Cellulitis/Viral Disorders

Question 1

Cellulitis description

Answer 1

Confluent erythema

Significant edema

Warm, affected area

Question 2

Cellulitis treatment

Answer 2

1. Rest and elevate
2. Augmentin or Keflex (antibiotics)
3. X-Ray and culture

Question 3

Erysipelas

Answer 3

Sudden onset cellulitis

Lymphatic involvement (red streaking)

High fever, chills, myalgia, vomiting

Question 4

Pathognomonic symptoms

Erysipelas

Answer 4

Group A strep

Question 5

Erysipelas

Treatment

Answer 5

1. Antibiotics (Penicillin VK, Zithromax, Biaxin)

Question 6

HSV description

Answer 6

Painful, red blisters on genitals

Small, erythematous vesicles

Question 7

HSV detection methods

Answer 7

Tzanck smear

Can be spread with no outbreak (viral shedding)

Question 8

HSV treatment

Answer 8

1. Valcyvlovir and Famciclovir (antiviral) PRN
2. Patient education
3. Chronic suppressive therapy for 1 year (small amount of antiviral ea. Day then switch to PRN)

Question 9

Herpes Zoster/Shingles

Answer 9

Red blistering rash

Erythematous macular rash

Dermatomal pattern

Question 10

herpes zoster/shingles

Pathognomonic

Answer 10

Lesions don’t pass the midline

Pain out of proportion before the flare

Question 11

Herpes zoster/shingles treatment

Answer 11

1. Valcyclovir and Famciclovir (antiviral)
2. Amitryptiline (nerve pain)
3. Pain icontrol

Question 12

Hutchinson’s sign

Answer 12

Vesicles con on side or tip of nose

Can go blind

Found in herpes zoster/shingles

Question 13

Herpes varicella/chicken pox

Answer 13

Small, itchy bolsters

Multiple clear vesicles, crust and pustules

Erythematous base

Question 14

Herpes varicella

Answer 14

Spread by respiratory droplets or direct contact with vesicles

Dew drop on rose petal

Inject 2 days before presentation until all crusted

Question 15

Herpes varicella treatment

Answer 15

1. Antihistamine
2. Antivirals (if not normally healthy)
3. Calamine lotion

Question 16

Condylomata acuminata

Answer 16

Aka genital warts

Caused by HPV

Multiple filiform lesions to anus

Question 17

Condylomata acuminata

Pathognomonic

Answer 17

HPCC

Lesions get agitated before better

Linked to cervical CA

Question 18

Treatment Condyloma Acuminata

Answer 18

1. Iiquimoid cream or Condylox gel (irritant)
2. Cryosurgery

Refer to GI for internal lesions (could be CA)

Question 19

Rosella

Answer 19

Caused by herpes virus

High fever

Small pink macules

Diffusely spread

Question 20

Roseola

Pathognomonic

Answer 20

HSV 6 and 7

Fever breaks and they blood like a rose

Question 21

Roseola treatment

Answer 21

Acetaminophen/Ibuprofen

Recovers nicely

Virus has to run its course

Question 22

hand, foot and mouth disease

Answer 22

painful sores to the hands, feet, and mouth

Buccal mucosa sores

caused by Coxsackie A16 virus

treated with Tylenol and supportive care