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Preventive And Social Medicine II > CN4 Scabies > Flashcards

CN4 Scabies Flashcards

1
Q

Serpiginous; linear track which is a few mm long and slightly black dot visible on one end

A

Burrow

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2
Q

Where are scabies burrows commonly located?

A

Fingers, palms, and around the wrist

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3
Q

What is the etiologic agent of scabies?

A

Mite Sarcoptes scabies var. hominis

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4
Q

How long are adult mites?

A

0.3-0.4mm long

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5
Q

Measures 0.4mm in length
Has four sets of legs

Has a hemispheric body mark by transverse corrugation,
brown spines and a vessel on the dorsal surface

A

Female adult mite

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6
Q

Life cycle of scabies

A

Mating –> gravid female burrow into the most superficial layer –> lays eggs 1-3/day –> larva hatches 3-5 days before leaving the burrow –> nymph molts in 4-6 mos –> mature in abt 2-3 wks

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7
Q

Especially in children

Chronic skin condition characterized by eczematous, itchy, honey crusted, scaled plaques

A

Atopic/Seborrheic dermatitis

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8
Q

Lichenification in flexural areas in children and adult

A

Atopic/Seborrheic dermatitis

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9
Q

Common afflictions in children characterized by persistent papules and are often excoriated and crusted accompanied by pruritus

A

Arthropod bites

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10
Q

Common afflictions in children characterized by persistent papules and are often excoriated and crusted accompanied by pruritus

A

Arthropod bites

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11
Q

Considered particularly in the crusted variety

A

Psoriasis

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12
Q

Common skin condition in which hair follicles become inflamed. It’s usually caused by a bacterial or fungal infection. At first it may look like small red bumps or white-headed pimples around hair follicles

A

Folliculitis

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13
Q

What does the first sign of infestation consists of?

A

• 1-2 mm red papules

- some are excoriated, crusted, or scaly

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14
Q

A latent period of how many months follows an initial infestation?

A

1 month

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15
Q

On reinfection, reaction to mic antigens are noted within how many hours?

A

1 hr

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16
Q

Intermittent that worsens after bathing or undressing and in bed at night

A

Severe pruritus

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17
Q

What are the classic lesion but may not be seen in infants?

A

Threadlike burrows

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18
Q

In ink burrow test a drop of what on a lesion should be placed

A

Mineral oil

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19
Q

When gently scraping away epidermis beneath it, what blade should you use?

A

No. 15 blade

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20
Q

Positive Ink burrow test

A

(+) mite, scybala (mite feces), or ova under LPO

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21
Q

Can the mite still be transmitted after 24 hours post-treatment?

A

Unlikely

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22
Q

What complications of untreated scabies may lead to?

A 
Eczematous dermatitis
Impetigo ecthyma
Folliculitis
Furunculosis
Cellulitis
Lymphangitis
Id reaction/autoeczematization
Streptococcal glomerulonephritis
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23
Q

Drugs that are used against parasites in human beings

A

Pediculocides and miticides

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24
Q

What is the best known anti ectoparasitic medication?

A

Lindane (Gamma benzene hexachloride; Kwell; Scabene)

25
Q

The mixture lindane is applied in a thin layer over the entire cotton surface (from the neck down 30 grams cream for an adult) and is not removed for how many hours?

A

8-12 hrs

26
Q

Why can’t lindane be used for pregnant, nursing women, and infants?

A

Neurotoxic effect (rare)

27
Q

What is slightly more effective scabicide than lindane but is more expensive?

A

Permethrin 5% cream (Acticin; Elimite)

28
Q

What is a better alternative for infants?

A

Permethrin 5% cream (Acticin; Elimite)

29
Q

What is poorly absorbed, rapidly metabolized by tissue esterases therefore very low toxicity?

A

Permethrin 5% cream (Acticin; Elimite)

30
Q

What is an alternative therapy for infants younger than two months, pregnant and nursing women?

A

6-10% Precipitated Sulfur

31
Q

What is applied nightly for three nights from neck to toes?

A

6-10% Precipitated Sulfur

32
Q

Messy, malodorous, stains clothing and commonly causes irritant dermatitis

A

6-10% Precipitated Sulfur

33
Q

What is not recommended because of lack of efficiency but it is available for topical application 10% cream?

A

Crotamiton (N-ethyl-o-croronotoluidide; Eurax)

34
Q

This is applied five successive nights and washed of 24 hours after last use

Paradoxically the preparation also has anti pruritic properties

A

Crotamiton (N-ethyl-o-croronotoluidide; Eurax)

35
Q

Untoward effects include occasional irritation especially on inflamed skin or when applied over a long period of time; can also cause sensitization

A

Crotamiton (N-ethyl-o-croronotoluidide; Eurax)

36
Q

Untoward effects include occasional irritation especially on inflamed skin or when applied over a long period of time; can also cause sensitization

A

Crotamiton (N-ethyl-o-croronotoluidide; Eurax)

37
Q

What is used in dermatology to treat pruritus?

A

Oral antihistamines

38
Q

In oral antihistamine what does not cause edition and are as effective as the older h1 blockers?

A

Newer h1 receptor blockers (second generation)

39
Q

What are highly selective h1 receptors that are Piperidines (prototype: Terfenadine) H1 antagonists of this class (2nd generation) include

A

Terfenadine (Seldane)
Astemizole (Hismanal)
Loratidine (Claritin)

40
Q

What does the drug do to your body AKA pharmacodynamics? Pipedrines

A

H1 antagonists suppress the itchiness caused by the release of histamine

41
Q

What does the body do to the drug AKA pharmacokinetics? Pipedrines

A
  • rapidly absorbed from the GI tract and metabolized in the liver to active metabolized by hepatic microsomal P450 system
  • peak plasma concentration achieved in 2-3 hours
  • effects lasts 4-6 hrs
  • cannot cross the BBB
42
Q

What are the untoward effects of piperidines?

A
  • CNS: dizziness, tinnitus, lassitude, fatigue, incoordination, blurred vision, diplopia, euphoria, nervousness, tremors, and insomnia
  • GI tract: loss of appetite, nausea, vomiting, epigastric distress, and constipation or diarrhea
43
Q

What is an active metabolite of hydroxyzine and acrivastine?

A

Piperazine (Cetirizine hydrochloride)

44
Q

What is well absorbed from the gastrointestinal tract but primarily excreted renal e in the unmetabolized form?

A

Piperazine (Cetirizine hydrochloride)

45
Q

What may alleviate pruritus dt hypersensitivity to mite antigens which may persist for a number of days?

A

Topical glucocorticoids

46
Q

What may be used to relieve pain and itching due to insect bites, minor cuts and burns, and to resolve rashes due to an allergy?

A

Topical antihistamines

47
Q

Scabies causes a diffuse, pruritic eruption after an incubation pd of how many weeks?

A

4-6 weeks

48
Q

pearl-like, translucent,
white, eyeless, and oval in shape with four pairs
of short stubby legs. The adult female mite is 0.4 ×
0.3 mm with the male being slightly smaller—just
slightly too small to be seen by the naked eye

A

scabies

49
Q

The scabies mite is able to live for __ days away from the host
in a sterile test tube, and for __ days if placed in mineral
oil mounts.

A

3 days away fr host;
7 days in mineral oil mounts

50
Q

What is the definitice diagnosis of scabies?

A

microscopic identi”cation of the scabies mites, eggs, or fecal pellets
(scybala)

51
Q

Pathognomonic lesion

A

Burrow

52
Q

DDx of Scabies

A

Most Likely
Atopic dermatitis
Dyshidrotic eczema
Pyoderma
Contact dermatitis
Insect bite reaction

Consider
Dermatitis herpetiformis
Psoriasis
Bullous pemphigoid
Drug eruption
Systemic causes of pruritus
Delusions of parasitosis

53
Q

scabies infestation can also trigger

A

bullous pemphigoid

54
Q

Oral antihistamines

A
  • Piperadine (Terfenadine, Astemizole, Loratidine) Terfe & Astemizole not recommended bcs potentially fatal - alternative: Fexofonadine
  • Piperazine
55
Q

Erythematous, scaling, papules and plaques

A

Psoriasis

56
Q

Marked thickening, NONpurritic and crusting of the skin

A

?????

57
Q

Folliculitis etiology

A

S. aureus

58
Q

Etiology of Seborrheic dematitis

A

Malassezia furfur

59
Q

Well-demarcated red plaques w white scaly surfaces and bleeding points localized on elbows and knees

A

Psoriasis

Preventive And Social Medicine II (32 decks)

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