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NURS 875: Pediatrics > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Name this

A

atopic dermatitis

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2
Q

Key phrase to ID atopic dermatitis

A

erythematous salmon colored patches

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3
Q

Atopic dermatits is primarily what kind of dysfunction?

A

barrier

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4
Q

A patient tells you that steroids bleached his skin. What do you say?

A

steroids cause hypopigmentation, not skin bleaching; it will resolve over time

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5
Q

Kiddos with more barrier dysfunctions are at risk for what?

A

skin infections:

  • staph
  • strep
  • HSV
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6
Q

How is atopic dermatitis managed?

A
  • regular (Daily?) bathing
  • gentle soap
  • moisturizer
  • topical steroids
  • manage infections
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7
Q

Steroid maintenance schedule

A

3 days on

4 days off

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8
Q

Good steroid ointment for face

A

Hydrocortisone 2.5%

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9
Q

Good steroid ointment for body

A

Triamcinolone 0.1% ointment

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10
Q

Non-steroid medications for atopic dermatitis

A
  • tacrolimus
  • pimecrolimus
  • Crisaborole
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11
Q

Name this

A

port wine stain

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12
Q

Name this

A

infantile hemangioma

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13
Q

What is an infantile hemangioma?

A
  • capillary overgrowth
  • grows quickly during the 1st year, then fades
  • NOT cancer
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14
Q

When do we get concerned about infantile hemangiomas?

A
  • if on the face
  • if on the neck (breathing)
  • if on the back (spinal involvement)
  • if they bleed
  • if 5 or more, might be on the liver (do abdominal U/S)
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15
Q

How are infantile hemangiomas treated?

A

oral propranolol

OR

topical propranolol + topical steroid

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16
Q

Who manages facial hemangiomas?

A

dermatology

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17
Q

If a child is on propranolol, of what do we need to be aware?

A
  • propranolol can mask wheezing, so be aware that any wheezing may be worse in severity than it appears
  • can cause hypoglycemia, so give with food
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18
Q

Name this

A

molluscum contagiosum

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19
Q

Name this

A

chicken pox

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20
Q

What causes molluscum contagiosum?

A

pox virus

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21
Q

Classic description of molluscum contagiosum

A

small “waxy” dome shaped flesh colored papules with an umbilicated core

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22
Q

What common skin condition can worsen molluscum contagiosum?

A

eczema

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23
Q

How to keep molluscum contagiousum from spreading if it is surrounded by eczema?

A

use a maintenance steroid regimen, 3D on, 4D off

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24
Q

What irritants can be used on molluscum contagiousum lesions?

A

zutea tree oil, apple cider vinegar, Zymaderm, Canthiridin

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25
Q

What is this?

A

impetigo

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26
Q

Name this

A

acne vulgaris

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27
Q

4 components of acne

A
  • abnormal keratinization
  • sebum overproduction
  • bacteria
  • inflammation
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28
Q

Name the therapeutic ladder for acne

A
  • retinoid
  • benzoyl peroxide + retinoid or topical ABX
  • TRIPLE THERAPY: BP + retinoid + oral ABX
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29
Q

What antibiotic–and what dosing–is used for acne vulgaris?

A

doxycycline 100mg PO daily or BID x 3 months

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30
Q

What should patients be taught about doxycycline?

A

photosensitivity –> use sunscreen

take with water to avoid pill esophagitis

take with food to avoid stomach upset

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31
Q

Name a retinoid

A

differin

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32
Q

How long will a retinoid take to address acne?

A

6W to kick in; 3-4 months to plateau

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33
Q

What do patients need to be taught about retinoids?

A
  • causes photosensitivity –> use sunscreen
  • dries the skin; use a moisturizer
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34
Q

What benzoyl peroxide concentrations are used?

A

4-10%

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35
Q

How does benzoyl peroxide address acne?

A

kills bacteria that are responsible for white heads and inflammation

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36
Q

What is this?

A

verruca vulgaris

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37
Q

What causes the black dot appearance in warts?

A

thrombosed blood vessels

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38
Q

What causes warts?

A

HPV

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39
Q

Medical terminolgy to describe a wart

A

verrucous EXOPHYTIC papules with “black dot” appearance

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40
Q

Name this

A

Alopecia

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41
Q

Name this

A

tinea capitis (Ringworm of the scalp)

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42
Q

What organisms cause impetigo?

A
  • group A beta-hemolytic streptococcus (Streptococcus pyogenes)
  • Staph. aureus
  • MRSA
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43
Q

How long does a patient with impetigo need to be out of day care/school?

A

until at least 24 hours of antibiotic treatment is completed

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44
Q

2 most common causes of cellulitis

A
  • Strep. pneumonia
  • Staph. aureus
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45
Q

What patients with cellulitis should be hospitalized?

A
  • neonate or febrile infant
  • acutely ill or toxic
  • periorbital cellulits
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46
Q

common history with candidiasis infection

A
  • antibiotic or steroid use over previous weeks
  • occurrence of rash in warm, moist area
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47
Q
A
48
Q

What causes tinea capitis?

A
  • Trichophyton tonsurans or Microsporum canis
  • fomites invade the scalp and hair shaft, causing inflammatory response and hair shaft fragility
49
Q

What medications are used for tinea capitis?

A

griseofulvin or terbinifine

**be sure to dose correctly in children

50
Q

What skin condition has a classic honey-colored crust?

A

impetigo

51
Q

What ointment is used for impetigo?

A

mupirocin ointment TID x 10 days

52
Q

What oral antibiotic is used for impetigo?

A

Keflex

53
Q
A
54
Q

What is pediculosis capitis?

A

head lice

55
Q

What is tinea cruris?

A

jock itch

56
Q

What is tinea pedis?

A

athlete’s foot

57
Q

What is onychoycosis?

A

fungal infection of the nails

58
Q

For head lice, how long does it take a nymph to become an adult? What is the implication of this?

A

7 days, must be treated 2x to kill all lice

59
Q

Describe a louse’s dependence on humans

A
  • cannot hop or fly
  • dies w/in 2-3 days w/o feeding
  • viable eggs are w/in 6mm of skin for warmth
60
Q

Active ingredient of Nix

A

permetherin 1% cream rinse

61
Q

How to kill lice in the home

A

launder bedding > 5min at temps > 128.3 degrees F

62
Q

How to kill lice with shampoo?

A
  • Nix
  • Treat 2 x, once and then again 7-9 days later
  • leave cream on scalp 10 min, then rinse
  • comb out nits with fine-toothed comb
63
Q

3 C’s of Measles

A
  • cough
  • coryza
  • conjunctivitis
64
Q

Where does the measles rash begin?

A

face/behind ears (spreads to trunk/extremities)

65
Q

What are the name of the enanthem found in the mouth in a measles infection?

A

Koplik spots

66
Q

What is coryza?

A

upper respiratory infection/common cold

67
Q

Name these lesions

A

Koplik spots

68
Q

How long does a patient with rubella need to avoid school?

A

7 days after rash onset

69
Q

Another name for the German measles

A

Rubella

70
Q

How does rubella impact a pregnant patient?

A

can cause serious birth defects; pregnant patients should stay away

71
Q

Name some symptoms that would make you suspect measles or German measles (Rubella)

A
  • cough, coryza, conjunctivitis
  • rash starting on the face and spreading to the trunk/extremities
  • Koplik spots
  • pink papules and blotchy blanchable macules
72
Q

Name this rash, associated with fever, headache, sore throat, and abdominal pain

A

Scarlatina (associated with strep throat)

73
Q

Name and describe the rash associated with strep throat

A

Scarlatina: fine rough textured blanchable papules on trunk and armpits

74
Q

What is this called?

A

palatal petichiae

75
Q

What oral lesions are associated with scarlatina?

A
  • palatal petichiae
  • strawberry tonuge
76
Q

Name some complications of GABHS infection

A
  • rheumatic fever
  • glomerulonephritis
  • PNA
  • pericarditis
  • meningitis
77
Q

When can a patient with strep throat return to school?

A

after 24 hours of antibiotics

78
Q

Name this infection

A

Fifth’s disease

79
Q

When does viremia end with fifths disease?

A

with rash onset

80
Q

A bath can make the rash of fifths disease reactivate; how long does this last?

A

weeks

81
Q

Describe the rash of fifths disease

A

lacey maculopapules on the extensor surfaces/trunk with a circumoral pallor

82
Q

What is Erythema infectiousum?

A

fifth’s disease

83
Q

Name this infection:

  • 6 months old
  • fever of 104F for 3 days
  • fever broke
  • rash appeared on trunk, spreading to extremities
A

roseola (sixths disease)

84
Q

What child’s rash has rose-pink macules and papules with halos of blanching?

A

Roseola

85
Q

Define defervescence

A

abatement of a fever

86
Q

What can cause this?

A

hand-foot-mouth disease

87
Q

What causes hand-foot-mouth disease?

A

coxsackie virus

88
Q

What causes Roseola?

A

HSV 6

89
Q

What does Exanthem subitum mean? What disease is this?

A

“sudden rash”;

Roseola

90
Q

A patient has hand-foot-mouth disease; when can he return to school/day care?

A

after resolution of lesions

91
Q

What disease is this: “mixed erythematous macules, papules, and vesicles in different stages of healing?

A

varicella

92
Q

What causes chicken pox?

A

varicella zoster

93
Q

Where does the chicken pox rash begin?

A

trunk

94
Q

Describe this lesion

A

“dew drop on a rose petal”

95
Q

When can a patient with chicken pox return to school?

A

when all the lesions are crusted over

96
Q

Describe the rash of chicken pox; how does it progress?

A

PRURITIC papular rash on the trunk, evolving to papules and vesicles; spreading to face and head

97
Q

Differentiate these lesions

A

LEFT: erythema migrans

RIGHT: nummular eczema

98
Q

Complications of Lyme Disease

A
  • arrhythmias and/or heart block
  • meningitis
  • arthritis
  • neurological sequelae
99
Q

medication and dosing to treat Lyme Disease in children

A

must be over 8 years old

doxycycline 4mg/kg/D

divided in 2 doses (BID)

up to 100mg

x 3-4W

100
Q

What life-threatening disease should be considered for a rash that starts peripherally and spreads centrally?

A

Rocky Mountain Spotted Fever

101
Q

For what disease is doxycycline used, regardless of age?

A

Rocky Mountain Spotted Fever

102
Q

What key symptoms might indicate Rocky Mountain Spotted Fever?

A
  • severe sudden headache unrelieved by analgesics
  • myalgias, particularly calf and thigh pain
103
Q

How does Rocky Mountain Spotted Fever start? How does it progress?

A
  • faint macules on wrists/hands
  • spreading centrally and becoming petechial
104
Q

How does the rash of Measles spread?

A

head down

105
Q

Another name for 3-day measles

A

German measles

106
Q

Erythema infectiousum rash looks like…

A

slapped cheeks

107
Q
A
108
Q
A
109
Q

cause of warts

A
110
Q

Why are there genital warts, plantar warts, common warts in certain parts of the body?

A

Some kinds of warts infect specific body sites

111
Q

name for common wart

A
112
Q

name for plantar wart

A
113
Q

name for flat (plane) warts

A
114
Q

options for treatment of warts

A
  • depends on location and type
  • spontaneous resolution can occur – happens quicker in children than adults
  • destruction of tissue (salycilic acid, cryotherapy, surgery, laser)
  • enhancement of immune response (imiquimod)
  • antiproliferative therapy (fluorouracil, bleomycin)
  • resolution is unpredictable
  • elmination of wart does not eliminate virus from body
115
Q

most common treatment of warts

A
  • cryotherapy and salycilic acid
  • can be used alone or in combination (salicylic acid in between cryotherapy sessions)
116
Q

patient education for cryotherapy to treat warts

A
  • response: pain, hemorraghic blistering, tenderness
  • healing usually in 4-7 days
  • local hypopigmentation can occur
  • occasionally: blistering can spread virus to adjacent skin and cause larger wart

NURS 875: Pediatrics (12 decks)

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