 10 to 21 days

Front 23

dew-drop on a rose petal describes what?

Back 23

Varicella (Chicken Pox)

Front 24

if you see The simultaneous presence of lesions in various stages of evolution what do you have?

Back 24

chicken pox

Front 25

when is the chicken pox vaccine given?

Back 25

at 12 months and 4-6 years

Front 26

what causes Hand-Foot-and-Mouth?

Back 26

Enteroviral exanthem, usually coxsackievirus A or B (fecal-oral spread)

Enterovirus=a virus that multiplies within the intestinal tract

Front 27

what does a patient have who presents with Grey-white vesicular lesions on the palms of the hands and dorsum of feet, maculopapular eruption on the buttocks

Back 27

Hand-Foot-and-Mouth

Front 28

a patient is brought into the hospital with severe dehydration and signs of anorexia. Upon examination you find Painful erosions and vesicles in the mouth in addition to a few gray vesicular lesions on the hands. What caused the patients condition?

Back 28

Hand-foot-and-mouth disease

Front 29

if you see erythematous macules or papules that evolve into erythematous or urticarial plaques, vesicles, bullae, or target lesions with violaceous centers what are you looking at?

Back 29

Erythema Multiforme

Front 30

what causes Erythema Multiforme

Back 30

herpes

these are the bulls-eye legions

Front 31

what causes the lesion in Erythema Multiforme

Back 31

Lesion is a result of epidermal cell necrosis

Front 32

what is the prodrome for erythema multiforme?

Back 32

NONE! you will be fine then covered in a shit ton of lesions

Front 33

what must you have in addition to skin problems to have Steven-Johnson Syndrome?

Back 33

two or more mucous membranes involved

Front 34

if you see High fever, pronounced constitutional symptoms, and varying degrees of generalized target lesions, bullae, epidermal detachment, and mucosal erosions (of at least two sites)

what does the person have?

Back 34

Stevens-Johnson Syndrome

Front 35

if you have a patient with necrosis evolving into vesicles, bullae, and then detach leaving raw, denuded skin along with a positive nikolsky sign, what does your patient have?

Back 35

Stevens-Johnson Syndrome

Front 36

what is a Nikolsky sign? What is it seen in?

Back 36

after exerting light pressure on an area of erythema, the epidermis becomes wrinkled and peels off like wet tissue paper


Stevens-Johnson Syndrome

Front 37

Stevens-Johnson Syndome vs. Toxic Epidermal Necrolysis

amount of skin involved?

Back 37

SJS: <10%

TEN: >30%

Front 38

if a patient presents to you with Extensive small bullae that will later coalesce and slough off
covering 30% of their body, what do they have?

Back 38

Toxic Epidermal Necrolysis

Front 39

drugs—sulfa, PCN, NSAIDS, anticonvulsants can strangely enough lead to what problem in infants?

Back 39

Toxic epidermal necrolysis and Stevens-Johnson syndrome

Front 40

what normally leads to Toxic epidermal necrolysis and Stevens-Johnson syndrome
in children?

Back 40

Mycoplasma infection

Front 41

are Toxic epidermal necrolysis and Stevens-Johnson syndrome serious?

Back 41

SHIT YES. super serious

! Discontinue all drugs administered within 2 months. Oropharyngeal involvement necessitates frequent mouthwashes and topical anesthetic. Ocular involvement necessitates ophthalmologic consult—frequent cleansing, antibacterial ointment

Front 42

if your patient has Toxic epidermal necrolysis and Stevens-Johnson syndrome what should you do with their previously administered drugs?

Back 42

DISCONTINUE THEM! They may be the cause

Front 43

for patients with Toxic epidermal necrolysis and Stevens-Johnson syndrome where do you want to send them?

Back 43

Burn unit or ICU to control massive fluid losses, secondary infection, and nutrition

Front 44

Which disorder does not have a prodrome including fever?

Measles
Erythema infectiosum
Roseola
Erythema multiforme

Back 44

Erythema multiforme

Front 45

In Toxic Epidermal Necrolysis, what percentage of the skin is affected?

<10%
No more than 10-20%
At least 30%
>70%

Back 45

At least 30%