Koplik's spots are seen in?

Appeared in: IGIMS Staff Nurse - 2018

Explanation

Koplik's spots are a pathognomonic sign of Measles (Rubeola), meaning they are a definitive indicator of the disease.
These spots are described as small, bluish-white lesions on an erythematous (red) base, often compared to 'grains of salt'.
They typically appear on the buccal mucosa (inner cheek) opposite the lower molars, 1-2 days before the onset of the characteristic measles rash.
The presence of Koplik's spots, along with the '3 Cs' (cough, coryza, conjunctivitis), is a key diagnostic feature in the prodromal stage of measles.

Option B: Mumps does not cause Koplik's spots. Its hallmark sign is parotitis, which is the painful swelling of one or both parotid salivary glands.
Option C: Diphtheria is characterized by the formation of a thick, gray, adherent pseudomembrane over the tonsils and pharynx, not Koplik's spots.
Option D: Chickenpox (Varicella) is characterized by a vesicular rash, often described as 'dewdrops on a rose petal.' It does not present with Koplik's spots.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of the pathognomonic sign of Measles (Rubeola) as background academic context rather than a clinical decision trigger.
Recognizing Koplik's spots is crucial for nurses as it allows for early diagnosis of measles, even before the more obvious rash appears. This enables prompt implementation of airborne isolation precautions to prevent outbreaks.
Early identification and reporting are vital public health functions, especially in hospital or community settings, to control the spread of this highly contagious virus.
What if? If a child presents with a high fever and a rash but no Koplik's spots or cough, the nurse should consider other differential diagnoses like Rubella (which has a milder rash and posterior auricular lymphadenopathy) or Roseola (where the rash appears after the fever subsides).

How to Approach the Question

This is a factual recall question that tests your knowledge of pathognomonic signs of common childhood infectious diseases.
First, identify the key term in the question stem: 'Koplik's spots'.
Recall the definition and association of this specific clinical sign.
Systematically evaluate each option. Measles is classically associated with Koplik's spots. Mumps is associated with parotitis. Diphtheria with a pseudomembrane. Chickenpox with a vesicular rash.
Select the option that directly corresponds to the clinical sign mentioned.

Concept Tested & Keywords

QPot_G7YQ56Vc6Po6bS6Or

E6 Medicine Harrison 22e Part 1 p. 1682-1684

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1965-1967

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 150-152

Practise the full IGIMS Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.