MINISTRY OF HEALTH OFTHE REPUBLIC OF UZBEKISTAN
CENTER OF DEVELOPMENT OF MEDICAL EDUCATION
TASHKENT MEDICAL ACADEMY
Department of infectious and pediatric infectious diseases
Subject: Infectious diseases
THEME: MEASLES. RUBELLA. SCARLET FEVER
Educational-methodical guideline for teachers and students of Treatment Faculty
TASHKENT
MINISTRY OF HEALTH OFTHE REPUBLIC OF UZBEKISTAN
CENTER OF DEVELOPMENT OF MEDICAL EDUCATION
TASHKENT MEDICAL ACADEMY
"A F F I R M E D"
Pro-rector of educational work
Professor Teshaev O.R.
__________________________
«____»____________2012
Department of infectious and pediatric infectious diseases
Subject: Infectious diseases
THEME: MEASLES. RUBELLA. SCARLET FEVER
Educational-methodical guideline for teachers and students of Treatment Faculty
"A F F I R M E D"
at a DNC meeting of Therapeutic Faculty
Protocol № ___from_________2012
Chairman of DNC, Professor
Karimov M.Sh.___________
TASHKENT
THEME: MEASLES. RUBELLA. SCARLET FEVER
1. Place of the lessons, equipping
- The auditorium;
- The emergency room;
- Children's Department;
- Diagnostic department;
- Boxes;
- The laboratory.
- TCO: Case sick slaydoskop; TV-video, teaching, supervising the program, methods of work
scenarios in small groups, case studies.
2. The duration of the study subjects
Number of hours - 3
3. The purpose of classes
- To develop skills early and differential diagnosis of measles, scarlet fever and rubella in
children and adults using data from medical history, clinical and laboratory examination;
- To define a rational therapeutic tactics and preventive measures at the source;
- Bring a sense of interest in the problem of measles, rubella, scarlet fever;
- Bring a sense of responsibility for the lives of patients with measles, rubella, scarlet fever;
- Develop scientific, logical thinking at the bedside;
- A creative approach to the diagnosis and treatment of measles, rubella, scarlet fever.
Objectives
The student should know:
- Statement of the clinical diagnosis of measles, scarlet fever and rubella;
- Therapeutic tactics measles, scarlet fever, measles, and rubella;
- Measles, scarlet fever and rubella.
The student should be able to:
- To collect patient complaints;
- To collect epid.anamnez;
- Examine the patient for organs and systems;
- To make a differential diagnosis of lymphadenopathy;
- Make a differential diagnosis of rash;
- Supporting distinguish the symptoms of clinical history and to form a presumptive diagnosis;
- To formulate a preliminary clinical diagnosis;
- Interpret the results of laboratory tests;
- Draw the patient's medical history;
- Draw up a plan of treatment.
As a result of training the student should learn practical skills:
- Differentiate the elements of the rash;
- To take blood for serology;
- Take material from the pharynx to the tank. research;
- To hold the primary control measures at the source.
4. Motivation
In the last two years of a 10-in wide of active immunization failed to achieve a significant
reduction in the incidence of measles. Changed the age structure of patients precisely because of
a sharp decline in measles vaccinated children ages there was increasing the proportion of cases
among adolescents and adults, decreased foci of measles in children's groups, and disrupted the
frequency characteristic of measles rise and fall of disease. There is reduction of disease severity
and frequency of complications. Have increased difficulties in identifying measles leads to a
large number of diagnostic errors and adverse impact on the quality control activities, which
apparently is one of the objective reasons for the increasing incidence of measles among children
and adults during the last few years. All of the above described necessitates the study of this
infection.
5. Interdisciplinary communication and INTER
Teaching this topic is based on the knowledge bases of students of biochemistry metabolism,
microbiology, immunology, pathological anatomy, pathological physiology, physiology of the
upper respiratory tract. The findings of the studies of knowledge will be used during the passage
of medicine, surgery, obstetrics, gynecology, hematology and other clinical disciplines.
6. The content of training
6.1. The theoretical part
Measles (morbilli) - an acute infectious disease of viral etiology transmitted by airborne droplets,
characterized by a cyclical flow of intoxication syndromes, catarrh, and exanthema.
Etiology. Measles virus - Rolyinosa morbiliorum belongs to a group of large miksovirusov is a
single-stranded RNA, has a complex antigenic structure and has a contagious, complementfixing, hemagglutinating and hemolyzing properties.
The virus has a stable antigenic structure, in response to antigens of the virus in the body (of a
sick or vaccinated) produced the corresponding antibodies, which can be detected by serological
reactions.
Measles is unstable in the environment, sensitive to heat, UV and direct sunlight.
Resistant to antibiotics. The virus has a tropism for lymphoid, reticuloendothelial tissues, airway
epithelial cells and the nervous system.
Epidemiology. Measles is the most common infections across the globe. Susceptibility to bark
almost absolute index of contagiousness is 0.96. Because of the high infectiousness and
susceptibility of the general, almost all people suffer measles in early childhood.
The source of infection is a patient at the end of the incubation period, all the prodromal period
and the first 3 days the rash period.
The disease is transmitted by airborne droplets by direct contact with patients. Tiny droplets of
mucus, patients allocated to talking, coughing, sneezing contain a large number of measles virus,
which is dissipated through the air. Since the virus is spread by air currents in the neighboring
room through keyholes, open doors, windows and vents. Therefore, all susceptible to measles,
which are in a closed room with the patient may be infected.
Autumn-winter, but you can get sick at any time of year.
Transmitted from mother to child immunity if the mother is infected with measles or been
vaccinated, the child is breastfed. In this case, children under 6 months of age do not suffer from
measles. After transferring the disease produces lifelong immunity resistant. Repeated cases are
extremely rare.
Pathogenesis. Measles is a common generalized process of the electoral defeat of the central
nervous system, respiratory organs.
Atrium - the mucous nasopharynx and upper respiratory tract and possibly through the
conjunctiva.
Pathogenesis of measles in the process consists of five phases: Phase 1 - acquiring and adapting
the virus to lymphoid tissue, printing it to the regional lymph nodes. Two-phase - the virus in the
blood (primary viremia) and generalized lymphocytic system of defeat: the virus spreads to all
organs and systems, implemented in the lymphoid tissue and retikulogistiotsitarnye, multiplies
them, which leads to the formation of multinucleated giant cells.
In this phase of restructuring is happening with the accumulation of immune T and B
lymphocytes, plasma cells and the production of measles-specific antibodies. 3-phase secondary viremia, and allergic reactions under the influence of specific antibodies and immune
cells is cytolysis of virus-containing cells. The released virus is embedded in the surrounding
epithelial cells, striking them again. Phase 4 - parallel to the body develops an allergic processes
by protein components of the virus, histamine and gistaminpodobnyh substances, which leads to
sensitization of the tissues.
At the same time greatly damaged vessel walls, increasing their permeability, edema and
exudation, especially pronounced in the tissues of the upper airways, which leads to catarrhal
inflammation of mucous membranes, necrotic oropharyngeal and upper respiratory tract. Each
element of the rash - is the focus of inflammation around the vessel, focal, infiltrative nature. As
a result, the spread of rash on malpighian and granular layer of the skin there are pockets of
destruction, which leads to the appearance of flaking on the site of heavy eruptions.
Spot Belsky, Filatov, Koplik - this is a superficial necrosis of the epithelial lining of the mouth.
Phases of the rash in measles is associated with the highest concentration of virus infection at the
gate, with an abundance of blood vessels in the area that causes a rash, first on the face, mucous
membranes of the mouth, and then on the trunk and then to the extremities. In the period of rash
virus affects the nervous, endocrine system, which shows the growth of intoxication.
Functional disturbance of the nervous system, in turn, improves adrenal function, release into the
blood of a large number of SCS has immunosuppressive effects
(Measles anergy).
5-phase - the formation of persistent immunity - in the blood increases the concentration of
specific antibodies and the virus is neutralized.
The pathogenesis of vaccination process. If vaccination of live measles vaccine virus enters the
body parenterally, and multiplies in lymphoid tissues, but not in airway epithelia.
Immunity depends on the initial state of immunological reactivity, quality and dose, the correct
storage.
Post-vaccination measles continue to experience mild catarrhal symptoms, the absence of
pulmonary lesions and nervous systems are less pronounced changes in the immune cells without
the development of measles anergy. Patients with measles contagious vaccinatum.
Clinic. The clinical picture of measles distinguish four periods of the disease. The incubation
period of 8-10 days in children vaccinated or received measles immune globulin can be
lengthened to 21 days. Catarrhal period lasts 3-4 days, can be extended to 5-7 days. Period rash
lasts 3-4 days. Period pigmentation lasts for 1-2 weeks. The clinical picture of measles
supporting and leading are the following syndromes: the severity of catarrhal symptoms, the
nature of the temperature curve, the severity of intoxication typical Makulo-papular rash.
The features of measles are catarrhal period - an acute onset of illness characterized by an
increase in temperature to 38 ° C, the appearance of catarrhal symptoms and conjunctivitis,
which progress, copious nasal discharge, mucous, muco-purulent. Voice of the patient is
hoarseness, joins
cough - dry haunting, sometimes early in the disease symptoms of croup can be observed
There is photophobia, lacrimation, conjunctival hyperemia, eyelid edema, vascular injection of
sclera. Looseness of the oral mucosa, gums. There are spots Belsky, Filatov, Koplik - on buccal
mucosa, opposite the molars grayish-white dots, surrounded by a rim of hyperemia. In the soft
and hard palate appears enanthema measles - small pinkish-red spots.
The period of eruption begins with 4-5 days of illness and is characterized by the appearance of a
maculopapular rash. The first elements of the rash appearing behind the ears, on the back of the
nose, the forehead in the form of small pink spots, which are increasing rapidly, merge with each
other, did not have the correct form. At the 2nd day of the rash completely covers the whole
body and upper arms, on a 3-day, the rash spreads to the limbs, hands and feet.
Stages of rash - a characteristic feature of measles.
In the period of eruption temperature is high up to 39-40 ° C, catarrhal symptoms are worse. The
general condition of patients with severe, there is anxiety, delirium, drowsiness, may be
nosebleeds.
Characteristic form of the patient - the face puffy, pasty eyelids, nose and lips swollen, red eyes,
profuse nasal discharge. Period rash lasts 3-4 days, then the disease goes into the next period the period of pigment accounts for the 6-7th day of illness. In this period of measles rash begins
to darken, grow brown, take brown. Pigmentation begins in the same manner as the rash appears.
In the field of continuous eruption may be defurfuration. Low analytically reduced to normal
values. Catarrhal symptoms diminish and disappear. Overall condition is slowly recovering.
In the period of pigmentation for a long time is the state of anergy, and asthenia.
Clinical classification of measles: 1. A typical form: The severity is divided into: a) easy and b)
moderate and c) severe. Two. Atypical form of: a) erased (abortive), b) mitigirovannaya measles
c) hypertoxic d) hemorrhagic (very rare).
Features mitigirovannoy measles. This form of measles can occur in receiving immunoglobulin,
blood products, or vaccinated. It is characterized by elongation of the incubation period to 21
days, shortening of the catarrhal period of up to 1 day with mild catarrhal symptoms, the lack of
sunspots and enantemy Belsky, Filatov. The period of eruption is shortened to 1-2 days, the rash
is soft, fine in violation of the phasing of the rash. Pigmentation short and pale.
Features abortive measles. The process, beginning as it typically ends after 1-2 days from the
appearance of the rash. The rash is small, neobilnaya, only appears on the face and torso, and
limbs are free from rashes. Pigmentation pale and short-term (1-3 days). The body temperature
can be increased only 1 day rash.
Features of Measles in adults. Has a high specific gravity. Proceeds with a predominance of
severe and moderate forms of the disease. Severe toxicity (fever, headache, dizziness, fainting,
vomiting, nasal bleeding, loss of consciousness). Pronounced cough, conjunctivitis. Rash
extended period of 4-5 days, the rash is large, bright, exuberant. Complications are rare.
Mild form of measles: Appears moderate or mild catarrhal symptoms and intoxication, the
patient's condition is satisfactory, the body temperature is not higher than 38,5 ° C. The rash can
be spotty nature, with a weak trend towards mergers and pale pigmentation.
Moderately severe form of measles. Intoxication rather pronounced, being significantly impaired
the patient may be delirium, vomiting, body temperature rises to 39 ° C. The rash is profuse,
bright, Makulo-papular in the background of unmodified skin, prone to mergers.
Severe measles. It is characterized by pronounced symptoms of intoxication, in the form of
convulsions, loss of consciousness, repeated vomiting, fever to 40 ° C and above. The rash is
profuse, with haemorrhagic bluish tint, locally confluent. Pronounced catarrhal symptoms: face
puffy, pasty eyelids, purulent conjunctivitis phenomenon, rhinitis, frequent wet cough. Frequent
addition of various suppurative complications.
Diagnosis. Clinical and epidemiological method. Hematological data (leukopenia, neutropenia,
lymphocytosis, moderately increased erythrocyte sedimentation rate). Cytological method (nasal
discharge tsitoskopiya to detect multinucleated giant cells typical of measles). Virological
method - the method of detection of viral immunofluorescence. Serological method - RPGA, HI
(detection of specific measles antibodies using paired sera). Immunosorbent assay (ELISA) for
antibodies to measles virus class IgM, IgG.
The differential diagnosis.
In the catarrhal period - from ARI - acute onset, marked catarrhal symptoms include tearing,
photophobia, rhinitis, injection vessels sclera, looseness of the oral mucosa, stain-Belsky Filatov
enanthema.
In the period from the rash of rubella - cross-sectional appearance of the rash, hives, fine, no
pigmentation, increased occipital and zadnesheynyh limfauzlov, weak expression of intoxication
and catarrhal symptoms.
With pseudotuberculosis - no phasing eruptions, catarrhal syndrome, inflammatory changes of
the oral mucosa, polymorphism of symptoms.
With scarlet fever - no catarrhal symptoms, the presence of Punctate rash on the skin hyperemic
background with concentration in areas of natural folds, sore throat, "raspberry tongue", peeling
skin, blood - leukocytosis.
With meningokokktsemiey - rapid start, hyperthermia, severe headache, vomiting, rash appears
immediately over the body with hemorrhagic shade, growing before our eyes, is localized on the
buttocks and lower extremities.
Since allergic rash - do not have the inherent characteristic symptoms of measles bizarre shape,
itchy skin.
Treatment.
Bed rest for the entire febrile period. Caring for measles: health of body, face, hands, toilet
mouth, nose, eyes. Power supply - milk-vegetable diet, drinking plenty of fluids. Symptomatic
therapy. Antibiotics for the prevention and treatment of complications. Vitamin therapy.
Indications for hospitalization: severe and complicated forms, children under 2 years, the
epidemic. situation.
Prevention. Active immunization with live measles vaccine (ZHKV A-16, Ruvaks, MMR
(measles, rubella, mumps). Vaccination scheme - 9 months and 16 months.
Passive immunization - measles donor immunoglobulin injected at 3-5 days of contact.
General control measures - isolation of patients up to 5 days after the rash, the presence of
complications up to 10 days.
Airing the room for 30-45 minutes.
Kvartsevanie premises.
Scarlet fever - an acute infectious disease characterized by general intoxication, sore
throat and rash.
The causative agent of B-hemolytic streptococcus.
The source of infection - the patient of streptococcal infection. Modes of transmission - airborne,
contact and home through the third person, the wound surface, Ceylon. Infectious period - just
not installed. Index contagious - 40%.
Immunity - antitoxic resistant.
Pathogenesis. A. Causes of inflammation at the entry gate of infection (sore throat). Two. The
toxin enters the bloodstream and has a tropism for the CNS, the autonomic nervous system,
cardiovascular (there are high fever, rash, general intoxication). Allergy Infectious Diseases (the body's sensitivity to the protein components of the microbe and its giperergicheskaya
reaction). Septic manifestations (suppurative processes in the pharynx, nasopharynx, paranasal
sinuses, etc.).
Clinic. The incubation period - 2-7 days. The disease begins acutely with high fever, vomiting,
sore throat. A few hours later a rash on the body. Punctate rash on the skin hyperemic
background with concentration in the natural folds, which disappears by 3-5 days of illness, free
from the rash nasolabial triangle - a symptom of Filatov. In the throat - a sore throat from
bluetongue to necrotic, bright red flushing delimited. Increased regional limfauzlov. The typical
language - beginning of the disease is covered with a thick white coating on the 3-4 day illness
becomes a "raspberry" and lasts for 2 weeks.
Cardiovascular changes in the form of "infection of the heart" are held for 2-4 weeks. In the
blood - leukocytosis, neytrofillez, increased erythrocyte sedimentation rate.
Clinical classification of scarlet fever: 1. The typical shape of severity: a) easy b) moderately,
and c) severe. Two. Atypical form of: a) ekstrabukkalnaya b) worn out (scarlet fever without the
rash) and c) hypertoxic d) hemorrhagic.
Complications: early and late.
Rubella (Rubeola) - an acute infectious disease characterized by morbilliform rash,
slight catarrhal symptoms of the VAR and an increase in peripheral limfauzlov.
Pathogen - viruses.
The source of infection - the patient. Transmission - airborne path. The susceptibility of children
is high - from 1 year to 7 years. Rubella is especially dangerous for pregnant women in the first 3
mes.t.k. may be a threat to congenital malformations. Infectious period - two weeks from the
time of illness.
Immunity resistant.
The virus penetrates through the VDP, enters the bloodstream, has a tropism for lymphoid and
fetal tissue.
The incubation period is 15-24 days. The main symptom - a pink rash, papular, smaller than the
measles. Catarrhal symptoms are mild, the general condition does not suffer pathognomonic
symptom - increased zadnesheynyh and occipital limfauzlov.
Used in this lesson, new teaching technologies:
"THE HANDLE ON THE MIDDLE OF THE TABLE," "BEE SWARM".
USE OF "PEN CENTER OF THE TABLE."
It is proposed the task to the whole group. Each student writes on a piece of a variant of the
answers and sends it to a neighbor, and his hand moves to the middle of the table.
The teacher monitors the work of the group and participation in each, a generic version of all
written in the notebook. While working on this task can be adapted to use the OCP.
USING "a swarm of bees."
The method is intended for discussion of either the entire group, or with 2 small groups. Tasks
may be different, or one job is given to the entire group. During the 10-15-minute group
discusses the problem and report to his colleagues. Selects the best option, and the teacher asks
questions to students.
Options for abstracts:
A. Determination of measles: an acute viral illness characterized by general intoxication,
Makulo-papular rash, lesions of the upper respiratory tract.
Two. Source of measles infection: a sick man.
Three. Modes of transmission of measles: airborne (coughing, sneezing, crying, speaking).
4. Immunity in measles: when the disease remains a strong immunity.
Five. Seasonality of measles: the autumn-winter, but you can get sick at any time of year.
6. Pathogenetic stages of measles: the primary replication, primary viremia, secondary viremia,
formation of immunity.
7. Clinical measles periods: incubation, catarrhal, rash and depigmentation.
Eight. For catarrhal period characteristic triad of symptoms: runny nose, conjunctivitis and
cough.
9. Symptom Belsky-Filatov-Koplik: located on the mucosa of the cheeks in the form of small
white spots.
10. Nature of the rash in measles: Stages are prone to fusion, consists of small papules,
surrounded by irregular patches
11. The duration of depigmentation in measles: about 1.5-3 weeks.
12. Complications of measles: laryngitis, pneumonia, otitis, colitis, encephalitis.
13. Diagnosis of measles: clinical, epidemiological and serological techniques (TPHA).
14. Treatment of measles: symptomatic, antibiotics if indicated.
15. Determination of Rubella: an acute infectious disease characterized by morbilliform rash,
slight catarrhal symptoms of the VAR and an increase in peripheral limfauzlov.
16. Route of infection with rubella: airborne (coughing, talking, sneezing).
18. Seasonality of rubella: the winter-spring period.
19. The main symptoms of rubella: catarrhal symptoms (runny nose, dry cough), small-papular
rash Makulo and poliadenit.
20. Diagnosis of Rubella: clinical and epidemiological data.
21. Treatment for rubella: symptomatic, antibiotics if indicated.
22. Definition of scarlet fever: an acute infectious disease characterized by symptoms of
intoxication, sore throat and rash.
23. The mechanism of transmission of scarlet fever: aerogenic, the predominant route of
infection - airborne (sneezing, coughing, crying) may contact mechanism.
24. Seasonality of scarlet fever: the autumn-winter period.
25. Pathogenic components of scarlet fever: toxic, allergic, septic.
26. The main symptoms of scarlet fever: fever, common throat congestion, primary
lymphadenitis melkopyatnistye lesions located in the natural folds, nasolabial white triangle,
white dermographism, raspberry tongue.
27. What day of the disease there is a "raspberry tongue": a 3-4-day illness.
28. What is a symptom of the "Pasta": in the field of mechanical trauma, as well as in the folds
appear grouped petechial elements, which live longer than the point of vascular rash.
29. Complications of scarlet fever: the most frequent: lymphadenitis, otitis media, sinusitis,
mastoiditis, jade, synovitis, purulent arthritis, and other allergic complications (simple
lymphadenitis, synovitis, nephritis) usually develop during the second stage of the disease.
Suppurative complications may arise as a in the early and late periods of the disease. They are
more common in young children.
30. Diagnosis of scarlet fever: clinical and epidemiological data.
31. Differential diagnosis of scarlet fever: pseudotuberculosis, intestinal yersiniosis, rubella, and
allergic rashes.
32. Treatment for scarlet fever: the diet, antibiotics, rinse throat (chamomile, furatsillin),
detoxification therapy
6.2. The analytical part of
Case studies:
Objective number one. The child is 2 years, the disease started acutely with fever up to 38,5 º
C. Concerned about a cough, runny nose and conjunctivitis phenomenon. At 4-5 days of illness
on the face appeared spotty - papular rash. The next day the rash spread to the upper and lower
limbs and the whole body. The fever lasts for 6 days.
1.Your preliminary diagnosis?
2.Write a plan for the survey?
3.Write a plan of treatment at home?
№
Answer
1
Based on the above complaints are diagnosed with measles.
2
Leukogram, Phragmites, and HAI.
3
Bed rest. Eye Care, toilet nasal and oral cavity. Vitamin therapy. Calcium gluconate.
Desensitization tool.
Problem number 2. The patient was 4 years old. Admitted to the hospital on the second day of
illness with complaints of fever up to 38,0 º C, headache, sore throat, vomiting and rash. From
epidemiological. history: a week ago was in contact with the patient's temperature, which is
observed eruptions. From the history of the disease: disturbed above complaint.
OBJECTIVE: state of moderate severity, the temperature of 38,0 º C, nasolabial triangle of pale.
Dry Skin on the hands and feet were observed Punctulata red rash. Eruptions are located on the
lateral parts of the body below the belly and belly button are located around the groin area.
Hyperemia of the pharynx expressed. On the tonsils white pus visible plaque. Limfauzly slightly
enlarged, dense and painful.
1.Your diagnosis?
2.Determine the severity of the disease?
3.Write a plan for the survey?
№
Answer
1
Scarlet fever.
2
Moderate.
3
Complete blood count, urine and feces.
Subsidiary - bacteriological method.
Problem number 3. In the clinic received - four year old child with the following complaints:
the weakness, fever up to 37,5 º C and a rash. Consider themselves to be sick for 2 days. The
rash appeared on the second day of illness. From history: 20 days ago have been in contact with
the patient rubella.
OBJECTIVE: state of moderate severity, body temperature is 38,2 º C. On the face, neck and
around the body has an oval-Makulo papulleznaya rash. Eruptions are located on the intact skin
and do not merge. Eruptions are determined on the extensor sides of the upper and lower parts of
the body. Occipital, posterior cervical limfauzly increased to bean-sized, painful. Breathe freely
through the nose. No wheezing. Heart sounds are slightly muted. A decrease in appetite.
Abdomen soft and painless. The liver and spleen were not enlarged. A chair every day,
decorated. Adequate urine output. KLA: leukopenia, lymphocytosis, determined by plasma cells.
1.Your preliminary diagnosis?
2.Plan examination.
3.The plan of treatment.
№
1
2
Answer
Rubella.
Total blood.
3
During the period of confinement to bed sores.
Drink plenty of water
6.3. The practical part
Characteristics of the rash.
Purpose: Preliminary diagnosis of diseases associated with exanthema syndrome.
Indications: Diseases accompanied by the appearance of lesions on the skin.
Equipment Needed: couch, the light source, a mask.
Running steps (steps):
№
1
2
3
4
5
6
7
Action
The physician must be in the mask. Ask the patient to undress
Place patient closer to the source of light (artificial or natural)
Inspect the color of the skin
Identify the elements of the rash (macula, papule, etc.)
Determine the location of the rash
Define a tendency to merge elements of an eruption
QUESTION: Stages of rash
Not
fulfilled
(0 points)
0
0
0
0
0
0
0
Fully
completed
correctly (10
points)
10
10
10
10
10
10
10
8
9
10
Identify the elements of the secondary rash (pigmentation, 0
lihenifikatsiya, peeling, etc.)
Identify dermographism
0
Ask the patient to wear.
0
Wash your hands.
0
10
10
10
100
10. Test questions:
1. What is measles?
2. Modes of transmission of measles?
3. Index of measles contagious?
4. Pathogenic periods of measles?
5. Classification of measles?
6. Clinical periods of measles?
7. The main symptoms of catarrhal period?
8. Characteristic rash of measles?
9. Diagnosis of measles?
10. Treatment of measles?
11. Complications of measles?
12. What is rubella?
13. Transmission of rubella?
14. The main symptoms of rubella?
15. Diagnosis of rubella?
16. Treatment for rubella?
17. Give the definition of scarlet fever?
18. The mechanism of transmission of scarlet fever?
19. Pathogenetic stages of scarlet fever?
20. The main symptoms of scarlet fever?
21. Complications of scarlet fever?
22. Diagnosis of scarlet fever?
23. Differential diagnosis of scarlet fever?
24. Treatment for scarlet fever?
11. Recommended Reading
1. Madzhidov VM Yukumli kasalliklar. T., 1992.
2. Makhmudov OS Bolalar yukumli kasalliklari, T., 1995.
3. Uchaikin WR Guide to Infectious Diseases in Children, M., 1999.
4. Shuvalov, EP Infectious Diseases, Moscow, 1999.
5. Musabayev IK "Guide to intestinal infections", T., 1982.
6. Pokrovsky VI, Pak SG et al, "Infectious disease and epidemiology." - Moscow, 2003
7. Yushchuk ND, Vengerov YY "Lectures on infectious diseases." - M., 1999.
8. Uchaikin VF "Guidelines for Infectious Diseases in Children", - M., 1998.
9. Internet resources ( www . medlinks. RU , www. cdc. gov