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Derm > Bites & stings > Flashcards

Bites & stings Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the order Hymenoptera

A

Bees, wasps, hornets, ants –> 1/4 of anaphylaxis cases

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2
Q

Insect sting hypersensitivity is associated with what

A

Atopy

Mastocytosis

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3
Q

Exaggerated insect bites signifies what

A

Normal in children

Adults CLL, or rarely other haematologic malignancies

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4
Q

Hypersensitivity to mosquito bites with bullous and necrotic lesions occurs to who

A

Asians, Hispanics, adolescents and children with chronic EBV infection

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5
Q

Unusual reaction to insect bites - what should you do

A

Screen for haematologic malignancy and latent EBV, including in situ hybridization to detect EBV RNA

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6
Q

Rare complication of bee sting

A

Atrial arrhythmias

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7
Q

Killer bee and wasp attacks associated with what

A

Myoglobulinuria or haemoglobinuria and ANT

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8
Q

Beekeepers are at risk of what

A

Inflammatory arthritis –> chronic arthropathy

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9
Q

Dengue virus mosquitoes bite more in day or night

A

Day

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10
Q

Malaria virus mosquitoes bite more in day or night

A

Night

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11
Q

List of insect repellants

A 
DEET - effective against wide range of arthropods, long hx of use, less proteciton in women
Picaridin
IR3535
p-Menthane-38 diol
Botanicals: best evidence for neem oil
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12
Q

Safest level of DEET in children

A

Most products 10%

AA of paeds says as high as 30% fine over 2 months

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13
Q

Latin name for fire ant, and who is at risk of them

A

Solenopsis invicta

Electricians

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14
Q

Fire ant - how does it work

A

Venom increases membrane permeability causing histamine release from mast cells
Less concentrated in winter, so milder then
Grasps the skin with its mandibles, then pivots in a circular fashion forming a rosette pattern

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15
Q

Latin name for bed bug and what do they look like

A

Cimex lectularis most common, other is C hemipterus
Flattened oval body, segmented abdomen, retroverted labium, dorsal sclerotic plate, antennae with 4 segments
5-7 mm long, females slightly longer
C hemipterus is ~25% longer than lectularis

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16
Q

Triatomine bug: what does it transmit and what does it look like

A

Chagas disease - trypanosomiasis
1.503 cm in size, and have a tiger striped abdomen. Long antennae, thin and composed of 4 segments
Mouth is straight and has 3 segments
Behing head is a trianngular first segment of the thorax with a broad posterior base

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17
Q

Triatomine bug clinically

A

Kissing bug: bites face, particularly around lips Unilateral eyelid and periorbital swelling 1-2 weeks after conjunctival exposure to infected triatomine faeces - Romana sign in chagoma
Painless

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18
Q

Blister beetle: what does it use to keep eggs safe, and what would a biopsy look like

A

Cantharadin

Acantholysis with suprabasal keratinocytes

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19
Q

What do rove beetles cause and what have they been called before

A

Nairobi fly
Cause vesiculopustular eruption
Have narrow bodies 0.5-1.5 cm long, red-orange abdomen and short forewings

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20
Q

Dog flea

A

Ctenocephalides felis (the cat flea)

21
Q

Human flea, what does it look like

A

Pulex irritans, a common dog flea in some locations

Has a single pair of hairs behind antennae

22
Q

What does the Ctenocephalides flea look like

A

Two combs that resemble a mane of hair and a moustage: 2 ctenidia with a pronotal comb and genal comb
The felis has 6 hair bearing notches, the canis 8

23
Q

What can stimulate fleas to hatch rapidly

A

Vibration

24
Q

What do fleas serve as a vector for

A

Typhus, spotted fever, plaque, Bartonella henselae, tungiasis

25
Q

Flea treatment

A

Lufenuron: oral and injectable - for animals

26
Q

Lepidopterism

A

Caterpillar dermatitis - larval form of a butterfly or moth causes it. Often purely mechanical
Australia’s white stemmed gum moth – Chelepteryx collesi produces yellow discolouration of the skin
Can also cause ophthalmia nodosa: conjunctivitis etc

27
Q

Which tick causes neurotoxins, after how many days and where is it usually found

A

Dermacentor tick, 4 days after attachment, commonly found in the Scalp

28
Q

In Australia, which tick causes paralysis

A

Ixodes

29
Q

Hard ticks transmit what

A

Lyme disease
Ehrlichiosis
Human granulocytic anaplasmosis
Rickettsia

30
Q

How many legs do ticks have

A

Larval (seed) have 6 legs

Nymphs and adults have 8

31
Q

What does the Ixodes scapularis tick look llike

A

8 legs
Females have a red thorax
Black legs

32
Q

What does the Lone star tick look like (not in Aus)

A

(Amblyomma) White spot on back in females, male - pale ‘inverted horseshoe’ on posterior portion of dark scutum, and have hard dorsal plate

33
Q

What have Amblyomma ticks been associated with in terms of allergy (not in Aus)

A

Allergy to beef, pork and lamb via development of IgE to galactose alpha 1,3 galactose –> urticaria/angioedema 3-5 hours after eating red meat

34
Q

What does the rhipicephalus tick look like (in Australia)

A

Brown with brown legs, teardrop shape, hard dorsal plate

35
Q

What is the paralysis tick in australia

A

Ixodes holocyclus

36
Q

What do the Ixodes ticks look like

A

Small inornate brown cutum, large soft cream coloured engorged abdomen
Short anterior mouthpart
Prominent broad antennae
U shaped ventral groove with apex anterior to anus
(I think holocyclus just looks all brown)

37
Q

Latin name for dust mite

A

Euroglyphus maynei

38
Q

How to collect mites for microscopic examination

A

Clear with lactic acid or alctophenol (may take days), wash with water and mount on Hoyers medium
Alternatively just mount live or alcohol fixed mites in Hoyer’s medium or Live mites in Permount

39
Q

What rash do mites cause

A

Papular, papulovesicular, bullous, urticarial, morbilliform

Chigger bites: lower legs, skin at edges of underwear, genital region

40
Q

Clinical signs of Chigger bites

A

Intensely itchy, particularly in those sensitized
Grouped papules, vesicles or bulale on lower extremities where elastic meets skin
Summer penile syndrome: seasonal penile swelling, pruritis and dysuria seen in children wtih hypersensitivity

41
Q

Latin name for red back spider + clinical features and treatment

A

Latrodectus hasselti
Skin: erythema, oedema, sweating and piloerection (secretes latrotoxins that act by depolarizing neurons), extra-c: painful mm spasms
Rx: benzos, IV calcium gluconate to prevent tetany, antivenin

42
Q

Which funnel web spiders are endemic to Australia and what’s wrong with them

A

Tegenearia Hadronyche and Atrax: produce potent neurotoxins: pain, puncture marks, redness, bleeding, autonomic excitation: diaphoresis, hypersalivation, brady or tachycardia, hypertension and neuromuscular sx

43
Q

Scorpion clinical manifestations and treatment

A

Pain out of proportion
Can get cardiorespiratory manifestations: cardiogenic shock, APO in those < 10 years (?must be renal excretion)
Antivenin and supportive care for rx
For minor: ice

44
Q

What do centipedes clinically cause

A

Pain, erythema and oedema, and bleed ++ and paraesthesia

If ingested can be toxic

45
Q

What do millipedes cause

A

Chemical ICF, can cause brownish skin discolouration

46
Q

Clinical signs of bed bugs

A

Red-brown faecal staining and nit like ova on mattress seams
Pruritic, erythematous, oedematous papules, sometimes with a visible central haemorrhagic punctum
Clinical appearance and duration of lesions varies depending on individuals degree of sensitisation
Some individuals have little or no reaction to bedbug bites - so some family members are fine
Breakfast lunch and dinner
Wake up with new lesions, but can take several days to appear, latency tends to decrease with exposure
Does not transmit infections

47
Q

Bed bug pathogenesis

A

Reaction results from immune response to salivary proteins
Bedbugs digest their meals very slowly, the blood in the bug’s gut remains relatively unclotted and is not membrane bound

48
Q

Bed bug treatment

A

Eradication of bedbugs from infested homes is difficult: requires exterminators
Other: heating/seeaming, freezing, elimination of cracks and crevices

Derm (57 decks)

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