Skin Bugs

Question 1

American trypanosomias is caused by>

Answer 1

Trypanosomiasis Cruzi

Question 2

African trypanosomiasis is caused by

Answer 2

T. Brucei

Question 3

In what regions is American trypanosomiasis endemic

Answer 3

Central and South America

Question 4

Transmission of T. Cruzi occurs through

Answer 4

Reduvid bugs and infected blood

Question 5

What is American trypanosomiasis?

Answer 5

A serious systemic disease that affects primarily the autonomic nervous system, the heart, and GI tract

Question 6

What is a Romana sign?

Answer 6

edema of the periocular tissue due to entry through the conjunctiva

Question 7

Know the life cycle of the disease

Answer 7

ok

Question 8

What characterizes the acute phase of Chagras disease

Answer 8

Localized erythema, swelling in regional lymph nodes
Romana sign- painless edema of papebrae occurs in 80% of infected bites
Fever, malaise, anorexia, edema of face and lower extremities

Question 9

Chronic phase of Chagras disease

Answer 9

Occurs many years after the acute phase
Most prominent involvement is the heart.
You get cardiac failure, cardiomegally, arrythmias, etc.
In the GI you get megacolon and megaesophagus.

Question 10

Chagas disease treatment?

Answer 10

Nifurtimox and Benzimidazole

Question 11

What organism causes African trypanosomiasis?

Answer 11

In west africa it is T. brucei gambiense and in East Africa it is T. Brucie rhodiense

Question 12

African trypanosomiasis is carried by what bug

Answer 12

tsetse fly

Question 13

Clinical presentation of African trypanosomiasis

Answer 13

You get a trypanosome chancre, enlargement of lymph nodes, neurologic manifestations, irritability, personality changes, day time somnolence, insomnia in some

Question 14

What is onchocerciasis?

Answer 14

River blindness. Predominantly effects cutaneous and ocular tissue

Question 15

What causes onchocerciassis?

Answer 15

Onchocerca vovulus….a nematode

Question 16

What transmits onchocerca volvulus

Answer 16

Simulium Black Fly. exclusively affects humans living in tropical african belt and South America.

Question 17

Clinical presentation of onchocerciasis?

Answer 17

Subcutaneous nodules that are located over bony prominences.
Intermittent pruritic dermatitis
Chronic Onchocerciasis: Thickened wrinkled skin with hyperpigmentation (elephant skin)
Microfilariae in conjunctiva move through cornea of posterior and anterior eye chambers causing conjunctivitis, sclerosing keratitis, optic atrophy, glaucoma
Blindness in severe cases.

Question 18

treatment of onchocerciasis?

Answer 18

Ivermectin, potential nodulectomy

Question 19

What is the Mazzotti reaction

Answer 19

Immune system goes haywire after treatment. You get fever, chills, feel terrible. Probably due to break up of the organism

Question 20

Tungiasis is what

Answer 20

an infestation caused by the burrowing flea tunga penetrans

Question 21

Where is Tungiasis endemic?

Answer 21

central and south america, carribean, Africa, Pakistan, India

Question 22

Cutaneous Myiasis>

Answer 22

Inhabit skin wounds or burrow into the dermis causing boil like lesions

Question 23

Bedbugs appearance

Answer 23

flat oval body, red brown in color, about the same size as a tick (you can see them)

Question 24

Bedbug behavior?

Answer 24

feed at night, hide in cracks and crevices during day

Question 25

Pediculosis capitis>

Answer 25

head lice

Question 26

pediculosis corporis

Answer 26

body lice

Question 27

phthiriasis

Answer 27

pubic lice

Question 28

Body lice

Answer 28

hide in seams of clothing, nits attach to clothing, pruritis may be the only symptom, red bumps under arms, upper shoulders, neck

Question 29

Maculae Cerulae

Answer 29

Bluish/brown hemosidering laden molecules (intradermal hemorrhage at lice feeding sites.

Question 30

Body lice can be a vector for

Answer 30

Epidemic Typhus, Trench Fever, Relapsing Fever

Question 31

Pubic lice (crabs)

Answer 31

Generally transmitted through sexual contact. May also effect eyebrows, eyelashes, hair, scalp

Question 32

May also cause maculae cerulae

Answer 32

true. They are bluish brown hemosiddering laden molecules

Question 33

Look at scabies in pwrpt

Answer 33

ok

Question 34

Most common clinical presentation

Answer 34

severe pruritis, often at night | Burrowing is the primary lesion

Question 35

Where are scabies lesions most commonly found

Answer 35

interdigital web, wrist flexor surface, elbows, penis, scrotum, belt line

Question 36

Infants can have scabies where?

Answer 36

head and face

Question 37

How do you diagnose scabies>

Answer 37

``` Skin scraping. scrape hard and deep Look for: -the mite itself -scybala (feces) - eggs ```

Question 38

Spiders to worry about in the US

Answer 38

Brown recluse, hobo spider, black widow spider

Question 39

All spiders have 8 legs, 4-6 pairs of eyes, 2 body sections (cephalothorax) and abdomen

Answer 39

true

Question 40

Brown recluse hotspot

Answer 40

Oklahoma, Arkansas, Missouri, Tennessee

Question 41

Brown recluse bite clinical presentation

Answer 41

vary from mild to ulcerative necrosis (25%), bite often appears with central mottling and blister. surrounded by halo and redness

Question 42

Systemic reactions from brown recluse bites?

Answer 42

Shock, hemolysis, renal insufficiency and DIC especially

Question 43

What is the major toxin released by brown recluses

Answer 43

sphingomyelinase D, it interacts with serum amyloid protein, Hyaluronidase allows eschar to spread

Question 44

Brown recluse spider bite treatment

Answer 44

- Rest, Ice, Elevation - Interdermal injection of polyclonal anti-loxoxceles Fab fragments - hyperbaric oxygen - Dapsone - Prednisone

Question 45

Hobo spider

Answer 45

lives in dark, moist areas, Large and hairy, very aggressive

Question 46

Hobo spiders are found mostly where?

Answer 46

Pacific Northwest.

Question 47

Clinical presentation of Hobo spider bite

Answer 47

not painful, necrosis ensues and can lead to amputation Systemic symptoms include headache, nausea, weakness Hemolysis and thrombocytopenia have been reported

Question 48

Black widow clinical presentation

Answer 48

local redness and sweating at wound site Venom in black widow bites causes depletion of acetylcholine and release of catecholamines at nerve endings. Muscle Spasms, ABDOMINAL PAIN, headache, paresthsias, nausea, vomitting

Question 49

Treatment for black widow bites

Answer 49

IV calcium gluconate