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Med Prep > Derma - urticaria, bacterial skin infxns > Flashcards

Derma - urticaria, bacterial skin infxns Flashcards

0
Q

Urticaria/angioedema

Edema extends to deep dermis and /or subcutaneous and submucosal layers

A

Angioedema

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1
Q

Urticaria/angioedema

Circumscribed, raised, erythematous, evanescent areas involving the superficial dermis

A

Urticaria

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2
Q

Pathogenesis of urticaria and angioedema

A

Mast cells, basophils, eosinophils releases histamine and cytokines
Results to vascular permeability
Then extravasation of fluids and proteins
Causing edema

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3
Q

Acute urticaria recurs for how many days

A

<30d

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4
Q

Chronic urticaria recurs for how many days

A

> 30d

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5
Q

Wheals of acute urticaria.

A

Large wheals, associated with angioedema

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6
Q

Wheals of chronic urticaria.

A

Small and large wheals

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7
Q

Acute/chronic urticaria

IgE-dependent (with atopic background)

A

Acute urticaria.

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8
Q

Acute/chronic urticaria

Due to anti-FcR autoantibodies

A

Chronic urticaria

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9
Q

Acute/chronic urticaria

Related to alimentary agents, parasites and penicillins

A

ACute urticaria

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10
Q

Acute/chronic urticaria

Intolerance to salicylates and benzoates

A

Chronic urticaria

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11
Q

Chronic urticaria cannot tolerate

A

Salicylates and benzoates

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12
Q

Acute/chronic urticaria

Complement mediated in serum sickness-like reaction (whole blood, ig, penicillin)

A

Acute urticaria

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13
Q

Chronic urticaria common in children/adult, M/F

A

Adult, F

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14
Q

Acute/chronic urticaria

May persist for 10yrs

A

Chronic urticaria

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15
Q

Acute/chronic urticaria

Rarely persists for >24hrs

A

Acute urticaria

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16
Q

Localized urticarias

A

Solar
Pressure
Vibration
Cold urticaria

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17
Q

Immunologic urticarias

A

IgE-mediated urticaria
Complement-mediated urticaria
Immunologic contact urticaria
Autoimmune urticaria

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18
Q

Immunologic urticaria due to type 1 HPS with atopic background. Common Ag are food, drug and helminths

A

IgE mediated urticaria

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19
Q

IgE mediated urticaria HPS type

A

Type 1 HPS

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20
Q

Acute immunologic urticarias

A

IgE mediated
Complement mediated
Immunologic contact

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21
Q

Immunologic urticaria which releases anaphylotoxin causing mast cells degradation. Common in serum sickness, ig and admin of whole blood

A

Complement mediated urticaria

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22
Q

Chronic immunologic urticaria

A

Autoimmune urticaria

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23
Q

Immunologic urticaria common in children with atopic dermatitis sensitized to environmental allergens and individuals sensitized to latex rubber gloves. Accompanied by anaphylaxis.

A

Immunologic contact urticaria

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24
Q

Autoimmune urticaria is positive in what test

A

Autologous serum skin test

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25
Q

The remission of disease activity of autoimmune urticaria is due to

A

Plasmapheresis
IVIg
Cyclosporin

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26
Q

Physical urticaria with positive linear lesion after storming or scratching skin

A

Dermographism

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27
Q

Demographics fades in …

A

30min

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28
Q

Physical urticari confined to sites exposed to cold

A

Cold urticaria

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29
Q

Diagnosis of cold urticaria

A

Ice cube test

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30
Q

How to do ice cube test

A

Application of ice for 10min

Wheal appears within 5min

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31
Q

Diagnostic test for solar urticaria

A

Test with UVB, UVA and visible light

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32
Q

How to test solar urticaria

A

260-690nm uv expo for 30-120s

Wheal appears within 30min

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33
Q

Wheezing for <1hr is seen in what Physical urticaria

A

Solar urticaria

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34
Q

Mediator of solar urticaria

A

Histamine

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35
Q

Wheezing physical urticaria

A

Solar

Cholinergic urticaria

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36
Q

Physical urticaria which appears with exercise and sweating

A

Cholinergic urticaria

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37
Q

Physical urticaria in which the intracutaneous of ACH and mecholyl will produce micropapular whealing

A

Cholinergic urticaria

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38
Q

Very rare phys urticaria with water of any temperature

A

Aquagenic urticaria

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39
Q

Aquagenic urticaria lesion is same with

A

Cholinergic urticaria

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40
Q

Sites of predilection of pressure urticaria

A

Soles
Palms
Waist

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41
Q

Applications of p perpendicular to skin in pressure urticaria will produce WHEAL after..

A

1-4hrs

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42
Q

Pressure urticaria is delayed for (time)

A

30min-12hrs

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43
Q

Physical urticaria which is painful and interferes with quality of life. No lab abnormalities. Associated with fever

A

Pressure angioedema

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44
Q

Familial, autosomal dominant physical urticaria

A

Vibratory angioedema

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45
Q

Distinct angioedema syndrome

A

Hereditary angioedema HAE

Angioedema-urticaria-eosinophilia syndrome AUES

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46
Q

Major mediator of chronic idiopathic urticaria

A

Histamine.

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47
Q

Eicosanoids and neuropeptides

A

Urticaria due to mast cells releasing agents and pseudo allergens and chronic idiopathic urticaria

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48
Q

Urticaria due to mast cells releasing agents and pseudo allergens and chronic idiopathic urticaria AGENTS

A 
FAARS
Food preservatives
Ace inhibitors
Additive azo dyes
Radio contrast media
Salicylate
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49
Q

Due to direct effects of exogenous urticants penetrating into skin and blood vessels

A

Non immune contact urticaria

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50
Q

Urticaria associated with vascular/connective tissue autoimmune disease

A

SLE

Sjögren’s syndrome

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51
Q

Urticaria vasculitis lesion persists for

A

> 12-24hrs

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52
Q

Urticaria associated w vascular or connective tissue autoimmune disease has SLOW/RAPID changes in size and config

A

Slow

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53
Q

Urticaria associated w vascular or connective tissue autoimmune disease may or may not have residual pigmentation due to

A

Hemosiderin

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54
Q

Urticaria often with hypocomplementemia and renal disease

A

Urticaria associated w vascular or connective tissue autoimmune disease

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55
Q

HAE is autosomal dominant/recessive

A

Dominant

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56
Q

T or F: Uritacaria usually occurs in HAE

A

Does not usually occur

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57
Q

Lab abnormalities in HAE

A

Decreased C1-esterase inhibitor

Low C4

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58
Q

May follow trauma (phys/emotional)
AE of face and ext, laryngeal edema, acute abd pain (presents as surgical emergency)
With bradykinin formation
Can be life threatening

A

HAE

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59
Q

Treatment for HAE

A

Danazol (long term)

Whole fresh plasma

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60
Q

With severe AE with pruritic urticaria of face, neck, trunk and ext

A

AUES

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61
Q

AUES lasts for how many days

A

7-10d

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62
Q

Lab abnormalities of AUES

A

Leukocytosis

Eosinophilia

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63
Q

HAE/AUES:
No family history
Fever
Marked increase in wt

A

AUES

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64
Q

Treatment for AUES

A

Prednisone

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65
Q

HAE/AUES: good prognosis

A

AUES

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66
Q

Lab in urticarial vasculitis

A

Increased ESR

Hypocomplementemia

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67
Q

Flushing. Burning. Wheezing.

A

Cholinergic urticaria

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68
Q

Fever.

A

Serum sickness

AUES

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69
Q

Hoarseness. Stridor. Dyspnea.

A

AE

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70
Q

Arthralgia.

A

Serum sickness

Urticarial vasculitis

71
Q

Abdominal colicky pain.

72
Q

Medications.

A

Penicillin
Aspirin
NSAIDs
Ace inhibitors

73
Q

Treatment when severe urticaria is associated with anxiety and depression

74
Q

Treatment for urticaria with AE

A

Prednisone

75
Q

Treatment for AUES

A

Prednisone

76
Q

Treatment for acute attack of HAE

A

Whole fresh plasma or

C1-esterase inhibitor

77
Q

H2 antihistamine

A

Cimetidine
Famotidine
Ranitidine

78
Q

3rd gen H1 antihistamine

A

Piperadine - desloratadine, fexofenadine

Piperazine - levocetirizine

79
Q

2nd gen H1 antihistamine

A

Piperadine - loratadine, terfenadine

Piperazine - cetirizine

80
Q

1st gen H1 antihistamine

A

Alkylamine - chlorpheniramine maleate, dimethindene maleate
Aminoalkyl ether (ethinolamine)- clemastine fumarate, diphenhydramine
Ethylenediamine- antazoline
Phenothiazine- mequitazine, phomethazine
Piperidine- azatadine maleate, cyproheptadine
Piperazine- hydroxyzine

81
Q

Age of onset: eryhtrasma

82
Q

Age of onset: impetigo and ecthyma

A

Primary - children
Secondary- any age
Bullous- children/young adult

83
Q

Age of onset: abscess, furuncle, carbuncle

A

Children up to young adult (boys)

84
Q

Age of onset: erysipelas and cellulitis

85
Q

Age of onset: staph-scalded-skin syndrome (Ritter’s dse)

A

Neonate up to <5y/o

86
Q

Commonly called as Ritter’s disease

A

Staph-scalded-skin syndrome

87
Q

Etiology: eryhtrasma

A

C. Minutissimum

88
Q

Etiology: impetigo and ecthyma

A

Staph aureus-most common

GAS

89
Q

Etiology: abscess, furuncle, carbuncle

A

MSSA, MRSA

90
Q

Etiology: erysipelas and cellulitis

A

Adult- S.aureus, GAS

Children- HiB, S.aureus, GAS

91
Q

Etiology: Ritter’s disease

A

S.aureus grp2

92
Q

Site of predilection: eryhtrasma

A 
Toe web spaces >groin folds > axilla
Interiginous areas (intra gluteal, infra mammary)
93
Q

Site of predilection: abscess, furuncle, carbuncle

A

Hair follicles

Break of integrity of skin

94
Q

Macules, sharply marginated, red-brown, scaling at sites not continuously occluded.
Post-inflammatory Hyperpigmentation
Associated with dermatophytoses and candidiasis

A

Eryhtrasma

95
Q

Woods lamp of erythrasma

A

Coral-red fluorescence

96
Q

Heavy growth of corynebacterium

A

Erythrasma

97
Q

T or F: eryhtrasma may relapse if predisposing causes are not corrected

98
Q

Prophylaxis for erythrasma

A

Benzoyl peroxide
Medicated powders
Topical antiseptics- isopropyl, ethanol

99
Q

Topical therapy for erythrasma

A

Benzoyl peroxide
Eythromycin, clindamycin
Mupirocin
Antifungals

100
Q

Nonspecific inflammation of opposed skin and between redundant skin.
Common among obese.

A

Intertriginous infection and intertrigo

101
Q

Management for intertrigo

A

Wt reduction
Moist dressing/ castellani’s paint
Zinc oxide ointment- reduce friction
Pimecrolimus, tacrolimus

102
Q

Etiology of pyoderma

A

Coagulase neg staph

S.aureus, GAS

103
Q

Portal of entry of primary impetigo

A

Minor breaks in skin

104
Q

Portal of entry of secondary impetigo

A

Traumatic breaks

105
Q

Duration of lesion of impetigo

A

Days to wks

106
Q

Duration of lesion of ecthyma

A

Wks to mos

107
Q

Impetigo/ecthyma: variable pruritus (associated w/ AD)

108
Q

Impetigo/ecthyma:
pain and tenderness (indurated)
Induration with thick adherent crust

109
Q

Site of predilection of ecthyma

A

Distal ext

110
Q

T or F: mimoetigo is associated with lymphangitis or LA

111
Q

Bullous/nonbollous;

Golden yellow crusts

A

Nonbullous

112
Q

Bullous/nonbollous; clear yellow, brown crusts with shallow moist erosion

113
Q

Bullous/nonbollous; with normal appearing skin

114
Q

Bullous/nonbollous; scattered discrete with satellite lesions by auto inoculation

A

Nonbollous

115
Q

Distribution of nonbollous

A

More in intertriginous areas

116
Q

What happens to an untreated impetigo

A

leads to ecthyma resulting to healing with scar

117
Q

T or F: with MRSA infection, impetigo and ecthyma is associated with high morbidity and mortality

118
Q

Topical treatment for impetigo and ecthyma

A

Mupirocin 3x/d for 7-10d

119
Q

Systemic treatment for impetigo and ecthyma

A

Pen G or V

Cephalosporin, vancomycin etc

120
Q

Prevention of impetigo and ecthyma

A

Daily bath
Benzoyl peroxide
Check family member
Ethanol or isopropyl for hands

121
Q

It occurs as a foreign body response to splinter, ruptured inclusion cyst and injection sites

A

Sterile abscess

122
Q

Represents as a continuum of severity of staph aureus infection

A

Folliculitis
Carbuncle
Furuncles

123
Q

site of predilection of abscess, furuncle, carbuncle

A

Hair follicle

Break on intergrity of skin

124
Q

Synonym for abscess, carbuncle, furuncle

125
Q

Acute /chronic localized infection with collection of pus and tissue destruction. Arise from dermis, subQ fat and ms or deeper

126
Q

SOP of abscess

A

Any cutaneous sites, sites of trauma

127
Q

Acute, deep seated from staph folliculitis. Firm tende nodule with central necrotic plug with central pustule with or without surrounding cellulitis.

128
Q

SOP of furuncle

A

Any hair-bearing region

129
Q

Deeper infection with interconnecting abscess with similar evolution to furuncle.
Multiple adjacent coalescing furuncle.

130
Q

SOP of. Carbuncle

A

Several contiguous hair follicle.

131
Q

Possible HEMATOGENOUS seeding of abscess, furuncle and carbuncle

A 
Heart valves 
Joints
Spine 
Long bones 
Viscera
132
Q

Abscess/carbuncle/furuncle: accompanied with fever and malaise

133
Q

Management for abscess furuncle carbuncle

A

I and D plus systemic antimicrobial

134
Q

Adjunctive therapy for absces, Furuncle, carbuncle

A

Application of heat (promotes localization or consolidation and aids early spontaneous drainage)

135
Q

Aka soft tissue infection

A

Cellulitides

136
Q

An acute, diffus, spreading, edematous, suppurative inflammation of dermis and subQ tissues.
Often with malaise, fever and Chills

A

Soft tissue infection a

137
Q

History of human bite

A

Erysipelas and cellulitis

138
Q

Spread on infection in soft tissue infection is due to

A

Hyaluronidase - polysaccharide ground subs
Fibrinolysin - fibrin barriers
Lecithinase - cell mem

139
Q

Soft tissue infection is more on a reaction to..

A

Cytokine and bacterial superantigens

140
Q

SOP of erysipelas in adult

141
Q

SOP of erysipelas in young male

142
Q

SOP of erysipelas in female

A

Post mastectomy

143
Q

SOP of erysipelas ff rhinitis and conjunctivitis

144
Q

SOP of erysipelas in operative wound site

145
Q

SOP of erysipelas in children

A

Head and neck - HiB

Ext - staph aureus, GASP

146
Q

Unlike other types of cellulitis, that which is cause by ___ usually ff a primat enteritis with bacteremia and dissemination

A

V. Vulnificus

147
Q

Management for erysipelas and cellulitis: primary with pneumococcus

A

Benzoyl peroxide plus immunize those at risk

148
Q

Management for erysipelas and cellulitis: primary with HiB

A

Benzoyl peroxide plus chemo prophylaxis for household contacts of <4y/o

149
Q

Management for erysipelas and cellulitis: primary with vibrio

A

Benzoyl peroxide plus avoid eating uncooked seafood

150
Q

Antimicrobial treatment for erysipelas and cellulitis

A

S. Aureus and beta lactam antibiotics

151
Q

Staph aureus phage grp 2 in Ritter’s dse produces what toxin

A

Exfoliating toxin A and B

152
Q

Site of ET production

A 
Purulent conjunctivitis
Otitis media
Omphilitis
Occult nasopharyngeal 
Bullous impetigo
153
Q

Pathogenesis of Ritter’s disease.

Colonize. ET production. Transport by blood to skin. _________ = __________

A

Acantholysis and intraepidermal cleavage within stratum granulosus = local Bullous imopetigo or mild scarlatiniform rash

154
Q

Ritter’s disease spont heals in

155
Q

Macular scarlatiniform rash or diffuse ill defined erythema.
Fine stippled sandpaper apparance.

A

SSS syndrome or Ritter’s disease

156
Q

Ritter’s disease spreads within

157
Q

(+) nikolsky sign

A

Ritter’s dse

158
Q

Ddx for Ritter’s disease

A

TEN
TSs
Kawasaki syndrome

159
Q

T or F: In Ritter’s disease, staph aureus is seen at site of infection, NOT from sites of sloughing skin or bullae

160
Q

T or F: In Ritter’s disease, gram(+) cocci only at colonized site

161
Q

Ritter’s disease spont heals with adeq antibiotic treatment in

162
Q

T or f: Ritter’s disease lesion produces scarring

163
Q

Psedudomonas aeroginosa prefers dry/moist environment

A

Moist environment

164
Q

Pseudomonas aeroginosa colonized what part of the body

A 
Skin
External ear
URT
Large bowel 
(In those who are compromised )
165
Q

Entry sites of pseudomonas infection

A

Breaks in MC barrier
Aspiration
Decubitus or skin ulcers
Thermal burns

166
Q

3 stages of infection of pseudomonas

A

Bacterial attachemt and colonization
Local invasion and damage of tissue
Disseminated systemic disease

167
Q

T or F: psedomonas infection may stop at any stage

168
Q

Clinical syndrome of pseudomonas infection

A 
Nail colonization
Folliculitis
Toe web infection
1and2 pyoderma
Ext. otitis
169
Q

Nail colonization of pseudomonas infection is seen undersurface of oncholytic nails. What is the discoloration

170
Q

Hot tub folliculitis of pseudomonas infection infects multiple hair follicle. Is it self limited?

171
Q

Color of exudate and odor ofPyoderma of pseudomonas infection

A

Blue green exudates and fruity odor

172
Q

Is external otitis in pseudomonas infection self limited?

173
Q

Invasive infection of pseudomonas

A

Ecthyma gangrenosum

174
Q

Erythematous macule which leads to hemarhagic bluish infarction to black in central necrosis with erythematous halo

A

Ecthyma gangrenosum

175
Q

SOP of ecthyma gangrenosum

A

Axilla
Groin
Perianal
Everywhere

Med Prep (52 decks)

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