Chapter·MicrobiologyVaccine-preventable diseases

Measles, mumps, rubellaDownloads

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1

A 35-year-old woman from San Francisco has been refusing to vaccinate her children due to the claims that vaccinations may cause autism in children. Her 10-year-old male child began developing a low-grade fever with a rash that started on his face; as the rash began to spread to his limbs, it slowly disappeared from his face. When the child was taken to a clinic, the physician noticed swollen lymph nodes behind the ears of the child. Which of the following are characteristics of the virus causing these symptoms?

ANonenveloped, DS segmented RNA

BEnveloped, SS - nonsegmented RNA

CEnveloped, SS + nonsegmented RNA

DNonenveloped, SS linear DNA

EEnveloped, DS linear DNA

2

A 4-month-old boy is brought to the physician by his parents for a well-child examination. He has cystic fibrosis diagnosed by newborn screening. His parents report frequent feedings and large-volume and greasy stools. His 4-year-old brother has autism. Current medications include bronchodilators, pancreatic enzyme supplements, and fat-soluble vitamins. He is at the 18th percentile for height and 15th percentile for weight. Scattered wheezes are heard throughout both lung fields. Examination shows a distended and tympanic abdomen with no tenderness or guarding. Which of the following is a contraindication for administering one or more routine vaccinations?

AAllergy to egg protein

BHistory of cystic fibrosis

CHistory of febrile seizures

DFever of 38.2°C (100.7°F) following previous vaccinations

EHistory of intussusception

3

A 2-year-old boy is brought to the physician because of the rash shown in the picture for 2 days. His mother says that the rash initially appeared on his face and neck. He has had fever, cough, and poor appetite for 5 days. The boy's family recently immigrated from Asia and is unable to provide his vaccination records. His temperature is 38.8°C (102.0°F), pulse is 105/min, and respiratory rate is 21/min. Physical examination shows fading of the rash over the face and neck without any desquamation. Examination of the oropharynx shows tiny rose-colored lesions on the soft palate. Enlarged tender lymph nodes are palpated in the suboccipital, postauricular and anterior cervical regions. The clinical presentation in this patient is most compatible with which of the following diseases?

AMumps

BRubella

CRoseola

DParvovirus B19 infection

EMeasles

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