Derm 2

Question 1

early: myalgia, edema eyes & hands; late: coma, cerebral edema, ARDS. tx?

Answer 1

rocky mtn spotted fever. doxy 100mg bid, 2.2mg/kg peds, chloramphenicol for preg but terato 3rd semester -> gray baby

Question 2

diffuse macular erythroedema, desquam esp palm/sole, 3+ organ system, conjunctivitis

Answer 2

toxic shock syndrome

Question 3

staph vs strep toxic shock tx. strep toxic shock is more painful

Answer 3

yep

Question 4

rapid progressive inflam nec of subq tissue usually LE, abd, perineum; d/t DM, PVD. Type I-III. dx?

Answer 4

nec fasciitis. LRINEC, dishwater pus, creptius, dusky purple

Question 5

morbilliform rash on face -> UE -> LE (almost all over), facial edema, fulm hep, transaminitis, eos, latent or new HH6

Answer 5

DRESS

Question 6

drugs triggering SJS/TEN. signs present?

Answer 6

sulfonamides, aromatic anti-epi, allopurinol, NSAIDs, lamotrigine, antiretroviral nevirapine. +Nikolsky & absoe

Question 7

lightning strikes can cause?

Answer 7

lichenburg figures, keraunoparalysis, stunt medullary resp center -> prolonged apnea, asystole, TM rupture, reverse triage

Question 8

how to tx alk/acid burns? what about HF?

Answer 8

lots of irrig, call Poison Ctrl. hypoCa2+ & Mg+; tx w/ Ca2+ gluconate

Question 9

f/u for dog/cat bites?

Answer 9

cat bites = puncture wound -> more likely to get infected; rabies/tetanus, irrig, debride, amox/clav

Question 10

painful & pruritic bite bc piercing thru skin but same rxn as mosquitoes vs tx w ice, analgesics, abx if 2o infxn, ana prn vs tungiasis -> burrows into skin & lays eggs; tx w excision

Answer 10

flies vs ants vs sand flea

Question 11

neurotox in saliva -> paralysis, alopecia; +/- dorsal shell vs lays eggs in stratum corneum; from personal contact, sex, fomites vs immunocomp/HIV, dirty hyperkeratosis, highly contagious

Answer 11

ticks vs scabies vs Norwegian scabies

Question 12

neurotox opens Na+ channels -> constand depol -> pain/paresthesia, SLUDGE, cranial n palsy vs a-iatrotox, painful bite, SLUDGE vs central blister w/ nec surrounded by blanched skin

Answer 12

scorpions vs black widow vs brown recluse

Question 13

dry bite; irrig, tetanus, serial exams vs dry bite, resp mm paralysis; antivenom

Answer 13

pit viper vs coral snake

Question 14

dx & tx hyper vs an vs bromhidrosis

Answer 14

Minor starch test. OTC perspirant, AlCl3 6H2O, botulinum, thermolysis, glycoporrolate, clonidine vs skin punch bx. underlying, ctrl primary heat exposure vs clinical. freq washing, deodorant, clean/dry clothes, botulinum

Question 15

dz to dx w/ PCR. sx vs dx vs tx chromoblastomycosis. what can grow on CHROM agar?

Answer 15

shingles, mpox, HSV1/2. trauma site, lymph stasis/edema, can progress to SCC vs KOH then histo/cx -> sclerotic medlar bodies/copper pennies vs itraconazole +/- flucytosine. candida

Question 16

punched out ulcers that are painful & heal slowly, by staph/strep, high temp/humid, LE on children & neglected elderly tx w/ Keflex or diclox

Answer 16

ecthyma