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40 Cards in this Set
- Front
- Back
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16,17Q:
What causes measles? |
-single stranded RNA virus
-spread by respiratory droplets (SNOT!) |
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16,17Q:
presentation of measles |
High Fever and 3 C's
-Cough -Coryza (runny nose) -Conjunctivitis |
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16,17Q:
Prodrome of measles |
incubation is 3-5 days:
get the fever and 3 c's without the rash. final stage: maculaopapular eruption *goes from HEAD TO TOE |
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16,17Q:
Measles Complications |
Pneumonia, bronchitis, otitis, gastroenteritis, myocarditis, and encephalitis
Neurologic complications are more common than in any other exanthematous illness |
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16,17Q:
Rubella Prodrome |
low grade fever, headache, rhinorrhea, malaise, myalgias, sore throat, and cough 2 to 5 days before the exanthem appears
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16,17Q:
Rubella skin findings |
nonspecific, “rose-pink” macules and papules on the trunk of a boy with German measles
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16,17Q:
Primary target of B19 Parovirus |
the primary target is the erythroid cell line (pronormoblast stage) leading to a transient anemia or aplastic crisis
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16,17Q:
3 stages of Erythema Infectiosum rash |
1.Facial flushing “slapped cheeks” appearance
2. Trunk and proximal extremities are quickly covered in a diffuse, macular erythema 3. Central clearing of eruption gives a lacy, reticulated appearance |
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16,17Q:
Roseola Infantum |
Sixth Disease, Caused by HHV-6 or 7 ,Herpesviridae family
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16,17Q:
Prodrome for roseola |
very very very high fever. rash doesnt show up until the fever goes away. rash starts from the middle and moves outwards.
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16,17Q:
Chicken Pox, how does it spread |
Respiratory droplets, or contact with lesion
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16,17Q:
Vesicular Stage of Chicken Pox |
Rash starts as a red macule or papule that progresses to the vesicular stage—classically the “dew-drop on a rose petal”
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16,17Q:
Hallmark of chicken pox.. |
The simultaneous presence of lesions in various stages of evolution is characteristic
(small pox, in comparison, will have the same stage pox all over) |
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16,17Q:
Hand-Foot-and-Mouth |
Grey-white vesicular lesions on the palmar surfaces of the hands and feet, macular eruption on the buttocks and thighs (PAIN!)
-blisters on tongue and mouth, so its tough to eat/drink |
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16,17Q:
Erythema Multiforme |
A self limited hypersensitivity syndrome with a distinct symmetrical, fixed, erythematous eruption that evolves into target lesions
*target lesions with violaceous centers |
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16,17Q:
Prodrome of Erythema Multiforme |
NO PRODROME!!
you're fine, then all of a sudden you're covered in target lesions! Yikes! |
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16,17Q:
Stevens-Johnson Syndrome |
-Serious systemic disorder in which two or more mucous membranes and the skin are involved
-High fever, pronounced constitutional symptoms, and varying degrees of generalized target lesions, bullae, epidermal detachment, and mucosal erosions (of at least two sites) |
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16,17Q:
SJS Prodrome |
Prodromal period 1-14 days of fever, malaise, and URI symptoms
- way to distinguish from erythema multiforme. This time they look sick. |
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16,17Q:
Nikolsky sign |
after exerting light pressure on an area of erythema, the epidermis becomes wrinkled and peels off like wet tissue paper
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16,17Q:
Distinguish Steven-Johnson and Toxic Epidermal Necrolysis |
Based on amount of skin covered:
Less than 10% is SJS More than 30% is TEN between 10-30% is SJS-TEN |
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16,17Q:
TEN |
extensive small bullae that later coalesced and led to widespread denudation.
sloughing of skin at the level of the epidermal cells and melanocytes |
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16,17Q:
Stuff in SJS and TEN |
-Purpuric and bullous macules
-Mucous membrane involvement with severe swelling and hemorrhagic crusting -Conjunctival injection, eyelid edema, and exudative crusting |
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16,17Q:
Tx for SJS and TEN |
Tx can lead to these diseases. Any drugs that were started in the last two months, STOP THEM! Because you don't know what it was yet.
* get 'em to a burn unit for wound care. |
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16,17Q:
Henoch-Schönlein Purpura |
aka anaphylactoid purpura
-Sites of inflammation include skin, synovium, GI tract, and kidneys -Begins with an initial urticarial eruption of macules and papules progressing rapidly to palpable,NON-BLANCHING, purpuric lesions |
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16,17Q:
Patients with HSP have bruising (echymoses) in spite of... |
...normal platelets.
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16,17Q:
HSP and kidneys, GI |
Systemic involvement (80% of cases) occurs in kidneys, GI tract, and joints. Kidney problems can rapidly progress to glomerulonephritis. GI tract symptoms are a result from edema and hemorrhage of the bowel wall as a result of vasculitis.
-Intussusception (intestinal blockage) is seen in up to 2%, more commonly in boys |
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16,17Q:
Serum Sickness is an example of this type of hypersensitivity |
a vasculitis of type III (immune complex) hypersensitivity.
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16,17Q:
Why do you get Serum Sickness? |
Current culprits are primarily antibiotics or viral infections. Nowadays its more like Serum Sickness-Like Reactions
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16,17Q:
Serum Sickness-Like Reactions |
caused by antibiotics such as Associated with cefaclor, penicillins (amoxicillin), minocycline, cefprozil, griseofulvin, and bupropion (1-3 wks after the antibiotic is taken)
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16,17Q:
Difference between SSLR and classick Serum Sickness? |
SSLR more likely to be urticarial than classic serum sickness, with fever, arthritis, and periarticular swelling
-Children may also demonstrate lymphadenopathy and eosinophilia -The vasculitis, renal dz, and hypocomplementemia that are seen with true serum sickness are absent in SSLR |
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16,17Q:
Cross reactivity of SSLR |
Cross reactivity among β-lactam antibiotics is low, and pts who have reacted to cefaclor or cefprozil will usually tolerate other cephalosporins
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16,17Q:
Kawasaki Disease |
Aka Acute febrile mucocutaneous lymph node syndrome
Vasculitis of the coronary arteries, small and medium sized blood vessels Occurs generally in children less than 5yo Difficult to diagnose, and should be considered in any infant with prolonged, unexplained fever. can't just look at the rash (polymorphic disease) |
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16,17Q:
Diagnostic Criteria of Kawasaki Disease |
Fever for 5+ days (cla$$ic)
and 4 of the 5 following: -Bilateral non-exudative conjunctivitis -Oral mucous membrane changes: injected pharynx, injected or fissured lips, strawberry tongue -Peripheral extremity changes: erythema or edema (acute), periungual desquamation (convalescent) -Polymorphous rash -Cervical lymphadenopathy (at least 1.5cm) |
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16,17Q:
CRASH and Burn |
mnemonic to remember Kawasaki Dieasese:
Burn=fever C= conjunctivitis R= rash A= adenopathy S= strawberry tongue H= hands and feet (swelling) |
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16,17Q:
Most serious complication with Kawasaki Disease? |
The heart issues (coronary dilation/vasculitis)
tx is IV Immuneglobulin (IVIG) -increased risk of thromboembolic events or stenosis causing MI even after treatment. (5yr olds can still get heart attacks) |
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16,17Q:
How do we spread measles? |
respiratory droplets
(nasoendothelial system) |
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16,17Q:
Which virus ONLY replicates in erythroid cells? |
B19 Parovirus
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16,17Q:
Which disorder does not have a prodrome including fever? |
erythema multiforme-- NO PRODROME!!!!!L:DFjgkdhglkjdfgk;
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16,17Q:
In TEN, what percentage of the skin is infected? |
at least 30%!!
less than 10% is Stevens-Johnson 10-30%- in betwixt |
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16,17Q:
The typical rash of erythema infantum is preceded by? |
high fever
-erythema infantum= roseola or sixth disease |
