Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPNP Boards > Dermatology > Flashcards

Dermatology Flashcards

1
Q

First degree burn

A

dry, red, no blisters

-involves the epidermis only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Second degree burn

A

= partial thickness burn

moist, blisters, extends beyond the epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Third degree burn

A

= full thickness burn
dry, leathery, black, pearly, waxy
extends from epidermis to dermis to underlying tissues, fat, muscle, and/or bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rule of 9s to measure the extent of burn body surface injury only applies after the age of

A

9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary management of burns

A
  1. Assess ABCs. Intubate if necessary.
  2. Drench the burn thoroughly with cool (not icey) water to prevent further damage and remove all burn clothing - this stops the burn.
  3. Do NOT cover with lotion, toothpaste, butter, etc.
  4. If the burn is limited, immerse the site in cold water for 30 minutes to reduce pain; then, apply a clean wrap.
  5. If the area of the burn is large, after it has been doused with cool water, apply clean wraps about the burned area to prevent systematic heat loss and hypothermia.
  6. Hypothermia is a particular risk in young children.
  7. The first 6 hours following the injury are critical - transport a patient with severe burns to the hospital ASAP.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Burn patients will require prophylactic intubation if

A
  • singed nares or eyebrows

- evaluate nares/mouth for soot/mucous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Evaluation of skin disorders must identify what 3 things?

A

Morphology
Configuration
Distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Morphology

A

The character of the lesion itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Macule

A

A flat discoloration

ex: ephelides (freckles), petechia, flat nevi (moles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patch

A

A flat discoloration that looks as thought it is a collection of multiple, tiny pigment changes

  • may be some subtle surface change
    ex: Mongolian spot, cafe au lait spot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nodule

A

An elevated, firm lesion > 1 cm

ex: Xanthoma and fibroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tumor

A

A firm, elevated lump

ex: benign or malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Papule

A

A small < 1 cm, elevated, firm skin lesion

ex: ant bite, elevated nevus (mole), verruca (wart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Plaque

A

A scaly, elevated lesion

ex: classic psoriasis lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vesicle

A

A small < 1 cm lesion filled with serous fluid (clear liquid)
ex: herpes simplex, varicella (chicken pox), herpes zoster (shingles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bulla

A

Serous fluid-filled vesicle > 1 cm

  • a big vesicle
    ex: burns, superficial blister, contact dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Wheal

A

A lesion raises about the surface and extending a bit below the epidermis

  • many times an allergic reaction/response (either contact or systemic
    ex: PPD test and mosquito bites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pustule

A

A small < 1 cm pus-filled lesion

ex: acne and impetigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Abscess

A

A pus-filled lesion > 1 cm

*a great big pustule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cyst

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Primary lesion

A

First appearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Secondary lesions

A

Follows primary lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Configuration

A

How the lesions present on the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Solitary or discrete configuration

A

Individual or distinct lesions that remain separate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Grouped configuration

A

Linear cluster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Confluent configuration

A

Lesions that run together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Linear configuration

A

Scratch, streak, LINE, or stripe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Annular configuration

A

Circular, beginning in the center and spreading to the periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Polycyclic configuration

A

Annular lesions merge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Distribution

A

Where the lesions appear on the body

Ex: face, trunk, upper extremities, groin, dermatomal, feet, axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Acne

A

A polymorphic skin disorder characterized by comedones, papule, bustles, and cysts

  • cause unknown by appears to be activated by androgens in genetically predisposed individuals
  • can be exacerbated by steroids and anticonvulsants
  • more common and severe in males
  • *food has NOT been demonstrated to be a contributing factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

S/S of acne

A
  1. Comedones, papules, bustles, nodules, and/or cysts on the face and/or upper trunk
  2. Depressed or hypertrophic scars
  3. In women, may be exacerbated just prior to menses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Open comedones

A

Blackheads - opening in the skin capped with blackened mass of skin debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Closed comedones

A

Whiteheads - obstructed opening which may rupture, causing a low-grade local inflammatory reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Labs/diagnostics for acne

A

NONE indicated, except to identify causative organism in atypical folliculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Non-pharmacologic management of acne

A
  • avoidance of topical, oil-based products

- use of oil-free, mild soaps, cleansers, and moisturizers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Pharmacologic management of mild acne

A
  1. Topical treatment with Benzoyl peroxide (2.5-10%)
    - - If not responsive, retinoic acid (0.025-0.1%) cream or gel (pregnancy category C)
    - - Tretinoin is inactivated by UV light and oxidized by benzoyl peroxide; this agent should only be applied at night and not used concomitantly with benzoyl peroxide
  2. Salicyclic acid preparations (Neutrogena 2% wash)
  3. Topical antibiotics: Erythromycin or clindamycin lotion or pads (d/t staph infections)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pharmacologic management of moderate (or severe pustular) acne

A

Requires systematic antibiotics along with topical treatments

  • use -cyclines first, followed by macrolides if needed
  • Doxycycline: 100 mg BID
  • Erythromycin: 1 g in 2-3 divided doses
  • Minocycline: 50-100 mg BID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Fungal infections

A
  • a variety of fungal infections disguised by the causal species of fungi and the location on the body
  • Trichophyton (80%) and Microsporum causative agents in most fungal infections
  • pharmacologic management centers on anti-fungal therapy and the prevention of transmission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tinea capitis

A

Fungal infection on scalp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Tinea corporis

A

Body ringworm (fungal infection on body)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tinea cruris

A

Jock itch (fungal infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Tinea magnum and tine pedis

A

Athlete’s foot (fungal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Tinea versicolor

A

Hypo/hyperpigmentation macules on limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

S/S of fungal infection

A
  • *vary by location on body
    1. May be asymptomatic (capitits)
    2. Some forms presents with severe itching (cruris and pedis)
    3. Erythematous rings (corporis)
    4. Solitary areas of hypo pigmentation or hyperpigmentation (versicolor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Labs/diagnostics for fungal infection

A

“Spaghetti and meatballs” hyphae microscopically when treated with potassium hydroxide (KOH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Primary treatment for fungal infections

A

Griseofulvin 20mg/kg/day for 6 weeks

*big or severe lesions, skip topical and go right to systemic antifungals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Treatment for tinea capitis

A

Primary management is Griseofulvin 20mg/kg/day for 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Treatment for tinea corporsis

A

Use of topical antifungals is usually adequate:
Miconazole 2%
Ketoconazole 2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Treatment for tinea cruris

A

Topical antifungals (Miconazole 2%, Ketoconazole 2%)

Terbinafine cream curative in more than 80% of cases when used BID x 7 days

Griseofulvin 20mg/kg/day for 6 weeks for severe cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Treatment for tinea mannum and pedis

A

In macerated stage, use aluminum sub acetate solution to soak for 20 minutes BID

Topical antifungals (Miconazole 2%, Ketoconazole 2%) in the dry, scaly stage

Oral Griseofulvin in severe cases

52
Q

Treatment for tinea versicolor

A

Selenium sulfide shampoo for 5-15 minutes daily x 7 days OR 200 mg Itraconzole (Sporanox) every day by mouth

53
Q

Varicella Zoster Virus

A

= chickenpox

  • acute, contagious disease caused by herpes virus, transmitted by direct contact with lesions or airborne
  • infected individuals are contagious for 48 hours before outbreak of any rash/bumps and until lesions have crusted over
  • most common in ages 5-10
54
Q

S/S Varicella zoster virus

A
  • erythematous macules
  • papule develop over macules
  • vesicles erupt: usually distributes initially on the trunk, then scalp and face
  • intense pruritus ***
  • low grade fever
  • generalized lymphadenopathy
55
Q

Labs/diagnostics for varicella zoster

A

None - typically a clinical diagnosis

56
Q

Management for varicella zoster

A
  1. Supportive treatment
    - calamine/caladryl lotion
    - antihistamine
    - acetaminophen for fever
  2. PO Acyclovir 20 mg/kg 5 times a day - given in the first 24 hours, this can reduce the magnitude and/or duration of symptoms
    * IV Acyclovir used for immunocompromised
57
Q

Molluscum Contagiosum

A

A common, benign viral skin infection

  • lesions frequently disappear on their own in a few weeks to a few months and are NOT easily treated
  • diagnostic criteria: pruritis and the presecnce of very small, firm, pink- to flesh-colored discrete papule, which become umbilicate papule with a cheesy core
  • children who are sexually active or abused may have grouped lesions in the genital area
  • children with eczema or immunosuppression may have severe infections
58
Q

S/S Molluscum Contagiosum

A
  • lesions most commonly present on face, axillae, antecubital fossa, trunk, crural fascia, and extremities
59
Q

Labs/diagnostics for Molluscum Contagiosum

A

None - clinical diagnosis

*History of exposure to Molluscum Contagiosum

60
Q

Management for Molluscum Contagiosum

A

***Resolves spontaneously if left alone! But it can take 6-9 months, or even up to a year, but educate that they are benign lesions (viral) and are not dangerous

  1. Mechanical removal of the central core prevents spread and autoinnoculation.
  2. Curettage, after anesthetizing the area with prilocaine 2.5% and lidocaine 2.5% cream (EMLA), is a useful treatment in a few lesions but should not be used on sensitive areas as it may scare.
  3. Pharmacological agents
  4. Prevent scratching and touching lesions to stop from spreading.
  5. Spontaneous resolution may occur after 6-9 months in immunocompetent patients.
  6. If patient has extensive lesions or the diagnosis is unclear, refer to a dermatologist.
61
Q

Pharmacological agents for Molluscum Contagiosum

A
  • Tretinion 0.025% gel or 0.1% cream at bedtime
  • Salicyclic acid daily at bedtime
  • Liquid nitrogen applied for 2-3 seconds
  • Trichloracetic acid peel 25-50% applied by dropper to the center of lesion, followed by alcohol, repeated every 2 weeks
  • Silver nitrate, iodine 7-9%, or phenol 1% applied for 2-3 seconds
  • Cantharidin 0.7% applied to individual lesions and covered with clear tape; blistering within 24 hours and possible clearing without scarring; should be avoided on facial lesions
62
Q

Atopic Dermatitis

A

= Eczema

Chronic skin condition characterized by intense itching along a typical pattern of distribution with periods of remission and exacerbation

  • particularly sensitive to low humidity and often worsens in the winter when the air is dry
  • a personal or family history of asthma, allergic rhinitis, atopic dermatitis, elevated serum IgE levels, and a tendency for skin infections is helpful to the diagnosis!!!
  • any allergic reaction = eosinophils
63
Q

S/S Atopic Dermatitis

A
  1. Intense pruritus along face, neck, trunk, wrists, hands, antecubital and popliteal folds
  2. Dry scaly skin
    - acute flare-ups may show red, shiny, or thickened patches
    - inflamed and/or scabbed lesions with diffuse erythema and scaling
    - dry, leathery, and lichenified skin (secondary skin condition, trying to prevent this from occurring)
64
Q

Labs/diagnostics for Atopic Dermatitis

A
  1. Radioallergosorbent test (RAST) or skin tests may suggest dust mite allergy.
  2. Serum IgE may be elevated.
  3. Eosinophilia may be present.
65
Q

Management of Atopic Dermatitis

A
  1. HALLMARK treatment = dry skin management: moisturizing lotion immediately after bathing; must blot dry
  2. Topical steroids applied 2-4 times daily and rubbed in well
    * *Start with hydrocortisone or other steroids (Fluocinonide cream 0.05%, Desonide, triamcinolone 0.1%)
    * *Adverse effects of hydrocortisone: bladder dysfunction, hyperglycemia, etc
  3. Systemic steroids only in extremely severe cases: Prednisone taper over 5-7 days
  4. In acute weeping: use saline or aluminum sub acetate solution and/or colloidal oatmeal baths (Aveeno)
66
Q

Allergic Contact Dermatitis

A

An acute or chronic dermatitis that results from direct skin contact with chemicals or allergens

Ex: poison ivy

67
Q

S/S Allergic Contact Dermatitis

A
  1. Redness, pruritus, scabbing
  2. Tiny vesicles and weepy, encrusted lesions in acute phases
  3. Scaling, erythema and thickened skin (lichenification) in chronic phase
  4. Location with suggest cause
  5. Affected areas hot and swollen
  6. History of exposure to the offending agent
68
Q

Labs/diagnostics for Allergic Contact Dermatitis

A

None indicated

69
Q

Management of Allergic Contact Dermatitis

A
  1. Eliminate allergic item
  2. Depends of severity - compresses locally, avoid scrubbing with soap and water
  3. High potency topical steroids locally
  4. If severe and systemic: Prednisone taper
70
Q

Irritant (Diaper) Dermatitis

A

Common skin irritation of the genital-perianal region

  • most common type of diaper rash, typically due to exposure to chemical irritants and prolonged contact with urine and/or feces
  • occurs at some time in 95% of infants; peaks at 9-12 months
71
Q

S/S Irritant (Diaper) Dermatitis

A
  1. Fiery red rash
  2. Papules, vesicles, crusts, ulcerations
  3. Infant may be irritable!!!
72
Q

Labs/diagnostics for Irritant (Diaper) Dermatitis

A

None indicated

73
Q

Management of Irritant (Diaper) Dermatitis

A
  1. In mild cases, barrier emollients
  2. When erythema/papules present, 1% hydrocortisone
  3. Use Burow’s (Domeboro) compresses for severe erythema and vesicles
  4. Secondary bacterial infection may beed topical antibiotics
  5. Secondary fungus may need topical antifungals
  6. Educate parents about preventative measures.
  7. Allow diaper area to air several times daily.
74
Q

Psoriasis

A

A common benign hyper-proliferative inflammatory skin disorder (acute or chronic) based on genetic presidpostion (affecting ~ 3-5% of the population.

  • The epidermal turnover time is reduced from 14 days to 2 days.
  • Normal maturation of the skin cells cannot take place and keratinization is faulty.
  • The epidermis is thickened, and immature nucleated cells are seen on the horny layer.
  • May be immunologically mediated
75
Q

S/S Psoriasis

A
  1. Often asymptomatic; itching may occur
  2. Lesions are red, sharply defined plaques with silvery scales ***
  3. Scalp, elbows, knees, palms, soles, and nails are common sites
  4. Fine pitting of the nails is strongly suggestive of psoriasis, as is separation of the nail plate from the bed
  5. Pink or red line in the intergluteal fold
  6. Auspitz sign: Droplets of blood when scales are removed ***
76
Q

Labs/diagnostics for Psoriasis

A

None indicated

77
Q

Management of Psoriasis

A
  1. Topical for the scalp:
    a. Tar/salicylic acid shampoo
    b. Medium potency topical steroid oil
  2. Topical steriods for the skin:
    a. Topical steroids BID for 2-3 weeks; resume with calcipotriene (Dovonex), a synthetic vitamin D3 derivative
    b. Betamethason dipropionate 0.05% (Diprolene AF)
    c. Triamcinolone acetonide 0.5% (Aristocort)
  3. UVB light and coal tar exposure if more than 30% of the body surface is involved
  4. Moisturizers
78
Q

Pityriasis Rosea

A

A mild, acute inflammatory disorder that is usually self-limiting, lasting 3-8 weeks

  • If the cause is unknown, the current theory is that it is viral in origin.
  • More common in the spring and fall seasons, and patients typically report a recent URI.
  • More common in females than males
79
Q

S/S Pityriasis Rosea

A
  1. May be asymptomatic
  2. Initial lesion (2-10 cm) known as “herald patch” - usually macular, oval, and fawn-colored with a crinkled appearance and collarette scale
  3. Pruritic rash in a CHRISTMAS TREE pattern (usually mild) may be found on the trunk and proximal extremities within 1-2 weeks
80
Q

Labs/diagnostics for Pityriasis Rosea

A

Serologic test for syphilis should be performed if:

  • the rash does not itch
  • palmar surfaces, genitalia, or mucous membranes involved
  • if a few typically perfect lesions are not present
81
Q

Management for Pityriasis Rosea

A
  1. None usually required
  2. Control pruritus.
  3. Daily sunlight exposure will hasten healing; most effectively UVB daily x 1 week.
  4. Oral erythromycin (2 week course) is effective in most cases (when it is d/t staph)
82
Q

Pruritus remedies for Pityriasis Rosea

A
  1. Atarax (hydroxyzine
  2. Oral antihistamines (loratadine, fexofendaine (allegra), cetirizine)
  3. Topical antipruritic (Sarna lotion, Prax lotion, Itch-X gel, Cetaphil with menthol 0.25% and phenol 0.25%)
  4. Cool compresses, baths (with or without colloidal oatmeal)
  5. Topical steroids (medium strength): Triamcinolone 0.1%
83
Q

Scarlet Fever

A

Generally mild infection caused by group A beta-hemolytic streptococci (GAHGS)

  • contracted through contact with infected respiratory droplets or skin exudate, as a complication of strep throat, or as a result of food borne bacteria
  • most common in children 5-15 yo
84
Q

Initial presentation of Scarlet Fever

A

Days 1-2:

  • fever (101F or higher)
  • exudate pharyngitis
  • swollen tongue with white exudate and/or red papillae
  • young children: abdominal upset, vomiting, seizure
85
Q

Rash presentation of Scarlet Fever

A

Typically 12-48 hours after fever onset:

  • confined, bright red, flat blotches that progress into widespread sandpaper-like papillae
  • initially presents on neck, armpits, and groin before spreading across the trunk and extremities
  • reddened cheeks with circumoral pallor
86
Q

Diagnostics for Scarlet Fever

A

Primarily diagnosed through a physical exam

*Throat culture may be used to prove it was strep

87
Q

Management of Scarlet Fever

A

10-14 day course of penicillin or amoxicillin – should see improvement in 24-48 hours

Emollients or oral antihistamines for desquamating rash

88
Q

Impetigo

A

A bacterial infection of the skin typically caused by gram positive streptococcus or staphylococcus (S. aureus) organisms

  • predominantly involved the face but can occur anywhere on the body
  • occurs most often in the summer
  • highly contagious and autoinoculable
89
Q

S/S of Impetigo

A
  1. Signs of inflammation
  2. Pain, swelling, warmth
  3. Regional lymphadenopathy
  4. Classic honey-crusting lesions ***
90
Q

Labs/diagnostics for Impetigo

A
  1. None indicated - clinical diagnosis

2. Culture wound to confirm causative organism if desired – only necessary in severe cases

91
Q

Topical antimicrobials for minor Impetigo infections

A

Mupirocin
Fusidic acid
Retapamulin

+ apply Burrow’s (Domeboro) solution to clean lesions

92
Q

Systemic treatment for Impetigo

A

Should be directed at offending organism; use PO beta lactamase resistant antibiotics when oral route is preferred:
Amoxicillin-clavulanate
Dicloxacillin
Cephalexin
Erythromycin (if PCN or cephalosporin allergy)
Clindamycin

93
Q

Severe Impetigo management

A

IV antibiotics:
nafcillin
vancomycin
doxycycline

94
Q

Isolation d/t Impetigo

A

Abstain from school and other community events until 48 hours of treatment

95
Q

Scabies

A

Highly contagious skin infection caused by a parasitic mite that burrows into stratum corneum

  • incubation of 4-6 weeks
  • spread through the direct or indirect contact with personal items
96
Q

S/S Scabies

A
  • intense itching
  • irritability in infants
  • linear or curved burrows
  • infants: red-brown vesiculopapular lesions on head, neck, palms, or soles
  • older children: red papule on skin folds, umbilicus, or abdomen
  • may see regional lymphadenopathy
  • interdigital lesions (in between the fingers/toes) ***

“burrowing lesions”
“girate lesions”
“snake-like lesions”

97
Q

Labs/diagnostics for Scabies

A

Skin scrapings shoe mites, ova, and/or feces

None typically necessary

98
Q

Management for Scabies

A
  1. Medications
  2. Rash may persist for 1 week
  3. Wash all washable items
  4. Store non-washable items x 1 week.
  5. Antihistamines for pruritis
99
Q

Medications for Scabies

A

Permethrin (Nix) 5% rinse (1st treatment, leave on for 8-14 hours) and repeat treatment in 1 week – need 2 treatments

OR

Ivermectin

  • only need 1 treatment
  • do not use if mother is pregnant, lactating, or for children under 15kg
100
Q

Pinworms

A

Thin, white roundworms that live in the colon and rectum of humans

Occurs most commonly among school-age children and younger

Spread by fecal-oral route

101
Q

S/S Pinworms

A

Itching in the perineal area

102
Q

Labs/diagnostics for Pinworms

A

“Tape test” - press clear tape to the skin around anus, place on slide and look at under microscope

103
Q

Management of Pinworms

A
  1. Symptomatic treatment
  2. Anthelmintics to eradicate infection:
    Pyrantel (Pin-X) - OTC
    Mebendazole or albendazole (Rid-X) - require Rx
104
Q

Lyme Disease

A

A spirochete disease, and the most common vector-borne disease in the US

Most cases in the NE, upper Midwest, and Pacific Coast.

Mice and deer TICKS are the major animal reservoirs, but birds may also be a source.

105
Q

Etiology of Lyme Disease

A

Borrelia burgdorferi (Spirochete)

Ticks must ffed more than 24-36 hours to transmit the infecting organism.

Congenital infection has been documented but is questionable.

106
Q

Stage 1 of Lyme Disease

A

Erythema migrans: A flat or slightly raised red lesion that expands over several days but has central clearing; commonly appears in areas of tight clothing
–bulls-eye/target lesion

50% of patients have flu-like symptoms

107
Q

Stage 2 of Lyme Disease

A
  • Headache, stiff joints
  • Migratory pains
  • Some patients may have cardiac symptoms (dysrphtymias, heart block)
  • Aspetic meningitis
  • Bell’s palsy
  • Peripheral neuropathy
108
Q

Stage 3 of Lyme Disease

A
  • Joint and periarticular pain
  • Subacte encephaolopathy
  • Acrodermatitis chronic atrophicans: Bluish red discoloration of the distal extremity with edema (localized DIC)
109
Q

Labs/diagnostics for Lyme Disease

A
  1. Detection of antibody to B. burgdorferi via ELISA screening
  2. Western blot assay is CONFIRMATORY
  3. B. burgdorferi may be cultured from skin aspirate
  4. Elevated ESR
110
Q

Diagnostic criteria for Lyme Disease

A

Exposure to tick habitat within the last 30 days with:

  • erythema migrans or
  • one late manifestation and
  • laboratory confirmation
111
Q

Management of Lyme Disease

A

If infection is confined to the skin:
Amoxicillin or Cefuroxime axetil: children under 7 yo
Doxycycline: children over 7

Referral to ID for stage 2 or 3 disease

112
Q

Rubeola

A

= Ordinary measles; red measles

occurs at any age

causes by viral pathogen

113
Q

S/S Rubeola

A
  • fever
  • runny nose
  • cough
  • red eyes
  • Koplik’s spots ***appear a couple days before rash
  • spreading skin rash

*Supportive treatment, vaccinate

114
Q

Rubella

A

= 3-day measles

Contagious viral disease caused by RNA virus known for teratogenicity (BAD - birth defects & neurologic devastation)

occurs at any age

causes by viral pathogen

115
Q

S/S Rubella

A
  • erythematous maculopapular rash
  • starts of face, spreads to extremities, trunk; gone in 72 hours ***
  • malaise
  • joint pain
  • post auricular and subocciptal lymphadenopathy
116
Q

Erythema infectiosum

A

= Fifth disease
“5 fingers slapped their face”

Typically occurs between 5-14 years old

Caused by Human parvovirus B19

117
Q

S/S Erythema infectiosum

A
  • “slapped cheek” appearance
  • lacy reticular exanthema
  • face then arms, legs, trunk and dorm of hands/feet
  • rash can last up to 40 days! average = 1.5 week duration
  • NOT contagious after fever breaks

Can cause fetal aplastic crisis

118
Q

Roseola infantum

A

= Sixth disease

Typically occurs between 6 months - 2 years
*VERY rare after age 4

Caused by Herpesvirus 6

119
Q

S/S Roseola infantum

A
  • URI symptoms
  • small pink, flat to raised bumps
  • trunk then extremities
  • high fever, abrupt end when rash develops
  • high fever for up to 8 days with abrupt end when rash breaks out
120
Q

Coxsackie Virus

A

= Hand-Foot-and-Mouth disease

A highly contagious viral illness resulting in ulceration and inflammation of the soft palate (herpangina) and papulovesicular exanthema on the hands and feet

  • Affects children < 10yo
  • Resolves spontaneously in less than a week
  • Peeling/loss of nails is common
121
Q

S/S Coxsackie Virus

A
  • fever
  • malaise
  • vomiting
  • drooling
  • papulovesicular rash
122
Q

Labs/diagnostics for Coxsackie Virus

A

None indicated

123
Q

Management of Coxsackie Virus

A
  1. Acetaminophen

2. Topical applications for comfort

124
Q

Mumps

A

A HIGHLY contagious viral infection primarily affecting the salivary glands

  • resolves within 2 weeks

**MMR vaccine to prevent

125
Q

S/S of Mumps

A
  1. Swollen salivary glands (ie parotitis) causing puffy cheeks and a tender, swollen jaw ***
  2. Fever
  3. HA
  4. Muscle aches
  5. Weakness and fatigue
  6. Loss of appetite
126
Q

Labs/diagnositics for Mumps

A

Mumps IgM

127
Q

Management of Mumps

A
  1. Rest and isolation
  2. NSAIDs
  3. Warm or cold compresses for swollen glands

CPNP Boards (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions