Spots & Rashes Flashcards
(142 cards)
1
Q
Dark skinned newborn with discolouration at base of spine + buttocks. Looks like bruising. What’s this?
A
Mongolia blue spots
fades!
2
Q
Who gets strawberry naevi?
A
preterm girls
3
Q
Unilateral, don’t cross midline (capillary malformation in dermis)
Associated with Sturge Weber syndrome (convulsions)
What’s this?
A
port wine stain
4
Q
How many cafe au lait spots make it into neurofibromatosis?
A
> 5
5
Q
Uncommon but serious blistering form of impetigo, affecting neonates? What bac?
A
bullous impetigo
staph aureus
6
Q
If a strawberry naevus (cavernous haemangioma) obstructs a neonate’s airway or vision, what do you give?
A
oral propanolol!
the answer to everything tehe
7
Q
Patches of urticaria arising at 2days old, which come and go and usually clear in a fortnight. What’s this?
A
erythema toxicum
8
Q
White spots of retained keratin on nose and cheeks. What’s this?
A
milk spots
9
Q
What causes albinism?
A
defective melanin synthesis
skin cancer risk
10
Q
What’s the most common cause of nappy rash?
A
irritant dermatitis
the irritant is the nappy :p
11
Q
Which kind of nappy rash is CREASE-SPARING?
A
irritant dermatitis
12
Q
When is nappy rash NON-crease-sparing?
A
When it’s complicated by Candida.
candida gets into the creases
13
Q
Two others causes of nappy rash that AREN’T irritant dermatitis…
A
seborrhoeic dermatitis,
eczema
14
Q
What’s the posh name for cradle cap?
A
infantile seborrhoeic dermatitis
15
Q
Is cradle cap itchy?
A
no,
unperturbed
16
Q
What % of UK children get atopic eczema?
A
20%
17
Q
Genetic deficiency of skin barrier function. What’s this?
A
eczema
18
Q
What % of eczema resolves by age 16?
A
75%
19
Q
when does eczema tend to present?
A
first yr of life
20
Q
When you itch eczema lots, it leads to excoriations, weeping and crusting. what can happen then
A
lichenification
21
Q
where do they get eczema if they’re an infant
A
face and trunk
22
Q
where do they get eczema if they’re older
A
flexor surfaces
23
Q
infection of eczema with HSV can cause
A
eczema herpeticum
24
Q
Name 5 causes of eczema exacerabations.
A
- skin infections
- contact with irritant / allergen
- psychological stress
- heat / humidity
- change in meds
25
Tell me all the human herpes viruses
```
hsv 1
hsv 2
vzv
cmv
ebv
hhv 6,7,8
```
26
What is caused by hhv 6 & 7?
roseola infantum
27
what is caused by hhv 8?
kaposi sarcoma
28
How do you avoid precipitants of eczema?
no soap,
soft clothing,
cut nails short,
avoid allergens.
29
Kate love there are 8 points to remember for the management of eczema. Fire away!
1. avoid precipitants
2. emollients
3. topical corticosteroids
4. immunomodulators
5. occlusive bandages
6. Abx / antivirals (if skin infected)
7. antihistamines
8. psychosocial.
30
give an example of an immunomodulator for eczema
tacrolimus
31
what is tacrolimus
immunomodulator for eczema
32
why would you prescribe antihistamines in eczema
stop itch
33
what could you recommend for psychosocial tips for eczema
national eczema society
34
put these on overnight, with cream underneath, to stop scratching eczema.... ?
occlusive bandages
35
what virus causes verrucas
HPV
36
how do you treat verrucas?
```
topical salicyclic acid + lactic acid
or cryotherapy (liquid nitrogen)
```
37
what virus causes molluscum contagiosum?
poxvirus
38
widespread small pearly papules with central umbilication. What's this?
molluscum contagiosum
39
How soon should molluscum contagiosum disappear?
within 1 yr
40
How do you treat molluscum contagiosum if it's persisting past 1 yr?
cryotherapy
| anti-bac cream if overlying infection
41
Infant has febrile illness and roseola infantum. What infective agent?
hhv 6&7
42
What is the incubation period for chickenpox?
10-21 days
43
how long do you keep IgG to VZV for?
life
44
how is VZV spread?
airborne!
45
after chickenpox VZV can stay latent in dorsal root ganglion. what can it reactivate as?
shingles
46
First there was papules. Then there was
vesicles .... pustules ... crusts
47
what are chickenpox 'crops'?
vesicles with surrounding erthyema
| last 7ds
48
4 COMPLICATIONS OF CHICKENPOX PLZ
1. bac superinfection
2. encephalitis; ataxic cerebellitis
3. purpura fulminans
4. haemorrhagic eruptions
49
what can happen if you're immunocompromised and your chickenpox disseminates
haemorrhagic eruptions
50
which bac do superinfections of chickenpox?
staph / strep
| toxic shock! nec fasch!
51
vasculitis which is complication of chickenpox?
purpura fulminans
52
Do you use oral aciclovir to treat chickenpox?
NO decreases natural immunity
53
when would you treat chickenpox with aciclovir?
if imm comp, IV aciclovir
54
most imm comp chickenpox treat with IV aciclovir. If HIGH RISK imm comp treat with ...???
'human varciella zoster immunoglobulin'
55
Red maculopopular rash, starts on back of ears, spreads down
measles
56
where does the measles rash start
back of ears
57
is measles notifiable
yes obviously
58
how is measles spread?
droplet spread
59
how infectious is measles?
highly
60
how do you test for measles?
PCR blood or saliva
61
white grains on buccal mucosa – pathognomonic for measles...?
koplik's spots
62
what are koplik's spots?
white grains on buccal mucosa
| pathognomic for measles
63
I want the symptoms of measles, in order of appearance.
1. fever
2. cough, coryza, conjunctivitis
3. Koplik's spots
4. rash
64
Give me 2 complications of measles
measles encephalitis
| SSPE
65
What is 'SSPE' and when is it got?
subacute sclerosing panencephalitis
| measles
66
Describe the management of measles.
isolate
supportive.
(if imm comp, ribavarin)
67
An immmunocompromised child gets measles. What is the treatment?
isolate.
supportive.
RIBAVARIN
68
what kind of med is ribavarin?
anti-viral
69
what is the causative agent of mumps
mumps virus .
70
which infection causes swelling of parotids
mumps
71
what serum marker is raised in MUMPS?
plasma amylase
72
what is treatmentfor mumps?
self-limiting
73
apart from parotid swelling, what are 2 more symptoms of mumps?
earache
| pain on eating/drinking
74
This virus is devastating as a congenital infection but mild as a childhood infection, It causes maculopapular rash and lymphadenopathy...
rubella
75
If a child with sickle cell or thalassaemia gets slapped cheek (parvovirus b19) what can happen?
aplastic crisis
76
What are the enteroviruses?
coxsackie, polio, echovirus
77
coxsackie, polio and echovirus are all
enteroviruses
78
your little girl has impetigo. should you be sending her to nursery?
no
79
honey coloured lesions makes you think of
impetigo
80
what kind of lesions do you get in impetigo
honey coloured
| on face neck and hands
81
what causes impetigo
staph / strep
| superficial skin infection
82
how contagious is impetigo
highly
83
how do you treat mild impetigo
topical Abx cream
84
how do you treat severe impetigo
fluclox
| or co-amox
85
what infection causes boils
staph aureus
| infections of hair follicles and sweat glands
86
child with fever, erythema and oedema of eyelid. What's this?
periorbital cellulitis
| from local trauma to skin, dental abscess, sinus inf
87
Treatment for periorbital cellulits?
IV CEFTRIAXONE, quick!
to prevent ORBital cellulitis (proptosis, meningitis) (where supected, do CT head to check for posterior spreadintohead)
88
Which bac cause toxic shock syndrome
staph
| strep
89
when i say strep in skin i mean
strep pyogenes (group A strep)
| not group B strep, that's strep agalactiae
(strep throat = strep pyogenes too)
90
1. Fever >39
2. Hypotension
3. Diffuse macular erythematous rash
what you thinking?
toxic shock syndrome
91
What are the three signs of toxic shock syndrome?
1. Fever >39
2. Hypotension
3. Diffuse macular erythematous rash
92
Toxic shock syndrome is caused by toxins released from bac at any site, causing organ dysfunction! Which bacterias?
staph / strep
93
Signs of toxic shock are fever, hypotension and rash. But what are some symptoms?
```
Mucositis,
vomiting/diarrhoea,
renal & liver,
clotting & thrombocytopenia,
...altered consciousness.
```
94
Toxic shock syndrome needs treatment on ICU. With what?
IV Abx and surgical debridement of infection :/
95
Cellulitis can be staph or strep, whereas erysipelas almost always...
group A strep
96
What is the difference between where gets infection in cellulitis and in erysipelas?
erysipelas - upper dermis + superficial lymphatics
| cellulitis - lower dermis + subcutaneous fat
97
The rash is more RAISED in which, cellulitis or erysipelas?
ERYSIPELAS (rash more raised)
98
What are the symptoms of scarlet fever?
```
fever
headache
sandpaper maculopapular rash, starting at neck / chest
tonsilitis, sore throat
strawberry tongue
flushed cheeks w perioral sparing
```
99
Scarlet fever rash is MACULOPAPULAR sandpaper rash. Where does it typically start?
neck
100
What might a child with scarlet fever's face look like?
flushed cheeks w perioral sparing
strawberry tongue
(red exudatey tonsils)
101
Diagnosis of scarlet fever usually clinical. What investigations if in doubt?
throat swab and culture
102
What is the difference between strep throat and scarlet fever?
both group A strep.
scarlet fever = strep throat with a rash
(caused by the TOXIN)
103
How is scarlet fever spread?
droplet
104
How is scarlet fever spread?
droplet
105
Treatment for scarlet fever and strep throat?
10 days Pen V
| rest, fluids, paracetamol
106
Give me two rare but feared complications of scarlet fever.
rheumatic fever
| post-strep glomerulonephritis
107
What is tinea capitis?
scalp ringworm
| scaling and alopecia
108
dermatophytosis , a.k.a
ringworm
| fungal
109
Annular fungal skin lesions in ringworm. Severe ring is called...
kerion
110
Give me three types of tinea fungus ..
capitis, corporis, pedis, cruris (groin)
111
How do you diagnose ringworm?
skin scrapings:
microscopy and culture
(fungal hyphae)
112
What is the treatment for ringworm?
topical or systemic antifungal e.g. clotrimazole
treat dog or cat if infected
113
eight-legged mite burrows down epidermis.
scabies
114
differential of ringworm?
```
granuloma annulare
(raised edge, yrs)
```
115
what kind of agent is scabies?
parasitic
116
when do you get itching from scabies?
2-6wks after infection
117
what is main symptom of scabies?
ITCHING
(worse at night and in warmth)
can turn into RED RASH
118
where on the body does scabies tend to go?
between fingers and toes
armpits
nipples, penis, buttocks
119
If scabies burrows get really scratched, what might happen?
secondary infection
| crusted pustular lesions
120
How do you diagnose scabies?
skin scraping
- microscopy - mites/eggs/mitepoo
121
what is the scabies mite called?
sarcoptes scabei!
| parasitic
122
What is the treatment for scabies?
PERMETHRIN cream over whole body
treat whole family!!
hotwash bedding and put clothes in sealed bag for 3ds
dont share towels / have sex
123
what is pediculosis capitis?
head lice
| nits are eggs
124
What's the treatment for nits?
DIMETICONE lotion
| wet combing
125
As well as acute glomerulonephritis, what else happens in Henoch Schonlein purpura?
symmetrical rash on
buttocks; arm/leg extensors; ankles
arthralgia
abdo pain
126
What actually is Henoch Schonlein purpura?
VASCULITIS iga+g complexes
| unknown cause, preceded by URTI
127
Arthralgia
Abdo pain
Symmetrical rash on buttocks, arms/legs, ankles
and Acute glomerulonephritis.
What's this?
Henoch Schonlein purpura
128
sever bullous erythema multiforme involving mucus membs. from infection or drug reaction.
steven johnson syndrome
sepsis, electrolyte imbalance ://
129
Word to describe rash which is...
| flat, altered colour / texture
macular
130
Word to describe rash which is...
| raised
papular
131
Roughening and accentuated skin markings is called
lichenification
132
What is ulcer?
loss of epidermis and dermis
133
Purpura = ?
bleeding into skin or mucosa
134
Small purpura are called...
| whereas large purpura are called...
petechiae
| ecchymoses
135
What do measles, rubella, scarlet fever, and slapped cheek all have in common?
MACULOPAPULAR
136
give me some key infective causes of maculopapular rash
measles, rubella, scarlet fever, slapped cheek
137
What kind of rash is chickenpox and shingles?
VESICULAR
138
what kind of rash is impetigo?
VESICULAR
139
Give me 3 things which would give PURPURIC rash?
Henoch Schonlein purpura
malaria
septicaemia
140
Give me 4 VIRAL causes of fever and rash?
parvovirus
measles
rubella
chickenpox
(eczema herpeticum, roseola infantum)
141
Give 2 BACTERIAL causes of fever and rash?
scarlet fever
| impetigo
142
Give me 3 non infective causes of fever and rash?
kawasaki
systemic JIA
henoch schonlein purpura
