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Infectous Rashes (Varicella Zoster (Path: VZV (Adult Pt: Shingles…

- - - - Dx: Clinical
        
        Tx: Acyclovir
        
        reduce duration
        
        F/u: Post herpetic neuralgia
        
        px lasting after shingles is gone
        
        Tx: TCA, Gabapentin, pregabalin
        
        Prophy: Shingles vaccine
        
        for ppl who have had chicken pox & ≥60yo
        
        only can reduce the chances of getting shingles
        
        :pencil2:w/ MMRV, in the future no-one will get shingles
    - - Dx: Clinical
        
        old test: ~~Tzank (perinuclear halos)~~
        
        ~~PCR~~ don't test for this virus!
        
        Tx: Supportive
        
        Prophy: MMRV
        ~~Pox Parties~~: immunity conferred by younger infection prevents complications in older kid
        
        Still causes disfigurement (scars)
        
        no protection vs. shingles
  - - - Path: Coxsakie A
        
        Pt: same presentation as Varicella except only occurs on...
        the ~~penis... (j/k)~~
        
        Hands
        
        Foot
        
        Mouth
        
        maybe buttocks too
        
        Dx: clinical
        
        Tx: supportive
        
        Prophy: no vaccine
    - - Pt: (any age but often) pubertal males :man::skin-tone-2:
        
        Parotid swelling
        
        Orchitis
        
        Dx: Clinical
        
        Tx: Supportive
        
        Prophy: MMRV
        
        f/u: May lead to infertility
        
        check for vaccine status & poss reason why no vaccine in vignette
- - - - Erythema Infectiousum
        
        Path: Parvo
        5th's disease (slapped cheek)
        
        like 2 big slaps across the cheeks (red, rosy)
        
        Fever :fire:
        
        Rash (@ same time)
        
        Dx: Clinical
        
        Tx: Supportive
        
        F/u:
        
        Danger in hemoglobinopathy
        
        Aplastic Crisis
        
        SCD kids
        
        Hydrops Fetalis (dead baby :skull_and_crossbones::baby_bottle:)
        
        a sick baby should be isolated from pregnant :pregnant_woman::skin-tone-2: mom
      - Path: Paramyxovirus
        
        Pt: presents w/ prodrome
        
        Prodrome ("4 C's")
        
        Cough
        
        Coryza
        
        Conjunctivitis
        
        Koplick spots (little white dots in mouth :tongue:)
        
        then fever :fire:
        
        & rash (@ same time)
        
        begins on face
        
        spreads down trunk & arms
        
        clears in same way (descending improvement)
        
        Dx: Clinical
        
        Tx: supportive
        
        Prophy: MMRV, (nobody should get this in US)
        
        must have all elements of clinical picture
        
        must have excuse not to get vaccine
        
        allergy
        
        antivaxx mom
        
        immigrant
        
        Post exposure prophy (NEJM)
        
        <72hrs after exposure, MMR or IgG
        
        at risk: young children :girl::skin-tone-4:, pregnancies :pregnant_woman::skin-tone-2:, immunosuppressed :wheelchair:
        
        F/u: If baby gets measles later in life:
        
        SSPE :ghost:
        
        Reportable disease
        Recommend giving Vit A for severe measles
    - - Pt: Identical to measles
        
        Prodrome
        
        Generalized & Tender LAD
        
        fever :fire:
        
        & rash
        
        on face
        
        spreads to trunk & arms :muscle::skin-tone-3:
        
        Dx: Clinical
        
        Tx: Supportive
        
        Prophy: MMRV
        
        f/u: no associated sequelae for baby
        
        mom has one though
  - - - Dx: Clinical
        
        Tx: Supportive
        
        F/u: :warning:beware of febrile seizures
        
        abort w/ BZD if >5min
        
        can control fever :fire: (doesn't reduce freq)
        
        use acetaminophen (not ASA-Reye's)
        
        Mnemonic: Chill Pill for high spiking fever: Xanax & Tylenol for Roseola
        
        should be ridiculous enough to remember