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PNCB2 > Dermatologic Disorders and Communicable Diseases > Flashcards

Dermatologic Disorders and Communicable Diseases Flashcards

1
Q

Coxsackie Virus

A

Hand-Foot-Mouth Disease:
highly contagious viral illness resulting in ulceration and inflammation of the soft palate and exanthema on hands and feet

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2
Q

S/Sx of coxsackie virus

A 
fever
malaise
vomiting
drooling
papulovesicular rash
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3
Q

What is the management of coxsackie virus?

A

acetaminophen

possible topical applications

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4
Q

Rubeola AKA

A

ordinary measles or red measles that can occur at any age

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5
Q

Rubeola s/sx

A 
VIRUS that leads to fever:
fever
runny nose 
cough
red eyes
spreading skin rash
koplik's spots
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6
Q

What are koplik’s spots?

A

small, white, granular spots surrounded by red rings found inside the mouth–particularly on the inside of the cheek opposite the first and second molars

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7
Q

Rubella AKA

A

3 day measles or german measles that can occur at any age

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8
Q

Rubella s/sx

A

erythematous maculopapular rash
starts on face and spreads to extremities and trunk
gone in 72 hours
associated malaise
joint pain
postauricular and suboccipital lymphadenopathy

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9
Q

What is one consideration to remember with rubella?

A

it is teratogenicity

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10
Q

Roseola Infantum AKA

A

sixth disease in 6 months to 2 year olds (rare after 4 years)

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11
Q

What causes roseola infants?

A

Herpesvirus 6

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12
Q

What are the s/sx of roseola infantum?

A

URI symptoms
small pink, flat to raised bumps that start on trunk then move to extremities
High fever for 8 days with an abrupt end when rash develops
possible seizures associated with fever

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13
Q

Erythema Infectiosum AKA

A

fifth disease in 5-14 years olds

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14
Q

What causes erythema infectiosum?

A

human parvovirus B19

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15
Q

What are the s/sx of erythema infectiosum?

A

slapped cheek appearance
lacy reticular exanthem
face then arms, legs, trunk and dorsum of hands/feet
rash can last up to 40 days–average of 1.5 weeks
can cause fatal aplastic crisis and arthralgias

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16
Q

What are the laboratory tests to check for erythema infectiosum?

A

Parvovirus B19 IgM, IgG

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17
Q

What are special considerations of erythema infectiosum?

A

patient education–intrauterine infection can produce fatal anemia
If a pregnant woman is exposed, may need immunoglobulin
Infectiosum erythema is not contagious once the fever breaks

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18
Q

What is lyme disease?

A

Most common vector-borne disease in the US–mice and deer ticks are the major animal reservoirs, but birds may also be a source

Birrelia burgdorferi (spirochete)
Ticks must feed for more than 24 to 26 hours to transmit infecting organism
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19
Q

What is stage 1 of lyme disease?

A

erythema migrants: a flat or slightly raised red lesion that expands over several days but has central clearing–most commonly appears in areas of tight clothing–looks like a target, concentric circles
50% of pts have flu like symptoms

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20
Q

What is stage 2 of lyme disease?

A 
Headache, stiff joints
migratory pains
cardiac symptoms--dysrhythmias, heart block
aseptic meningitis
bell's palsy 
peripheral neuropathy
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21
Q

What is stage 3 of lyme disease?

A

joint and periarticular pain
subacute encephalopathy
acrodermatitis chronicum atrophicans: bluish red discoloration of the distal extremity with edema–localized DIC coagulation problem

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22
Q

How do you screen/dx lyme disease?

A

detection of antibody to b. burgdorferi via ELISA screening
western blot assay is confirmatory
elevated ESR

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23
Q

What are the diagnostic criteria of lyme disease?

A

Exposure to tick habitat within the last 30 days with:
erythema migrans or:
one late manifestation and:
laboratory confirmation

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24
Q

How to manage lyme disease?

A

7 yrs old: doxycycline
refer for stage 2 and 3
let health dept know

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25
Q

What is scabies?

A

skin infestation caused by a parasitic mite that burrows in startup corneum requiring
spread through the direct or indirect contact with personal items

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26
Q

Signs and symptoms of scabies

A

intense itching
irritability in infants
linear or curved burrows (snake like)
infants: red-brown vesiculopapular lesions on head, neck, palms, or soles
older children: red papillose on skin folds, umbilicus or abdomen
may see regional adenopahty

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27
Q

What is the management of scabies?

A

permethrin (nix) 5% rinse (1st treatment leave on for 8-14 hours), repeat in one week, OR:
ivermectin (not used if mother is pregnant, lactating or for children under 15 kg)
can give antihistamines for pruritus

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28
Q

What is impetigo?

A

a bacterial infection of the skin typically caused by gram positive strep or staph (staph aureus)
involves the face mostly, but can occur anywhere
occurs most often in summer–very contagious

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29
Q

S/sx of impetigo

A

signs of inflammation
pain, swelling, warmth
regional lymphadenopaty
HONEY, CRUSTING LESIONS

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30
Q

Treatment of impetigo

A

topical antimicrobials for minor infections (bacitracin, bactroban)
Use the oral lactase resistant antibiotics when oral route is preferred:
dicloxacillin, cephalexin, erythromycin (will treat staph and strep)
severe cellulitis: IV antibiotics–vanco, nafcillin, doxycycline
abstain from school and community until 48 hrs after treatment
apply burrow’s solution to clean lesions

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31
Q

Psoraisis

A

inflammatory skin disorder based on genetic predisposition in which the epidermal turnover is reduced from 14 days to 2 days. Normal maturation of skin cells cannot take place, and keratinization is faulty and epidermis is thickened

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32
Q

Signs and symptoms of psoraisis

A

can be asymptomatic
itching possible
lesions are red, sharply defined plaques with silvery scales
scalp, elbows, knees, palms, soles, and nails are common sites
fine pitting of the nails is strongly suggestive of psoriasis–as is separation of nail plate from bed
pink or red line in intergluteal fold
auspitz’s sign

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33
Q

What is auspitz’s sign?

A

drops of blood appear when scales are removed in someone with psoraisis

34
Q

What is the treatment for psoriasis?

A

topicals for scalp: tar/salicyclic acid shampoo, topical steroid oil
Topical steroids for skin: 2x/day for 2-3 weeks, resume with calcipotriene, a synthetic vit B3 derivative, betamethasone or triamcinolone
Use UVB light and coal tar exposure if more than 30% of body surface is involved
moisturizer

35
Q

What is pityriasis rosea?

A

mild, acute inflammatory disorder, which is self-limiting and can last 3-8 weeks
more common in spring/fall and pts typically have a URI prior
more common in females

36
Q

Signs and symptoms of pityriasis rosea?

A

possibly asymptomatic
initial lesion (herald patch) is 2-10 cm–usually macular, oval, and fawn color with a crinkled appearance and collarette scale
**if on palms of hand, genitals, or mouth–think syphilis
pruritic rash in a christmas tree pattern may be found on turn and proximal extremities within 1-2 weeks–follows ripples on back

37
Q

Management of pityriasis rosea?

A

possibly check for syphillis
if itching: ataraxic, oral antihistamines, topical antipuritic, cool compresses, topical steroids (triamcinolone)
daily sunlight exposure will hasten healing–UVB x1 week
oral erythromycin x2week is very effective

38
Q

Irritant dermatitis

A

diaper rash–peaks at 9-12 months

39
Q

Allergic contact dermatitis s/sx

A

redness, pruritus, scabbing
tiny vesicles and weepy, encrusted lesions in acute phases
scaling, erythema and thickened skin in chronic phase
location will suggest cause
affected areas hot and swollen
history of exposure

40
Q

If severe allergic contact dermatitis what is the treatment

A

prednisone starting at 60 mg daily and tapering over 14 days

41
Q

Atopic dermatitis

A

Eczema–sensitive to low humidity and worse in winter when air is dry

42
Q

Signs and symptoms of atopic dermatitis

A

intense pruritis along face, neck, trunk, wrists, hands, antecubital, and popliteal folds
dray scaly skin

43
Q

Diagnostics for eczema

A

RAST test–or skin tests whence may suggest dust mite allergy
serum IgE
eosinophilia may be present

44
Q

Management of eczema

A

hallmark treatment: moisturizing lotion immediately after bathing–must blot dry
topical steroids applied 2-4x daily and rubbed in well
systemic steroids in severe cases: prednisone 40 mg daily, taper over 5-7 days
In acute weeping: use saline or aluminum sub acetate solution and colloidal oatmeal baths

45
Q

Molluscum Contagiosum

A

pink to flesh-colored discrete papules, which become umbilicated papillose with a cheesy core

46
Q

Varicella Zoster Virus

A

Chickenpox
caused by herpes virus and transmitted by direct contact with lesions or airborne
infected individuals are contagious for 48 hours before outbreak and until lesions have crusted over
most common in ages 5-10

47
Q

S/sx of varicella zoster

A 
erythematous merciless
papules develop over merciless
vesicles erupt--usually distributes initially on trunk, then scalp, then face 
intense pruritus
low grade fever
generalized lymphadenopathy
48
Q

Treatment for varicella zoster

A

calamine/caladryl lotion
antihistamine
acetaminophen

Oral acyclovir 20 mg/kg x 5 days–given in first 24 hours can reduce the magnitude and duration

49
Q

Tinea capitus

A

fungal infection of scalp

50
Q

Tinea cruris

A

jock itch

51
Q

Tinea corporis

A

body ringworm

52
Q

Tinea manumm and tinea pedis

A

athlete’s foot

53
Q

Tine versicolor

A

hypo/hyperpigmentation macules on limbs

54
Q

Fungal infection under a microscope

A

spaghetti and meatballs hyphae microscopically when treated with KOH

55
Q

Treatment of fungal infections

A

primary treatment: griseofulvin 20 mg/kg/day x 6 weeks

topical typically work for tinea carpers

For tinea versicolor: use selenium sulfide shampoo for 5-15 minutes daily x7 days; 200 mg itraconazle every day by mouth as an alternative

56
Q

What do you need to be worried about with antifungals?

A

liver function

57
Q

First degree burn

A

dry, red, no blisters involves epidermis only

58
Q

2nd degree burn

A

partial thickness, moist, blisters, extends beyond dermis

59
Q

3rd degree burn

A

full thickness–dry leathery, black, pearly, waxy, extends from epidermis to dermis to underlying tissues, fat, muscles, and or bone

60
Q

Rule of 9s for adult and child:

A

Adult:
head, each arm: 9%
genitals: 1%
each leg, front, back: 18%

Child:
Head, front, back: 18%
each arm: 9%
each leg: 14%

61
Q

Macule

A

a flat discoloration

62
Q

Patch

A

a flat discoloration that looks as though it is a collection of multiple, tiny pigment changes; may be some subtle surface change

63
Q

Papule

A

a small (

64
Q

Nodule

A

an elevated, firm lesion >1 cm (big papule)

65
Q

Tumor

A

a firm, elevated lump

66
Q

Wheal

A

a lesion raised above the surface and extending a bit below the epidermis; many times an allergic reaction (either contact or systemic)

67
Q

Plague

A

a scaly, elevated lesion–classic lesion of psoriasis

68
Q

vesicle

A

a small (

69
Q

bulla

A

serous fluid-filled vesicles >1 cm

70
Q

pustule

A

a small (

71
Q

abscess

A

a pus-filled lesion (>1 cm)

72
Q

cyst

A

large, raised lesions filled with serous fluid, blood and pus

73
Q

solitary or discrete configuration

A

individual or distinct lesions that remain separate

74
Q

grouped configuration

A

linear cluster

75
Q

confluent configuration

A

lesions that run together

76
Q

linear configuration

A

scratch, streak, line or stripe

77
Q

annular configuration

A

circular, beginning in the center and spreading to the periphery

78
Q

polycyclic configuration

A

annular lesions merge

79
Q

Open comdeone

A

blackheads; opening in the skin capped with blackened mass of skin debris

80
Q

Closed comdeone

A

whiteheads; obstructed opening which may rupture, casing low-grade local inflammatory recation

81
Q

Pharmacologic mild acne treatment

A

topical treatment with benzoyl peroxide, if not responsive–retinoic acid cream (pregnancy category C)

retinoin (only applied at night and not used concomitantly with benzoyl)
salicylic acid preparations
topical antibiotics (erythromycin or clindamycin)

82
Q

Pharmacologic treatment for moderate acne

A

systemic along with topical treatments:
doxycycline (100 mg 2x daily)
erythromycin (1 gram in 2 to 3 divided doses)
minocycline (50-100 mg twice daily)

**tetracycline: can damage enamel of teeth, so don’t give before age 12)

PNCB2 (18 decks)

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