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Simmons NURP 503 Exam 1 > 3: Derm 1 > Flashcards

3: Derm 1 Flashcards

1
Q

What causes hand foot and mouth dz?

A

Coxsackievirus A16

Enterovirus 70

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2
Q

What are the complications of early stage lyme dz?

A

Fever, fatigue, malaise, headache, neck/joint stiffness (myalgias/arthralgias), lyme meningitis

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3
Q

Subclass of cellulitis that is superficial with sharp, defined borders caused by GABHS.

A

Erysipelas

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4
Q

What is treatment for measles?

A

Supportive

Avoid ASA

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5
Q

What is the treatment for neurologic lyme dz (2)?

A
  1. Ceftriaxone 2 g once daily IV x 14 days (range 10-28 days)
  2. Doxy 200-400 mg/day in 2 divided doses PO x 10-28 days if intolerant to beta-lactam ABX
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6
Q

What are the complications of early disseminated lyme dz?

A

Multiple erythema migrans (3–5 weeks after bite), facial palsy, aseptic meningitis, cardiac involvement (AV block and myocarditis), musculoskeletal pain

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7
Q

What can fifth’s dz cause in a pregnant woman?

A

Hydrops fetalis

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8
Q

Organism that causes Lyme disease.

A

Borrelia burgdorferi spirochete

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9
Q

What diameter is the target rash in lyme dz?

A

5-15 cm

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10
Q

When is vaccination for meningococcemia done?

A

Age 11 and before starting college.

Ages 2-5 for certain high-risk children.

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11
Q

Erythematous papule/pustule around a hair follicle.

A

Folliculitis

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12
Q

T/F Scarlet fever requires rapid strep test or throat culture.

A

True (caused by same organism)

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13
Q

DDx of shingles?

A

HSV

Impetigo

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14
Q

A mild illness also known as German measles.

A

Rubella

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15
Q

Where does staph scalded skin syndrome usually start?

A

Respiratory site such as nose or mouth

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16
Q

Reactivation of latent varicella infection that is more common after a mild case of chickenpox.

A

Shingles

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17
Q

What are transmission routes for hand foot and mouth?

A

Fecal
Oral
Respiratory

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18
Q

Manifests as a subcorneal pustule with erosions and honey-colored crusts

A

Impetigo

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19
Q

How is rubella acquired?

A

Respiratory secretions. Invades respiratory epithelium.

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20
Q

What is the treatment for hand foot and mouth?

A

Symptomatic. May require tylenol or benadryl/maalox solution for oral lesions (can use non-salicylate antacid if concerned for salicylates).

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21
Q

What animals/rodents carry the lyme spirochete?

A

Deer
Rodents (white tailed mouse)
Ticks

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22
Q

When does varicella occur?

A

Late autumn, spring, and winter

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23
Q

What is staph scalded skin syndrome called in neonates?

A

Ritter’s disease

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24
Q

What is the medication treatment for impetigo (6)?

A
  1. Beta lactamase-resistant penicillin or cephalosporin for 5–10 days
  2. Oral if sick. Topical if not sick.
  3. Mupirocin (Bactroban) TID for 5–10 days
  4. Altabax (retapamulin)
  5. Bleach baths
  6. Penicillin alternatives: erythromycin and clarithromycin
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25
Q

May follow a break in the skin caused by nail biting or tearing a hangnail.

A

Acute paronychia

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26
Q

Clinical manifestions: low-grade fever, HA, chills, followed by erythematous facial rash, and lacy, maculopapular rash

A

Fifth’s dz

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27
Q

What is the prevention for rubella?

A

May give IG for pregnant, nonimmunized, exposed women.
MMR vaccine at 12 months and 4 years old.
Vaccine for postpartum women if not immune during pregnancy.

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28
Q

Localized skin infection, involving dermis and subcutaneous tissue with obstruction of local lymphatics.

A

Cellulitis

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29
Q

Chronic paronychia causes inflammation and edema without _____.

A

Pain

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30
Q

T/F Cellulitis can be associated with fever, chills, and malaise.

A

True

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31
Q

Rubbing erythematous skin sideways causes superficial epidermis to slough off.

A

Nikolsky’s sign (staph scalded skin syndrome)

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32
Q

In meningococcemia, leakage of the endotoxin in the bacterial cell walls can cause what (3)?

A

DIC
Irreverisible shock
Multisystem failure

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33
Q

Treatment for chronic paronychia (2).

A
  1. Antifungals

2. Antibiotics

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34
Q

What is the treatment for staph scalded skin syndrome?

A
  1. ICU

2. Systemic antistaph ABX

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35
Q

What is the treatment for rubella?

A

Supportive

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36
Q

Name 3 sequelae of scarlet fever.

A
  1. Rheumatic fever
  2. Heart problems
  3. Acute glomerulonephritis
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37
Q

Treatment for cellulitis.

A
  1. Outpatient oral antibiotics (Keflex [cephalexin], Augmentin [amoxicillin/clavulanate]) for early onset cellulitis
  2. Consider coverage for MRSA
  3. Follow up closely to watch for sepsis
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38
Q

Upper respiratory prodrome followed by high fever, chills, headache, toxicity, and hypotension.

A

Meningococcemia

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39
Q

Caused by circulating staph toxin which can exfoliate the skin.

A

Staph scalded skin syndrome

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40
Q

Staph scalded skin syndrome can be related to _____ if no peeling.

A

nonstrep scarlet fever

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41
Q

What is a complication of fifth’s dz?

A

Aplastic anemia (esp for those with sickle cell or pregnant women)

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42
Q

What are long term complications of lyme dz?

A

Chronic arthritis

Neurological sequelae

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43
Q

How is rubella diagnosed?

A

Viral isolates from nasopharyngeal secretions

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44
Q

10 complications of impetigo.

A
  1. Sepsis
  2. Arthritis
  3. Pneumonia
  4. Lymphadentitis
  5. Toxic shock
  6. Osteomylitis
  7. Endocarditis
  8. Cellulitis
  9. Staph scalded skin syndrome
  10. APSGN (Acute poststreptococcal glomerulonephritis)
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45
Q

What is incubation period for varicella?

A

10-21 days (mean 14 days)

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46
Q

What is the prophylaxis for lyme dz?

A

Tests not necessary.

Single dose of doxy (200 mg for adults, 4 mg/kg for children >8 with max of 200)

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47
Q

Ill, miserable child with dusky red maculopapular rash on face that spreads to trunk. Rash lasts 7-10 days, but brown macules can last u to 3 weeks.

A

Measles

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48
Q

Organism that causes meningococcemia.

A

Neisseria meningitidis

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49
Q

What is the treatment for meningococcemia?

A

High dose penicillin G q 4-6 hours

Alternatives are cefotaxime, ceftriasone, and chloramphernicol

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50
Q

Describe the 2 phases of staph scalded skin syndrome.

A
  1. Prodromal phase - Bright erythema around mouth, fever, irritability
  2. Exfoliative phase - Tender, inflamed peeling skin. Red oral mucosa. Peeling on trunk.
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51
Q

T/F Rubella has a periodic occurrence of wintertime epidemics.

A

False. Springtime.

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52
Q

Resembles impetigo but extends through to dermis.

A

Ecthyma

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53
Q

Most common ages and times for fifth’s disease?

A

School-age children

Late winter or spring

54
Q

T/F N. meningitidis is a gram-negative bacteria that contains endotoxin in the cell walls.

55
Q

What causes fifth’s dz?

A

Parvovirus B19

56
Q

Recurrent varicella infection.

A

Herpes zoster (Shingles)

57
Q

What organism causes scarlet fever?

58
Q

Superficial bacterial infection of the epidermis that can be bullous or nonbullous.

59
Q

What causes varicella?

A

Herpes virus varicellae

60
Q

In impetigo, bullae result from toxin-producing strains of _____.

A

Staph aureus

61
Q

What is the incubation period of hand foot and mouth/

A

3-6 days after exposure

62
Q

Most common bacteria in acute paronychia (2)?

A
  1. Staph

2. Strep

63
Q

Is N. meningitidis gram positive or negative?

A

Gram negative

64
Q

Upper respiratorycatarrhal prodromal phase that can include Koplik’s spots on buccal mucosa and conjunctivitis, rhinitis, and otitis media.

65
Q

When is varicella contagious?

A

48 hours before onset of rash to 6-7 days after (until all lesions have crusted).

66
Q

Often related to GABHS (Group A Beta Hemolytic Streptococcal) infection.

A

Perianal streptococcal dermatitis

67
Q

Prodrome of low fever, URI symptoms that leads to maculopapular crop lesions. Diffuse vesicles and erythema in varying stages. Poor appetite, malaise, pruritis.

68
Q

T/F Chronic paronychia can cause secondary nail dystrophy.

69
Q

What causes rubella?

A

Single-stranded positive-sense RNA virus with glucolipid envelope.
Member of the togavirus family.

70
Q

Clinical manifestations: lymphadenopathy, erythematous macular papular discrete rash, mild pharyngitis, conjunctivitis, anorexia, HA, malaise, low-grade fever (LGF).

71
Q

T/F Meningococcemia contacts do not require chemoprophylaxis.

72
Q

Non medication treatment for impetigo (2)?

A
  1. Handwashing, cleanliness, exclusion from day care/school for 24–48 hours after start of antibiotic
  2. Cool compresses to debride crusts
73
Q

What is the treatment for herpes zoster (shingles)?

A

Supportive.

Urgent referral to ophthalmology if lesions on face.

74
Q

T/F Scarlet fever rash is nonblanchable.

A

False. Scarlet fever rash blanches. Late stage rocky mountain spotted fever does not.

75
Q

Occurrence between 6 months and 3 years of age. Abrupt onset of illness with high fever. Possible URI symptoms, otitis media. Diffuse erythema of posterior pharynx and soft palate. GI manifestation. Macular erythematous rash during febrile phase or after fever resolves.

76
Q

Fulminant purpural, urticarial, maculopapular, and petechial eruptions over trunk and extremities.

A

Meningococcemia

77
Q

Most common bugs in chronic paronychia (2)?

A
  1. Candida albicans (yeast)

2. Mixed bacterial flora

78
Q

Meningococcemia has symptoms similar to _____ and _____ which can cause a delay in diagnosis.

79
Q

Meningococcemia is most often caused by serogroups _____ and _____.

80
Q

What is prevention of measles?

A

MMR at 12 months and 4 years.

81
Q

Linear petechiae in flexural creases that can appear in scarlet fever.

A

Pastia’s lines

82
Q

_____ is teratogenic in pregnant women, while _____ in children can cause pneumonia.

A

Rubella

Measles

83
Q

Which rashes are caused by viruses?

A 
Measles
Mumps
Rubella
Varicella
Fifth's Dz (erythema infectiosum)
Hand foot and mouth
Shingles
84
Q

What causes roseola?

A

Human herpes virus (6 or 7)

85
Q

Rash that begins as red macules or papules and expands to a large, annular, erythematous rash with a pale center within 1 week.

A

Lyme dz (really, it can occur from 1 day to 1 month after bite, but asynch stages 1 week)

86
Q

Causes circumoral pallor.

A

Scarlet fever

87
Q

What is the treatment for roseola?

A

Symptomatic

88
Q

Complications of varicella (5).

A 
Impetigo
Necrotizing fasciitis (severe) from group A strep
Pneumonia
Meningitis
Encephalitis
89
Q

Manifests as erythematous, warm, and tender plaques with local swelling and proximal lymphadenopathy.

A

Cellulitis

90
Q

When does hand foot and mouth usually occur?

A

Summer, early fall

91
Q

2 most common bacteria in impetigo.

A
  1. Strep

2. Staph

92
Q

If acute paronychia does not respond to conservative treatment, what is the next step?

93
Q

What is the incubation period for lyme dz?

94
Q

Thrives in abrasions, lacerations, arthropod bites, burns, chicken pox, and dermatitis.

95
Q

What is the treatment for lyme dz (2)?

A

14-21 days of ABX therapy:

  1. Doxycycline 100 mg (8+ yo)
  2. Amoxicillin 25-50 mg/kg TID or cefuroxime or ceftriaxone
96
Q

What are complications of roseola (2)?

A

Seizures
Dehydration
Rule out sepsis and meningitis

97
Q

How is lyme dz diagnosed?

A

Serology for borrelia burgdorferi

98
Q

What is the epidemiology of measles?

A

Prodrome 1-2 days before rash. Incubation 8-12 days from exposure to onset of symptoms.

99
Q

Other than face and neck, where does the scarlet fever rash appear (4)?

A 
Groin
Axillae
Abdomen
Trunk
Spares palms and soles
100
Q

Both measles and scarlet fever have a maculopapular rash. What are the differences?

A 
Scarlet fever
- Rash day 1
- Rash spares palms and soles
- Sandpaper like appearance
- Strawberry tongue
Measles
- Koplik's spots
- Rash 3-5 days after symptoms
- Rash starts on face and spreads down
101
Q

Impetigo can be diagnosed by _____ and _____.

A

Culture

Gram stain

102
Q

Most common cause of folliculitis?

A

Staph aureus

103
Q

When does the rash appear in scarlet fever?

A

After 24 hours

104
Q

Underlying punch-out ulcer with exudate.

105
Q

What is the incubation period of meningococcemia?

106
Q

Causes of cellulitis (4).

A
  1. GABHS
  2. Staph
  3. Strep pneumoniae
  4. H. inlfuenzae
107
Q

What is treatment for varicella?

A

Symptomatic (Aveeno baths, baking soda baths, calamine lotion).
In select cases, acyclovir can be used.
Hospitalize immunocompromised and possibly give immunoglobulin.

108
Q

Treatment for acute paronychia.

A

Treated with warm soaks, topical antibiotics, and systemic antibiotics (clindamycin or Augmentin).

109
Q

When does a scarlet fever rash desquamate?

110
Q

Clinical presentation: one week of burning, tingling, and stinging. Rash follows dermatomes but do not cross midline.

111
Q

DDx for scarlet fever (5)?

A
  1. Rubella
  2. Drug reactions
  3. Viral exanthems
  4. Staph scalded skin syndrome
  5. Kawasaki dz
112
Q

Scarlet fever rash starts on _____ and then spreads in _____ days.

A

Face and neck

1-2 days

113
Q

What is the infectious period for rubella?

A

7 days before through 5-7 days after the rash.

114
Q

How do you diagnose staph scalded skin syndrome?

A

Nikolsky’s sign

115
Q

Red, roughened, diffuse, sandpaper-like rash.

A

Scarlet fever

116
Q

Present in axillae and groin.

A

Folliculitis

117
Q

What treatment for meningococcemia would a person who is G6PD sensitive receive?

A

Chloramphenicol

118
Q

Clinical presentation: vesicles or red papules found on tongue, buccal mucous membranes, hands, and feet (rash often appears when fever abates)

A

Hand foot and mouth disease

119
Q

Manifests with redness, warmth, swelling, and tenderness of the proximal nail folds.

A

Acute paronychia

120
Q

What are routes of transmission for varicella?

A

Direct contact
Airborne
Droplet

121
Q

Causes white or strawberry tongue.

A

Scarlet fever

122
Q

Often occurs in people with a history of prolonged or frequent immersion of hands in water, and in children who suck on fingers/thumbs.

A

Chronic paronychia

123
Q

What is the incubation for rubella?

A

14-21 days

124
Q

If fever and chills are present with cellulitis, what may be needed for diagnosis?

A

CBC and blood culture

125
Q

T/F When those vaccinated for varricella get it, it does not look like varicella.

126
Q

How is fifth’s dz spread?

A

Respiratory route

127
Q

T/F Fifth’d dz is not contagious once the rash appears.

128
Q

Subclass of cellulitis that is caused by Group A strep and requires immediate hospitalization.

A

Necrotizing fasciitis

129
Q

Portals of entry can include tinea, eczema, burns, abrasions, lacerations, etc.

A

Cellulitis

130
Q

What bacteria cause ecthyma (3)?

A
  1. Strep
  2. Staph
  3. Pseudomonas
131
Q

Common among young children and in warm weather.

Simmons NURP 503 Exam 1 (34 decks)

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