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Acute Care PNP Exam > Dermatology/Burns Review > Flashcards

Dermatology/Burns Review Flashcards

1
Q

When is antibiotics recommended for dog bites?

A

Moderate to severe bite wounds and punctures
Facial bites, hand/foot, or genital area wounds
Immunocompromised or asplenic host

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2
Q

What is typical of the workup for a dog and human bite?1

A

X-ray for suspected fracture, penetrating wound over bone/joint, foreign body
Wound culture

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3
Q

What antibiotics is recommended for dog bites?

A

Amoxicillin-clavulanate PO

Consider vancomycin for MRSA coverage if severe

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4
Q

What are signs of systemic toxicity for a snake bite?

A

Tachycardia, hypotension
Swelling of airways
Altered mental status

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5
Q

What are the common labs after a snake bite?

A 
Hemoglobin and Hematocrit
Platelet
Creatinine
ALT/AST
Coagulation studies
CK
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6
Q

How do you dose anti-venom for snake bites?

A

Based on severity!

NOT based on weight/age

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7
Q

A snake bite that causes inflammation, redness, and joint pain along with tissue necrosis?

A

Brown recluse

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8
Q

A snake bite that causes intense pain with tachycardia, flushed appearance, and altered mental status

A

Black widow

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9
Q

Snake bite that causes ring of white tissue ischemia then blisters then has a bull’s eye effect

A

Brown recluse

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10
Q

Snake bite with acute pain, swelling, muscle spasms, tachycardia, hypertension, and agitation

A

Black widow

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11
Q

What is the “tap test” for a snake bite?

A

You tap the bite area and it causes severe pain

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12
Q

What is the best way to treat a jellyfish sting?

A

Double glove and remove adherent tentacles

Baking soda slurry (baking soda and water)

Topical steroids

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13
Q

Epidermal erythema and superficial necrosis with consistent pattern of progression with prodrome of URI and purulent conjunctivitis

A

Staph Scalded Skin Syndrome

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14
Q

Presents with erythema (redness around mouth and spreads with Nikolsky’s sign) and in the next 24-48 hours, there is exfoliation; then the next couple of days there is desquamation and then 5-7 days later there is new skin

A

Staph Scalded Skin Syndrome

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15
Q

What is the treatment for staph scalded skin syndrome?

A

Vancomycin IV/Clindamycin IV

Fluid and electrolyte management

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16
Q

What are the most common venomous snake species?

A

Rattlesnakes, cottonmouth moccasins, copperheads, and coral snakes

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17
Q

What are the diagnostic tests for brown recluse?

A

No specific lab tests

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18
Q

What are the diagnostic tests for black widow?

A

CBC, metabolic panel, coagulation studies, ECG, and urinalysis

19
Q

What is the treatment for brown recluse bites?

A

Local debridement, elevation, loose immobilization, and cool compresses

Avoid strenuous activity

20
Q

What is the treatment for black widow bites?

A

Local wound care, tetanous prophylaxis, pain control, cool compresses/ice packs

Treat infection with broad-spectrum antibiotics

Monitor for 6 hours in mild cases

21
Q

How do you treat muscle cramps associated with black widow bites?

A

Benzodiazepines, opioids, or dantrolene

22
Q

How do you treat bee and wasp stings?

A

Remove the stringer

Treat local reactions symptomatically

23
Q

How do you treat anaphylaxis reaction to bee and wasp stings?

A

Epinephrine, corticosteroids, inhaled beta-adrenergic agonists, and H1 and H2 antihistamines

24
Q

What is a rapidly progressing deep tissue involving fascial and muscle layers, skin, and subcutaneous tissue

A

Necrotizing fasciitis

25
Q

Erythema, warmth, induration, and edema of skin at local inflammatory site; rapidly progressing; fever >39C

Associated with limited mobility of nearest joint

May progress to gangrene and tissue sloughing

A

Necrotizing fasciitis

26
Q

What are the signs of compartment syndrome?

A

Edema, pain, loss of sensation, decreased/absent pulses on associated extremity

27
Q

What are the common antibiotic types for necrotizing fasciitis?

A

Aerobic (penicillin G, ampicillin-sulbactam, clindamycin)

Anaerobic coverage (metronidazole, 3rd generation cephalosporin)

28
Q

What is a hypersensitivity reaction affecting skin and mucous membranes that is commonly attributed to medication, infection, and environmental causes?

A

Stevens-Johnson Syndrome

29
Q

What medications are associated with Stevens-Johnson Syndrome?

A

Antibiotics (sulfonamides), anticonvulsant medications (phenobarbital, lamotrigine, carbamazepine), nonsteroidal anti-inflammatory medications

30
Q

A patient has high fevers, cough, rhinorrhea, pharyngitis, vomiting, diarrhea, headache, myalgia, and arthralgia. What disease are these symptoms related to?

A

Stevens-Johnson Syndrome

31
Q

What is hypersensitivity reaction resulting in damage to epidermis?

A

Toxic epidermal necrolysis

32
Q

A child presents with fevers, malaise, localized skin tenderness and diffuse erythema, painful, burning, erythematous, or dusky macule rash after 24 hours

A

Toxic epidermal necrolysis

33
Q

Widespread blister formation or confluent erythema with skin tenderness

Absence of target lesions

Sudden onset within 24-48 hours

Full thickness epidermal necrosis

A

Toxic epidermal necrolysis

34
Q

Localized injury to skin and/or underlying tissue usually over a bony prominence

A

Pressure ulcer

35
Q

What is a non-blanchable erythema of intact skin that doesn’t resolve within 30 minutes of pressure relief?

A

Stage I pressure ulcer

36
Q

What involves epidermis, dermis, or both presenting as shallow open ulcer with red pink wound bed without slough?

A

Partial thickness (Stage II) pressure ulcer

37
Q

What is it when there is a full-thickness tissue loss with subcutaneous fat may be visible but bone, tendon or muscle is not exposed?

A

Full-thickness skin loss (Stage III) pressure ulcer

38
Q

What is it when there is full-thickness tissue loss with exposed bone, tendon or muscle?

A

Full-thickness tissue loss (Stage IV) pressure ulcer

39
Q

A 3-year-old girl presents to the ED for a progressive erythematous rash to her torso and bilateral lower extremities. She has had a fever for 1 day and has been receiving ibuprofen for the past 24 hours. What is the likely diagnosis?

A. Stevens-Johnsons syndrome
B. TEN
C. Necrotizing fasciitis
D. Kawasaki disease

A

TEN

40
Q

Which of the following is a contraindication for NPWT in the pediatric patient?

A. Placing NPWT dressing over nerves
B. Using NPWT in a clean wound bed
C. Using a NPWT pressure setting appropriate for the child’s age
D. Using NPWT on a pediatric patient after flap surgery

A

A. Placing NPWT dressing over nerves

41
Q

Which of the following is an advantage of using NPWT?

A. Decreases perfusion
B. Increases edema
C. Inhibits granulation tissue formation
D. Prepares wound bed for closure

A

D. Prepares wound bed for closure

42
Q

When examining a patient with a confluent, erythematous sloughing rash. TEN is suspected. Which of the following physical examination supports diagnosis of TEN?

A. Target lesions
B. Crusted lesions
C. Petechiae
D. Skin tenderness

A

D. Skin tenderness

43
Q

When evaluating a child with a prolonged hospitalization, it is noted that he has a blister on his sacrum. This lesion is categorized as which of the following pressure ulcer stages?

A. Stage I
B. Stage II
C. Stage III
D. Stage IV

A

B. Stage II

44
Q

Which combination is the best choice for empiric antibiotic treatment of suspected necrotizing fasciitis?

A. Ampicillin and Flagyl
B. Vancomycin and ciprofloxacin
C. Bactrim and fluconazole
D. Rocephin and gentamycin

A

B. Vancomycin and ciprofloxacin

Acute Care PNP Exam (4 decks)

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