Dermatology

Question 1

Normal Flora - skin

Answer 1

staph epidermis
corynebacterium
staph aureus
streptococci (A&B)

Question 2

Lice

Answer 2

pediculus humanus capitis; p. humanus corporis

Tx: Permethrin

Question 3

Scabies

Answer 3

Sarcoptes scabiei
PE: red, crusty, papillar; burrows
Tx: permethrin, 7d

Question 4

Molluscum Contagiosum

Answer 4

Et: DNA poxvirus
*close contact
Hx: dome shaped papules; umbillication
Tx: self-limiting; 2 months

Question 5

Varicella Zoster Virus

Answer 5

Et: herpes alpha virus
Hx: Chkpox - fever, rash 1-2d
      Shingles - vesicles crust/scab 7-10d
Tx: Chkpox - supportive
      Shingles - acyclovir w/i 72hr

Question 6

Human Papilloma Virus

Answer 6

Warts
Et: DNA papovavirus
Tx: cryotherapy; spontaneous remission

Question 7

Rubeola

Answer 7

Et: RNA morbillivirus
Hx: prodromal - fever, malaise
      exanthem - rash
PE: koplik spots; fine, macular rash diffused over trunk
Tx: supportive

Question 8

Mumps

Answer 8

Et: RNA paramyxovirus
Hx: prodromal - malaise
wk 1 - parotid tenderness
Tx: acetaminophen, supportive

Question 9

Rubella - German Measles

Answer 9

Et: RNA togavirus, eveloped
Hx: rash face spreading downward
Tx: supportive

Question 10

Erythema Infectiousum - 5th Disease

Answer 10

Et: DNA paravovirus B19; spring; outbreak 4-6yrs
PE: mild fever; 3 stage rash
1. bright red cheek, 2. spread distal, 3. last weeks
Tx: supportive; 2 weeks

Question 11

Hand, foot, mouth

Answer 11

Et: coxsackie virus
Tx: supportive

Question 12

Cellulitis

Answer 12

Et: staph esp w/abscess; strep
Hx: red, warm, tender, lymphangitis
Tx: I&D, culture, HP, soaks, +/- abx; if abx - cephalexin, MRSA - trimethoprim/sulfamethoxazole

Question 13

Impetigo

Answer 13

Et: Bullous - S. Aureus
non-bullous - S. Aureus, Grp A strep
Tx: topical mupirocin
**F/U: 7-10d

Question 14

Rocky Mt Spotted Fever

Answer 14

Et: Tick w/rickettsia rickettsii
Hx: blanching macular rash ankles, wrist, & forearms; no target
Tx: doxycycline
F/U: closely

Question 15

Diabetic Foot Ulcers

Answer 15

Et: S. Aureus, S. agalactiae, S. pyogenes

*peripheral neuropathy & arterial disease

Question 16

Viral Exanthem

Answer 16

macular rash following viral infection

Question 17

Yeast

Answer 17

candida albicans

Question 18

paronychia

Answer 18

nail fold inflammation
Et: S. Aureus; assoc w/ingrown nail
Tx: I&D; empiric abx

Question 19

Syphilis

Answer 19

Et: treponema pallidum-spirocete; systemic STD; endotoxin LPS
Hx: primary - painless ulcer, secondary, tertiary
Tx: penicillin; doxycycline

Question 20

Lyme Disease

Answer 20

Et: tick w/Borrelia Burgdorferi-spirochete
Hx: 3 stages
PE: erythema migrans (target)
Tx: doxycycline, NSAID
*endotoxin, resists phagocytosis, sequester in jts, skin, CNS; relapse