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Dermatology > Infections > Flashcards

Infections Flashcards

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Dermatology Board Prep flashcards
1
Q

Varicella zoster (chicken pox) vaccine offered to who

A

Non immune health care workers
Pregnant women
Those in contact with i/s patients

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2
Q

Reactivation of dormant VZvirus?

A

Shingles (herpes zoster)

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3
Q

Opthalmic shingles = reactivation of virus in what nerve?

A

Trigeminal nerve (V1)

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4
Q

Management of opthalamic shingles?

A

Urgent referral to opth

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5
Q

Reactivation of the virus (shingles) within the geniculate nucleus of the facial nerve - Dx??

A

Ramsay hunt syndrome

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6
Q

Presentation of ramsay hunt syndrome?

A 
Rash and pain in auditory canal 
Associated:
Bells palsy
Deafness
Vertigo
Tinnitus
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7
Q

Whats bells palsy?

A

Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The condition causes one side of your face to droop or become stiff.

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8
Q

Treatment of shingles?

A

Oral aciclovir and analgesia

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9
Q

Shingles main complication?

A

Post herpetic neuralgia (dermatomal pain following resolution)

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10
Q

Recurrent herpes simplex disease can present with what skin rash?

A

Erythema multiforme

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11
Q

Inoculation of herpes simplex virus in the finger - solitary painful lesion?

A

Herpetic whitlow

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12
Q

Monomorphic punched out lesions (disseminated infection) seen in children with atopic eczema ?

A

Eczema herpecticum

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13
Q

Herpes simplex treatment ?

A

Analgesia
Oral/IV aciclovir
Education about spread

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14
Q

HPV virus
types 1-4 cause ?
types 6 and 11 cause?
types 16 and 18 (and 33) cause?

A

common warts

genital warts

Cervical cancer

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15
Q

Treatment of common warts?

A

salicyclic acid
cryotherapy
imiquimod

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16
Q

Treatment of genital warts ?

A

Podophyllin or cryotherapy

Imiquimod

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17
Q

itchy solid pearly pink papules with umbilicated centre?

A

molluscum contagiosum

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18
Q

cause of molluscum contagiosum?

A

pox virus

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19
Q

Molluscum contagiosum - lesion usually where ?

Treatment?

A

head neck and trunk

self limiting - nil treatment

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20
Q

Initially Bilateral macular erythema on cheeks of a child and then maculopapular rash with lacy erythem on trunk/limbs Dx?

A

Slapped cheek disease (Erythema infectiosum)

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21
Q

What is erythema infectiosum (slapped cheek) caused by?

A

Parvovirus B19

can be detcted by B19 IgM

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22
Q

Slapped check ass symptoms?

Management?

A

Fever and polyarthritis

Self limiting - nil T

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23
Q

Paropox virus (found in sheep) can cause what skin problem ?

A

Orf

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24
Q

Orf (parapox virus) normally seen in what occupation?

A

farmers

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25
Q

Orf morphology?

Treatment?

A

Single firm fleshy nodules on hands

Self limiting

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26
Q

Coxsackie virus can cause what skin problem?

A

Hand foot and mouth disease

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27
Q

Presentation/symptoms of hand foot and mouth disease ? Rash?

Where?

A

Prodromal fever and malaise
Grey vesicles surrounded by erythema and mouth ulcers
Rash - hands and feet

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28
Q

Treatment of hand foot and mouth disease?

A

Nil - self limiting

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29
Q

Majority of dermatophyte fungal infections caused by what organism?

A

trichophyton rabrum

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30
Q

Body part affected :

a) Tinea capitis
b) barbae
c) corporis
d) tinea mannum
e) tinea unguium
f) tinea cruris
g) tinea pedis

A 
head 
beard
body
hand
nail
groin
foot
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31
Q

Appearance of fungal rash? Shape of lesion??

A

Erythematous scaly itchy ring shaped lesion with actively expanding edge and resolving centre

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32
Q

Dx?

A

Skin scraping

or nail clipping

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33
Q

Skin scraping taken from where in lesion

A

edge of lesion

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34
Q

Treatment if localized ?

Treatment continued for how many days after lesions healed?

A

Topical antifungals
clotrimazole, miconazole
(2-3 times daily apply)

10

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35
Q

Treatment for athletes foot ?

A

Terbinafine (for a week)

36
Q

Widespread infection or nail infection T?

A

ORAL anti fungals

37
Q

If finger nails affected - T and how long?

A

Terbinafine (6-12 weeks)

38
Q

If toenail fungal infection - T and duration?

A

Terbinafine ( 3-6 months)

39
Q

Yeast infection particularly common in i/c patients ?

A

Candida albicans

40
Q

Candida albicans - normally affects what regions ?

A

Mouth genitals and flexural areas

under breasts, fat rolls, nappy area

41
Q

Candida albicans - morphogoly of rash ?

a) oral?
b) genital?

A

a) white lesions that can be scraped off

b) white discharge (cottage cheese and non offensive) and itch (may be satellite lesions)

42
Q

if candida affects skin - morphology? (under breats etc)

A

itchy scaly erythema with ragged peeling edges and satellite lesions

43
Q

what are satellite lesions?

A

pustules or erythema that are just beyond the margins of the primary lesion

44
Q

Ix for candidiasis ?

A

skin scraping

45
Q

Treatment of candida infection:

1) if oral ?
2) genital?
3) skin?

A

1) nystatin
2) topical clotrimazole (pessary)
can give oral itraconazole - but oral treatments CI in pregnancy)
3) topical clotrimazole or oral antifungal

46
Q

Treatment with oral anti fungals (especially Terbinafine) requires monitoring of what and why?

A

LFTs

hepatotoxicity

47
Q

Well defined macular lesions with fine scale that are either hypo or hyper pigmented - often noticed after being on holiday?

A

Pityriasis versicolor

48
Q

Why noticed after being on holiday?

A

May be where infection picked up

Tan development will show up the hypopigmented areas

49
Q

Cause of pityriasis versicolor? organism?

A

Yeast infection - Melassezia

50
Q

most commonly melassezia inf occurs where ?

A

hot humid conditions

51
Q

rash appears where on body?

A

back chest arms

52
Q

Treatment of pityriasis versicolor?

A

Topical anti fungals
Ketoconazole
If extensive/failure to respond to topical - oral itraconazole

53
Q

Highly contagious superficial bacterial skin infection affecting face of children - erythematous base and honey golden crust??

A

Impetigo

54
Q

Cause of impetigo?

A

Staph aureus +/- strep pyogenes

55
Q

T of impetigo?

A

Topical fusidic acid

56
Q

T of impetigo if extensive or severe?

A

oral flucloxacillin or clartihromycin +

topical fusidic acid

57
Q

Folliculitis (superficial or deep infection of hair follicile) organism?
Hx of hot tub use - organism?

A

staph aureus

pseudomonas

58
Q

rash with folliculitis?

A

erythematous papules/pustules on hair bearing sites

itch

59
Q

infection of single follicie?

A

boil (large papule)

60
Q

infection of multiple follicles?

A

furnacle (nodules)

61
Q

Treatment folliculitis:

a) 1st line?
b) if boils/furnacles ?

A

usually mild and self limiting

a) topical BPO (benzoyl peroxide) + loose clothing
b) oral flucloxacillin

62
Q

Acute serious infection of skin/soft tissues m/c in the legs?

A

Cellulitis

63
Q

causative organisms - cellulitis ?

A

Strep pyogenes +/- staph aureus

64
Q

Cellulitis normally seen where ?

More common in pts with what condition?

A

Legs

DM

65
Q

typical rash of cellulitis?

A

macular hot erythema ill defined edges and spreading

66
Q

signs and symptoms ass with cellulitis?

A

malaise, flu like, leg pain and swelling, local lymphadenopathy

67
Q

Ix/Dx?

A

Bacterial swab for culture and sensitivity

68
Q

Cellulitis

1st line T?

A

Flucloxacillin

alternative - doxycycline

69
Q

Treatment if SEVERE cellulitis ?

A

IV flucloxacillin (and benzylpenicillin) or Vancomycin if allergic

70
Q

What is ersipelas?

A

superficial form of cellulitis

71
Q

organism in ersipelas?

A

strep pyogenes

72
Q

Ersipelas - m/c affects where?

rash appearance ?

A

face and it spreads

well demarcated, erythematous plaque

73
Q

associated symptoms in ersipelas ?

A

fever and systemic upset

74
Q

Treatment of ersipelas ?

A

IV flucloxacillin

75
Q

highly contagious skin infestation? (caused by sarcoptes scabei)

A

Scabies

76
Q

Presentation of scabies?

Rash?

A 
Severe itch (worse at night) 
Erythematous papules, vesicles, pustules or nodules and visible skin burrows
77
Q

scabies rash normally where on body?

A

web spaces, wrists, axillae, umbilicus, buttocks and groin

78
Q

Highly contagious form of scabies seen in the elderly or i/c pts ?

A

Norweigan scabies

79
Q

scabies treatment ?
1st line ?
2nd line?

A

1) Permethrin

2) malathion

80
Q

how long might itch persist even after eradication of scabies?

A

4-6 weeks

81
Q

severe itch and visible eggs in hair - Dx?

A

head lice

82
Q

head lice management ?

A

Malathion and physical removal via combing

83
Q

Disease caused by tick bite (USA and europe)? organism = borrelia burgdoferi

A

Lyme disease

84
Q

Presentation of lyme disease has 3 stages - 1st ?
2nd?
3rd?

A

1) 2 weeks after bite - bullseye lesion
2) 6 months after bite - malaise/arthralgia + bluish/red swellings on ears and nipples
3) 6mth - 8 yrs after bite. bluish discolouration/atrophy of skin. Chronic pain.

85
Q

Dx lyme disease ?

A

Serology

86
Q

T of lyme disease ?

A

Remove tick
Doxycycline
Amoxicillin

Dermatology (9 decks)

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