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Bright red maculopapular rash, face to trunk, lasts 7-10 days. Koplick spots, Rash becomes confluent and may desquamate. Fever falls after rash appears.
Prodrome: cough, rhinitis, conjunctivitis
small, red, irregularly-shaped spots with blue-white centers like "grains of salt." Pathognomonic for measles.
Maculopapular, red, face to trunk, becomes confluent and may desquamate.
Rubella/German Measles cause
Postauricular, occipital adenopathy common. Polyarthralgia in some older girls. Mild clinical illness.
Rash: Mild maculopapular; rapid spread face to extremities; gone by day 4
Mild maculopapular, rapidly spreads and clears from face to extremities. Gone by day 4.
Roseola Infantum (exanthema subitum) cause
HHV-6 or HHV-7
Roseola infantum (exanthema subitum) H/P
Well appearing child with high fever (101-104) which disappears with appearance of rash develops.
May cause seizures from rapid fever spikes.
Prodrome: 3-4 days of fever
Incubation: 10-14 days
Roseola infantum (exanthema subitum) rash
pink macular rash after a fever, transient.
Fifth disease (erythema infectiosum) cause
Fifth disease (erythema infectiosum) H/P
Rash with fever which appears over weeks, esp. w heat or sunlight exposure.
Fifth disease (erythema infectiosum) complications
Red cell maturation arrest may cause aplastic crisis in children with chronic hemolysis.
Fifth disease rash
erythematous "slapped" cheeks; then lacy, reticular rash on extremities, trunk
Chickenpox (varicella) cause
Varicella zoster virus
Chickenpox (varicella) H/P
Widely scattered pruritic red macules rapidly progressing to clear vesicles, pustules, ("dew-drop on a rose leaf") and then crusting, over 5-6 days. Begins on the trunk then later on the face. Variable fever and nonspecific systemic symptoms.
Zoster is endogenous and reactivated infection that is infectious only as chickenpox to those who are not immune.
pruritic red macules rapidly progressing to clear vesicles, pustules, ("dew-drop on a rose leaf") and then crusting, over 5-6 days. Begins on the trunk then later on the face.
Scarlet Fever cause
Group A Beta Hemolytic Strep (GABHS) aka Strep pyogenes
Scarlet fever H/P
Rash follows strep throat or strep skin infection. Marked cervical lymphadenopathy. Most common in kids age 2-10.
Scarlet Fever rash
Diffuse erythema with sandpaper texture, strawberry tongue, rash spares periorbital areas, palms and soles. Desquamates in 7-14 days.
Bullous Impetigo cause
Bullous impetigo H/P
Bacterial infection of skin causing large bullae, can culture S. aureus. Scalded skin appearance.
Bullous impetigo rash
Large bullae full of serous fluid which may desquamate
S. aureus and sometime group A strep, S. pneumoniae
Most common skin infection, localized erythema, swelling, warmth, pain. Can spread locally, or go lymphatic or into blood stream.
Cephalexin a penicillin if no concern for MRSA. Doxy, Bactrim and Clinda have MRSA coverage.
Cellulitis vs. Erisypelas
Erysipelas has more rapid spread and is associated with group A strep rather than Staph
Rocky Mountain Spotted Fever cause
Rickettsia rickettsia, spread by ticks
Rocky mountain spotted fever H/P and rash
Fever and rash. Rash begins on palms and soles, spreads centrally to arms and trunk. Red macules and papules that progress to petechiae.
Rocky mountain spotted fever treatment
Hand-foot-mouth disease cause
Hand-foot-mouth disease H/P
Toddlers or young children. Several days of fever, sore throat malaise. Rash appears, vesicles or red papules on tongue, oral mucosa and feet. Oral lesions may be so painful they result in not eating.
Hand-Foot-Mouth disease rash
Herpes cold sore cause
Herpes Simplex virus. HHV-1 and HHV-2.
Herpes simplex H/P
May have 10 or more small ulcers of the buccal mucosa, anterior pillars, inner lips, tongue or gingiva. Associated fever may last 7-10 days. may have tender cervical lymph nodes, oral inflammation. Herpes sores in genital region of a pediatric patient should prompt concern for abuse.
Infectious mononucleosis cause
Infectious mononucleosis H/P
After 1-2 months, a 2- to 3-day prodrome of malaise and anorexia yields, abruptly or insidiously, to a febrile illness with temperatures exceeding 39 degrees C. Pharyngitis, enlarged, firm and mildly tender lymph nodes. Anterior and post. Cervical nodes almost always involved. Must check for hepatosplenomegaly. 5% have rash: macular, scarlatiniform or urticarial. Rash almost universal in pts. on PCN or ampicillin. Soft palate petechiae and eyelid edema are also observed.
Infectious mononucleosis rash
Kawasaki disease cause
Kawasaki Disease H/P
Fever, cervical adenopathy, irritability. Polymorphous rash on trunk and extremities; red palms and soles, conjunctiva, lips, tongue, and pharynx. Ill looking child with abnormal labs and negative cultures and streptococcal serology. Prolonged illness with resting tachycardia, swollen hands, feet. Can develop uveitis; aseptic meningitis, vasculitis and aneurysms of coronary and other arteries occur. Mandatory cardiac ultrasound to evaluate coronary arteries.
Kawasaki Disease rash
Toxic shock syndrome cause
S. aureus strain that produces a profound systemic shock
Toxic shock syndrome H/P
Infection is most common post operatively with an S. aureus abscess. The syndrome was commonly seen prior to universal advice to change tampons frequently and removal of extremely absorbent tampons from the market. Removal of the source of the toxin (abscess or tampon) is required for supportive treatment to be effective. Antibiotics alone will not treat the toxin.
Toxic shock syndrome rash
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