amboss 6/28 Flashcards
what is the treatment for a pilonidal cyst
incision and drainage. the wounds are typically packed with gauze and healing occurs by secondary closure
what is the typical presentation of pilonidal cyst
obese, sedentary men with deep gluteal cleft and excessive body hair
what is the presentation of rubella
The typical exanthem of rubella is preceded by a prodromal phase in which the patient presents with postauricular and suboccipital lymphadenopathy, symptoms of a common cold, and in some cases a maculopapular enanthem on the soft palate (Forchheimer sign). Patients subsequently develop a non-confluent, pink maculopapular rash beginning at the head (often behind the ears) and spreading to the trunk and extremities. The palms and soles are usually spared by the exanthem.
what is the cause of angioedema from ACEi
inhibition of bradykinin breakdown. presents with swelling of the face and the lips and eyes
what is the presentation of roseola infantum
also known as exanthem subitum, is a disease caused by the human herpesvirus 6 that primarily affects infants and young children. It is characterized by a 3-day high fever (causing a tonic-clonic febrile seizure in this child) that ends abruptly (“3-day fever”) and is immediately followed by a blanching, maculopapular, nonpruritic rash. The rash appears mainly on the trunk but may spread to the face and extremities. It is commonly associated with cervical, postauricular, and/or occipital lymphadenopathy.
what is the cause of bullous impetigo
staph aureus
what is the cause of nonbullous impetigo
staph aureus or strep pyogenes
what is the treatment for impetigo
topical mupirocin
what is the treatment for actinomyces if the person has sensitivity to penicillin
doxycycline
what must be done if a pregnant mother has a child with fifth disease and why
serology on the mother to see she has immunity to parvovirus. If she becomes infected then she will need close monitoring as Parvo can cause fetal hydrops
what are the first Line therapies for pinworm infection
albendazole or pyrantel pamoate
what is the treatment for pinworm in a pregnant woman
reassurance and supportive measures such as strict cleanliness until the third trimester or after birth and then
what is the presentation of bullous impetigo
The rash is typically comprised of flaccid and superficial bullae, which may rupture and leave thin brown crusts. Lateral traction causes sloughing of the skin, which indicates a positive Nikolsky sign.
what is the treatment for bullous impetigo
Bullous impetigo is treated with first-generation cephalosporins such as cephalexin.
what is the treatment for cutaneous larva migrans
oral ivermectin or albendazole. this just relieves symptoms most of the time the infections are self-limiting and do not require treatment resolving within 2 months
what is eczema herepeticum
symptoms (fever, malaise, lymphadenopathy) and his rash indicate eczema herpeticum, a cutaneous manifestation of herpes infection (usually HSV-1 or HSV-2). This condition is associated with pre-existing skin conditions, most often atopic dermatitis. Eczema herpeticum is considered a dermatological emergency because the rash on the patient’s shoulder can disseminate rapidly.
eczema herepeticum treatment
Treatment with oral or IV acyclovir should be initiated as soon as possible
what is the most common cause of erysipelas and lymphangitis
strep pyogenes
what is the treatment for head lice infection
topical permethrin
what is the treatment for tinea capitis
oral griseofulvin
what lesions does papilloma virus cause
cauliflour-like
what lesions does pox virus cause
skin colored, round, with a dimpled center
what type of virus causes molluscum
poxvirus
what is the treatment for bartonella infection and why
azithromycin because it reduces the lymphadenopathy
what is the typical course for cat scratch disease
limited course that resolves on its own
what is the best way to diagnose pityriasis versicolor
through KOH prep –meatballs and spaghetti appearance
what is the treatment for veriscolor
topical selenium sulfide. shampoo or a lotion
what is the causative organism for versicolor
malassezia furfur
what is the treatment of choice for someone with erysipelas with systemic symptoms
IV cefazolin
alternatively penicillin
what is the strongest predisposing factor for cellulitis
tinea pedis
what are the indications for inpatient IV acyclovir for herpes zoster
immunocompromised patients, involving several dermatomes, or if it becomes disseminated
what is the treatment for jarisch-herxheimer reaction
supportive like NSAIDs
what is second line treatment for scarlet fever/tonsillopharyngitis
azithromycin
what is a rare complication of measles infection
subacute sclerosing panencephalitis
what is the presentation of subacute sclerosing panencephalitis
It usually develops at least 7 years after the initial infection with measles and is characterized by dementia, myoclonus, and epilepsy, leading to coma and death.
what is the treatment for measles virus
vitamin A
what is the presentation of parvovirus in an adult
mild URI symptoms, followed by poly-, symmetrical arthritis. rash may be present or absent (lacy macular)
what is the presentation of disseminated gonococcal
Clinical triad (arthritis-dermatitis syndrome)
Polyarthralgias: migratory, asymmetric arthritis that may become purulent
Tenosynovitis: simultaneous inflammation of several tendons (e.g., fingers, toes, wrist, ankle)
Dermatitis: vesicular, pustular, or maculopapular lesions, possibly with a necrotic or hemorrhagic center
Most commonly distributed on the trunk, extremities (sometimes involving the palms and soles)
Typically < 10 lesions that have a transient course (subside in 3–4 days)
what is an epidermoid cyst
a firm, mobile, slow-growing nodule that arises from the epidermis. Common locations for epidermoid cysts include the neck, face, head, back, and genital area. These lesions can be distinguished from those arising below the epidermis, as the overlying skin cannot be pinched.
Dermatofibromas are
small, skin-colored growths that most commonly develop on the lower extremities. Because dermatofibromas arise from the dermis, the epidermis overlying the lesion is pinchable and produces a central dimple (Fitzpatrick sign). Since the skin overlying this patient’s nodule cannot be pinched, it is not likely to be a dermatofibroma.
Lipomas are
painless, slow-growing, mobile nodules that are more rubbery in consistency rather than firm (they are made of mature fat cells). Unlike this patient’s nodule, lipomas do not arise from the cutaneous layers; the overlying skin can be pinched.
what is the treatment of a circumferential third degree burn that is causing impaired perfusion
escharotomy
what is the surface area of the anterior surfaces of the upper extremities
4.5%
what is the surface area of the chest
9%
what is the surface area of the abdomen
9%
what is the surface area of the anterior lower extremities
9%
what should be considered in someone with a chronic non healing ulcer with chronic venous insufficiency
marjolin ulcer. cutaneous squamous cell carcinoma
when must a sentinel lymph node study be conducted for superficial spreading melanoma
when the lesion is greater than 1.mm
what is the treatment of choice for superficial spreading melanoma
1-2cm safety margins excision with or without sentinel lymph node study
what can be given to immunocompromised patients with chickenpox
acyclovir they should recieve within 24 hours to reduce the duration and the severity of disease
what must be done before mohs surgery on basal cell carcinoma
excisional biopsy to confirm
pyoderma gangrenosum
In a patient with a history of Crohn’s disease, skin lesions could be an extra-intestinal manifestation of the systemic disease. A history of a small lesion which grew in size to become ulcerated and necrotic makes pyoderma gangrenosum most likely. It typically presents on the extensor side of the lower limbs.
what is the presentation of herpangina and what is it
vesiculopapular lesions on the posterior oropharynx with systemic symptoms
caused by coxsackie virus
what causes herpangina
coxsackie A hand foot and mouth
when is a tetanus shot indicated
every 10 years or when there is injury and the injury occurred greater than 5 years after a tetanus and if the wound is dirty or looks contaminated
what is the treatment for mild rosacea
topical metronidazole
what is the treatment for moderate to severe rosacea
systemic doxycycline
Bullous pemphigoid
can be caused by captopril and would present with cutaneous blisters. However, the blisters are typically tense and occur symmetrically, with a predilection for intertriginous areas. Moreover, a prodromal phase that is characterized by pruritus and papules/urticarial lesions/skin excoriations would occur, the Nikolsky sign would be negative, and mucous membranes (especially those of the genitalia) would typically be spared.
what is the treatment for acute dacryocystitis
amoxicillin-clavulnate; warm compresses and NSAIDs
where does squamous cell carcinoma most likely occur the upper or lower lip
lower lip
what is the treatment for a diabetic ulcer that has sloughing and callusing
sharp tool debridement
what is the treatment for a cat bite
empiric treatment with amoxicillin clavulanate prophylaxis
what can skin condition can be caused by warfarin treatment and what causes it
skin necrosis from protein C deficiency
what is the treatment of warfarin skin necrosis
protein C concentrate
