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    The document discusses several pediatric cases presenting with rashes, fevers, or other symptoms and asks for the likely diagnoses and causal organisms. It includes: 1) A case of itchy lesions on the arm from bed bugs after staying in a questionable motel. 2) A diffuse rash in a child who immigrated from Albania, showing Koplik spots diagnostic of measles. 3) A rash, fever, and parotitis consistent with mumps caused by an RNA virus. 4) Intracranial calcifications, hepatomegaly, and rash in a neonate caused by congenital cytomegalovirus. 5) "Slapped cheek"

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    The document discusses several pediatric cases presenting with rashes, fevers, or other symptoms and asks for the likely diagnoses and causal organisms. It includes: 1) A case of itchy lesions on the arm from bed bugs after staying in a questionable motel. 2) A diffuse rash in a child who immigrated from Albania, showing Koplik spots diagnostic of measles. 3) A rash, fever, and parotitis consistent with mumps caused by an RNA virus. 4) Intracranial calcifications, hepatomegaly, and rash in a neonate caused by congenital cytomegalovirus. 5) "Slapped cheek"

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    2 views2 pages

    Derm 7

    Uploaded by

    Nao Pertea
    The document discusses several pediatric cases presenting with rashes, fevers, or other symptoms and asks for the likely diagnoses and causal organisms. It includes: 1) A case of itchy lesions on the arm from bed bugs after staying in a questionable motel. 2) A diffuse rash in a child who immigrated from Albania, showing Koplik spots diagnostic of measles. 3) A rash, fever, and parotitis consistent with mumps caused by an RNA virus. 4) Intracranial calcifications, hepatomegaly, and rash in a neonate caused by congenital cytomegalovirus. 5) "Slapped cheek"

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    of 2

    19F + recent travel through southern US + stayed at dodgy AF motel on the side of the highway next

    to a Denny’s and a Sonic + itchy lesions on arm as shown in image below; Q asks for organism:

    MEHLMANMEDICAL.COM

    MEHLMANMEDICAL.COM 20

    MEHLMANMEDICAL.COM

    o Answer on NBME = bed bugs; caused by an insect called Cimex.


    - 6M + family recently immigrated to US from Albania + diffuse maculopapular rash + photograph of

    buccal mucosa is shown below; Dx + Tx?

    o Dx = measles (rubeola); Tx is supportive; image shows Koplik spots (pathognomonic whiteish lesions on buccal
    mucosa); immigrant Hx on USMLE sometimes implies unvaccinated status.

     - 6M + diffuse maculopapular rash + tenderness at base of occiput and behind the ears; Dx + Tx?àDx

    is rubella (German measles); Tx is supportive; suboccipital and post-auricular lymphadenopathy are

    characteristic.

     - 4M + fever + image shown below; what is the most likely causal organism (DNA vs RNA; enveloped vs

    non-enveloped; segmented vs non-segmented)?


    MEHLMANMEDICAL.COM 21

    o Dx is mumpsàcauses POMàParotitis, Orchitis, Meningitis; virus is RNA, enveloped, non- segmented.

    - Neonate + intracranial calcifications + hepatomegaly + rash as shown in image below; no murmurs; Q asks most
    likely causal organism:

    o Answer = congenital cytomegalovirus (CMV); image shows blueberry muffin rash; no murmurs implies not rubella
    (causes patent ductus arteriosus).

    - 5M + fever 2-3 days ago + brought in by mother to emergency with appearance as shown below; the most likely
    causal organism can also cause what?

    o Answer = aplastic anemia; Dx = Parvovirus B19 (Fifth disease); image shows classic “slapped cheek” appearance;
    next best step in Dx = Parvovirus B19 IgM titers; if IgM titers are not listed, choose bone marrow biopsy; increased
    risk of aplastic anemia in sickle cell. Once child has developed the red cheeks, he/she has immunologically cleared
    the illness (i.e., if they turn it into a communications style Q, tell parents to chill the fuck out / Relax because the
    child has cleared the virus).

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