DERM 3

Question 1

chicken pox symptoms 
infective when 
when can go back into school 
cx
treatment

Answer 1

fever, itch, macules - papules - vesiscles - scabs - recovery

infective 4d before rash and 5d into onset of rash. can go back into school 5d into rash/lesions crusted over

can be life threatening in immunocomp. encephalitis. secondary bacterial. pneumonitis. scarring

vaccinations in susceptible people calcamine lotion. acyclovir 800mg 5 times a day for 7 days in over 14 yo

Question 2

neonatal VZV has a high what
secondary to what
rx

Answer 2

mortality
secondary to chicken pox in mother during pregnancy
vaccination

Question 3

shingles symptoms

treatment

Answer 3

neuralgic pain. vesicles. red. crust. ramsay hunt - otic herpes zoster. facial palsy. irritation of CNs. deafness. vertigo. tinnitus

live attenuated vaccine in over 70s to decrease shingles impact. acyclovir 800mg oral 5 times a day for 7-10 days

Question 4

orf is what 
caused by what 
symptoms 
ix
treatment

Answer 4

virus of the mouth. scabby mouth
paradox virus
firm fleshy node in hands in farmers
clinical diagnosis 
self limiting

Question 5

erythema multiform

Answer 5

erythema. mild = bullseye/target lesion 1-3mm
major = SJS -> mucosal involvement

triggered by infection - HSV, pneumonia
drug reaction

Question 6

lyme disease cause 
early 
late
ix
proph after tick bite
treatment 
in disseminated

Answer 6

ticks

erythema migrans, systemic
HB, nerve palsies, arthritis, meningitis

lab confirmation of late, AB test, blood test

Doxy 200mg single dose in adults

Doxy 100mg BD. Amox in preg

ceftriaxone

Question 7

mallicosum contagious

Answer 7

common in children 
firm umbilicate nodule 1-2mm
can be sexually transmitted 
self limiting 
liquid nitrogen

Question 8

erythema infectosium

Answer 8

slapped cheek syndrome
paravirus B19
cx: spontaneous abortion, chronic in anaemia in immunosuppression, arthritis in wrists common as rash fades in adults

Question 9

HSV first thingy

Answer 9

primary gingovituamitis HSV1
blisters, rash at vermillion border, extensive ulceration around mouth. in preschool children
lasts a week. resolves spontaneously

Question 10

HSV

Answer 10

HSV1 oral lesions 5-% genital. encephalitis

HSV2 more likely to reoccur. 50% genital. disseminated infection. encephalitis

AB tests. swab with viral transport medium

aciclovir

Question 11

warts caused by what
common in who
treatment

Answer 11

HPV 1-4
common in children
topical salicylic acid cryotherapy

Question 12

herpangiomas cause 
who 
symptoms 
ix
treatment

Answer 12

enterovirus
pre school kids
blistering rash at back of mouth/soft palate
swab. stool sample 
self limiting

Question 13

hand foot mouth disease

Answer 13

children family
outbreak common
enteroviruses - coxaschie vA16, enterovirus 71

Question 14

syphilis

Answer 14

primary painless ulcer
seoncdayr - snail track ulcers - rash
tertiary - CNS, CV
blood test. swab of ulcer
penicillin IM

Question 15

staph aureus causes what

how many have it not doing it any harm

Answer 15

cellulitis
impetigo
boils and carbuncles
would infections 
infected eczema
staphylococcal scalded skin syndrome - treat aggressively with IV fluids and ABs

30% of hospital stage carrying SA

Question 16

necrotising fasciitis is what 
symp
type 1
type 2
treatment

Answer 16

bacterial spread below skin surface
acute onset. v painful. rapid
type 1: mixed anaerobes and coliform usually post abd surgery

group A strep pyogenes

urgent surgical debridement and ABs depending - on organism

Question 17

group A strep

Answer 17

cellulitis, impetigo, infected eczema, necrotising fascitis

Question 18

single room isolation and contact precautions

Answer 18

Group A strep
MRSA
scabies

Question 19

scabies incubation period 
symptoms 
treatment 1
2
when should stay out of school

Answer 19

6w
intensely itchy due to type 4 hs, rash affecting fingernails, wrists, genital areas

Permethrin 5% topical rash wash off after 8-14 hours. do again after 7s

benzyl benzoate - not in children - wash off after 24 hours

stay out of school till treatment

Question 20

norweignen scabies

Answer 20

chronic crusted scabies - high infectious elderly/immunocomprimised (HIV)
ivermectin

Question 21

lice symptoms

treatment

Answer 21

phithrus pubic
pedicculus captious - head
pediculus corpus - body

intense rash and pruritus

malathion lotion 0.5%
dimeticone 4%

Question 22

ringworm head
beard
hand
groin
nail
symptoms 
ix

Answer 22

capitus
barbae
maniom
clous
ungular nail
grows outward and heals in centre
clinical appearance - woods lights. skin scarping. nail/hair clipping

Question 23

treatment of ringworm

Answer 23

clotrimazole 1% or miconazole 2%. 1-3 times a day for 10 days
PO therapy needs for lab proof for harder skin of sole and palms. PO terbinafine 250mg OD for 2-6 weeks
nails need lab proof - PO terbinafine 6-12 weeks fingernail 3-6 months toenail

Question 24

candida symptoms
candida intertrigo
ix

Answer 24

red moist skin with ragged peeling edges and possibly pustule/papules at margin

infection in skin folds where area is warm and moist

swab is dc is not clear, bacterial infection, treatment not working, or patient immunocomprimising

Question 25

treatment for candida

Answer 25

topical clotrimazole
steroid cream if itchy/inflam
topical terbinafine
PO floconazole 50mg OD 2-4 weeks - if topical treatment not working, widespread infection or patient imunocomprimised