Skin Conditions

Question 1

Fiery red well demarcated cellulitis

Answer 1

Erysipelas

Org: Strep

Treatment: PCN

Question 2

Honey colored crusty lesions around mouth and chin

Answer 2

Staph

Question 3

Cellulitis that gets worse.

Punctate abscess points

Answer 3

Community acquired MRSA

Question 4

Diffuse rash
Hypocalcemia
Hyponatremia
AKI
Hypotension
Fever

Answer 4

Toxic Shock Syndrome

Early onset, culture + = STREP

Late onset, culture - = STAPH

Question 5

Hit leg on bed railing
Patient fishing, fell, scraped arm

Brawny edema, severe tenderness -> Erythema
24h Bullous lesions, fever
Gram positive cocci

Answer 5

Necrotizing fasciitis

caused by group A strep

Question 6

Patient fishing in warm waters (Florida, Gulf coast)
Liver transplant patient eating sushi

Cellulitis with hemorrhagic bullae and necrosis
+Lymphadenopathy

Answer 6

Vibrio vulnificus

Question 7

Fish tank cleaner
Swimming instructor

Non healing skin ulcers
Started single lesion, now multiple lesions on arm

AFB+

Answer 7

Mycobacterium marinum

Question 8

Florist
Gardener

multiple nodules on hand and forearm, following lymphatic channels

Answer 8

Sporotrichosis

org: Sporothrix schenkii

treat:
local disease -> Itraconazole
disseminated dz/DM/transplant -> Amphotericin B

Question 9

History of Jacuzzi or bathtub

Folliculitis rash

Answer 9

Hot tub rash

org: Pseudomonas aeruginosa
treatment: symptomatic; anti-itch cream

Question 10

Cough
Dyspnea
CXR +infiltrates and THIN walled cavities
**Uses HOT TUBE 3 days/week

Answer 10

Interstitial Lung disease caused by MAC

Question 11

NEUTROPENIA

cellulitis with
black lesion and central ulceration

Answer 11

Ecthyma gangrenosum

org: Pseudomonas aeruginosa

Question 12

Rash - Vesicles - Pustules
evolve CONCURRENTLY

Pharynx/Face -> Extremities and Trunk

Answer 12

Small Pox

or Monkey pox

Question 13

Rash -> Vesicles -> Pustules
evolve IN STAGES

generally, chest and back

Answer 13

Chicken Pox

Question 14

Vesicular lesions on the finger
with Erytehma and tenderness

Nurse, Respiratory tech, Health care worker
Pet kitten at home (red herring)

Answer 14

Herpetic whitlow

Question 15

Young patient

Fever, malaise, sore throat

Vesicles on tongue, buccal mucosa

Painful vesicles on hands and feet

Answer 15

Hand, Foot, Mouth disease

org: Coxsackie A virus

Question 16

Cat owner

Pustular lesion on hand
Tender axillary LN

Answer 16

Cath scratch disease

org: Bartonella henselae
treat: Doxycycline or Erythromycin

Question 17

HIV patient

Multiple nodular lesions on extremities
Transaminitis
Biopsy: modified silver stain +
Biopsy: warthin starry organisms +

Liver: pelisses hepatis

Answer 17

Bacillary angiomatosis

org: Bartonella henslae
treat: Doxy/Erythromycin

Question 18

HIV w/ low T cells
Homeless

Severe skin excoriation and itching
Transaminitis
Fevers
Holosystolic murmur at apex (mitral regurg)
Blood cultures NEGATIVE

Answer 18

Culture negative Bartonella endocarditis

org: Bartonella Quintana
aka: TRENCH FEVER