Warts

Question 1

Tx warts?

Answer 1

liquid nitrogen - 2 freeze cycles every 2-4 weeks

keratolytics (candtharidin, occlusal, duofilm, duoplant, virasal)

podophyllum resin - patient applies 3x week for 4-6 weeks

tretinoin - BID 4-6 weeks

imiquimod (aldara) - depends on wart location! is an immumodulator

laser therapy - best reserved for treatment resistant warts

Question 2

Cellulitis S&S

Answer 2

warm ,red, edematous area with sharply demarcaet borders

lymphadenitis and necrosis rarely occur

Question 3

tx cellulitis?

Answer 3

dicloxacillin

MRSA resistant or abscess - TMP-SMX, cindamycin, doxycycline, minocycline

Question 4

tx of abscess

Answer 4

incision, drainage, and localised care with warm soaks

Question 5

tx abscess >/ 5cm

Answer 5

antimicrobial + incision/drainage, localized care

Question 6

Tx asbcess MRSA resistant?

Answer 6

TMP-SMX (1 daily for 5-10 days or if > 40 BMI 2 tablets BID)
doxycycline or minocycline (sulfa allergy)
clindamycin

linezolid - if not tolerated or ineffective

Question 7

Lyme Disease is caused by what?

Answer 7

B burgdorferi, psirochete. feeds for more than 24 hour

Question 8

Stage one of lyme disease?

Answer 8

mild flu-like symptos winth single annular lesion with central clearing. rarely pruritic or painful resolve 3-4 week.

Question 9

Stage 2 of lyme disease>

Answer 9

months later, classic rash with multiple lesions, arthralgias, HA, fatigue, cardiac manifestations (heart block, bells palsy) aspetic meningitis.

Question 10

Stage 3 of lyme disease.

Answer 10

1 year after initial infection, MS signs from joint pain to frank arthritis with evidence of joint damange. neuro spych - memory problems, depression, and neuropathy.

Question 11

Diagnosis of lyme disease

Answer 11

serum testing for b burgdorferi and confirmatory western blot assay for IgM antibodies.

Question 12

tx of lyme disease?

Answer 12

doxycycline, ceftin (ceruroxime axetil), amoxicillin, and select macrolides. 14-21 days

for immed care if tick bite and suspect - 200 mg single dose of doxy

Question 13

rosacea s&S

Answer 13

erythema, telangiectasia, inflamm papulopustular eruptions.

Question 14

triggers rosacea?

Answer 14

UV sunlight, hot/cold, exercise, stress, coffee, chocolate, caffeine, alcohol, spicy foods, certain meds of cosmetics

Question 15

Erythematotelangiectatic type description?

Answer 15

central facial flushing with burning or stinging

Question 16

papulopustular type description?

Answer 16

red central porion of facce with erthematous papules sumounted by pinpoint pusutules

Question 17

Phymatous rosacea type?

Answer 17

skin thickenings and irreg surgafe nodularities of nose, chin, forehead or ears or eyelids.

Question 18

ocular rosacea type?

Answer 18

blephartis, conjuctivitis, inflamm lids, and conjunctival telangiectasis.

Question 19

tx rosacea?

Answer 19

mechanial dermabrasion, laser peel, and surgical shave/

oral and topical medication :minocycline, doxycycline, tetracycline, metronidazole, or erythromycinm accutane but only if severe.

• antimicrobials - topical –> metronidazole gel common first line. erythromycin and clindamycin. oral –>
• immunosuppresants - tacrolimus ointment (protopic)
• acne products - aze;aoc acod, sulfacetamide prdocut, benzoyl peroxide, retinoid , dapsone severe cases.