Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pharmacy 1 - Term 1 > 7 - Lice & Scabies > Flashcards

7 - Lice & Scabies Flashcards

1
Q

What are 3 species of lice that exist?

A

1) Head lice
2) Body lice
3) Pubic lice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where do the different species of lice live?

A
  • Head and pubic lice live on the skin

- Body lice live in seams of clothing (only come onto body to feed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the shape of head louse compared to pubic louse?

A

Pubic louse are more round and fat b/c pubic hair is thicker than head hair, so it needs to be round to move up the hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How long can adult lice survive off of a host?

A

1-4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How long do female louse live and when do they lay eggs?

A
  • Live about 30 days

- Lay eggs daily which hatch 8-10 days later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do the different species of lice lay their eggs?

A
  • Head and pubic lice lay eggs at base of hair shafts

- Body lice lay eggs in clothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long do the different species of lice take to mature?

A
  • Head and body = 8-15 days

- Pubic = 14-22 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are risk factors for head lice?

A
  • Ages 3-11
  • Female (tend to have longer hair)
  • Lice may prefer clean hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are risk factors for body lice?

A
  • Has correlation w/ personal hygiene and socioeconomic status
  • Poverty, overcrowding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are risk factors for pubic lice?

A
  • Sexually active

- Young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is head lice transmitted?

A
  • Hair-to-hair contact

- Fomites such as clothing or hair accessories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is pubic lice transmitted?

A
  • Sexual or close body contact

- Fomites such as bed linens and towels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is body lice transmitted?

A
  • Shared clothing or linens

- Direct body contact w/ infested person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are signs and symptoms of head lice?

A
  • Itching, especially back and side of scalp
  • Some will be asymptomatic
  • Bite sites (red lesions/papules)
  • Presence of lice and nites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does itching occur from head lice?

A
  • When individual becomes sensitized to saliva from louse feeding
  • May take 4-6 weeks during first infestation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nits are located w/in __ mm of scalp

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are signs and symptoms of body lice?

A
  • Nocturnal pruritus
  • Bite marks around waist and axillae
  • Potential secondary bacterial infection
  • Lice and eggs in seams of clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are signs and symptoms of pubic lice?

A
  • Pruritus
  • Bite marks (bluish discolouration around bite marks from anti-coagulant that lice inject when they feed)
  • Risk of secondary bacterial infection
  • Can also occur in other thick-haired areas like beard or eyelashes
  • Lice may appear as small, yellow-brown or grey dots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is required for a definitive diagnosis of head lice?

A

Visualization of live louse; best way is w/ wet combing technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the wet combing technique?

A
  • Wash hair and apply conditioner (leaving it in hair)
  • Brush hair w/ normal brush to remove tangles
  • Comb through hair w/ lice comb starting w/ comb flat against scalp and comb to edge of hair
  • If there are head lice, 1 or more will appear on comb; if unsure, observe for movement on paper towel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some differential diagnoses for head lice?

A
  • Dandruff (flakes of dandruff will be easily removed)
  • Seborrheic dermatitis (will present yellowish greasy scales)
  • Accumulation of hair cosmetics
  • Pseudo-nits (accumulation of dead skin cells that form around hair shaft causing white dead skin cells at hair shaft, easily removed)
  • Psychogenic itch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some differential diagnoses for pubic lice?

A
  • Seborrheic dermatitis
  • Folliculitis
  • Dermatophytosis (jock itch)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some differential diagnoses for body lice?

A
  • Seborrheic dermatitis
  • Folliculitis (will appear infected)
  • Eczema/atopic dermatitis (look at location and history
  • Impetigo
  • Flea or insect bites (location differentiates lice from bed bugs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the goals of therapy for lice?

A
  • Exterminate head, body, or pubic lice
  • Relieve pruritus
  • Prevent secondary bacterial infections
  • Prevent spread of infestation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the pathophysiology of scabies?

A
  • Highly contagious infestation of skin w/ human mite Sarcoptes scabiei var hominis
  • Impregnated female mite burrows into uppermost layer of epidermis, depositing feces along its path, and lays eggs daily
  • Remains in burrow and continues to lay eggs for her lifespan of 4-6 weeks
  • Eggs hatch in 3-4 days and maturation into an adult mite takes 14-17 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are risk factors for scabies?

A
  • Children, mothers of young children, sexually active adults, and elderly in nursing homes at greatest risk
  • Epidemics occur in poor living conditions (poverty, poor hygiene, overcrowding) and institutions
27
Q

How is scabies transmitted?

A
  • Skin-to-skin contact

- Fomites (furniture, towels) is extremely rare unless px has a very high parasite load

28
Q

What are signs and symptoms of scabies?

A
  • Pruritus (may take 3-4 weeks to appear for first infestation, or 24-48 hours to appear w/ reinfestation)
  • Primary lesions (burrows, vesicles, and papules)
  • Secondary lesions
  • Mite eggs and feces on skin scraping
  • Common on waist, armpits, webbings of fingers, back of elbows, knees, and feet; also genitalia and nipples (not common on heads of adults)
29
Q

What is a diagnostic tool for scabies?

A

Skin scraping

30
Q

What are some differential diagnoses for scabies?

A
  • Seborrheic dermatitis
  • Impetigo
  • Body lice
  • Bed bugs/insect bites
  • Eczema (atopic dermatitis)
31
Q

What are the goals of therapy for scabies?

A
  • Exterminate scabies mite
  • Relieve pruritus
  • Prevent secondary bacterial infections
  • Prevent spread of infestation
32
Q

Which types of lice are self-treatable?

A

Head and body

33
Q

Which conditions should be referred?

A

Pubic lice and scabies

34
Q

What are immediate red flags?

A
  • Presence of secondary bacterial infection
  • Resistant/recurrent cases where self-care options are no longer viable
  • Suspected scabies or pubic lice
  • Lice infestation of eyebrows/eyelashes
35
Q

What are some non-pharms and prevention of lice?

A
  • Remove nits
  • Avoid sharing personal items
  • Items should be dry cleaned, washed in hot water, or stored in plastic bag for 10-14 days
  • Soak combs and brushes in hot water for 5-10 mins or wash w/ pediculicide
  • Vacuum carpets, rugs, and furniture
  • Inspect close contacts for lice and treat all infested contacts at same time to prevent reinfestation
  • Treat bedmates prophylactically
36
Q

Define pediculicide

A

Ability to kill lice

37
Q

Define ovicidal

A

Ability to kill viable eggs

38
Q

Define residual activity

A

Products ability for retention of pediculicide on the hair and scalp after washing

39
Q

What are some non-Rx treatment options for head lice? Which has residual activity?

A
  • Permethrin (first line tx; has residual activity)
  • Pyrethrin/piperonyl butoxide (second line)
  • Isopropyl myristate (3rd line)
  • Dimeticone (3rd line)
  • 5% benzyl alcohol lotion
40
Q

What are contraindications to permethrin and PPB?

A

Allergy to ragweed or chrysanthemum

41
Q

When is dimeticone a good option?

A

Curly hair

42
Q

What are possible mechanisms of pediculicide resistance?

A
  • Knockdown resistance (Na channel gene mutation)

- Enzyme upregulation

43
Q

What should be considered when head lice tx fails?

A
  • Misdiagnosis
  • Improper application
  • Re-infestation
  • Resistance
44
Q

What should be done when head lice tx fails and it was properly applied?

A

Switch to a product in a different pharmacologic class

45
Q

What is the dosing for 5% benzyl alcohol lotion?

A
  • Apply to dry hair for 10 mins then rinse

- 2nd tx needed after 9 days

46
Q

What is the most common alternative tx for head lice when standard tx fails?

A

Permethrin 5% left on hair overnight covered w/ plastic shower cap

47
Q

What is the drug of choice in pregnant and lactating women w/ head lice?

A

Permethrin, PPB is 2nd choice

48
Q

Which drugs can be used in children under 2 months old w/ head lice?

A

Permethrin and PPB

49
Q

Isopropyl myristate can be used in children over __ years old

A

4

50
Q

Dimeticone can be used in children over ___ years old

A

2

51
Q

What is the first line tx for pubic lice?

A
  • Permethrin 1% cream rinse
  • Pyrethrin w/ piperonyl butozide applied to affected areas then washed off after 10 mins
  • 2nd tx in 7-9 days
  • Treat sexual contacts from the past month
52
Q

What is the tx for lice in eyelashes?

A
  • Remove lice and nits w/ tweezers

- Apply white petrolatum BID for 10 days

53
Q

What is the tx of choice for body lice?

A

Hygenic measures (pediculicides only used if lice are adherent to body hairs)

54
Q

What is the monitoring for lice?

A

Monitor detection of live lice, presence of nits, pruritus, and inflammatory pustules daily for 2 weeks

55
Q

What must be done before initiating scabies tx?

A

Diagnosis by physician

56
Q

Who should be treated for scabies?

A

Infested person and their close contacts (sexual and household) from the previous month

57
Q

What are some non-pharms and prevention of scabies?

A
  • Wash clothing and linens in hot water w/ soap and then through hot cycle of dryer
  • Store unwashed clothing in plastic bag for 5-7 days
  • Vacuum rugs, furniture, and unwashable items
  • Avoid body contact w/ others until tx complete
58
Q

What is the pharm tx of scabies?

A
  • 1st line = permethrin 5% (cream or lotion) for adults and children over 2 months
  • 2nd line = crotamiton 10% or topical sulfur 5-10% (preferred tx in infants under 2 months)
59
Q

How much permethrin 5% should be applied?

A
  • 12 y/o and over = 30 g tube
  • 5-12 y/o = 15 g
  • 2-5 y/o = 7.5 g
  • Under 2 y/o = 4-7 g
  • *May require more if px is obese of if scalp is involved
60
Q

How is permethrin 5% applied?

A
  • Apply to clean, cool, dry skin
  • Massage cream into skin from neck to soles of feet and put on clean clothes (note crevices, fingers, toes, nails, and genitalia)
  • Remove after 8-14 hours by taking a shower/bath and dress in clean clothes
  • Reapply 7 days later if necessary
61
Q

What is the monitoring for scabies?

A
  • Monitor burrows, papules, pruritus, and pustules/impetigo daily for 2 weeks
62
Q

How long can transmission of scabies occur?

A

As long as infested person remains untreated and until 24 hours after tx

63
Q

What should be done if new burrows appear?

A

Re-treat w/ scabicide

64
Q

What should be done if new papules appear?

A

Re-treat w/ scabicide after 7-10 days

Clinical Pharmacy 1 - Term 1 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions