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FCM > Block 1- skin infestations > Flashcards

Block 1- skin infestations Flashcards

1
Q

scabies Etiology

A

microscopic mites (Sarcoptes scabiei)

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2
Q

scabies Epidemiology

A

skin-to-skin, fomites, communal living

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3
Q

usual location of scabies on human body

A

Location - finger webs, flexor surfaces, groin

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4
Q

SYMPTOMS OF SCABIES

A

intense pruritus

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5
Q

What to expect on physical exam of scabies

A

scratch marks, burrows, vesicles, pustules, crusts

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6
Q

how to make diagnosis of scabies? (test)

A

mineral oil prep (or KOH)

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7
Q

in scabies, when is itching most severe?

A

at night

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8
Q

scabies treatment

A
  • PERMETHRIN 5% (Elemite) cream
    o from the neck to the toes (avoid face and scalp) for 8 hrs then rinse;
    o repeat Rx in one week: whole household every time
    o Launder and vacuum ALL fomites (towels, bedding, carpet, sofa)
  • Oral ivermectin is very safe and extremely effective, in 1 single dose
    Excellent option for nursing home outbreaks
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9
Q

is Crusted scabies (Norwegian scabies)

common in US?

A

NO very rare

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10
Q

presentation of a person infected with Crusted scabies (Norwegian scabies)

A

marked thickening and crusting of the skin, Can involve face

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11
Q

describe what lesions look like for Crusted scabies (Norwegian scabies)

A

Lesions are often hyperkeratotic, crusted, and cover large areas

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12
Q

what kind of patients tend to get infected with Crusted scabies (Norwegian scabies)?

A
  • Immunocompromised patients only: HIV, Lymphoma, neglected or homeless
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13
Q

name the insect:

  • Common tiny red arachnid
  • Barely naked-eye visible
  • eight legs
  • Forests and vegetated areas, humid climates
A

chiggers

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14
Q

do chiggers burrow into and remain inside the skin?

A

no- common myth

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15
Q

process of chiggers infecting human and then releasing from host

A
  • Chiggers attach to the skin and inject enzymes that cause destruction of host tissue.
  • Hardening of the surrounding skin results in the formation of a feeding tube called a stylostome
  • Chigger s then feed upon the destroyed tissue for 2-4 days then drop off…
  • Days after they release, the host is left with persistent red itchy bumps!
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16
Q

treatment of chiggers

A
  • Nail polish: Does not kill chigger, but reduces itchiness -seals the area off from the air, which reduces itch, also keeps fingernails off the bump!
  • Tx the Pruritis:
    o Ultrapotent topical class I or II topical steroid creams
    o Antihistamines of limited value, mostly if patient has trouble sleeping
    o Systemic steroids for severe cases
    o Nail polish or cyanoacrylate (super glue)
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17
Q

3 forms of lice:

A
  • Pediculus humanus capitis (head louse) [age 2-11]
  • Pediculus humanus corporis ( body louse) [homeless]
  • Phthirus pubis (“crabs”, pubic louse) [sexually transmitted]
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18
Q

head lice is most commonly found in ___?

A

school aged white children

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19
Q

body lice is most commonly found in ___>

A

homeless or disabled/neglected pts

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20
Q

pubic lice is most commonly found in

A

promiscuous individuals/ prostitutes

21
Q

lice Feed on human blood after piercing the skin and injecting saliva, this causes what kind of lesion?

A

pruritus

22
Q
  • Lice die of starvation within __ days off host, eggs die within __ days off host
A

3

14

23
Q

lice treatment

A
  • Over the Counter medication
    o Pyrethrin shampoos /rinses and spray for surfaces: ineffective due to widespread resistance
    o Various dry-on-the scalp remedies (cetaphil, mayonnaise, etc.) to suffocate lice
    o Nit-picking services: expensive but effective
  • Rx medication
    o Permethrin : ineffective due to widespread resistance
    o Lindane (Kwell): NEVER use this. It can cause seizures
    o Spinosad (Natroba)
    Very low toxicity
    Very high efficacy
    Over $100 if no insurance
    Only takes 10 minutes, and no need to comb out nits!
    o Topical ivermectin (Sklice)
    Also single-dose of 10 minutes, and no nit-combing
24
Q

what medicine should you never use to treat lice?

A

lindane

25
Q
  • P. pubis infestations of the eyelashes are treated with occlusive therapies such as?
A

o Petrolatum (twice daily for 7-10 days) - asphyxiant for eyelash infestation

26
Q

treatment of body lice

A
  • launder in hot water
  • iron with a hot iron
  • dry in a hot dryer

no medications necessary

27
Q
  • Primary lesion is for insect bite
A

variably excoriated papular urticaria

28
Q

what kind of secondary infection could you get from insect bites if you scratch?

A

staph/strep (impetigo) from scratching

29
Q

for insect bites, can bite reactions be delayed?

A

yes

30
Q

treatment of insect bites

A

class I or II topical steroid to closed lesions; consider oral antihistamines if severe

31
Q

characteristics of black widow bites

A

painful mild local reaction, hours later cramps due to neurotoxin

32
Q

characteristics of brown recluse bites

A

mild to severe acute reaction, days later: necrosis

33
Q

name disease:

serpiginous eruption caused by burrowing larvae of the dog hookworm (Ancylostoma sp.)

A

Cutaneous Larva Migrans:

34
Q

Cutaneous Larva Migrans is commonly found where?

A

tropical countries

35
Q

Cutaneous Larva Migrans treatment

A

anthelmintic drugs such as albendazole

36
Q

Seabather’s Eruption is caused by?

A

jellyfish larvae

37
Q

usual site of Seabather’s Eruption

A

under clothing

38
Q

Seabather’s Eruption treatment

A

remove clothing before rinsing with cool water or more stings will occur
- Supportive care with topical corticosteroids and antihistamines as needed

39
Q

jellyfish sting (envenomation) Immediate therapy:

A

Neutralize stings via irrigation with vinegar:
- soak or rinse the area in vinegar (acetic acid) for 15-30 minutes to stop the nematocysts from releasing their toxins.

Alternatives: rinse in sea water, 70% isopropyl alcohol

40
Q

can you use fresh water to treat jellyfish sting?

A

no

- Fresh water will cause the nematocysts to continue to release their toxin.

41
Q

after neutralizing jelly fish sting with vinegar, what should you do?

A
  • Shave the area with a Razor or Credit card: apply shaving cream or baking soda powder paste
  • Shave next-Removes any adherent nematocysts
  • Then reapply vinegar or alcohol

The shaving cream or paste prevents nematocysts that have not been activated from releasing their toxin during removal with the razor

42
Q

if jellyfish sting in eye, how to treat it?

A

rinse with normal saline

43
Q

if symptoms persist in the following days of a jellyfish sting, what should you treat with?

A
  • In the following days, treat with topical corticosteroids if symptoms persist.
44
Q

can Box jelly fish sting be fatal?

A

yes

45
Q

bed bug Bites are typically painless, but the subsequent allergic reaction can cause intense _____.

A

pruritus

46
Q

presentation of bed bug bites

A
  • erythema, wheals, vesicles, or hemorrhagic nodules
47
Q

common places to get infected by bed bugs

A
  • Mattresses, suitcases
48
Q

how to treat bed bugs

A
  • Hyperthermia (whole house heating) or insecticides to kill bugs

FCM (9 decks)

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