Exam 2

Question 1

Bacterial Infections

Answer 1

Staphylococcus
-Bacteria that appearsin clumps on skin and/or the upper respiratory tract.

Streptococcus
-Chain bacteria often associated with systemic disease and skin infections

Bacillus
-Spore forming, aerobic and occasionally mobile, and can cause systemic damage.

Question 2

Methicillin-Resistant Staphylococcus Aureus (MRSA)

Answer 2

Strains of staphylococcus that are resistant to some antibiotics.
Often occurs in individuals that are already sick, hospitalized or have open wounds.
Easily contagious and transmitted via superficial abrasions and minor skin trauma.

Sx. Redness, swelling, tenderness. White fucking gross bubbles.

Management
Antibiotics provided intravenously
Treatment last several weeks
Always refer

BACTERIA

Question 3

Impetigo Contagiosa

Answer 3

Caused by streptococci, S aureus or a combination of these bacteria.
Its is spread through close contact.

Sx. Mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust.
Generally develops in body folds that are subject to friction.

BACTERIA

Question 4

Furuncles

Answer 4

Infection of a hair follicle that results in pustule formation.
Generally the result of a staph infection.
Pain and tenderness increase with pressure.
Most will mature and rupture.

Management
Care involves protection from additional irritation.
Refer
Keep them away from contact while boil is draining

BACTERIA

Question 5

Carbuncles

Answer 5

Sx. Larger and deeper than furuncles and has several opening in the skin.
May produce a fever and elevation of WBC count.
Starts hard and red and over a few days emerges into a lesion that discharges yellowish pus.

Management
Surgical drainage combined with the administration of antibiotics.
Warm compress is applied to promote circulation.

Question 6

Folliculitis

Answer 6

inflammation of a hair follicle
Caused by infectious or non-infectious agents

Management
Management is much like impetigo.
Moist heat is used to increase circulation
Antibiotics can also be used depending on the condition.

Question 7

Hidradentis Suppurativa

Answer 7

Inflammation of the hair follicle resulting in secondary blockage of the apocrine gland.
Chronic inflammatory condition of sweat glands.
Cause is unknown.

Question 8

Acne Vulgaris

Answer 8

Inflammatory disease of the hair follicle and the sebaceous glands.
Hormones can affect

Question 9

Paronychia and Onychia

Answer 9

Caused by staph, strep and/or fungal organisms.

Sx. Rapid onset; painful with bright red swelling of proximal and lateral fold of the nail.
Accumulation of purulent material within the nail fold.

Management
Soak in Epsom salts, warm water solution up to 3 times a day.
Topical antibiotic
Systemic Antibiotic
Drainage, incision.

Question 10

Paronychia

Answer 10

infection involving the lateral nail fold.

Question 11

Onychia

Answer 11

Infection involving the nail bed,

Question 12

Tetanus Bacillus Infection

Answer 12

BACTERIA

Acute infection of the CNS and muscles.
Caused by tetanus Bacillus

Sx. Stiffness of the jaw and muscles of the neck. Muscles of facial expression become contorted and painful.
Fever

Management
Hospitalization/ICU
Immunization

Question 13

Fungal Infections

Answer 13

Group of organisms that include yeast and mold.

grows best in unsanitary conditions with warmth, moisture and stratum corneum.

Question 14

Ringworm

Answer 14

FUNGAL

Raised border.

Question 15

Tinea Capitis

Answer 15

Tinea of the scalp.
Sx. begins as a small papule that spreads peripherally.
Appears as small grayish scales resulting in scattered balding.
Easily spread through close physical contact.

Management
Topical creams and shampoos are ineffective in treating fungus in hair shaft.
Systemic antifungal agents are replacing older agents due to increased resistance
Some topical agents are used in conjunction

FUNGUS

Question 16

Tinea Corporis

Answer 16

FUNGAL
Sx. extremities and trunk.
Itchy red-brown scaling plaque that expands peripherally.

Management
Topical antifungal cream

FUNGUS

Question 17

Lamisil and Tinactin

Answer 17

Topical anti-fungal creams.
The athlete must finish the whole course of treatment.
Cover and protect
Refer if not resolving.

Question 18

Tinea Unguium/Onychomycosis

Answer 18

FUNGAL
Fungal infection of the nail. The nail becomes thick, brittle and separated from its bed.

Management
Some topical anti-fungal agents have prove to be useful.
Systemic meds are the most effective.
Surgical removal of the nail may be necessary.

Question 19

Tinea Cruris

Answer 19

FUNGAL
Tinea of the Groin
Symmetric re-brown scaling plaque with snake like border.

Sx. Mild to moderate itching
May progress to secondary bacterial infection

Management
Responds to non-percription medications

Question 20

Tinea Pedis

Answer 20

FUNGAL
Sx. Extreme itching on soles of feet, between and on top of the toes.
Appears as dry, scaling patch of inflammatory, scaling red palpules forming larger plaques.
May develop secondary infection from itching and bacteria.

Management
Topical anti-fungal agents and good foot hygiene.

Question 21

Candidiasis

Answer 21

FUNGAL
Infections within body folds
Beefy red patches with possible satellite pustules.
White macerated border may surround the red area, deep fissures may develop at skin creases.

Question 22

Tinea Versicolor

Answer 22

FUNGAL
Caused by yeast
Appears commonly in area in which sebaceous glands actively secrete body oils.
Usually asymptomatic

Managements
Topical creams and Shampoos

Question 23

Viral Infections

Answer 23

Ultamicroscopic organisms that require host cells to compete their life cycle.

Question 24

Herpes Simplex Labialis, Gladiatorum and Zoster

Answer 24

VIRUS
Type 1 can be anywhere
Type 2 are only on the gentials

Highly Contagious and usually transmitted directly through a lesion in the skin or mucous membrane.

Resides in sensory nerve neurilemmal sheath following initial outbreak.

Recurrent attacks stimulated by sunlight, emotional disturbances, illness, fatigue or infection.

Sx. Early indication = tingling or hypersensitivity in an infected area 24 hours prior to appearance of lesions.
local swelling followed by outbreak of vesicles.
Patients may feel ill w/ headache, sore-throat, swollen lymph glands and pain in area of lesions.
Vescilces generally rupture 1-3 days spilling serious material
Heal in generally 10-14 days
The athlete should be disqualified from contact during an outbreak.

Management
Can only reduce recurrance of outbreaks

Question 25

Verruca Virus and Warts

Answer 25

Verruca plana (flat wart), verruca plantaris (plantar wart) and condyloma accuminatum (venereal wart) Wart enters through lesion in skin.

Question 26

Verruca Plana (Common Wart)

Answer 26

Sx. Small, round, elevated lesion with rough dry surfaces. Painful if pressure is applied. May be subject to secondary infection. Management Electrocautery, topical salicylic acid or liquid nitrogen.

Question 27

Verruca Plantaris (Plantar Warts)

Answer 27

Spread through papilloma Virus Sx. Sole of foot, or adjacent to areas o abnormal weight bearing Areas of excessive epidermal thickening discomfort, point tenderness Hemorrhagic puncta Management In general, protect and prevent spreading Shave callus and apply keratolytic agent Can be removed by freezing or electrodessication.

Question 28

Molluscum Contagiosum

Answer 28

Poxvirus infection Contagious with direct body contact Sx. small, flesh or red colored, smooth-domed papules Management Physican reffereal Removed with a counterirritant, surgically or cryosurgery.

Question 29

Allergic, Thermal and Chemical Skin Reactions

Answer 29

Allergens may be food, drugs, clothing, dust, pollens, plants, animals, heat, cold, dyes, or light. Reddening and swelling of tissue, hives, burning, and/or itching. ATC must: Recognize gross signs of allergic responses. be prepared to remove allergens Treat topically or systemically

Question 30

Contact Dermatitis

Answer 30

Plants, poison ivy, poison oak, sumac, ragweed, primrose Topical medications Chemical found in fragrences, soaps and detergents Pre-wrap, tuf skin, tape or ice and heat. Sx. Redness, swelling, formation of vesticles that ooze fluid and form crust, constant itching. Can change to lichenified papules and plaques Management Avoid Allergen Compresses or soaks, topical corticosteroids.

Question 31

Miliaria (Prickly Heat)

Answer 31

Continued exposure to heat and moisture causing retention of perspiration. Sx. Itching and bruning vesciles and pustules. Occurs most often on arms, trunks, and bending areas of the body. Management Avoidance of overheating, frequent bathing with non-irritating soap, wearing loos fitting clothing and use of antipruritic lotions

Question 32

Scabies

Answer 32

Caused by mites that tunnel and lay eggs which causes extreme nocturnal itching. Sx. Dark lines between fingers and toes, body flexures, nipples and genitalia.

Question 33

Lyme Disease

Answer 33

From Ticks | Headaches, fever, maliase, myalgia and rash

Question 34

Pityriasis Rosea

Answer 34

Acute inflammatory skin rash of unknown origin Occurs between the ages of 10-35 May be the result of a virus Can be spread to others. Sx. Single pinkish -red patch on the chest of back. Red and scaley with a clearing in the center. Within 2 days - weeks a sceondary eruption occurs on chest or upper extremities. Management Typically does not require treatment

Question 35

Psoriasis

Answer 35

Exact cause is unknown --genetic factors may play a role in condition. Infection, smoking, some drugs and hormonal factors may cause an outbreak. Sx. Lesion begins as reddish papules that progress to plaques. Lesions progress to yellowish, white scaly condition that tends to be located on the elbows, knees, trunk, genitalia, and umbillicus. Management Glucocorticoids and kerolytic agents can be used in conjuction with each other. Long term oral medications may be necessary. Counseling may e necessary for psychological aspects of the condition

Question 36

Skin Cancer

Answer 36

Exposure to Sun Malignant tumore thata rows in the skin, that accounts for 50% of all cancers. Basal cell and squamous cell carcinoma. Malignant melanoma - high mortality rate as it often spreads to other parts of the body.

Question 37

Malignant Mole

Answer 37

``` Begins as a mole May show: Asymmetry Border (irregular or jagged) Color (variations throughout the mole) Diameter (larger than a pencil eraser) ```

Question 38

Metabolic Heat Production

Answer 38

Normal metabolic function results in production of heat.

Question 39

Conductive Heat Exchange

Answer 39

Physical contact with objects resulting in heat loss of gain.

Question 40

Convective Heat Exchange

Answer 40

Body heat can be lost of gained depending on circulation of medium.

Question 41

Radiant Heat Exchange

Answer 41

Sunshine will cause an increase in temperature.

Question 42

Dehydration

Answer 42

Mild Dehydration occurs when 2% of the body weight is lost in fluid. ``` Sx. Thirst Dizziness Dry mouth Irritability Excessive fatigue Possible cramps ``` Move athlete to a cool environment and begin re-hydration. Return to activity only after fluid weight loss has been regained and the absence of any heat illness symptoms

Question 43

Fluid and Electrolyte Replacement

Answer 43

Body requires 2.5L of water daily when engaged in minimal activity. If thirst is ignored, dehydration results in: nausea vomiting fainting and increased risk for heat illness

Question 44

Heat Illness

Answer 44

More likely to occur when exercising outdoors, sweating heavily and engaging in strenuous exercise. Prevent through hydration Don't ignore thirst Fluids should be replaced before, during and after exercise.

Question 45

Gradual Acclimation

Answer 45

Progressive exposure to heat and exercise over a 7-10 day period is reccommended. greatly reduces risk of heat illnesses.

Question 46

NCAA Mandated Guidelines/FB

Answer 46

Day 1: Only one practice a day. Equipment restrictions Day 1 and 2: Helmets only Days 3 and 4: Helmets and shoulder pads only. Day 5: full pads After day 5: Twice a day practices every other day.

Question 47

Identifying Susceptible Individuals

Answer 47

Athletes with large muscle mass Overweight athletes Death from heat stroke increases 4:1 as body weight increases Women re more physiologically more effecient at temperature regulation Susceptible individuals include those with poor fitness, a history of heat illness of febrile condition, the young and elderly.

Question 48

Heat Rash

Answer 48

Prickly heat Benign condition associated with red raised rash. Result of the skin being continuously wet from in-evaporated sweat. Keep skin dry. towels, powder. Generally localized to areas covered with clothing.

Question 49

Heat Syncope

Answer 49

Standing in heat for long periods of time. Fatigue Overexposure to sun. Dizzy, Fainting Caused by peripheral vasodilation or pooling of blood in extremities. Treat by placing athlete in cool environment, consuming fluids, laying down, elevating legs.

Question 50

Heat Cramps

Answer 50

Painful muscle spasms due to excessive water loss and electrolyte imbalance. Lose sodium, calcium, potassium, magnesium through sweating. A result of overexertion in a hot environment Occurs primarily in calf and abdomen Treat with light stretching, ice massage and hydration plus electrolyte consumption.

Question 51

Exertional Heat Exhaustion

Answer 51

``` A result of inadequate fluid replacement. Unable to sustain adequate cardiac output Signs: Profuse sweating Pale skin Mildly elevated temperature Dizziness Nausea, vomiting or diarrhea Hyperventilation Muscle Cramping Loss of coordination ```

Question 52

Heat Exhaustion

Answer 52

``` May develop heat cramps May become faint and/or dizzy Core temperature will be less than 104 Will affect athlete performance It affects people for a couple of days, they're outa it! ``` Treatment Fluid ingestion (intavenous replacement) Place in a cool environment Remove excess clothing Return to play must be fully hydrated and be cleared by a physician. If not appropriately treated heat exhaustion could progress to heat stroke.

Question 53

Exertional Heat Stroke

Answer 53

A serious life threatening condition. Specific cause is unknown. breakdown of thermoregulatory system Sudden collapse LOC,CNS Dysfunction Flushed hot skin, minimal sweating, shallow breathing, strong rapid pulse, core temperature is Greater than or equal to 104 F ``` Drastic measures must be taken to cool the athlete: Strip clothing Sponge with cool water Use of ice packs Transport to the hospital immediatly Cool first, transport second. ```

Question 54

Malignant Hyperthermia

Answer 54

A rare genetic muscle disorder causing hypersensitivity to anesthesia and extreme exercise in hot environments. They experience similar signs to heatstroke

Question 55

Acute Extertional Rhabdomyolysis

Answer 55

Sudden catabolic destruction and degeneration of skeletal muscle. Occurs during intense exercise in heat and humidity Signs: Gradual muscle weakness, swelling, pain, dark urine, renal dysfunction. Can lead to sudden collapse, renal failure and death. Associated with sickle cell trait Refer to a physician immediatly

Question 56

Extertional Hyponatremia

Answer 56

Fluid/electrolyte disorder resulting in abnormally low concentration of sodium in blood. Caused by ingesting too much fluid before, during or after exercise. Sx. Progressively worsening headache, nausea and vomiting. Swelling of hands and feet, lethargy, apathy or agitation Low blood sodium Could compromise CNS and create a life-threatening situation

Question 57

Frostbite (Chillblains)

Answer 57

Results from prolonged exposure to cold causing redness swelling, tingling pain in toes and fingers as a result from poor circulation. Superficial and Deep

Question 58

Superficial Frostbite

Answer 58

Involves only skin and subcutaneous tissue. Appears pale, hard, cold and waxy. The area will feel numb, then sting and burn as it rewarms May blister and be painful for several weeks.

Question 59

Deep Frostbite

Answer 59

Indicates frozen skin requiring hospitalization. Gradual re-warming is necessary Tissue will become blotchy red,swollen, painful and may become gangrenous.

Question 60

Frost Nip

Answer 60

Affects the ears, nose, cheeks, chin, fingers, and toes. It commonly occurs when there is high wind, svere cold, or both. The skin initially appears very firm, with col, painless areas that may peel or blister in 24 to 72 hours. Can be treated by pressure. Do Not RUB!

Question 61

Skin Cancer Types

Answer 61

Basal Cell Carcinoma Squamous Cell Carcinoma Malignant Melanoma

Question 62

Taping and Wrapping Purpose

Answer 62

Minimize swelling, provide support to injured areas and prevent injury. Correct application requires a solid background in anatomy. Tape limits abnormal or excessive motion. Supports muscles and tendons. Provide proprioceptive feedback. Secures pads, dressings and splints. Countless variations by athletic trainers

Question 63

Common Viruses that attack the Skin

Answer 63

Herpes Simplex Herpes Zoster Verruca Molluscum Contagiosum