amboss 6/28 Flashcards by sic transit gloria mundi

what is the treatment for a pilonidal cyst

incision and drainage. the wounds are typically packed with gauze and healing occurs by secondary closure

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what is the typical presentation of pilonidal cyst

obese, sedentary men with deep gluteal cleft and excessive body hair

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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.

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what is the cause of angioedema from ACEi

inhibition of bradykinin breakdown. presents with swelling of the face and the lips and eyes

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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.

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what is the cause of bullous impetigo

staph aureus

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what is the cause of nonbullous impetigo

staph aureus or strep pyogenes

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what is the treatment for impetigo

topical mupirocin

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what is the treatment for actinomyces if the person has sensitivity to penicillin

doxycycline

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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

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what are the first Line therapies for pinworm infection

albendazole or pyrantel pamoate

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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

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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.

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what is the treatment for bullous impetigo

Bullous impetigo is treated with first-generation cephalosporins such as cephalexin.

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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

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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.

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eczema herepeticum treatment

Treatment with oral or IV acyclovir should be initiated as soon as possible

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what is the most common cause of erysipelas and lymphangitis

strep pyogenes

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what is the treatment for head lice infection

topical permethrin

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what is the treatment for tinea capitis

oral griseofulvin

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what lesions does papilloma virus cause

cauliflour-like

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what lesions does pox virus cause

skin colored, round, with a dimpled center

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what type of virus causes molluscum

poxvirus

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what is the treatment for bartonella infection and why

azithromycin because it reduces the lymphadenopathy

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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

what is the surface area of the abdomen

what is the surface area of the anterior lower extremities

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