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Emergency Med > Derm > Flashcards

Derm Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Things that must be documented by ED in a derm complaint

A

distribution, pattern, arrangement, morphology, extent, evolutionary changes

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2
Q

rash to flexor surfaces DDx

A

atopic dermatitis, candidiasis, eczema

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3
Q

sun exposure pattern rash ddx

A

sunburn, photosensitive drug rxn, SLE, viral exanthem

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4
Q

rash to distal extremities ddx

A

viral exanthema, atopic dermatitis, contact dermatitis, eczema, Rocky mountain spotted fever, gonnococemia,

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5
Q

rash to front and back of chest ddx

A

pityriasis rosea, syphilis, drug eruption, psoriasis

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6
Q

clothing covered distribution rash ddx

A

contact dermatitis, psoriasis, folliculitis

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7
Q

aciniform rash ddx

A

acne is the main one

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8
Q

Viral exanthems that start distal

A

erythema multiform, secondary syphillis, meningococcemia, dengue fever

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9
Q

conditions that you want to consult derm BEFORE you start the pt on steroids

A

erythema multiform, toxic epidermal necrolyisis and vasculitis

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10
Q

contraindications for PO steroids

A

DM, HTN, active PUD, psych disease, immunodef.

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11
Q

Area where silver sulfadiazine cannot be applied

A

the face! it will stain the face.

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12
Q

the least potent topical steroid

A

hydrocortisone. safe for face, finger, toes and no goes. and for kids.

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13
Q

the most potent topical steroid

A

Clobetasol or Halobetasol

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14
Q

medium potency topical steroids

A

Betamethasone, Triamcinalone, Fluticasone

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15
Q

steroid formulation that cannot be used in pregnacny

A

fluorinated formulations

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16
Q

conditions that require high potency steropid

A

psoriasis, severe eczema, severe poison ivy, severe atopic dermatitis

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17
Q

conditions that require moderate potency steroid

A

atopic dermatitis, stasis dermatitis, Tinea, seborrheic dermatitis, scabies

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18
Q

in genreal, 9 grams of topical steroid will cover

A

9% of body surface area for 1 day if applies 3x.day

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19
Q

amount of topical steroid that should be Rx in the ED

A

only enough for 2-3 days worth because they need follow up with derm/PCP

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20
Q

Wound and laceration things to worry about in the ED

A
  1. cosmesis
  2. Pain
  3. Infection
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21
Q

C/I for lidocaine with epi

A

fingers, toes, nose, and no-goes

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22
Q

most common suture used in ER

A

Nylon or proline, monofilament

23
Q

suture in the face should be removed when?

A

3-4 d kids, 3-5 d adult

24
Q

suture in the neck should be removed when?

A

2-3d kid 3-4 d adult

25
Q

suture in the UE should be removed when?

A

7-10 d

26
Q

suture in the hand should be removed when?

A

10-14 d

27
Q

suture in the chest should be removed when?

A

7-10 d

28
Q

suture in the back should be removed when?

A

10-14 d

29
Q

suture in the legs should be removed when?

A

8-10d

30
Q

suture in the foot should be removed when?

A

10-14d

31
Q

suture over a joint should be removed when?

A

10-14d

32
Q

wound with the highest risk of infection

A

puncture wound and animal bites (cats > dogs)

33
Q

Tx for puncture/animal wound

A

IRRIGATION. allow for primary closure and do not give prophylactic abx if it is not a high risk plantar wound, but do give tetanus if indicated

34
Q

Abx prophylaxis for animal/human bites

A

Augmenting

35
Q

Utility of soaking wounds

A

NONE

36
Q

Utility of specific solutions to irrigate

A

NONE. water works just fine.

37
Q

Irrigation guidelines

A

35cc syringe with 19g needle. Be sure to use universal precautions and avoid splashing.

38
Q

If had primary tetanus series and have had last dose within 5-10 years and you have a major wound

A

you need vac. booster

39
Q

If had primary tetanus series and have had last dose within 5 years and you have a major wound

A

dont need anythign

40
Q

If had primary tetanus series and have had last dose >10 years and you have a major wound

A

you need vac booster

41
Q

if you have less than 3 tetanus series or are not sure and you have a minor wound

A

get tetanus vac. booster

42
Q

if you have less than 3 tetanus series or are not sure and you have a major wound

A

give tetanus immunoglobulin and vaccine

43
Q

S/Sx of black widow bite

A

redness and swelling (20-60min), pain and cramps (20-40min)

44
Q

Tx options for black widow bites

A

Lyovac antivenin, benzos, opiates

45
Q

S/Sx brown recluse bite

A

Bulls eye pattern, bluish discoloration, skin necrosis, pain (2-8 hrs)

46
Q

tx options for brown recluse bite

A

Dapsone to halt tissue necrosis

47
Q

Tx for urticaria

A

OTC cortrizine, ranitidine or cimetidine or steroids up to 1 week for severe

48
Q

Tx for Contact dermatitis

A

remove offending agents, topical baths, OTC antihistamines, Hydracortazone of kenalog cream.

49
Q

poison ivy steroid dose

A

can give 30-80mg/day of prednisone taper x 21 days for severe

50
Q

PUP tx

A

high potency steroid, oral antihistamine. Can consider PO steroid

51
Q

Tx for abscess

A

incision and drainage at bedside. Send home with bacterium X7-10 d if cellulitic or fever

52
Q

Tx for mild cellulitis

A

PO outpatient Clindamycin or Cephalexin

53
Q

Tx for cellulitis with systemic signs

A

admit to hospital for IV Ceftriaxone. If severe do IV vanco + Zosyn

Emergency Med (10 decks)

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