Varicella Diagnosis
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Questions and Answers

What is the characteristic of the rash in scarlet fever?

  • Maculopapular and respects palms and soles (correct)
  • Lasts for a week
  • Itchy
  • Fades on the 24-48h after palms and soles
  • What is the order of the rash development in measles?

  • D1 trunk → D2 face → D3 extremities
  • D1 face → D2 extremities → D3 trunk
  • D1 extremities → D2 trunk → D3 face
  • D1 face → D2 trunk → D3 extremities (correct)
  • What is a complication of varicella that can occur if the patient scratches the lesions?

  • Bacterial superinfection (correct)
  • Reye syndrome
  • Hepatitis
  • Neurologic complications
  • What is the characteristic of the rash in rubella?

    <p>Very discrete and pink-coloured (A)</p> Signup and view all the answers

    Which of the following patients is recommended to receive antiviral treatment?

    <p>Patients aged &gt;12 years with severe cases (A)</p> Signup and view all the answers

    What is the dose of acyclovir for adults with varicella?

    <p>800mg x 5/day (A)</p> Signup and view all the answers

    What is the complication of varicella in adults, pregnant patients, and immunodeficient patients?

    <p>Pneumonia (C)</p> Signup and view all the answers

    What is the laboratory diagnosis of varicella?

    <p>Tzanck test (C)</p> Signup and view all the answers

    What is the duration of antiviral treatment for varicella?

    <p>7 days (D)</p> Signup and view all the answers

    What is the route of administration for specific anti-VZV immunoglobulins in prophylaxis?

    <p>Intravenous (A)</p> Signup and view all the answers

    What is the characteristic of the rash in varicella?

    <p>Not itchy and maculopapular (A)</p> Signup and view all the answers

    What is the differential diagnosis of scarlet fever?

    <p>Varicella, measles, and rubella (D)</p> Signup and view all the answers

    What is the time frame for administering specific anti-VZV immunoglobulins in prophylaxis?

    <p>Within 72-96 hours after contact (A)</p> Signup and view all the answers

    What is the characteristic of the rash in measles?

    <p>Becomes brownish after a few days (D)</p> Signup and view all the answers

    What is a neurologic complication of varicella?

    <p>Meningitis (A)</p> Signup and view all the answers

    What is a risk factor for developing Reye syndrome?

    <p>Administration of aspirin (A)</p> Signup and view all the answers

    What is the sign seen in rubella?

    <p>Forscheimer dots (B)</p> Signup and view all the answers

    What is the complication of measles?

    <p>Conjunctivitis (A)</p> Signup and view all the answers

    How long does the incubation period for varicella typically last?

    <p>10-21 days (D)</p> Signup and view all the answers

    What is the primary method of diagnosing varicella?

    <p>Clinical presentation (D)</p> Signup and view all the answers

    What is the characteristic of the rash in varicella?

    <p>Polymorphic, including macules, papules, vesicles, umbilicated vesicles, and crusts (C)</p> Signup and view all the answers

    What is the risk of scarring in varicella?

    <p>Low risk of scarring unless the patient scratches the lesions (C)</p> Signup and view all the answers

    When is a patient with varicella contagious?

    <p>From 1-2 days before the onset of symptoms until the rash crusts (C)</p> Signup and view all the answers

    What is a key feature of the epidemiology of varicella?

    <p>Highly contagious and can spread through contact with an infected individual (A)</p> Signup and view all the answers

    What is NOT a typical symptom of varicella?

    <p>Joint pain (C)</p> Signup and view all the answers

    What is the purpose of laboratory testing in varicella?

    <p>Only in atypical presentations (B)</p> Signup and view all the answers

    Study Notes

    Varicella (Chickenpox)

    • Isolation of VZV on cell cultures is not used anymore.
    • Tzanck test is used for diagnosis.

    Differential Diagnosis

    • Scarlet fever
    • Measles
    • Rubella

    Scarlet Fever

    • Rash is maculopapular, "sandpaper"-like, and not itchy.
    • Respects palms and soles.
    • Fades on the 24-48h after palms and soles.
    • Filatov Mask and Grozovici-Pastia sign may be present.

    Measles

    • Rash develops on the face on Day 1, trunk on Day 2, and extremities on Day 3.
    • Rash is maculopapular, not itchy, and becomes brownish after a few days.
    • Conjunctivitis is present.
    • Koplik sign may be present.

    Rubella

    • Rash is very discrete, pink-colored, and begins on the face but only lasts for a day.
    • Forscheimer dots may be present.
    • Lymphadenopathies persist for weeks.

    Complications of Varicella

    • Pneumonia, often seen in adults, pregnant patients, ID patients, and newborns.
    • Bacterial superinfection, neurologic complications (meningitis, encephalitis, etc.), and other organs can be affected.
    • Reye syndrome, an acute encephalopathy associated with hepatic dysfunction, can occur if aspirin is administered.

    Treatment of Varicella

    • Antiviral treatment is recommended for patients aged >12 years, severe cases, ID patients, newborns, pregnant patients, and those with chronic treatment with aspirin/corticosteroids or atopic dermatitis.
    • Acyclovir is the antiviral drug of choice, with doses depending on the severity of the case.
    • Valacyclovir is an alternative treatment.
    • Immunocompetent children with mild varicella can be treated with symptomatic treatment only.

    Prophylaxis

    • Passive immunization with specific anti-VZV immunoglobulins (anti-VZV IgG) can be used in pregnant patients, newborns, and those who come into contact with a confirmed case.
    • Must be administered within 72-96h after contact.

    Epidemiology of Varicella

    • Incubation period is 10-21 days.
    • Prodrome lasts 1-2 days.
    • Eruption lasts 10-15 days.
    • Asymptomatic cases can occur.

    Clinical Presentation of Varicella

    • Rash is polymorphic, very itchy, and develops in crops.
    • Each element goes through the following stages: macule, papule, vesicle, umbilicated vesicle, and crust.
    • The elements don't scar unless they become superinfected.

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    Description

    This quiz covers the diagnosis and differentiation of varicella (chickenpox) from other diseases such as scarlet fever, measles, and rubella. It includes the Tzanck test and characteristic rash symptoms.

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