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Master PA Deck > CM: Derm - Skin (Systemic and fungal) Infections > Flashcards

CM: Derm - Skin (Systemic and fungal) Infections Flashcards

1
Q

Roseola (Other names)

A

Exanthem subitum or sixth disease

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2
Q

Roseola (cause)

A

Human herpesvirus (HHV-6)

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3
Q

Roseola (symptoms)

A

Sudden high fever lasting 3-5 days followed by an erythematous (morbilliform) maculopapular rash that begins on the trunk and spreads to the neck and legs lasting hours to days. No other symptoms.

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4
Q

Roseola (population)

A

Children 6 months to 4 years, most commonly under age 2 years

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5
Q

Rubeola (other names)

A

Measles

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6
Q

Rubeola (symptoms)

A

Fever accompanied cough, coryza (stuffy nose), conjunctivitis followed by a maculopapular rash that begins on the head and spreads to the trunk and extremities. May experience extreme lethargy, weakness, decreased appetite, difficulty breathing, and periocular edema.

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7
Q

Rubeola (unique characteristics)

A
  1. Koplik spots 2. Rash begins at hairline/ears and spreads head to toe 3. Rash leaves faint-brown stain after fading around day 6
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8
Q

Koplik spots

A

2 to 3 mm gray-white raised lesions on erythematous base of the buccal mucosa

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9
Q

Rubeola (communicated)

A

Airborne, often inhaled

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10
Q

Varicella (other names)

A

Chickenpox, shingles

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11
Q

Varicella (cause)

A

varicella-zoster virus (VZV) (HHV-3)

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12
Q

Varicella (shingles development)

A

Virus remains dormant in basal root ganglia until activated during a period of immunosuppression. Presents as neuropathic pain then rash that follows dermatomal patterns.

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13
Q

Varicella (rash cycle)

A

Rash evolves from papular (hard to see) to vesicular. Vesicles only last 4-6 hours before becoming pustular and rupturing to form a crust. Crust disappears in about 2 weeks.

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14
Q

Varicella (shingles unique characteristics)

A

Rash follows dermatomal lines (likely one sided)

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15
Q

Varicella (symptoms)

A

Fever, rash, headache, fatigue, loss of appetite, itching, sore throat

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16
Q

Hand-Foot-Mouth Disease (cause)

A

Coxsakievirus A16

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17
Q

Hand-Foot-Mouth Disease (communication)

A

Direct contact with body fluid (virus contained in saliva, tears and blister fluid)

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18
Q

Hand-Foot-Mouth Disease (Treatment)

A

Only supportive care

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19
Q

Varicella (Treatment)

A

Anti-viral medication, supportive care

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20
Q

Hand-Foot-Mouth Disease (symptoms)

A

Rash with vesicle lesions in the mouth (on the tongue and anywhere in the oral mucosa), palms of hands and feet Pain in lesions with older patients

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21
Q

Hand-Foot-Mouth Disease (immunity)

A

Immunity is developed with first exposure, will not reoccur

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22
Q

Fifth’s Disease (Name)

A

Erythema infectiosum, slapped-cheek disease

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23
Q

Fifth’s Disease (cause)

A

Parvovirus B19

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24
Q

Fifth’s Disease (population)

A

predominantly children 5-15 years old during winter and spring

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25
Q

Fifth’s Disease (transmission)

A

Respiratory secretions

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26
Q

Fifth’s Disease (symptoms)

A

Fever, respiratory symptoms and rash with “slapped cheek” appearance (fiery red maculopapular rash). Lesions will be warm and sometimes pruritic. Lesions will appear of extensor surface of extremities in 1-2 days and will involve the trunk, neck and buttocks. Palms/soles will be spared rash.

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27
Q

Fifth’s Disease (unique characteristics)

A

Extremely dangerous to pregnant women; can cause fetus to develop hemolytic anemia

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28
Q

Fifth’s Disease (complications)

A

Can cause the development of hemolytic anemia in children and fetuses Can cause development of arthritis in adults

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29
Q

Fifth’s Disease (immunity)

A

Immunity is developed with first exposure, will not reoccur

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30
Q

Fifth’s Disease (diagnosis)

A

Elevated IgM anti-parvovirus antibody

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31
Q

Impetigo (causes)

A

Staph. aureus or group A Strep. pyogenes

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32
Q

Impetigo (treatment)

A

systemic antibiotics and topical antibiotics, gentle debridement of crusts using antibacterial soap and HOT water

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33
Q

Impetigo (symptoms)

A

Honey colored crust, little to no pain

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34
Q

Erysipelas (other names)

A

St. Anthony’s fire

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35
Q

Erysipelas (cause)

A

Strep. A

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36
Q

Erysipelas (treatment)

A

Often need admission and IV antibiotics

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37
Q

Erysipelas (symptoms)

A

Edema, induration (palpable swelling), erythematic (looks like a burn), no distinct edges, enlarged lymph node

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38
Q

Erythrasma (cause)

A

Corynebacterium species

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39
Q

Erythrasma (diagnosis)

A

Coral-red fluorescence under Wood’s Lamp

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40
Q

Erythrasma (symptoms)

A

well-demarcated light brown to red-pigmented patch in hair-bearing or intertriginous areas

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41
Q

Erythrasma (treatment)

A

topical antibiotic (most common: clindamycin)

42
Q

Lyme Disease (cause)

A

Borrelia burdorferi (spirochete)

43
Q

Rocky Mountain spotted fever (cause)

A

Rickettsia rickettsii (Gram negative, coccobacilli/short bacilli)

44
Q

Lyme Disease (cause host)

A

White-tailed deer host the adult tick, white footed mouse host larval and nymph stage

45
Q

Lyme Disease (disease cycle)

A

Tick injects spirochetes into bloodstream. 3-32 days after tick bite, spirochetes replicate and migrate outward to skin, gives the erythema migrans “look” (targetoid rings)

46
Q

Lyme Disease (unique characteristics)

A

erythematous nodule with marked inflammation and a punctate center (targetoid lesion)

47
Q

Rocky Mountain spotted fever (symptoms)

A

Triad: tick bite, fever, rash (very uncommon)

48
Q

Rocky Mountain spotted fever (rash cycle)

A

small pink macules that blanch - deep red papules that do not blanch - hemorrhagic papules/macules

49
Q

EM

A

Erythema multiforme (bacterial)

50
Q

TENS

A

Toxic epidermal necrolysis syndrome (bacterial)

51
Q

SJS

A

Stevens-Johnson Syndrome (bacterial)

52
Q

SSSS

A

Staphylococcal scalded skin syndrome (bacterial)

53
Q

SSSS (unique characteristic)

A

Never involves the mucous membranes

54
Q

EM (complications)

A

Can develop into TENS/SJS at any time

55
Q

EM (Cause)

A

Drugs or viruses but can also be idiopathic

56
Q

SJS (Rash cycle)

A

Starts with vesicles that look like target lesions but crust in the center. Before lesions progress, a very small vesicle forms then the fluid of vesicle will rupture and form a crust. During this time, the patient will complain of their skin hurting.

57
Q

SJS (Treatment)

A

Lamictal or Bactrim

58
Q

TENS (Unique characteristics)

A

More severe form of SJS that is classified by amout of body surface involvement 90% mortality rate

59
Q

TENS (symptoms)

A

Niklosky sign, desquamation of skin

60
Q

Niklosky sign

A

Skin finding in which the top layers of the skin slip away from the lower layers when rubbed

61
Q

SSSS (cause)

A

Staph. aureus

62
Q

SSSS (disease cycle)

A

Staph. aureus produces an exfoliative exotoxin (Exotoxin A&B). The serine proteases bind to the cell adhesion molecules and causes epidermolysis at the stratum corneum and stratum granulosum junction.

63
Q

SSSS (population)

A

Newborns to 2-6 years (common in neonatal period)

64
Q

Tinea Corporis (cause)

A

overgrowth of fungi that thrive on skin keratinocytes located on body

65
Q

Tinea Cruris (other names)

A

Jock itch

66
Q

Tinea Capitis (symptoms)

A

itchy scalp with patchy hair loss (though hair loss not required)

67
Q

Tinea capitis (diagnosis)

A

pull hair from the center of the area of alopecia and lay hair in culture medium. The bulb of the hair contains greatest fungal yield

68
Q

Tinea pedis (other names)

A

athlete’s foot

69
Q

Tinea pedis (three types)

A
  1. Plantar mocassin type 2. Interdigital type 3. Vesiculobullis type
70
Q

Tinea pedis (Vesiculobullis characteristics)

A

Most rare, secondary to aggressive T cell response to fungal elements, blisters and bullae

71
Q

Tinea pedis (Interdigital characteristics)

A

Most common between D4 and D5. If maceration is present, likely fungal infection even if other symptoms are missing.

72
Q

Tinea Manuum (other names)

A

two foot one hand disease

73
Q

Tinea Manuum (symptoms)

A

rash uniformly on one hand (and commonly on feet, particularly between toes and on soles)

74
Q

Tinea versicolor (other names)

A

pityriasis versicolor

75
Q

Tinea versicolor (cause)

A

Malassezia furfur (normal flora that overgrows) interferes with melanocyte function due to overreaction of immune system

76
Q

Tinea versicolor (symptoms)

A

hypopigmented oval patches located on the chest, neck and back

77
Q

Tinea versicolor (treatment)

A

UV light (improves pigmentation)

78
Q

Tinea versicolor (diagnosis)

A

KOH (sodium hydroxide test) will appear as broad hyphae with budding clusters of cells

79
Q

Tinea versicolor (unique characteristics)

A

“spaghetti and meatballs” appearance on KOH

80
Q

Candidiasis (other names)

A

Monilia

81
Q

Candidiasis (cause)

A

overgrowth of normal yeast (commonly Candida Albicans) flora

82
Q

Candidiasis (symptoms)

A

Beefy red rash with multiple satellite regions commonly in the groin, axilla, underneath breasts and between abdominal flaps

83
Q

Candidiasis (diagnosis)

A

KOH shows pseudo hyphae fee with budding spores

84
Q

Onychomycosis (cause)

A

Fungal elements invade keratin of nail itself and remains there

85
Q

Tinea capitis (treatment)

A

Must be treated with oral anti-fungal medication

86
Q

Onychomycosis (unique characteristics)

A

If infecting fingernails, generally involves all ten. If infecting foot, can involve just one or two.

87
Q

Onychomycosis (treatment)

A

Topical antifungal; if in the foot, treat tinea pedis first then onychomycosis

88
Q
A

Roseola

89
Q
A

Varicella

90
Q
A

Rubeola

91
Q
A

Koplik Spots

92
Q
A

Hand-Foot-Mouth Disease

93
Q
A

Toxic Epidural Neurolysis

94
Q
A

Staphylococcal Scalded Skin Syndrome

95
Q
A

Lyme Disease

96
Q
A

Impetigo

97
Q
A

Candidiasis

98
Q
A

Erythema Multiforme

99
Q
A

Erysipelas

100
Q
A

Erythasma

101
Q
A

Rocky Mountain Spotted Fever

102
Q
A

Fifth’s Disease

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