Infections

Question 1

Classified CDC as a CAT A bioterorism agent

Answer 1

Bacillus anthracis

Question 2

Stages of Anthrax

Answer 2

1. purpuric macule/papule on exposed area
2. vesicle forms within 48 hours
3. central vesicle ulcerates
4. lesion becomes depressed and hemorrhagic with painless black necrotic eschar
5. escar dries and sloughs over 1-2 weeks with no scar

Question 3

anthrax occurs most often in

Answer 3

farmers, ranchers exposed to animals or hides

Question 4

how to dx anthrax

Answer 4

• gram stain vesicular fluid
  2 punch biopsy (1 for PCR and 1 for bacteria,fungal and mycobacterial)
  Debride

Question 5

How to treat anthrax?

Answer 5

fluoroquinolones cipro 60 days
Docy 100 mg bid
levofloxacin 750
debridement

Question 6

Cellulitis bacteria is most commonly

Answer 6

Group A strep, Staph Aureus
Child- think Haemophilus infleunza B

Question 7

What should one do when they suspect cellulitis?

Answer 7

See patient daily, draw around cellulitis to observe treatment results

Question 8

NCAA guidelines and NFHS guidelines for cellulitis

Answer 8

Active infections are not tolerated, all lesions must be scabbed with no purulence

Question 9

Bacterial infection of the upper dermis, streaking is prominent

Answer 9

erysipelas

Question 10

patient complaints with erysipelas

Answer 10

flu-like symptoms, red tender firm spots that rapidly increase in size, uniformly elvated, shining patch with raised border

Question 11

-involves one hair follicle
- painful, firm fluctuant mass
-prone to friction areas
- staph aureus most common pathogen

Answer 11

furuncle

Question 12

clinical pear for furuncle

Answer 12

no fever or systemic symptoms

Question 13

treatment of furuncles

Answer 13

self limited
warm compress
i&D
antibiotics for recurrent infections

Question 14

involves multiple hair follicles
deep painful mass

Answer 14

carbuncles

antibiotic cleansers
mupirocin inside nostrils
recurrent/resistant- treat all family member, culture for MRSA, clinda, rifampin, cephalosporins

Question 15

Clinical pear for carbuncles

Answer 15

malaise, chills, fever precede or occur during active phase

Question 16

NCAA/NFHSS return to play guidelines for impetigo

Answer 16

No moist exudative or draining lesion

Question 17

Resembles scalded skin, large thin superficial bullae, desquamation and fissures around mouth and eyes(sad old man facies), resolves without scarring

Answer 17

SSSS

Question 18

Positive nikolskly sign is common in what?

Answer 18

SSSS

Question 19

oral mucosa and conjunctiva are not involved in

Answer 19

SSSS

Question 20

Do NOT use wet dressing as they will cause drying and cracking of skin

Answer 20

SSSS

Question 21

Spares mucous membranes, positive nikolsky, resolves without scarring

Answer 21

SSSS

Question 22

What medication is contraindicated in SSSS

Answer 22

Corticosteroids

Question 23

What is important to remember when treating a child with SSSS

Answer 23

They become dehydrated easily

Question 24

Slowly progressing
granuloma formation, single erythematous hypopigmented macule or infiltrated plaque, sharply defined circinate margins, central healing, peripheral border spread, yellow red papules/nodules, ACRAL NEUROPATHY is present

Answer 24

Hansen’s Disease

Question 25

Cannot be grown in a culture, no serologic test, non-infectious within 72 hours of beginning therapy

Answer 25

hansens

Question 26

treatment for hansens

Answer 26

rifampicin, dapsone, clofazimine, thalidomide

Question 27

HPV type 6 & 11 can cause what in infants?

Answer 27

laryngeal papillomatosis

Question 28

what to do for mom with HPV?

Answer 28

consistent cryotherapy for 2nd trimester on

Question 29

HPV vaccines guidelines

Answer 29

males/females age 11-16 years

Question 30

Pdoflox 0.5% can be given during pregnancy yes or no?

Answer 30

NO

Question 31

what can you treat condyloma acuminatum in pregnancy

Answer 31

TCA, Cryo, Laser therapy

Question 32

Clinical pearl for condyloma acuminatum

Answer 32

application of a gauze soaked pad over suspicious lesion for 5-10 minutes reveals sharply demarcated lesions with white opacity

Question 33

Papular Acrodermatitis of Childhood

Answer 33

giannati crosti Self limiting dermatitis Most often Epstein Barr increased risk with AD Symmetric, pink-brown papules or vesicles on buttocks and spread to face and extensors, trunk is typically spared

Question 34

symptomatic tx for gianotti crosti

Answer 34

topical corticosteroid

Question 35

monomorphic pink to brown papules

Answer 35

giannaticrosti resolves in 3-8 weeks, family usually frustrated as it lasts so long

Question 36

Central umbillication in dome shaped papules Palms and soles are uninvolved Red Halo (BOTE sign)

Answer 36

MC

Question 37

NCAA guidelines for MC

Answer 37

Return to play lessions are curetted or ermoved, site covered or 24 hours postcurettage with the site covered.

Question 38

What is important in patients with molluscum

Answer 38

They need to moisturize as to not autoinoculate and continue to acquire more lesions

Question 39

If lesions occur in the periocular area

Answer 39

refer to opthalmology

Question 40

MC TX

Answer 40

Cantharidin LN Cerretage Sal acid 2% TCA 35-50%