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Dermatology path > Bugs/stings/bites > Flashcards

Bugs/stings/bites Flashcards

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Dermatology Board Prep flashcards
1
Q

Location/transmission/presentation of American trypanosomiasis chagas disease

A

central and south america, Texas, florida;
transmission: T. cruzi infected reduviid bugs and infected blood
Present: systemic=> ANS, heart, GI

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2
Q

What sign is associated with American trypanosomiasis chagas disease? describe it

A

Romana sign=> edema of palpebral and periocular tissue from entry through conjunctiva

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3
Q

What is the life cycle of T. cruzi?

A

T. cruzi in feces of reduviid bug; bite then defecates into bite; T. cruzi enters wound; invades cells and amastigotes (multiplies); amastigotes change into trypomastigotes and enter blood; bug bites infected human again

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4
Q

When is Trypanosoma cruzi cause clinical disease?

A

once the trypomastigotes invade cells and change into amastigotes and multiply

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5
Q

What is the acute phase of chagas disease clincially?

A

localized erythema, LAD; anorexia; facial edema; lower extremity edema
Romana sign

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6
Q

How does chronic chagas disease present clinically?

A

occurs years to decades later with heart and GI manifestations

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7
Q

How is chagas disease treated?

A

Nifurtimox; Benzimidazole

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8
Q

What is the life cycle of Trypanosoma brucei?

A

bite then multiply in the midgut leading to metacyclic form->binary fission to trypomastigote then back to infecting the Tsetse fly again

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9
Q

How does the african trypanosomiasis present clinically?

A

Trypanosome chancre; node enlargement; neurologic manifestations (irritable, personality changes, day time restlessness)

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10
Q

What is the Tx for african trypanosomiasis

A

Suramin; Pentamidine; Eflornithine (CNS, hemolymphangitic)

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11
Q

What causes onchocerciasis (river blindness)?

A

onchocerca volvulus that is transmitted by the simulium black fly causing cutaneous and ocular tissue infestation (blind if chronic)

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12
Q

Who is at risk for Onchocerciasis?

A

humans living in tropical African belt and S. america

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13
Q

How does onchocerciasis present clinically?

A

Subcutaneous nodules over bony prominences; intermittent intensely pruritic dermatitis; microfilariae in conjunctivae cause sclerosing keratits, uveitis, optic atrophy, glaucoma

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14
Q

Onchocerciasis Tx

A

Nodulectomy; Ivermectin;

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15
Q

What is very important to avoid when doing a nodulectomy for onchocerciasis?

A

Mazzotti rxn causing fever, chills from immune response due to a breakup of the organism

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16
Q

Location/transmission/presentation of Tungiasis

A

endemic in Central and South america, caribbean, Africa, pakistan and india;
impregnated female flea burrows causing nodule and erythema;

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17
Q

Tungiasis Tx

A

may spontaneously resolve; early lesions (removal w/ needle); late lesions (excision); apply topicals;
PREVENT: WEAR SHOES

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18
Q

What is cutaneous myiasis?

A

infestation of skin by fly larvae that inhabit skin (scalp, face, forearms, legs)wound or burrow into dermis like a boil => sensation of movement

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19
Q

What is the Tx for myiasis?

A

self limiting that can be suffocated out via bacon

20
Q

How can a person take precaution to prevent human botfly infections?

A

avoid activities that increase risk of myiasis (no wet cloths, no resting on sandy areas, use insect repellent; AVOID BELIZE)

21
Q

Cimicids (bedbugs) have what distinguishing characteristic?

A

feed at night (mattress) by biting in linear groups of 3 (breakfast, lunch, dinner)

22
Q

Name the name and location for the different types of lice

A 
Pediculosis capitis (head lice at schools)
Pediculosis corporis (body lice from war/poor)
Phthiriasis pubis: (pubic lice from sex)
23
Q

What is the life cycle of a louse?

A

female 300 eggs; lives for 30 days; human host blood dinner

24
Q

How is head lice transmitted and treated?

A

transmitted by direct contact or fomites

Tx with 1% permethrin cream rinse and comb to remove nits

25
Q

What are the Sx of body lice and view histologically?

A

Pruritis and give a maculae ceruleae of bluish/brown hemosiderin laden macules

26
Q

Pubic lice from sexual contact is found where and causes what?

A

not limited to pubic areas but can be present in eyebrows, eyelashes, hair and scalp => cause maceulae ceruleae

27
Q

Location/transmission/presentation of scabies

A

world wide;
femal mite scabiei that lives w/in epidermis;
severe pruritus in INTERDIGITAL WEB SPACE, wrist flexors, elbows, penis

28
Q

How is scabies diagnosed?

A

skin scraping demonstrating mites, scybala, eggs

29
Q

What are characteristics of a brown recluse spider?

A

fiddle back; warmer climates; non agressive; not bite unless disturbed

30
Q

If a brown recluse does bite, how will it present clinically?

A

central mottling and blister with blanched halo and erythema;

31
Q

Why is it not good to surgically remove scab from spider bite?

A

toxin will become systemic =>shock, hemolysis, renal insufficiency and DIC

32
Q

What is the pathogenesis of a brown recluse spider bite?

A

Sphingomyelinase D major toxin; interacts with serum amyloid protein; Hyaluronidase allows eschars to spread in gravity dependent fashion

33
Q

What is the best Tx for a brown recluse bite?

A

R.I.C.E. with prednisone

34
Q

What is the characteristics of a Hobo spider?

A

large(4-5cm), hairy aggressive found in dark, moist areas

35
Q

What is the clinical presentation of a Hobo spider bite? Tx?

A

not painful; ensuing necrosis may lead to amputation

Supportive Tx

36
Q

What are the characteristics of the black widow spider?

A

North america, large, shiny spiders with hourglass on abdomen

37
Q

What are the clinical Sx of a black widow spider bite?

A

local erythema, sweating piloerection; venom causes depletion of Ach at release of catecholamines => leads to abdominal pain and muscle spasm

38
Q

Tx for black widow spider bite?

A

IV calcium gluconate, analgesics

39
Q

Lice associated diseases

A

typhus, relapsing fever, trench fever

40
Q

Fleas associated diseases

A

bubonic plague; typhus; tungiasis;

41
Q

budbugs associated diseases

A

possibly HBV

42
Q

flies, mosquitos associated diseases

A

cutaneous myiasis, malaria, yellow fever, dengue fever, viral encelphalitis onchocerciasis, sleeping sickness, West nile fever

43
Q

Reduviid bugs associated diseases

A

chagas disease

44
Q

spiders associated diseases

A

necrotic arachnidisim, paralysis

45
Q

Ticks associated diseases

A

granuloma formation; lyme borreliosis, RMSF, Q fever; tularemia

46
Q

Mites associated diseases

A

hypersensitivity dermatitis; scrub typhus; scabies; rosacea

Dermatology path (11 decks)

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