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Derm Block 3 Flashcards

1
Q

Staph A morphology and staining pattern

If this microbe infects the skin, what four infections can it cause?

The elaboration of these toxins can lead to ?

A

Gram + Cocci

Cellulitis Impetigo Folliculitits Furuncles

Bullous impetigo
SSSS

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2
Q

? are the secondary invaders of traumatic skin lesions

What four infections can it cause upon infecting the skin?

A

Group A B-hemolytic strep- Gram + Cocci

Lymphangitis Impetigo Cellulitis
Erysipelas

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3
Q

What causes Non-Bullous Impetigo

How does it start and what does if classically look like

This condition is more common in ? PT populations and frequently co-infected w/ ?

A

GABHS

Stratum Corneum pustule, ruptures to honey crusted lesion w/ regional adenopathy

2-5y/o Peds in warm/moist climates
Staph

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4
Q

How is Non-Bullous Impetigo Tx

If ABX are used, what is the purpose of their use

A

Soak, removes crust
Local: Topical Mupirocin
Wide: Diclox/Cephalexin

Prevent acute glomerulonephritis after impetigo

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5
Q

What causes Bullous Impetigo

What PT population is this MC in

How is this form different?

A

Staph impetigo

Infant/adolescent

Less exudative crusting- center collapses w/ tube-like rim

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6
Q

How is Bullous Impetigo Tx

If PTs have recurrent cases of impetigo, what test needs to be ordered?

A

Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex

Staph A carrier, Tx w/ Mupirocin

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7
Q

Cellulitis is a skin infection that extends to ? layer

How does it present

What are the microbe etiologies

A

Into SQ

Erythema Edema Pain

GABHS- MC
Pseudomonas in DM
Staph
H influenza

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8
Q

What parts of the body are more likely to be the portal of entry for cellulitis microbes?

How does cellulitis present in clinic?

A

Compromised areas by stasis/lympedema

Warm Adenopathy Red Tender Swollen w/ poor defined border
Streaks= lymphangitis

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9
Q

How are cellulitis PTs Tx outpatient

How are they Tx inpatient

How are DM w/ Pseudomonas Tx

How are PTs w/ H influenza Tx

A

Compress/Elevate
Diclox/Cephalexin/Clinda/TMP

Nafcillin
Vanc if PCN allergy

Aminoglycosides

Cephalosporin

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10
Q

Define Erysipelas and what microbe causes it

Erysipelas is AKA ?

A

Superficial cellulitis of lymphatics from Strep Pyogene

St Anthoneys Fire

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11
Q

How does Erysipelas present and what makes this presentation different

How is Erysipelas Tx

A

Sharp demarcated, raised plaque w/ pain/erythema on
face, ears, legs after 48hr prodrome

PO: Cephalexin Amox/Diclox
IV: Cephazolin Ceftriaxone

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12
Q

Define Blistering Distal Dactylitis

How is it Tx

A

Superficial infection of anterior finger pad MC 2-16y/o

InD w/ Anti-Strep ABX

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13
Q

Define Folliculitis

What is the MC form of infectious folliculitis

Define Superficial Folliculitis

A

Inflamed hair follicle from infection, chemicals or injury

Staph, common in nares or areas of occlusion

Perifollicular pustules w/ undamaged hair in center

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14
Q

How is folliculitis worked up

How is it Tx

What adjunct can be added for Tx

A

Culture pustule- scrape pustule off w/ 15 blade onto swab

Removal, hygiene
E/C-mycin Diclox Cephalexin

Benzoyl Peroxide (keratolytic, anti-bacterial)

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15
Q

How is persistent/deep folliculitis (sycosis barbae) Tx

If folliculitis is in the scalp and present long term, Tx PT for ?

A

Systemic ABX

Folliculitis decalvans

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16
Q

Define Sycosis Barbae

How is it Tx

What is done for PTs that have resistant cases or are Tx failures?

A

Inflammation of whole follicle, Staph Impetigo of beard

Local: Mupirocin
Wide: E/C-mycin Diclox Cephalex

Eval for dermatophyte infection
w/ hair removal, culture

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17
Q

Define Furuncle

Define Carbuncle

Where do both of these have in common?

A

Boil/abscess, walled collection of pus w/ pain

Multi-headed boil, associated w/ cellulitis

Painful perifollicular infections on traumatic areas of skin

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18
Q

How are furuncles/carbuncles Tx

Recurrent furuncles are commonly infected w/ MRSA and Tx w/ ?

How is MRSA furunculosis Tx

A

InD
ABX if cellulitis is present

Mupirocin
Chlorhexidine/bleach bath
Culture dependent: Clinda/TMP

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19
Q

What causes SSSS

Dec function of ? organ allows for toxins to accumulate?

How do the toxins spread in the body?

A

Staph A exfoliative toxins

Dec renal clearance

Hematogenously

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20
Q

SSSS typically starts as ? presentation in kids

What does the prodrome of this syndrome present as

A

Bullous impetigo

Malaise Fever Irritability
Skin tenderness

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21
Q

If mild case of SSSS presents and is going to be Tx on outpatient basis, what ABX are used?

Pseudomonas usually infects ? PTs in ? locations

A

B-lacatm resistant- Diclox, Cephalexin

DM
Warm/moist

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22
Q

What PE finding is indicative of Pseudomonas

What does this smell like?

A

Pyoverdin- light green pigmentation w/ woods lamp

Fruity/grape like

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23
Q

Define Hot Tub Folliculitis

These PTs are at low risk for ?

How are they Tx

A

8hrs-5d after exposure
Pruritic round, urticarial plaques w/ central pustule

Sepsis

Antihistamine PRN
Local- Vinegar soaks
Wide- Cipro

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24
Q

Pseudomonas Cellulitis is usually found in ? PTs

These types of growth are encouraged by presence of ?

How are these PTs Tx

A

Debilitate/DM PTs as secondary infection of tinea

Occlusion
Broad spectrum suppression

Acetic Acid
Aluminum acetate
PO Cipro

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25
Q

Where do Pseudomonas Toe web infections usually present?

How does it present on PE

How are Pseudomonas toe web infections Tx

A

Between 4-5th toe as secondary infection after tinea

Thick white macerated skin, w/ green glow on Woods

Post-op shoe (DM PT)
Acetic acid/Aluminum chloride
Gentamycin cream once dry
PO Cipro- topical Tx failure

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26
Q

What causes Trichomycosis Axillaris

This infection is associated w/ ? and produces ?

A

Corynebacterium, Gram + opportunistic infection

Heavy sweating, malordorous smell w/ white hair

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27
Q

How is Trichomycosis Axillaris Tx

What microbe causes Erythrasma

A

Shave area
Topical Erythro, Clinda Naftifine- fungal infection

Coryn minutissiumum

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28
Q

What are the predisposing RFs for Erythrasma?

A 
APHID HO
Advanced age
Poor hygiene
Humid/warm
ImmSupp
DM

Hyperhidrosis
Obese

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29
Q

? is the MC site for Erythrasma infections to appear

How does Erythrasma appear on PE

What color is it under Woods Lamp

A

4th interdigital space

Macular brown itching scales
Looks like T cruris, does NOT spare scrotum/labia

Coral red

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30
Q

How is Erythrasma Tx

Define Pitted Keratolysis

What are the distinctive features found on PE

A

Erythromycin
Clindamycin
Clarithromycin- severe or refractory

Pits on weight bearing areas of feet from Kytococcus sedentarius

Malodor
Slimy/hyper hydrosis skin

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31
Q

How is Pitted Keratolysis Tx

What med is added if case is unresponsive to topical Txs?

A

TxOC: Topical E/C-mycin, Mupirocin w/ Drysol

PO Erythromycin

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32
Q

Define Wart

What process causes these growths

Typically these are confined to ? and lack ?

A

Beningn epidermal neoplasm from HPV

HPV infection of keratinocytes induces hyperplasia/keratinosis

Epidermis, no roots

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33
Q

How would warts be described in PE

What causes the black dots mislabeled as ‘roots’?

A

Verrucous papule w/ cylinders that fuse= Dx mosaic pattern

Thrombosed vessels trapped in projections

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34
Q

Common Wart is called ? and are MC located ?

How are they Tx

A

Verruca Vulgaris
Hands

Salycylic acid
Imiquimod 5%
Cantharidin (by provider)
LN2

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35
Q

Define Filiform Warts and where are the MC found

How are they Tx

Flat warts are AKA ? and commonly found ?

A

Finger-like projection
Face

Curettage- TxOC

Verruca Plana on shaved areas of body

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36
Q

How are Verruca Plana warts Tx

How are Plantar Warts differentiated from clavi?

How are Plantar Warts Tx

A

Tretinoin cream
Imiquimod
Cryosurgery
5-FU

Llook for black dots/lack of skin lines (corns have skin lines)

Cantharidin LN2 Imiquimod
Pare/soak Salicyclic acid

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37
Q

Define Sub/Periungual wart

Since these types are more resistant to Tx, what can be done?

A

Painful wart next to nail from cuticle biting

Cryosurgery
Cantharidin
Salicyclic acid
Duct tape- last option (6d, 12hr break, 6 more days)

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38
Q

Genital warts are AKA and cause by ?

What preventative measure slows but does NOT prevent spread

How do genital warts appear in clinic?

A

Condyloma acuminata
Veneral warts
HPV 6 11 16 18 52 56

Condoms

Smooth pink w/ projections on broad base

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39
Q

ImmSupp PTs can present w/ ? alternative presentation?

? forms of HPV are the high risk/cervical sup-types

? forms are rarely associated w/ cervical Ca

A

Coalesce into large cauliflower masses

16*, 18

6, 11

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40
Q

How are genital warts Tx by providers/

How are they Tx by PT Tx methods

A 
Podophylin resin
Excision/curettage
Trichloroacetic acid
Cryosurgery
CO2 laser

Podofilox- 4d on, 4-6wks off
Imiquimod- every other day at bed time x 16wks
5-FU- LAST option

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41
Q

? two genital wart DDxs may be seen in 10% of normal male PTs

A

Pearly Penile Papules- angiofibromas on corona

Bowenoid- resemble flat genital warts
Sex transmitted HPV, quasi-premalignant, self resolve

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42
Q

Where is Molluscum Contagiosum commonly seen?

If found ?, suspect abuse

How does it present on PE

A

Kids via autoinnoculation on arms/face

Groin

Dome shaped papules w/ central umbilication, leak caseous material

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43
Q

What is the etiology of Molluscum Contagiosum

How are PTs w/ few lesions Tx

How are PTs w/ multiple lesions Tx

A

DNA Poxvirus

Curette w/ anesthesia- best
LN2

Trichloroacetic acid peel

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44
Q

? is the primary mode of herpes virus transmission

First outbreak usually appears ?days after innoculation and lasts ?

Viral cultures can occur for __ days when PTs present w/ active genital lesions

A

ASx viral shedding x 16 days after outbreak

6d, x 14days

5 days

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45
Q

? is the Gold Standard for Dx of herpes simplex

Why is this same day turn around so important

? form of HSV commonly has Abs found in PTs

A

PCR

Differentiates HSV 1 from 2

HSV-1

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46
Q

How are HSV and zoster PTs managed?

What PT education must go w/ this Rx

? medication is added to anti-viral therapy for herpes labialis

A

F/A/V-clovir <72hrs of onset

Improves/Shortens Sxs, but not curative

Penciclovir
Docosonal

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47
Q

Herpes zoster is reactivated ? and presents uniquely as ?

When is an emergent referral needed?

What vaccines are used for Herpes Zoster prevention

A

Varicella from dorsal root
Single dermatome

Ophthalamic branch of trigeminal d/t corneal blindness risk

Zostavax- live vaccine
Shingrix- recombinent vaccine
50 or older

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48
Q

Define Dermatophytes

Where is their existence limited to on the body?

What are the 3 genera of ringworms?

A

Fungi infecting stratum corneum (keratin layer), hair and nails

Can’t survive on mucosal layers

Microsporum Epidermophyton
Trichophyton

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49
Q

? mycoses infection have minimal, if any, inflammations

? infections commonly have inflammatory responses?

A

T versicolor (pityriasis)
T nigra
B/W piedra

T capitus (head)
T barbae (beard)
T faciei (face)
T corporis (body ring worm)
T cruris (groin, jock itch)
T manuum (hand)
T pedis (foot)
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50
Q

? is the MC mycoses infection of the skin?

Onchomycosis is AKA ?

A

T rubrum

Unguium, nails

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51
Q

What is the mode of transmission of dermatophytes?

How are these infections Dx

A

Human to human
Animal to human
Soil to human
Fomites

KOH Prep
DTM culture (red= +)
Woods lamp

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52
Q

Typically dermatophytes don’t have fluorescence response under Woods Lamp except for ?

How are superficial lesions from T Corporis Tx

How long are PTs to continue Tx?

A

T versicolor

Clotrim/Micon/Ketocon-azole

Continue x 7d after erythema resolves

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53
Q

What meds are used for T corporis if case is extensive/deep?

What med is reserved for Peds Tx?

A

Terbinafine
Itraconazole
Fluconazole

Griseofulvin

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54
Q

How are cases of T pedis Tx if interdigit presentation?

How is it Tx for moccasin presentations?

A

Topical: Terbinafine Clotrimazole

PO: Fluconazole Itraconazole
Terbinafine

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55
Q

T manuum is more common in ? and Tx as ? due to ?

T barbae is Tx w/ ?

T faciei is Tx w/ ? unless ?

A

MC men
Same as T pedis
2:1 ration presentation

PO agent only

Topicals unless near eyes

56
Q

T cruris usually presents ? on the body

How is T Cruris Tx

What PT education needs to go w/ these Tx

A

Scrotum/Labia
Eyrthrasma does not spare

Tx of fungal and candidia:
C/M/K-azole

2wks, 2cm past borders

57
Q

T capitis is more frequent in kids and can present in ranges from ? to ?

Of the 4 patterns of infection ? type is MC

How is this Dx and Tx

A

Scale/broken-Alopecia

Black dot type- hair broken at orifice

Gauze, Tooth brush
Kids: Griseofulvin
Adults: Griseofulvin Itraconazole Terbinafine

58
Q

Inflammatory T Capitis cases are called ? and presents as ?

What abnormal lab result would be seen

How is it Tx

A

Kerion
PAIN inflammation w/ tender/boggy nodules that drain

Negative KOH

PO Griseofulvin/Terbinafine

59
Q

Define T incognito

How does it present

Where is it MC seen on the body

A

Fungal infection Tx w/ topical steroids

Inflammation improves while fungi flourish

Groin Face Dorsal hands

60
Q

Candidiasis becomes pathogenic w/ damage to ? layer of skin

Can also become pathogenic if ? pre-existing conditions are present

A

Stratum corneum

Pregnant

DM
ImmSupp
ABX therapy
Topical steroids
OCPs
Maceration
61
Q

What are the 4 possible morphologies/distributions of candidiasis?

? lesions are a classic presentation for candidiasis

A

PO- thrush
Angular chelitis
Vulvovaginitis
Intertriginous

Satellite

62
Q

How is Candidiasis Dx

How is this Tx

How is it Tx if PT is pregnant

A

KOH- pseudohyphae w/ budding spores

Fluconazole

Clotrimazole
Miconazole
Nystatins

63
Q

How is Oropharyngeal candidiasis Tx

How is angular chelitis Tx

A

Nystatin (Peds)
Clotrimazole troche
Fluconazole

Topica antifungal then,
Group 5 steroid, d/c when inflammation is gone

64
Q

How is Candidiasis intertrigo, diaper/balantitis cases Tx

What causes Pityriasis/Tinea Versicolor

Where is it found in the body?

A

Topical M/K/C-azoles

Pityrosporum orbiulare and P Ovale growth

Highly sebaceous areas: stratum corneum/hair follciles

65
Q

What causes Pityriasis Versicolor yeast to change?

What is the changed form called?

A

Hot/humid climate

Budding form into mycolele form

66
Q

How does Pityriasis Versicolor present?

What causes PTs to present to clinic?

A

Rapidly enlarging round macules of various color, turn darker LPP and darker in DPP

ASx w/ itch during inflammation
Appearance concerns

67
Q

MC site of Pityriasis Versicolor

What other parts of the body may be affected?

Where are outbreaks MC seen in kids?

A

Mid chest, Upper back

Antecubital fossa
Neck
Extensive eruption- upper arm/lower face

Face

68
Q

How is a Pityriasis Versicolor presentation different from a Pityriasis Rosia presentation?

How are these cases Dx

A

No Herald patch

Woods lamp accentuates altered pigmentation

KOH- short, borad hyphae in clusters, ‘spaghetti, meatballs”

69
Q

How is Pityriasis Versicolor Tx?

What is used to prevent reoccurences?

A 
Limited dz w/ topicals: 
Ketoconazole shampoo 
Selenium sulfide 
Extensive dz w/ POs: 
K/I/Fluconazole

Ketoconazole 2% shampoo preents re-occurrences

70
Q

Define Sporotrichosis

What PT populations are most likely to have this condition?

A 
Saprophytic funus (Sporothrix) in SQ tissue,
MC, least serious deep infection

Florist Farmer Hunter

71
Q

How does Sporotrichosis present

What is the MC site?

A

Painless papule/ulcer that increases in number over wks

Finger

72
Q

How is Sporotrichosis Dx

How is it Tx

A

Punch/excision biopsy for stain and culture

Itraconazole x 3-6mon

73
Q

What are the 3 types of hair

A

Terminal- thick, pigmented; required androgen to regulate growth

Vellus- short, fine; independent of androgens

Lanugo- fetal hairs

74
Q

Average scalp has ? hairs w/ a growth phase lasting ?

How fast does hair grow?

A

100K
1000 days

0.3-0.4m/day
6”/year

75
Q

What are the 3 stages of hair growth?

A

Anagen (growth), 100 hairs enter phase each day, majority of hairs

Categen (transition)

Telogen (resting), 100 lost per day

76
Q

Define Pull Test

What result is neg/Dx

How do PTs prep for this test

A

60 hairs grasped and pulled from 4 areas of scalp

Neg= 6 or fewer hairs, normal
Pos= more than 6 hairs, active hair shedding

Don’t shampoo 24hrs prior

77
Q

Define Telogen Effluvium

This can be a following result of ?

A

Females w/ loss of resting hair, increases daily x 4wks

Delivery OCP d/c Weight loss

78
Q

How is Telogen Effluvium Dx

What DDx must be ruled out?

A

CBC CMP
Serum ferritin
Thyroid panel

Anagen effluvium: chemo/rad, poison (thalium, aresnic)

79
Q

How is Telogen Effluvium Tx

Male pattern baldness is AKA ?

A

Reassurance, Time for full recovery

Androgenetic alopecia from shorter anagen cycles
5a reduct: T into DHT

80
Q

What are the two types of hair follicles and their sensitivity to androgens?

What age group can this be seen in?

How is Androgenetic Alopecia Tx

A

Top/vertex: sensitive
Side: insensitive

12-40y/o

Dutasteride PO
Topical Minoxidil
Finasteride PO

81
Q

Who is the best androgenetic alopecia candidate for Minoxidil therapy?

How long does it take for results to be seen?

A

<30y/o w/ hair loss <5yrs

1/3 see results in 8-12mon

82
Q

What is the MOA of Finasteride in the Tx of Androgenetic Alopecia

How long does it take for PTs to see results?

How long to PTs take this med but w/ ? potential s/e?

A

Inhibits T to Dihydro-T conversion

3mon

Indefinitely
Sex dysfunction

83
Q

PT w/ BPH and Androgenetic Alopecia may benefit from ? med

? female PTs are more likely to develop Androgenetic Alopecia

A

Dutasteride- dual inhibitor of Type 1/2a 5a-Red
3x potency of Finasteride

Post-menopause d/t decrease of estrogen, causes increase of androgens

84
Q

What labs need to be checked in females presenting w/ Androgenetic Alopecia

What can be used for Tx

A

DHEA-S
Prolactin
T
SHGB

Minoxidil

85
Q

Define Alopecia Areata

Define Alopecia Totalis

Define Alopecia Universalis

A

Partial loss of any hair

Total loss of scalp hair

Loss of all hair

86
Q

Define Alopoecia Areats

What saying may be used to describe the hair in these PTs

What type of pattern does it take on?

A

Sudden ASx hair loss

Exclamation point hair

Ophiasis- band hair loss in P/O/T lobes

87
Q

? is the etiology of Alopecia Areata

How is this Tx

A

Autoimmune FamHx/genetic part

<10y/o: potent steroid + 5% minoxidil

+10y/o:
<50%: Triamcinolone (IL), Minoxidil

> 50%:
Minoxidil Anthralin Topical imm-therapy Systemic CCS

88
Q

When is the prognosis for Alopecia Areats the best?

When is it the worst?

Even w/ resolution, how are these PTs different?

A

Adults first attack of a small area

Totalis, universalis or ophiasis

Hair grows back fine/white

89
Q

Define Trichorrhexis Nodosa

How are they Tx

? lab work needs to be screened for

A

Brittle hair shafts due to over working causes weak points/nodes in shafts

Stop all hair Tx

Hypothryoidism

90
Q

Define Folliculitis Decalvans

What are the etiologies of this condition

What microbe may be cultured from follicles and how is it Tx?

A

Chronic pustular eruptions of scalp, leads to permanent alopecia patch

Chronic bacterial folliculitis
Altered host response

Staph A
Clinda

91
Q

Define Dissecting Cellulities

What can this condition cause to be formed on PTs heads?

How is it Tx

A

Rare inflammatory nodules in black men

Tracts, fibrosis and hypertrophic scars but PAINLESS

Isotretinoin

92
Q

Define Hirsutism

What is the etiology

A

Terminal hairs on females in male-like patterns (face, chest, areolae)

High androgens
Inc sensitivity

93
Q

What are 5 possible causes of hirsutism?

A

PCOS- MC cause of anovulatory infertility and hirsutism

Androgen secreting tumor (adrenal, ovary)

Cushing

CCS, PO

Obesity

94
Q

How is Hirsutism managed

Define Hypertrichosis

A

Spironolactone
OCPs
Low dose CCS
Eflonithine- removes facial hair

Excess hair density, length Not androgen sensitive

95
Q

? drugs can cause hypertrichosis

What non-medical issues can cause this condition?

A

Phenytoin
Cyclosporine
Minoxidil
Steroids

Genetic
Internal malignancy

96
Q

? part of the nail has parallel ridges w/ vessels at the base

Define Hyponychium

Eponychium may be AKA ?

A

Nail bed

Segment of skin lacking nail cover

Cuticle

97
Q

What nail variants may be seen on PTs w/ psoriasis?

What is the MC nail finding of Lichen Planus

What happens if the matrix becomes inflammed

A

Oil spots
Onycholysis

Longitudinal grooves/ridges

Pterygium unguis- proximal nailfold adheres to scarred matrix

98
Q

? types of drugs can cause nail changes?

Define Onychomycosis

What DDx must be r/o

A

Chemo
Tetracyclines

Tinea of nails, aka Tinea unguium

Psoriasis

99
Q

What step must be done prior to giving PO antifungals for onychomycosis Tx

What are the 3 types of patterns that may be seen

A

KOH and culture w/ 15 blade

Distal subungual- MC
White superficial
Proximal subungual

100
Q

How is Onychomycosis Tx

What needs to be monitored in these PTs

A

Terbinafine
Itraconazole

CBC, LFTs

101
Q

What med may be used for Onychomycosis that doesn’t involve the lunula

What med is used for distal lateral onychomycosis

A

Ciclopirox nail lacquier

Efinaconazole

102
Q

How is Onychomycosis prevented

What two habits increase the incidence of brittle nails, especially in females?

A 
Shoes/boots
Don't pick nails
Rotate foot wear/socks
No communal showers
Trim nails

Water imersion
Nail polish removers

103
Q

How can brittle nails from chronic exposure be Tx

What can be used/added to toes to help prevent recurrent ingrown toenails?

A

B7, biotin, increases thickness

Phenol

104
Q

Subungual hematoma is a result of trauma to ?

If severe, how is it Tx asap

A

Nail plate

Trephination

105
Q

Define Habit-tic Deformity

Since the Tx is for PTs to stop, what is the underlying cause?

A

Longitudinal band of horizontal grooves w/ yellow discoloration from irritating proximal nail fold of thumb

OCD/psych

106
Q

Define Acute Paronychia

How are they Tx

A

Rapid red/painful swelling of abscess on proximal/lateral nail

InD
Anti-Staph ABX

107
Q

How are Pseudomonas infections under the nails Tx

What ABX is added for severe cases or Tx failures

A

Chlorine bleach/vinegar w/ water

Cipro

108
Q

Define Beau’s Lines

Define Yellow Nail Syndrome

A

Transverse depressions of all nails at base of lunula weeks after stressful event, self resolves

Associated w/AIDS and respiratory/lymphedema dzs

109
Q

What is the name of the angle measured for finger clubbing

Define Koilonychia

What is this finding associated w/ ?

A

Lovibond’s angle, >180 abnormal

Spoon nails- central depression, lateral elevation of plate

IDA

110
Q

Define Mees Lines

What are the RFs

A

White line in nail plate

Sepsis
RF/LF
Arsenic poisoning
CHF
Chemo
111
Q

Define Terry’s Nails

What are the RFs

A

White/pink nails retain 0.5-3mm distal band of normal color

Cirrhosis
CHF
Adult onset DM
Age

112
Q

Define Sarcoptes Scabiei

What will Pts complain of

What is the most common location to see these?

A

Scabies mite from skin to skin contact

Itching worse at night

Finger webs
Wrists
Side of hand/feet
Penis/butt/scrotum
Palm/sole of infants
113
Q

What med is used for Human Scabies Tx

What med is used when the PT population changes

What PT education needs to happen

A

Permethrin over night x 7days
Anti-histamine PRN
Inflamed skin- 1% HC in Eucerin

Institutions/Nursing home/Topical failure:
Ivermectin 12mg on day 1, 8

Worsening Sxs day 2-3 is not Tx failure

114
Q

When/why would Lindane be sued for Scabies Tx

What PTs is this med c/i in?

A

Toxic from WW2

<2y/o, pregnant

115
Q

What is the name of scabies?

How does this variant present differently

What underlying Dx must be considered

A

Norwegian crusted scabies

Very little itch, primarily on hand/face

HIV

116
Q

Define Pediculosis

Where does Capitis present

How does Pediculosis Corporis present

A

Lice

Nits in hair
Red papules on neck

Red papules on wrist/ankles
Eyelash only in kids

117
Q

What color does pediculosis show on Wood’s lamp?

These bugs can carry what two dzs?

A

Yello-blue green

Typhus
Trench fever

118
Q

How is head lice Tx

How is body lice Tx

What would be the next test ordered/dx to r/o

A

1% Permethrin w/out shaving head

5% Permethrin

STDs

119
Q

Where/how do fleas present

How are these Tx

A

Grouped red bites on ankle/lower legs

Antihistamine
Topical ABX/steroids

120
Q

How doe bed bugs present

When is the best time to look for these

A

Pruritic edematous papules in rows of 3-5 bites

Look at night, 7mm

121
Q

What is the name of the etiology of bed bugs

How are they Tx

What are the stages of bed bug development

A

Cimex lectularius

Antihistamines
Topical steroids

Egg
Stage 1-5
Adult

122
Q

Define Chiggers

What is no longer an approved Tx method

A

Mites that attach to humans from grass

Nail polish removal

123
Q

What is different about fire ant presentations

What scientific family do they belong to along w/ ?

Why is this grouping important?

A

Stings

Hymenoptera:
Bees- Apoidea
Wasps/Hornet/yellow jacket- Vespoidea
Ants- Formicidae

Allergic to one group, allergic to others

124
Q

How are fire ant stings Tx

Brown spiders belong to ? family

A

Sarna lotion
Anti-histamine
Cool compress
Steroids if severe

Loxosceles

125
Q

What type of venom do Brown Recluse carry

What do PTs complain of on presentation

A

Cytolytic venom, leads to necrosis

Erythematous lesion
PainLESS bite

126
Q

What is the progression of a severe brown recluse reaction

What is the name for this sign

What department/surgeon may be consulted for grafting?

A

Hrs: Pain at site
24hrs: blister w/ blue discolor
3-4days: ecchymotic center
1wk: necrotic ulcer/eschar

Erythema Blanch Ecchymosis
(Red White and Blue) sign

GenSurg

127
Q

North American recluse spiders rarely cause?

? PTs are more likely to have this

A

Systemic effects: F/C N/V Arthralgia Petechia

Peds

128
Q

Since there is no anti-venom for brown recluse bites, how are these PTs managed

When is debridement considered?

A

Analgesic
Tetanus
ABX

> 2cm and 2-3wks later

129
Q

What is the name of the Recluse look alike but lacks violin

Name of Black Widow genus

A

Hobo spider Tegenaria agrestis

Latrodectus

130
Q

? type of venom do black widows have

This type of venom causes the body to release large amounts of ?

A

Neurotoxic

ACh, NorEpi

131
Q

Define Latrodectism

What is the name of the lesion seen

A

Trunk spasms in abdomen/back from Widow bite

Target lesion- white center, red rim

132
Q

How are Widow bites Tx

Creeping Eruption is AKA ?

This is ? MC

A

Benzos
Opioids
Antivenom for severe cases
Tetanus

Cutaneous Larva Migrans

MC skin dz among travelers in tropical countries

133
Q

What causes Cutaneous Larva Migrans

How are these Tx

A

Dog/cat hookworm

Topical steroids
Severe: Ivermectin
Albendazole, topical for kids

134
Q

Pseudomonas Cellulitis can occur around the ear due to ?

Pseudomonas cellulitis in DM PTs need to have ? monitoring?

A

External Otitis

Blood sugars

135
Q

Wart infections can be divided into what 3 categories?

A

Latent- normal, nothing happening

Sub-clinical- nearly ASx

Clinical- active Sxs

136
Q

Calvans Tx length

Dissecting cellulitis

A

Clinda x 10wks

Isotretinoin, not painful
Kerion, painful

IPAP (212 decks)

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