Question 1

Q: A 7-year-old child develops malaise, cough, coryza, and conjunctivitis with a high fever, preceded by a history of no childhood vaccinations due to parental religious beliefs. Examination reveals blue-white spots on a red base beside the second molars, and a subsequent erythematous, nonpruritic, maculopapular rash develops at the hairline and behind the ears, spreading over the body. Which of the following is the most likely diagnosis?

measles (rubeola). **_measles (rubeola)_** - The clinical presentation of **malaise, cough, coryza, conjunctivitis (the 3 Cs), high fever**, and characteristic **Koplik spots** (blue-white spots on a red base beside the second molars) are pathognomonic for measles. - The subsequent development of an **erythematous, nonpruritic, maculopapular rash** beginning at the hairline and behind the ears, spreading downwards, further confirms the diagnosis, especially in an unvaccinated child. *hand-foot-and-mouth disease (coxsackievirus)* - This disease typically presents with **fever, sore throat**, and characteristic **vesicular lesions** on the hands, feet, and oral mucosa, which are distinct from the described rash and Koplik spots. - The rash of hand-foot-and-mouth disease is usually vesicular and not a spreading maculopapular rash starting at the hairline. *rubella (German measles)* - Rubella is typically a milder illness with a **less prominent prodrome** and a **finer, pinker rash** that spreads more quickly than measles, often resolving within 3 days. - While it can cause lymphadenopathy, it does not typically present with the severity of prodromal symptoms (like the 3 Cs) or Koplik spots seen in measles. *mumps* - Mumps primarily causes **parotitis (swelling of the salivary glands)**, fever, and malaise. - It does not involve a distinct rash or Koplik spots as described in the patient's presentation. [Practice more Dental PYQs on OnCourse]

Question

A 7-year-old child develops malaise, cough, coryza, and conjunctivitis with a high fever, preceded by a history of no childhood vaccinations due to parental religious beliefs. Examination reveals blue-white spots on a red base beside the second molars, and a subsequent erythematous, nonpruritic, maculopapular rash develops at the hairline and behind the ears, spreading over the body. Which of the following is the most likely diagnosis?

Accepted Answer

measles (rubeola)

Answer

hand-foot-and-mouth disease (coxsackievirus)

Answer

rubella (German measles)

Answer

mumps

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