A 13 month old presents with fever, decreased oral intake with more than usual drooling, increased fussiness, and a rash that started in his diaper area and now parents noticed lesions on his feet and hands. You see this rash on exam:
Contact Dermatitis
Viral Rash
Coxsackie (hand, foot, mouth)
Chicken Pox
A 7 year old presents with fever, HA, sore throat and nausea. You have him change into a gown and notice this rash that began in his axilla and now has spread to his neck and rest of his trunk. What illness is this rash associated with?
Viral hives
Measles
Adenovirus
Strep throat
A pair of siblings check in with a very itchy rash. One sibling started with it and it is a non-descript papular rash that is in the webs of her fingers and move along the folds of her wrists. The other sibling started with the rash later and has lesions on the feet spreading up toward the knees. Upon exam this is what you see on the second sibling:
Scabies
Ringworm
A patient checks in for "rash on legs." The FSC calls and you go out to RVA the patient. You notice this rash and it does NOT blanch. The patient also complains of knee pain and abdominal pain. What are you concerned about and what other clinical findings would you look for?
HSP (Henoch-Schonlein purpura); you would also look for elevated blood pressure as well as blood and protein in the urine
Meningococcemia; you want to assess fever, nausea/vomiting, neck stiffness, and HA. You would also want to get a full set of vital signs and assess mental status
Thrombocytopenia; ask about history of previous viral infection (URI), assess for fever, decreased energy, potential bleeding in other sites (nose, gingiva)
HUS (hemolytic uremic syndrome); ask about history of diarrheal illness, also assess urinary output and blood pressure (will typically have oliguria which is a significant reduction of urine output)
An 8 year old male checks in with a fever, HA, nausea and some mild diarrhea. You notice he also has this rash on his face. What virus causes this and what illness is this associated with?
Parvovirus B19; Erythema infectiosum
Adenovirus; Kawasaki's
Herpesvirus; Roseola
Measles virus (paramyxovirus); measles
A 10 month old presents with this rash (blanches). Per dad, patient had a fever for three days and then today, the fever had resolved but now she has a rash that started on her neck and chest and has spread to her face, arms, and legs. She has also had a runny nose. What is it?
Viral rash
Strep rash
Roseola
Erythema multiforme
An FSC calls for a patient with a rash which started three days after a fever. The rash first appeared on the face, and has now spread to the neck, upper trunk and upper extremities. Per parents, patient has also been more fatigued, irritable, and his eyes are very red (conjunctivitis). What are you concerned for and what are the immediate next steps?
Strep throat; patient is okay to wait in lobby
Rubella; place patient in mask and in room on droplet precautions. Contact infection prevention immediately
Chicken pox; place patient in negative airflow room in Airborne contact and contact Infection Prevention
Measles; immediately mask patient and family and place in negative airflow room on airborne respiratory precautions and contact Infection Prevention Immediately
A 9 month old checks in with a rash that is scaly, dry and erythematous on his cheeks and some patches on his torso. No fevers or URI. It does seem to bother him because he scratches at it. What do you think it is?
Eczema
Erythema Multiforme
Dry skin
A 10 year old patient checks in with this rash that is localized to this specific spot on his abdomen. It is very itchy. What do you think it is?
Herpes Simplex-1
A 2 year old presents with this rash around her mouth. Per dad, it started out as red bumps and then became blisters which have been starting to for crusts and scab over. He said that the day care she goes to reported two other kids with the same looking rash. She has had no fevers. What is it and what is the most usual suspect to cause it?
Oral herpes; herpes simplex virus-1
Hand, foot, mouth; coxsackie virus
Chicken pox; varicella zoster virus
Impetigo; staph aureus
Which of the following statements about chicken pox is NOT true?
Caused by infection with varicella zoster virus
Appears in successive crops over several days that start as macules then develop into vesicles that crust over
Are not typically pruritic (itchy) but can be if vaccinated
Lesions are usually in different stages of development on the face, trunk, and extremities
A 4 year old presents with this non-blanching rash to his upper chest and back. Per mom, patient has also been having more frequent bloody noses. He had a cold 2 weeks prior with fever and she just noticed this earlier today. What are you concerned for and should this patient be brought immediately back?
ITP - idiopathic thrombocytopenia; YES
ITP - idiopathic thrombocytopenia; NO, safe to wait
Meningococcemia; YES
HSP (henoch-schlonein purpura); NO
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