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Nurs 629 Exam Hand, Foot, and Mouth Disease (HFMD) - Caused by the coxsacki virus 3-6 day incubation period Symptoms: -Low grade fevers -sore throat, poor appetite -malaise prior to rash -Petechial rash, blisters start. -Oral lesions, then hands and feet. -Sometimes can have on torso and extremities. -Look like canker sores with yellow ulcers and red halo. Treatment- tylenol, warm baths. Oragel depending on age. Magic moulthwash (benadryl and maalox) mixture. push hydration. Education: -very contagious- must have all of the lesions crusted prior to going back to school. -Illness can last up to one week. Hand-foot-and-mouth disease - · pustular, ulcerating lesions o on the hands and feet o oral ulcers Herpes Simplex Virus - Spread by respiratory droplets, contact with active lesion, and contact with body fluid. Symptoms -fever -malaise -fever -swollen glands -grouped vesicles with an erythematous base -gingiva that bleeds easily with small yellow ulcers. Treatment -Symptomatic treatments- oral antivirals or topical antivirals to shorten length of illness. -will most likely last 2-3 weeks Roseola - Caused by -human herpesvirus 6 (HHV-6) and 7 (HHV-7) Symptoms -High fever for several days -rash lasting for 1-2 days small pink spots that are patches with white rings around spots -rash usually starts on trunk and moves to extremities Treatment -Fluids, Tylenol, ibuprofen for fever, and rest. -Symptoms appear within two weeks post exposure Chickenpox - -Seeing an uptake in this disease as a lot of people are not vaccinating with MMR Caused by Varicella zoster Symptoms -crusted painful itchy lesions- can cause severe scabbing -huge incubation period (21 days) -fever -headache -URI symptoms Diagnostics -history and PE -VZV PCR Treatment -supportive care, tylenol, fluids, rest -Keep from scratching -Benadryl or caladyl -cool compreses -severe- admit for IV acyclovir Influenza - Multiple types: A and B most common Symptoms -high grade fever -headache -chills -body aches -runny nose -dry hacking cough -N/V and diarrhea -Croup Complications -myocarditis -pneumonia -atelectasis -Otitis media secondary bacterial infection Diagnosis -Rapid flu Treatment -supportive therapy -Tamiflu in the first 48 hours of onset of symptoms -for those under ages of 2, patients with respiratory disease, or immunocompromised patients Measals - Acute viral respiratory illness that is transported through contact Symptoms -fevers, malaise, cough -conjunctivitis -kolpik spots (maculopapular rash 14 days after exposure) -measles rash spreads from head to trunk to lower extremities so top to bottom. Treatment -supportive -High dose vitamin A Mumps - Paramyxoviridae family of virus Symptoms -painful enlargement of one or more salivary glands -fever -headache -anorexia -neck and muscular pain -can get a macular rash on trunk Diagnosis -PCR or serological tests Treatment -Corticosteroids for the swelling, and NSAIDS for pain Fifths disease - Erythema infectiosum Human parvovirus B19 Incubation 4-14 days Symptoms -Prodromal, fever, headache, nausea, and diarrhea -sore throat -Slapped cheek rash -Followed by reticular lace like rash on trunk -Maybe associated with arthralgia -petechia on hands and feet Diagnosis -parovirus IGM IGG Treatment -symptomatic treatment Fifth disease - · fiery red, maculopapular facial rash concentrated on the cheeks o Slapped cheek appearance Lime disease stage 1 - Borrelia burgdorferi- spread by deer ticks Stage 1 -2 weeks after the bite they will get that classic erythema migraines. -The ration starts with a nice annular macule or papule at the side of the bite within 24-48 hours and -within that first 1-2 weeks they will start noticing that classic bull's-eye lesion, so at first after the tech has expelled itself they will notice that maculopapular red lesion, and then you will notice the bull's-eye with a 1-2 weeks later Lyme Disease Stage 2 Symptoms - Secondary lesions Neurological cardiac generalized illness lasts weeks to 2 years without treatment. Lyme disease stage 3 - -months to years after if not treated -recurrent arthritis -encephalopathy and polyradiculoneuropathy -myalgia, arthralgias Treatment for lime disease - Less than 8 years old Amoxicillin 50mg/kg/day TID for 14 days older than 8 years doxycycline single 200mg daily or 4mg/kg/BID for 14 days Rocky mountain spotted fever - Spread by ticks Clinical features -fever greater than 104 -cough -photophobia -myalgias -GI upset -AMS -Maaculopapular rash Diagnosis IFA- gold standard PCR Treatment -doxycycline (only illness you give this under the age of 8) Cat scratch disease - Bartonella henselae Clinical features -systemic illness -erythematous popular 1 week after inoculation -linerar patter that follow the cat scratch -lymph node involvement that can last 1-2 months Diagnostic IFA Treatment -moist wraps -symptomatic treatments -needle aspiration -antibiotics if bacterial involvement or immunocomprimised Miningococcal disease - N. Meningitidis (A,B,C,Y & W-135) Clinical features -fever -headache -myalgia -cold hands and feet -flu like symptoms -septic shock -stiff painful neck -petechial rash