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Derm Block 3 Flashcards

1
Q

Staph A morphology and staining pattern

If this microbe infects the skin, what four infections can it cause?

The elaboration of these toxins can lead to ?

A

Gram + Cocci

Cellulitis Impetigo Folliculitits Furuncles

Bullous impetigo
SSSS

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2
Q

? are the secondary invaders of traumatic skin lesions

What four infections can it cause upon infecting the skin?

A

Group A B-hemolytic strep- Gram + Cocci

Lymphangitis Impetigo Cellulitis
Erysipelas

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3
Q

What causes Non-Bullous Impetigo

How does it start and what does if classically look like

This condition is more common in ? PT populations and frequently co-infected w/ ?

A

GABHS

Stratum Corneum pustule, ruptures to honey crusted lesion w/ regional adenopathy

2-5y/o Peds in warm/moist climates
Staph

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4
Q

How is Non-Bullous Impetigo Tx

If ABX are used, what is the purpose of their use

A

Soak, removes crust
Local: Topical Mupirocin
Wide: Diclox/Cephalexin

Prevent acute glomerulonephritis after impetigo

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5
Q

What causes Bullous Impetigo

What PT population is this MC in

How is this form different?

A

Staph impetigo

Infant/adolescent

Less exudative crusting- center collapses w/ tube-like rim

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6
Q

How is Bullous Impetigo Tx

If PTs have recurrent cases of impetigo, what test needs to be ordered?

A

Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex

Staph A carrier, Tx w/ Mupirocin

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7
Q

Cellulitis is a skin infection that extends to ? layer

How does it present

What are the microbe etiologies

A

Into SQ

Erythema Edema Pain

GABHS- MC
Pseudomonas in DM
Staph
H influenza

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8
Q

What parts of the body are more likely to be the portal of entry for cellulitis microbes?

How does cellulitis present in clinic?

A

Compromised areas by stasis/lympedema

Warm Adenopathy Red Tender Swollen w/ poor defined border
Streaks= lymphangitis

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9
Q

How are cellulitis PTs Tx outpatient

How are they Tx inpatient

How are DM w/ Pseudomonas Tx

How are PTs w/ H influenza Tx

A

Compress/Elevate
Diclox/Cephalexin/Clinda/TMP

Nafcillin
Vanc if PCN allergy

Aminoglycosides

Cephalosporin

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10
Q

Define Erysipelas and what microbe causes it

Erysipelas is AKA ?

A

Superficial cellulitis of lymphatics from Strep Pyogene

St Anthoneys Fire

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11
Q

How does Erysipelas present and what makes this presentation different

How is Erysipelas Tx

A

Sharp demarcated, raised plaque w/ pain/erythema on
face, ears, legs after 48hr prodrome

PO: Cephalexin Amox/Diclox
IV: Cephazolin Ceftriaxone

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12
Q

Define Blistering Distal Dactylitis

How is it Tx

A

Superficial infection of anterior finger pad MC 2-16y/o

InD w/ Anti-Strep ABX

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13
Q

Define Folliculitis

What is the MC form of infectious folliculitis

Define Superficial Folliculitis

A

Inflamed hair follicle from infection, chemicals or injury

Staph, common in nares or areas of occlusion

Perifollicular pustules w/ undamaged hair in center

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14
Q

How is folliculitis worked up

How is it Tx

What adjunct can be added for Tx

A

Culture pustule- scrape pustule off w/ 15 blade onto swab

Removal, hygiene
E/C-mycin Diclox Cephalexin

Benzoyl Peroxide (keratolytic, anti-bacterial)

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15
Q

How is persistent/deep folliculitis (sycosis barbae) Tx

If folliculitis is in the scalp and present long term, Tx PT for ?

A

Systemic ABX

Folliculitis decalvans

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16
Q

Define Sycosis Barbae

How is it Tx

What is done for PTs that have resistant cases or are Tx failures?

A

Inflammation of whole follicle, Staph Impetigo of beard

Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex

Eval for dermatophyte infection
w/ hair removal, culture

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17
Q

Define Furuncle

Define Carbuncle

Where do both of these have in common?

A

Boil/abscess, walled collection of pus w/ pain

Multi-headed boil, associated w/ cellulitis

Painful perifollicular infections on traumatic areas of skin

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18
Q

How are furuncles/carbuncles Tx

Recurrent furuncles are commonly infected w/ MRSA and Tx w/ ?

How is MRSA furunculosis Tx

A

InD
ABX if cellulitis is present

Mupirocin
Chlorhexidine/bleach bath
Culture dependent: Clinda/TMP

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19
Q

What causes SSSS

Dec function of ? organ allows for toxins to accumulate?

How do the toxins spread in the body?

A

Staph A exfoliative toxins

Dec renal clearance

Hematogenously

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20
Q

SSSS typically starts as ? presentation in kids

What does the prodrome of this syndrome present as

A

Bullous impetigo

Malaise Fever Irritability
Skin tenderness

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21
Q

If mild case of SSSS presents and is going to be Tx on outpatient basis, what ABX are used?

Pseudomonas usually infects ? PTs in ? locations

A

B-lacatm resistant- Diclox, Cephalexin

DM
Warm/moist

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22
Q

What PE finding is indicative of Pseudomonas

What does this smell like?

A

Pyoverdin- light green pigmentation w/ woods lamp

Fruity/grape like

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23
Q

Define Hot Tub Folliculitis

These PTs are at low risk for ?

How are they Tx

A

8hrs-5d after exposure
Pruritic round, urticarial plaques w/ central pustule

Sepsis

Antihistamine PRN
Local- Vinegar soaks
Wide- Cipro

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24
Q

Pseudomonas Cellulitis is usually found in ? PTs

These types of growth are encouraged by presence of ?

How are these PTs Tx

A

Debilitate/DM PTs as secondary infection of tinea

Occlusion
Broad spectrum suppression

Acetic Acid
Aluminum acetate
PO Cipro

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25
Where do Pseudomonas Toe web infections usually present? How does it present on PE How are Pseudomonas toe web infections Tx
Between 4-5th toe as secondary infection after tinea Thick white macerated skin, w/ green glow on Woods Post-op shoe (DM PT) Acetic acid/Aluminum chloride Gentamycin cream once dry PO Cipro- topical Tx failure
26
What causes Trichomycosis Axillaris This infection is associated w/ ? and produces ?
Corynebacterium, Gram + opportunistic infection Heavy sweating, malordorous smell w/ white hair
27
How is Trichomycosis Axillaris Tx What microbe causes Erythrasma
Shave area Topical Erythro, Clinda Naftifine- fungal infection Coryn minutissiumum
28
What are the predisposing RFs for Erythrasma?
``` APHID HO Advanced age Poor hygiene Humid/warm ImmSupp DM ``` Hyperhidrosis Obese
29
? is the MC site for Erythrasma infections to appear How does Erythrasma appear on PE What color is it under Woods Lamp
4th interdigital space Macular brown itching scales Looks like T cruris, does NOT spare scrotum/labia Coral red
30
How is Erythrasma Tx Define Pitted Keratolysis What are the distinctive features found on PE
Erythromycin Clindamycin Clarithromycin- severe or refractory Pits on weight bearing areas of feet from Kytococcus sedentarius Malodor Slimy/hyper hydrosis skin
31
How is Pitted Keratolysis Tx What med is added if case is unresponsive to topical Txs?
TxOC: Topical E/C-mycin, Mupirocin w/ Drysol PO Erythromycin
32
# Define Wart What process causes these growths Typically these are confined to ? and lack ?
Beningn epidermal neoplasm from HPV HPV infection of keratinocytes induces hyperplasia/keratinosis Epidermis, no roots
33
How would warts be described in PE What causes the black dots mislabeled as 'roots'?
Verrucous papule w/ cylinders that fuse= Dx mosaic pattern Thrombosed vessels trapped in projections
34
Common Wart is called ? and are MC located ? How are they Tx
Verruca Vulgaris Hands Salycylic acid Imiquimod 5% Cantharidin (by provider) LN2
35
# Define Filiform Warts and where are the MC found How are they Tx Flat warts are AKA ? and commonly found ?
Finger-like projection Face Curettage- TxOC Verruca Plana on shaved areas of body
36
How are Verruca Plana warts Tx How are Plantar Warts differentiated from clavi? How are Plantar Warts Tx
Tretinoin cream Imiquimod Cryosurgery 5-FU Llook for black dots/lack of skin lines (corns have skin lines) Cantharidin LN2 Imiquimod Pare/soak Salicyclic acid
37
# Define Sub/Periungual wart Since these types are more resistant to Tx, what can be done?
Painful wart next to nail from cuticle biting Cryosurgery Cantharidin Salicyclic acid Duct tape- last option (6d, 12hr break, 6 more days)
38
Genital warts are AKA and cause by ? What preventative measure slows but does NOT prevent spread How do genital warts appear in clinic?
Condyloma acuminata Veneral warts HPV 6 11 16 18 52 56 Condoms Smooth pink w/ projections on broad base
39
ImmSupp PTs can present w/ ? alternative presentation? ? forms of HPV are the high risk/cervical sup-types ? forms are rarely associated w/ cervical Ca
Coalesce into large cauliflower masses 16*, 18 6, 11
40
How are genital warts Tx by providers/ How are they Tx by PT Tx methods
``` Podophylin resin Excision/curettage Trichloroacetic acid Cryosurgery CO2 laser ``` Podofilox- 4d on, 4-6wks off Imiquimod- every other day at bed time x 16wks 5-FU- LAST option
41
? two genital wart DDxs may be seen in 10% of normal male PTs
Pearly Penile Papules- angiofibromas on corona Bowenoid- resemble flat genital warts Sex transmitted HPV, quasi-premalignant, self resolve
42
Where is Molluscum Contagiosum commonly seen? If found ?, suspect abuse How does it present on PE
Kids via autoinnoculation on arms/face Groin Dome shaped papules w/ central umbilication, leak caseous material
43
What is the etiology of Molluscum Contagiosum How are PTs w/ few lesions Tx How are PTs w/ multiple lesions Tx
DNA Poxvirus Curette w/ anesthesia- best LN2 Trichloroacetic acid peel
44
? is the primary mode of herpes virus transmission First outbreak usually appears ?days after innoculation and lasts ? Viral cultures can occur for __ days when PTs present w/ active genital lesions
ASx viral shedding x 16 days after outbreak 6d, x 14days 5 days
45
? is the Gold Standard for Dx of herpes simplex Why is this same day turn around so important ? form of HSV commonly has Abs found in PTs
PCR Differentiates HSV 1 from 2 HSV-1
46
How are HSV and zoster PTs managed? What PT education must go w/ this Rx ? medication is added to anti-viral therapy for herpes labialis
F/A/V-clovir <72hrs of onset Improves/Shortens Sxs, but not curative Penciclovir Docosonal
47
Herpes zoster is reactivated ? and presents uniquely as ? When is an emergent referral needed? What vaccines are used for Herpes Zoster prevention
Varicella from dorsal root Single dermatome Ophthalamic branch of trigeminal d/t corneal blindness risk Zostavax- live vaccine Shingrix- recombinent vaccine 50 or older
48
# Define Dermatophytes Where is their existence limited to on the body? What are the 3 genera of ringworms?
Fungi infecting stratum corneum (keratin layer), hair and nails Can't survive on mucosal layers Microsporum Epidermophyton Trichophyton
49
? mycoses infection have minimal, if any, inflammations ? infections commonly have inflammatory responses?
T versicolor (pityriasis) T nigra B/W piedra ``` T capitus (head) T barbae (beard) T faciei (face) T corporis (body ring worm) T cruris (groin, jock itch) T manuum (hand) T pedis (foot) ```
50
? is the MC mycoses infection of the skin? Onchomycosis is AKA ?
T rubrum Unguium, nails
51
What is the mode of transmission of dermatophytes? How are these infections Dx
Human to human Animal to human Soil to human Fomites KOH Prep DTM culture (red= +) Woods lamp
52
Typically dermatophytes don't have fluorescence response under Woods Lamp except for ? How are superficial lesions from T Corporis Tx How long are PTs to continue Tx?
T versicolor Clotrim/Micon/Ketocon-azole Continue x 7d after erythema resolves
53
What meds are used for T corporis if case is extensive/deep? What med is reserved for Peds Tx?
Terbinafine Itraconazole Fluconazole Griseofulvin
54
How are cases of T pedis Tx if interdigit presentation? How is it Tx for moccasin presentations?
Topical: Terbinafine Clotrimazole PO: Fluconazole Itraconazole Terbinafine
55
T manuum is more common in ? and Tx as ? due to ? T barbae is Tx w/ ? T faciei is Tx w/ ? unless ?
MC men Same as T pedis 2:1 ration presentation PO agent only Topicals unless near eyes
56
T cruris usually presents ? on the body How is T Cruris Tx What PT education needs to go w/ these Tx
Scrotum/Labia Eyrthrasma does not spare Tx of fungal and candidia: C/M/K-azole 2wks, 2cm past borders
57
T capitis is more frequent in kids and can present in ranges from ? to ? Of the 4 patterns of infection ? type is MC How is this Dx and Tx
Scale/broken-Alopecia Black dot type- hair broken at orifice Gauze, Tooth brush Kids: Griseofulvin Adults: Griseofulvin Itraconazole Terbinafine
58
Inflammatory T Capitis cases are called ? and presents as ? What abnormal lab result would be seen How is it Tx
Kerion PAIN inflammation w/ tender/boggy nodules that drain Negative KOH PO Griseofulvin/Terbinafine
59
# Define T incognito How does it present Where is it MC seen on the body
Fungal infection Tx w/ topical steroids Inflammation improves while fungi flourish Groin Face Dorsal hands
60
Candidiasis becomes pathogenic w/ damage to ? layer of skin Can also become pathogenic if ? pre-existing conditions are present
Stratum corneum Pregnant ``` DM ImmSupp ABX therapy Topical steroids OCPs Maceration ```
61
What are the 4 possible morphologies/distributions of candidiasis? ? lesions are a classic presentation for candidiasis
PO- thrush Angular chelitis Vulvovaginitis Intertriginous Satellite
62
How is Candidiasis Dx How is this Tx How is it Tx if PT is pregnant
KOH- pseudohyphae w/ budding spores Fluconazole Clotrimazole Miconazole Nystatins
63
How is Oropharyngeal candidiasis Tx How is angular chelitis Tx
Nystatin (Peds) Clotrimazole troche Fluconazole Topica antifungal then, Group 5 steroid, d/c when inflammation is gone
64
How is Candidiasis intertrigo, diaper/balantitis cases Tx What causes Pityriasis/Tinea Versicolor Where is it found in the body?
Topical M/K/C-azoles Pityrosporum orbiulare and P Ovale growth Highly sebaceous areas: stratum corneum/hair follciles
65
What causes Pityriasis Versicolor yeast to change? What is the changed form called?
Hot/humid climate Budding form into mycolele form
66
How does Pityriasis Versicolor present? What causes PTs to present to clinic?
Rapidly enlarging round macules of various color, turn darker LPP and darker in DPP ASx w/ itch during inflammation Appearance concerns
67
MC site of Pityriasis Versicolor What other parts of the body may be affected? Where are outbreaks MC seen in kids?
Mid chest, Upper back Antecubital fossa Neck Extensive eruption- upper arm/lower face Face
68
How is a Pityriasis Versicolor presentation different from a Pityriasis Rosia presentation? How are these cases Dx
No Herald patch Woods lamp accentuates altered pigmentation KOH- short, borad hyphae in clusters, 'spaghetti, meatballs"
69
How is Pityriasis Versicolor Tx? What is used to prevent reoccurences?
``` Limited dz w/ topicals: Ketoconazole shampoo Selenium sulfide Extensive dz w/ POs: K/I/Fluconazole ``` Ketoconazole 2% shampoo preents re-occurrences
70
# Define Sporotrichosis What PT populations are most likely to have this condition?
``` Saprophytic funus (Sporothrix) in SQ tissue, MC, least serious deep infection ``` Florist Farmer Hunter
71
How does Sporotrichosis present What is the MC site?
Painless papule/ulcer that increases in number over wks Finger
72
How is Sporotrichosis Dx How is it Tx
Punch/excision biopsy for stain and culture Itraconazole x 3-6mon
73
What are the 3 types of hair
Terminal- thick, pigmented; required androgen to regulate growth Vellus- short, fine; independent of androgens Lanugo- fetal hairs
74
Average scalp has ? hairs w/ a growth phase lasting ? How fast does hair grow?
100K 1000 days 0.3-0.4m/day 6"/year
75
What are the 3 stages of hair growth?
Anagen (growth), 100 hairs enter phase each day, majority of hairs Categen (transition) Telogen (resting), 100 lost per day
76
# Define Pull Test What result is neg/Dx How do PTs prep for this test
60 hairs grasped and pulled from 4 areas of scalp ``` Neg= 6 or fewer hairs, normal Pos= more than 6 hairs, active hair shedding ``` Don't shampoo 24hrs prior
77
# Define Telogen Effluvium This can be a following result of ?
Females w/ loss of resting hair, increases daily x 4wks Delivery OCP d/c Weight loss
78
How is Telogen Effluvium Dx What DDx must be ruled out?
CBC CMP Serum ferritin Thyroid panel Anagen effluvium: chemo/rad, poison (thalium, aresnic)
79
How is Telogen Effluvium Tx Male pattern baldness is AKA ?
Reassurance, Time for full recovery Androgenetic alopecia from shorter anagen cycles 5a reduct: T into DHT
80
What are the two types of hair follicles and their sensitivity to androgens? What age group can this be seen in? How is Androgenetic Alopecia Tx
Top/vertex: sensitive Side: insensitive 12-40y/o Dutasteride PO Topical Minoxidil Finasteride PO
81
Who is the best androgenetic alopecia candidate for Minoxidil therapy? How long does it take for results to be seen?
<30y/o w/ hair loss <5yrs 1/3 see results in 8-12mon
82
What is the MOA of Finasteride in the Tx of Androgenetic Alopecia How long does it take for PTs to see results? How long to PTs take this med but w/ ? potential s/e?
Inhibits T to Dihydro-T conversion 3mon Indefinitely Sex dysfunction
83
PT w/ BPH and Androgenetic Alopecia may benefit from ? med ? female PTs are more likely to develop Androgenetic Alopecia
Dutasteride- dual inhibitor of Type 1/2a 5a-Red 3x potency of Finasteride Post-menopause d/t decrease of estrogen, causes increase of androgens
84
What labs need to be checked in females presenting w/ Androgenetic Alopecia What can be used for Tx
DHEA-S Prolactin T SHGB Minoxidil
85
# Define Alopecia Areata Define Alopecia Totalis Define Alopecia Universalis
Partial loss of any hair Total loss of scalp hair Loss of all hair
86
# Define Alopoecia Areats What saying may be used to describe the hair in these PTs What type of pattern does it take on?
Sudden ASx hair loss Exclamation point hair Ophiasis- band hair loss in P/O/T lobes
87
? is the etiology of Alopecia Areata How is this Tx
Autoimmune FamHx/genetic part <10y/o: potent steroid + 5% minoxidil +10y/o: <50%: Triamcinolone (IL), Minoxidil >50%: Minoxidil Anthralin Topical imm-therapy Systemic CCS
88
When is the prognosis for Alopecia Areats the best? When is it the worst? Even w/ resolution, how are these PTs different?
Adults first attack of a small area Totalis, universalis or ophiasis Hair grows back fine/white
89
# Define Trichorrhexis Nodosa How are they Tx ? lab work needs to be screened for
Brittle hair shafts due to over working causes weak points/nodes in shafts Stop all hair Tx Hypothryoidism
90
# Define Folliculitis Decalvans What are the etiologies of this condition What microbe may be cultured from follicles and how is it Tx?
Chronic pustular eruptions of scalp, leads to permanent alopecia patch Chronic bacterial folliculitis Altered host response Staph A Clinda
91
# Define Dissecting Cellulities What can this condition cause to be formed on PTs heads? How is it Tx
Rare inflammatory nodules in black men Tracts, fibrosis and hypertrophic scars but PAINLESS Isotretinoin
92
# Define Hirsutism What is the etiology
Terminal hairs on females in male-like patterns (face, chest, areolae) High androgens Inc sensitivity
93
What are 5 possible causes of hirsutism?
PCOS- MC cause of anovulatory infertility and hirsutism Androgen secreting tumor (adrenal, ovary) Cushing CCS, PO Obesity
94
How is Hirsutism managed Define Hypertrichosis
Spironolactone OCPs Low dose CCS Eflonithine- removes facial hair Excess hair density, length Not androgen sensitive
95
? drugs can cause hypertrichosis What non-medical issues can cause this condition?
Phenytoin Cyclosporine Minoxidil Steroids Genetic Internal malignancy
96
? part of the nail has parallel ridges w/ vessels at the base Define Hyponychium Eponychium may be AKA ?
Nail bed Segment of skin lacking nail cover Cuticle
97
What nail variants may be seen on PTs w/ psoriasis? What is the MC nail finding of Lichen Planus What happens if the matrix becomes inflammed
Oil spots Onycholysis Longitudinal grooves/ridges Pterygium unguis- proximal nailfold adheres to scarred matrix
98
? types of drugs can cause nail changes? Define Onychomycosis What DDx must be r/o
Chemo Tetracyclines Tinea of nails, aka Tinea unguium Psoriasis
99
What step must be done prior to giving PO antifungals for onychomycosis Tx What are the 3 types of patterns that may be seen
KOH and culture w/ 15 blade Distal subungual- MC White superficial Proximal subungual
100
How is Onychomycosis Tx What needs to be monitored in these PTs
Terbinafine Itraconazole CBC, LFTs
101
What med may be used for Onychomycosis that doesn't involve the lunula What med is used for distal lateral onychomycosis
Ciclopirox nail lacquier Efinaconazole
102
How is Onychomycosis prevented What two habits increase the incidence of brittle nails, especially in females?
``` Shoes/boots Don't pick nails Rotate foot wear/socks No communal showers Trim nails ``` Water imersion Nail polish removers
103
How can brittle nails from chronic exposure be Tx What can be used/added to toes to help prevent recurrent ingrown toenails?
B7, biotin, increases thickness Phenol
104
Subungual hematoma is a result of trauma to ? If severe, how is it Tx asap
Nail plate Trephination
105
# Define Habit-tic Deformity Since the Tx is for PTs to stop, what is the underlying cause?
Longitudinal band of horizontal grooves w/ yellow discoloration from irritating proximal nail fold of thumb OCD/psych
106
# Define Acute Paronychia How are they Tx
Rapid red/painful swelling of abscess on proximal/lateral nail InD Anti-Staph ABX
107
How are Pseudomonas infections under the nails Tx What ABX is added for severe cases or Tx failures
Chlorine bleach/vinegar w/ water Cipro
108
# Define Beau's Lines Define Yellow Nail Syndrome
Transverse depressions of all nails at base of lunula weeks after stressful event, self resolves Associated w/AIDS and respiratory/lymphedema dzs
109
What is the name of the angle measured for finger clubbing Define Koilonychia What is this finding associated w/ ?
Lovibond's angle, >180 abnormal Spoon nails- central depression, lateral elevation of plate IDA
110
# Define Mees Lines What are the RFs
White line in nail plate ``` Sepsis RF/LF Arsenic poisoning CHF Chemo ```
111
# Define Terry's Nails What are the RFs
White/pink nails retain 0.5-3mm distal band of normal color Cirrhosis CHF Adult onset DM Age
112
# Define Sarcoptes Scabiei What will Pts complain of What is the most common location to see these?
Scabies mite from skin to skin contact Itching worse at night ``` Finger webs Wrists Side of hand/feet Penis/butt/scrotum Palm/sole of infants ```
113
What med is used for Human Scabies Tx What med is used when the PT population changes What PT education needs to happen
Permethrin over night x 7days Anti-histamine PRN Inflamed skin- 1% HC in Eucerin Institutions/Nursing home/Topical failure: Ivermectin 12mg on day 1, 8 Worsening Sxs day 2-3 is not Tx failure
114
When/why would Lindane be sued for Scabies Tx What PTs is this med c/i in?
Toxic from WW2 <2y/o, pregnant
115
What is the name of scabies? How does this variant present differently What underlying Dx must be considered
Norwegian crusted scabies Very little itch, primarily on hand/face HIV
116
# Define Pediculosis Where does Capitis present How does Pediculosis Corporis present
Lice Nits in hair Red papules on neck Red papules on wrist/ankles Eyelash only in kids
117
What color does pediculosis show on Wood's lamp? These bugs can carry what two dzs?
Yello-blue green Typhus Trench fever
118
How is head lice Tx How is body lice Tx What would be the next test ordered/dx to r/o
1% Permethrin w/out shaving head 5% Permethrin STDs
119
Where/how do fleas present How are these Tx
Grouped red bites on ankle/lower legs Antihistamine Topical ABX/steroids
120
How doe bed bugs present When is the best time to look for these
Pruritic edematous papules in rows of 3-5 bites Look at night, 7mm
121
What is the name of the etiology of bed bugs How are they Tx What are the stages of bed bug development
Cimex lectularius Antihistamines Topical steroids Egg Stage 1-5 Adult
122
# Define Chiggers What is no longer an approved Tx method
Mites that attach to humans from grass Nail polish removal
123
What is different about fire ant presentations What scientific family do they belong to along w/ ? Why is this grouping important?
Stings Hymenoptera: Bees- Apoidea Wasps/Hornet/yellow jacket- Vespoidea Ants- Formicidae Allergic to one group, allergic to others
124
How are fire ant stings Tx Brown spiders belong to ? family
Sarna lotion Anti-histamine Cool compress Steroids if severe Loxosceles
125
What type of venom do Brown Recluse carry What do PTs complain of on presentation
Cytolytic venom, leads to necrosis Erythematous lesion PainLESS bite
126
What is the progression of a severe brown recluse reaction What is the name for this sign What department/surgeon may be consulted for grafting?
Hrs: Pain at site 24hrs: blister w/ blue discolor 3-4days: ecchymotic center 1wk: necrotic ulcer/eschar Erythema Blanch Ecchymosis (Red White and Blue) sign GenSurg
127
North American recluse spiders rarely cause? ? PTs are more likely to have this
Systemic effects: F/C N/V Arthralgia Petechia Peds
128
Since there is no anti-venom for brown recluse bites, how are these PTs managed When is debridement considered?
Analgesic Tetanus ABX >2cm and 2-3wks later
129
What is the name of the Recluse look alike but lacks violin Name of Black Widow genus
Hobo spider Tegenaria agrestis Latrodectus
130
? type of venom do black widows have This type of venom causes the body to release large amounts of ?
Neurotoxic ACh, NorEpi
131
# Define Latrodectism What is the name of the lesion seen
Trunk spasms in abdomen/back from Widow bite Target lesion- white center, red rim
132
How are Widow bites Tx Creeping Eruption is AKA ? This is ? MC
Benzos Opioids Antivenom for severe cases Tetanus Cutaneous Larva Migrans MC skin dz among travelers in tropical countries
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What causes Cutaneous Larva Migrans How are these Tx
Dog/cat hookworm Topical steroids Severe: Ivermectin Albendazole, topical for kids
134
Pseudomonas Cellulitis can occur around the ear due to ? Pseudomonas cellulitis in DM PTs need to have ? monitoring?
External Otitis Blood sugars
135
Wart infections can be divided into what 3 categories?
Latent- normal, nothing happening Sub-clinical- nearly ASx Clinical- active Sxs
136
Calvans Tx length Dissecting cellulitis
Clinda x 10wks Isotretinoin, not painful Kerion, painful

IPAP (212 decks)

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