Dermatology, Ulcer, Burns Flashcards
What would someone with Impetigo look like?
Red sores that can rupture & Ooze
Itching
HONEY COLORED CRUST
(anywhere in the body as it heals)
What are complications of Impetigo?
Sepsis
Cellulitis
Hypertensive Encephalopathy
Pulmonary Edema, Rheumatic Fever
Acute post-streptococcal glomerulonephritis
What’s the Pathophysiology of impetigo?
A Break in the skin that allows BACTERIA to enter
It affects Infants + Young children
What causes Impetigo?
Bacteria:
Streptococcus
Staphylococcus
How do you Diagnosed Impetigo?
History
Physical exam
CBC
Culture
How do you Treat impetigo?
ABX (Topical/Oral)
What would someone with Cellulitis look like?
Fever
Pain/Redness/Swelling/Edema
Lymphadenopathy (Proximal to sight of injury)
What are complications of Cellulitis?
Sepsis
Endocarditis
Osteomyelitis
Necrotizing Fasciitis
Abscess (If left untreated)
What’s the Pathophysiology of Cellulitis?
A Break in the skin that allows bacteria to enter causing INFLAMMATION OF SUBCUTANEOUS TISSUE
Occurs from injury, burns, surgical wounds
It affects (Feet/Legs) and Can be anywhere
What causes cellulitis?
Bacteria: Streptococcus
Staphylococcus
How do you diagnosed Cellulitis?
History
Physical exam
CBC
Culture
How do you Treat Cellulitis?
ABX (Oral/IV)
Prophylactic Compression Therapy
What would someone with MRSA look like?
Fever
Abscess/Pus
Drainage
What are Complications of MRSA?
Sepsis
Death
What’s the Pathophysiology of MRSA?
A break in the skin that allows STAPH BACTERIA to enter.
What causes MRSA?
How is MRSA spread?
Bacteria: Staphylococcus aureus
Contact with an infected person or Things carrying the bacteria
It spreads in Healthcare/Community Associated
Staph Bacteria is RESISTANT to ABX
How do you diagnosed MRSA?
History
Physical exam
CBC
Broth 🧪
Agar Test 🔬
How do you treat MRSA?
Vancomycin
Linezolid
What would someone with Herpes Zoster Shingles look like?
Pre-Eruptive phase:
Pain, Tingling in 1 or more Dermatome
Fever, Fatigue, Headache, Gi upset (1-10
Acute Eruptive phase:
Pain, Redness, Vesicles (1-Face/Torso)
Don’t cross the midline, Clear/Cloud 1/10
Clears in 2-4weeks
Chronic phase:
Nerve pain that last Months/Years
What are complications of Herpes Zoster Shingles?
Prosthetic Neuralgia
Pneumonia
Encephalitis
Blindness
Hearing Loss
DEATH
What’s the Pathophysiology of Herpes Zoster Shingles?
Varicella Zoster Virus causes Chickenpox in Childhood
After healing from chickenpox, the virus hides & comes back later causing “SHINGLES”. Immune system can’t hold it anymore.
What causes
Herpes Zoster Shingles?
Varicella Zoster Virus
What are Risk Factors for Herpes Zoster Shingles?
Age ⬆️
Weak immune system
Immunosuppressant Medication
How do you diagnose
Herpes Zoster Shingles?
History
Physical exam
CBC
PCR (Check Viral DNA) 🧬
DFA (Direct Fluorescent Antibody)
Tzanck smear
Treatment
Herpes Zoster shingles?
Antiviral (⬇️72 hours)
Analgesics
Steroids
Vaccination (60 and ⬆️)
What would someone with Tinea Capitis/Corporis look like?
Itching
Circular/Oval rash
What are complications of Tinea Capitis/Corporis?
Capitis: Abscess (Kerion)
Corporis: Dermatophytide
What’s the Pathophysiology of Tinea Capitis/Corporis?
Fungal infection of the skin {Scalp/Body}
Transferred from Person to Person/Animal
Contagious! (Spread via Bed, Towel, Hat, Grooming tools)
What causes
Tinea Capitis/Corporis?
Fungus
How do you diagnosed
Tinea Capitis/Corporis?
History
Physical exam
CBC
KOH Test [Skin scrapping via Potassium Hydroxide on wet mount]
Treatment of
Tinea Capitis/Corporis?
1% Selenium Sulfide shampoo
Anti-Fungal: Topical, Oral, IV
Tolnaftate
Clotrimazole
Miconazole
Haloprogrin
Griseofulvin
What would someone with Pediculosis Capitis look like?
SEVERE ITCHING in the head/Behind the ears
What are complications of Pediculosis Capitis?
infections (impetigo/pyoderma)
What’s the Pathophysiology of Pediculosis Capitis?
Lice 🕷️inject their juice into the skin & sucking your blood.
How do you diagnosed
Pediculosis Capitis?
History
Physical exam
CBC
Magnifying glass
Treatment of
Pediculodis Capitis?
Medicated Shampoo (Permerthrin 1%)
Bath with Soap/Water
Wash all clothes in Hot water
What would a person with Scabies look like?
Itching
Redness
Pimples like rash/Burrows Track
Vesicles, Pustules, Papule
Ooze, Crust, Dry, Peel
What are complications of Scabies?
Sepsis
Heart Disease
Kidney problems
What’s the Pathophysiology of Scabies?
itch mites lay eggs under skin (Epidermis)
What causes Scabies?
itch mites
How do you Diagnose Scabies?
History
Physical exam
CBC
Penlight
Scalpel Blade (Under a microscope)
What’s the treatment for Scabies?
Warm Soapy Bath
Permethrin 5% (apply from head/Toes) 8hr
What would someone with Contact Dermatitis Eczema look like?
Itching
Redness
Burning
Blisters/Edema
{Vesicles, Papule, Oozing, Crust, Dry, Peel}
What are complications of Contact Dermatitis Eczema?
infection
Lichenification
What’s the Pathophysiology of Contact Dermatitis Eczema?
inflammation of Dermis
What causes
Contact Dermatitis Eczema?
Physical, Soap/Dertergent,
Chemical, Biological agents
Extreme Heat/Cold
Pre-existing skin Disease
What’s the risk factor for Contact Dermatitis Eczema?
Jobs that require repeated Handwashing
Food preparation workers
Cleaners
Hair Dresser
Women
How do you diagnose
Contact Dermatitis Eczema?
History
Physical exam
CBC
Assess for allergies
How do you treat
Contact Dermatitis Eczema?
Avoid itritants
Use mild Soap until healed
Cream:
Corticosteroids, Ceramide, Dimethicone
What would someone with Psoriasis look like?
itching
Red lesions
Silver plaques
(Nails, Elbow, Knee, Scalp, Lower back, Butt) ✨✨✨✨
Remission/Exacerbation (comes & go)
What are complications of Psoriasis?
Asymmetric Rheumatoid Factor
What’s the Pathophysiology of Psoriasis?
Skin cells makes TOO much Keratin (Epidermis)
Chronic inflammation of skin
What causes Psoriasis?
Genetics/Autoimmune
What’s the risk factor for Psoriasis?
White women
How do you Diagnose Psoriasis?
History
Physical exam
CBC
Biopsy
How do you Treat Psoriasis?
Topical corticosteroids + Dressing
Systemic agents
(Methotrexate, infliximab, Cyclosporine)
Phototherapy
(Take Psoralen before treatment)
Coal Tar preparation
What does someone with
Acne Vulgaris look like?
Pimples, Whiteheads, Blackheads
(Open/Closed Comedones)
Leaking Sebum, Keratin, Bacteria
What’s are Complications of
Acne Vulgaris?
infections
What’s the Pathophysiology of Acne Vulgaris?
Hormone 🔜 Sebaceous gland🔜 Sebum
Blocked hair follicle (Dead skin cell/Bacteria)
Inflammation of Pilosebaceous unit
How do you diagnose
Acne Vulgaris?
Physical exam (oily skin, Lesions, Comedones)
History (Women have flares before menses)
How do you Treat
Acne Vulgaris?
Wash Face 2x/day🔜 OTC Benzol Peroxide & salicylic acid.
Use oil free products & sunscreen
Diet: avoid carbs, Fruits/vegetables, water
Topical ABX
Vitamin A (Retinoid)
isotretinoin (SEVERE CASES)
Hormone Therapy
Steroid injections
Phototherapy
Surgery: Comedones extraction
What would a person with General Pruritus look like?
itching (worst at night)
Redness/Wheals
No rash or Lesions
What are complications of General pruritus?
Dryness
Eczema
Infection
Lichenification
What’s the Pathophysiology of General pruritus?
Histamine release causes itching.
What causes General pruritus?
The following underlying causes
Anemia
Endocrine
Gi (Hepatic)
Gu (Kidney)
Oncology
Radiation Therapy
Medication
Soap
How do you diagnose
General pruritus?
History
Physical exam
CBC
Find underlying cause
How do you Treat
General Pruritus?
Tepid Bath:
Cool compress (Menthol/Camphor)
Antihistamine:
Antihistamine (Diphenhydramine)
Topical anti-pruritic:
(Lidocaine, Prilocaine, Capsaicin)
Topical corticosteroids:
Corticosteroids
SSRI:
(Fluoxetine/Sertraline)
What would someone with
Skin cancer look like?
A: Half raise/Half flat (irregular is BAD)
B: Border (uneven edges)
C: Color changes & variations
(Black, Brown, Tan, Red)
D: Diameter ⬆️ 6mm (size of Nickel/coin)
E: Evolve change in (Size, Shape, color)
What are complications of
Skin cancer?
infection/Sepsis
Bleeding 🩸
What’s the Pathophysiology of skin cancer?
Uncontrolled cell growth in the skin
Basal cell, Squamous cell, Melanoma
What are risk factors of
Skin cancer?
Family History/Genetics
Environmental: UV light/Sunlight
Caucasian, Light skin, Freckles, Moles, Aging
Immunosuppressant Drugs
How is Skin cancer diagnosed?
History
Physical exam
CBC
Biopsy
How do you Treat Skin cancer?
Mohs/Cryosurgery
Topical Chemotherapy
Radiation
What’s the Pathophysiology of pressure ulcer?
Epidermis: Melanin, Keratin, Vitamin D
Electrolytes
Dermis: Nerves, Blood Vessels
Sweat glands, Hair follicles
Lymphatic
Hypodermis: Fatty Tissue/ Temperature regulation
What causes pressure ulcers?
Pressure
Bedridden
Moisture/incontinence
Shearing/Friction
Poor nutrition
Aging skin
Diabetic Neuropathy (sugar blood)
Liver cirrhosis (⬇️ Albumin)
What are the stages of pressure ulcer?
Stage 1: Non-Blanchable erythema of INTACT SKIN.
Stage 2: Damages (Epidermis/Dermis)
Stage 3: Damage (Epi, Dermis, Hypodermis
Stage 4: Muscle/Bone
Unstageable: Can’t see the base of the wound.
How do you Treat
Pressure ulcers?
Assess Skin within 24-hrs of admission
Turn every 1-2hrs to relieve pressure
Give Fluids 2-3 L/Day
Check I/O for adequate Fluid intake (⬇️ 30-ml is BAD)
Give protein
Check Albumin (3.5-5.0)
Check Braden scale to monitor risk every shift
Superficial Burn
Sunburn/Low Flash
Damage Epidermis
Intact Skin, Redness, Pain
(Pain sooth by cooling)
NO Edema/blisters
Superficial Burn
Diagnostic Test
History
Physical exam
CBC
Superficial Burn Treatment
No ICE, Butter, Egg whites
Analgesics, ABX, Systemic ointment
Clean wound daily/Change dressing
depends on severity of burn
Heal in 1-week
Deep Burn
Damage Epidermis/Dermis
Wet/Shiny/Blisters/White/Discolored/irregular
Painful to touch/sensitive to ANY air
Deep Burn Complications
Can lead 🔜 infection
Can lead 🔜 Full Thickness Burn
Deep Burn Diagnostic Test
History
Physical exam
CBC (⬆️K, ⬆️H/H, ⬇️Na)
Deep Burns Treatment
⬇️ 3-inches Treat it at home
NO ICE 🧊, Butter🧈, Egg white 🍳
Analgesic, ABX, Systemic ointment
Cool the Burn by covering it with
Sterile Gauze/No Cotton
Look for (Scars, Dipigmentation, Contractures)
Heal in 2-4 weeks
Full Thickness Burn
Epidermis, Dermis, Hypodermis, Bone
Dry, Fat exposed, Hair follicle, Sweat gland destroyed
No pain due to Nerve Damage
Eschar over injury
Moderate/Severe Edema
RR Failure
Electricity (Entrance/Exit wound)
Complications of
Full Thickness Burn
Respiratory failure
Hypovolemic Shock
Organ perfusion Renal failure
(⬇️30ml, ⬆️ BUN/Creatinine)
Compartment syndrome
Hyperglycemia
Infection (Sepsis)
Mobility issues (Contractures)
CBC: (⬆️K, ⬆️H/H, ⬇️Na)
Malnutrition
Full Thickness Burn Diagnostic test
History
Physical exam
CBC (⬆️K, ⬆️H/H, ⬇️Na)
Full Thickness Burn Treatment
ET/Tracheostomy
Remove clothes, Cool water
Rule of Nine, Parkland formula, IVF
Renal function (Catheter, I/O)
Monitor ECG for (K)
Analgesic, ABX, Systemic ointment
Topical Antimicrobial
Debridment, Escharotomy
Skin grafting, Surgery
Remodeling may last years
Emergent phase
ET/Tracheostomy
IVF
Pain medication
Lab, Art line, Carboxyhemoglobin
Acute phase
Wound care
Prevent infection
Prevent complications
Nutrition
Rehabilitation
Do ROM
Prevent Scars/Constractures
Return to Family roles
Support groups, Counseling, work