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ECN > Derma > Flashcards

Derma Flashcards

1
Q

Germs en DHBN-FN: polymicrobienne et monomicrobienne

A

polymicrobienne: anaerobi, coc G+, Bacils n-
Monomicrobienne: Strep. pyogenes ++, S. Aureus

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2
Q

Germs pour myosite

A

souvent monomicrobienne: Clostridium perfringes

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3
Q

Quelles FN sount toujours plymicrobiennes?

A

perineales- gangrene de Fournier

cervicofaciales

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4
Q 
Porte entre germs en:
DHBN perineale
DHNB cervicogaciales
Myonecrose
pyomyosites
A

DHBN perineale- origine perineal, chirurgie
DHNB cervicogaciales- dentaire, amygdale, gl. salivaire
Myonecrose: chirurgie ou traumatisme
pyomyosites: traumatisme + S. aureus ou strep

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5
Q

Fdr pour DHBN-FN

A 
age
DZ
imunosuprimee
cancer
insufficience veineuse
lymphoedeme chronique
IRC
chirrhose
arteriopathie
alcoolisme
obesite

CT
AINS

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6
Q

Fdr pour DHBN avec SARM

A 
hospitalisation recente
contact
institution
atcd 
hemodyalise chronique
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7
Q

Signes de gravite eryzipele

A 
Locaux- extension rapide
Bulles hémorragiques 
Douleur intense
Hypoesthesie
Indurence
Livedo
Necrose
Creptitations

Systhemique: tachycardie, hypoTA, confusion, tachypnee, oligurie, paleur
(PAS FIEVRE)

Dz, imunodeprime, precarite

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8
Q

Jambe rouge aigue- suspicion erysipele- cat

A

Hemocultures- pas specifiques
Prelevement derma oui
Imagerie- sans delai le ttt: rx, eco, irm
Eco-doppler MI: recherce insuffisance veineuse
Nfs: hyperleucocyt
Iono, cpk, creat

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9
Q

Si on voit bulles aeroqies a rx de membre en suspicion de DHBN, ca dire anaerobie?

A

Non

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10
Q

Eryzipel dz- germs

A

Pseudomonas aeruginosa
S. Aureus
Anaerobies

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11
Q

On cherche quoi si on trouve de DHBN chez un diabetique?

A

Osteite et décompensation dz

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12
Q

Germs DHBN chez imunodeprime

A

Pseudomonas aeruginosa

E. Coli- si neutropenie

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13
Q

Erysipel cause a quelle bacterie si notion de morsure de chat ou chien et mane ration d’ os de porc?

A

Chien ou chat: pasteurellose d’ inocullation

Os de porc: rougte de porc: erysipelotrix rhusopathie

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14
Q

Dermo-hypodermite inflamatoire: panicullite MI- caracteristiques

A

Nodules et plaques inflamatoires hypodermiques

Cuisses ++, abdomen et bras

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15
Q

TTT erysipele- AB + autres

A

amoxicilline pour 10-15 J
ou prystinamicine, clyndamicine, macrolide

Bandes de contention
AC si thrombo-embolique

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16
Q

TTT si erysipele recidivant

A

a tous les 2-3 SA:
amoxi 0,5-1 g
prystinamicine 0,5-1 g
benzathine-penicilline- Extencilline

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17
Q

TTT si DHBN

A

Chirurgie en urgence- chirurgie large: des tissus nécrosés : peau, aponévrose superficielle, muscle
clyndamicine + penicilline a spectre elargie (tazocilline) ou cephalosporine +- aminoside +- metronidazol

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18
Q

Causes d’erythrodermie

A
  1. VIH
  2. Lichen plan
  3. medicaments
  4. psoriazis
  5. gale
  6. eczema
  7. lymphome cutane
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19
Q

Localisation typiques de psoriazis

A

coudes, genoux, jambes (mais pas PLIS)
région lombo-sacrée
cuir cevelou

20
Q

Localisation eczema du nourrison

A

convexites des membres, visage
tronc
cuir chevelu

21
Q

Def. eczema atopique

A

anomalies structurelles de la barriere cutanee

+ predisposition genetique

22
Q

TTT eczema atopique

A

dermocorticoides quotidiennes

23
Q

Hypersensibilite Ig-E type 1- maadies

A

urticaire

oedeme de Quincke

24
Q

Eczeme- hypersensibilite de quel type?

25
Pyoderma gangrenosus- maladies associes
imuno: Chron PR
26
Dif. entre pyoderma gangrenosum et angiodermitis necrosis
Pyoderma gangrenosum: - faxe extenseru de jambe - rouge - douloureuse - origine immuno - tt: corticoides Angiodermitis: - noir, en carte geographique - douloureuse - origine arteriollaire
27
Germs plus souvent DHBN
strep B hemolitique groupe A
28
3 formes de rosacee
1. papulo-pustuleuse 2. vasculaire 3. hypertrophique
29
ttt rosacee: mineurs et diffueses
tt supresif mineure: Métronidazole, Acazélaique, Ivermectinetopique pdt 3 mois diffuse: Cyclines +/-topiques pdt 3 mois + photoprotection, larmes artificiales
30
TTT pustulose exanthemique aigue general
dermocorticoides | stop medicaments
31
pustulose exanthemique aigue generalise- en ? j ca apparait apres medicament? caracteristiques
< 4 J apres medicaments - fievre, AEG - plis, membres, tronc - sy. inflamateur
32
Erythem polymorphe: - comment ca semble - association de.. - localisation - causes plus frequante
- lesions " en cocarde" ou " cibles" (3 circles concentriques: au millieu il y a parfoi une bulle) - associe: erosions des muqueuses - distribution acrale: pieds, mains, coudes, genoux, visage - herpes virus, Mycoplasma pneumonie
33
Melanome: >= 2 criteres
``` A: asymetrie B: borders C: colour D: diametre > 6 mm E: evolution ```
34
Clasif. ancee
``` G0: hyperpigmentation ou erytheme G1: qqe. comedones et papules G2: < 1/2 face G3: > 1/2 face G4: toute la face G5: nodule, acnee vraiment inflamatoire ```
35
``` TT acnee 1er intention G1 G2 G3 G4 ```
``` G1: peroxyde benzoil (PB) ou retinoides G2: PB+retinoides G3: PB+retinoi ou cyclines po + retinoides ou PB G4: cyclines po + PB+ R G5: Izotretinine ```
36
TT acnee 2eme intention (apres 3 M de tt initial)
G1: peroxyde benzoil + retinoizi G2: 1. aug. tt initial. 2. AB local + Ret ou Ac. azaleic ou cycline po + BP + ret G3: izotretionine po G4: izotretionine po
37
TT de mentainance acnee (G0)
adapalene ou adapalene + PB
38
Evolution HSV
1. vesicules: uniques ou multiples 2. erosions: "en bouquet" ou simples + croutes 3. cicatrisation
39
TT HSV
acyclovir 200 mg X 5- 10 J ou | 8 mg/kg pour 5-10 J
40
l'hpv donne 3 types des verrues:
plantaire: HPV 1 plane: HPV 3 vulgaire: HPV2
41
tt verrues
disparition sontanee keratolytic: ac. salicilic, colloidon TT agresif: cryoablation, CO2 (CI enfants)
42
TT zona zoster: + antialgique non-immunodeprime immunodeprime
non-immunodeprime: <50 ans sans att. conjonctival: pas TT le rest: VALCICLOVIR 1gx3/J Immunodeprime: ACICLOVIR IV Antialgique palier II - gabapentine, pregabaline, amitriptiline, patch lidocaine
43
descrition urticaire
papule oedemateuses
44
Gale- clinique
prurite intense, insomniant, epargant la visage lesions interdigitales vesicules perles, sillons scabieux, nodule
45
tt gale
``` Ivermetacine systhematique: 1 prise pui renuveller de 7a 14 J Benzoat benzyl: topic Permehirat: topic Lavage a 60 d - tt. la famille, partenaires sex ```

ECN (29 decks)

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