Infectious Derm II Flashcards
1
Q
What are the three major variants of impetigo?
A
- Non-bullous
- Bullous
- Ecthyma
2
Q
What are the top two causes of impetigo in order?
A
S. aureus
S. Pyogenes
3
Q
What is the age range that is generally affected with impetigo?
A
2-5 years
4
Q
What is the treatment for impetigo?
A
Topical abx
5
Q
What is ecthyma? What does it look like?
A
- Ulcerative form of impetigo–lesions extend into the dermis
- Appear as punched out ulcers surrounded by raised margins, covered with yellow crust
6
Q
punched out ulcers surrounded by raised margins, covered with yellow crust = ?
A
Ecthyma
7
Q
Where on the body does ecthyma usually occur?
A
Distal extremities, with regional LAD present
8
Q
What are the preventative measures for impetigo?
A
Good handwashing
9
Q
What is the oral treatment for impetigo? Topical?
A
oral abx like dicloxacillin or cephalexin
Topical mupirocin
10
Q
Hot tub folliculitis = ?
A
Pseudomonas
11
Q
What is the usual infectious agent that cause folliculitis?
A
Staph aureus
12
Q
What is the treatment for folliculitis?
A
cleanse 3x/day and oral anti staph
13
Q
What is a furuncle?
A
Staph infection of an obstructed hair follicle
-Presents as a red, TTP, inflamed nodule that becomes fluctuant with central suppuration
14
Q
What is the treatment for a furuncle?
A
I and D
15
Q
What are carbuncles?
A
Coalesced furuncles–large abscesses that are usually of staph orign
16
Q
What is the treatment for a carbuncle?
A
I and D, maybe oral abx
17
Q
What is hidradenitis suppurativa?
A
Chronic suppurative infection of apocrine sweat glands, most often d/t staph
-Leads to recurrent abscesses
18
Q
What is the treatment for hidradenitis suppurativa?
A
Moist compresses and I and D
19
Q
What, generally, is cellulitis?
A
- Infection of the dermis that often begins at a wound.
- Presents as a spreading, red, nonfluctuant, TTP, plaque, that has a poorly defined border
20
Q
Where on the body is cellulitis usually found?
A
Legs
21
Q
What are the associated signs of cellulitis?
A
Lymph streaking
22
Q
What is characteristics of cellulitis if caused by strep?
A
Bullous lesions may form
23
Q
spreading, red, nonfluctuant, TTP, plaque, that has a poorly defined border = ?
A
Cellulitis
24
Q
What are the risk factors for cellulitis?
A
Preexisting skin infection or trauma
25
What usually causes cellulitis?
Gram positive organisms
26
What is the causative agent of animal bite and human bite cellulitis?
```
Animal = pasteurella multocida
Human = Eikenella Corrodens
```
27
What is the treatment for purulent vs nonpurulent cellulitis?
```
Purulent = treat for MRSA
Non-purulent = GAS
```
28
What are the causes of HA-MRSA? (3)
- Abx use
- Surgical site infection
- ICU
29
What are the causes of CA-MRSA? (3)
- proximity to others with MRSA
- Skin trauma
- Shaving
30
What causes erysipelas, and where does it tend to occur?
GAS
| Legs or face
31
What, generally, is erysipelas?
Superficial cellulitis with marked dermal lymphatic involvement
32
What are the systemic symptoms of erysipelas?
Fevers
Leukocytosis
HA
Emesis
33
What is the major difference between cellulitis and erysipelas?
Erysipelas is sharply demarcated, while cellulitis is not
34
What causes the rash with scarlet fever?
Strep exotoxin
35
Where does the rash begin with scarlet fever? How does it progress?
- Face
- Neck
- Upper chest
- Progresses downward
36
What are the oral findings of scarlet fever? (2)
- Strawberry tongue
| - Perioral pallor
37
What are the palpable characteristics of the rash with scarlet fever?
Feels like sandpaper
38
What are the pastia's lines that can be seen with scarlet fever?
a clinical sign in which pink or red lines formed of confluent petechiae are found in skin creases, particularly the crease in the antecubital fossa
39
Does the rash with scarlet fever blanch?
Yes
40
What areas are spared with scarlet fever?
Peri-oral area
41
Where is the rash accentuated with scarlet fever?
Antecubital areas
| Axillary folds
42
What happens to the scarlet fever rash?
After 4 days, there is extensive desquamation of the skin
43
What is the treatment for scarlet fever?
PCN
44
What is Ritter's disease?
SSSS
45
What causes SSSS?
Exfoliative exotoxin of staph aureus
46
What is SSSS called in neonates?
Pemphigus neonatorum
47
What is the progression of the rash with SSSS?
Within 24 hours, large clear bullae develop which gradually shed, leaving a red, denuded base
48
What causes toxic shock syndrome?
one or more exotoxins of staph aureus
49
What are the s/sx of toxic shock syndrome?
- n/v
- Hyperemia of the oral
- Kidney failure
- Hepatitis
50
True or false: bacteremia is not a feature of toxic shock syndrome
True
51
What is the treatment for toxic shock syndrome?
Abx, but more so aggressive supportive therapy
52
What part of the skin is affected with necrotizing fasciitis?
Fascia just above the muscle
53
What is the appearance of the skin with necrotizing fasciitis?
Rapidly expanding dusky, edematous, red plaques with blue discoloration.
54
Expanding dusky, edematous, red plaques with blue discoloration. = ?
Necrotizing fasciitis
55
What are the symptoms of nec fash?
Anesthesia of the skin
56
What is the treatment for nec fash?
WIdespread debridement and broad spectrum abx
57
What are types I - III of Necrotizing fasciitis?
Type I = poly microbial
Type II = GAS
Type III = Gas gangrene or Clostridial
58
What is Fournier's gangrene?
Necrotizing fasciitis of the perineum and scrotum
59
What are the x-ray findings that may be present with Necrotizing fasciitis?
gas
60
What area of the body is particularly bad for Necrotizing fasciitis?
Abdomen
61
Over what age is a bad prognostic factor for Necrotizing fasciitis?
50
62
What diseases are bad prognostic signs for Necrotizing fasciitis? (2)
- Atherosclerosis
| - DM
63
Which neisseria meningitidis strain is there no vaccine available for?
B
64
What is the rash that is seen with meningococcemia?
Erythematous macules, with brown stained appearance. Later lesions become purpuric with an irregular edge
65
True or false: the petechia with meningococcemia always spares the conjunctiva?
False-it can
66
What is the treatment for meningococcemia?
PCN
67
True or false: there is meningococcus in the rash with meningococcemia
True--don't touch it
68
What are the three types of fungi, based on their location/source?
Geophilic
Zoophilic
Anthrophilic
69
What are the three major genera of fungi that infect humans?
- Epidermophyton
- Microsporum
- Trichophyton
70
What area of the body do dermatophytes infect? What allow them to infect this area?
- Keratinized tissue
| - Have keratinase that allows them to live there
71
Yeasts are more likely to infect what parts of the body?
Deep skin or mucous membranes
72
What is the cause of tinea versicolor? What is the appearance with KOH prep?
Malassezia furfur
Spaghetti and meatballs
73
What is the causative agent of tinea pedis?
Trichophyton rubrum or mentagrophytes
74
What are the three major clinical patterns of tinea pedis? Which is most common?
- **Interdigital**
- Moccasin
- Vesiculobullous
75
What is the moccasin type of tinea associated with?
Onychomycosis
76
What are the findings of tinea manus?
Whiteness in the creases of the hand
77
What are the characteristics of the vesiculobullous type of tinea?
Grouped, 2-3 mm vesicles, often on the arch of the instep of the foot
78
What are the topical agents for tinea?
Azoles
| Terbinafine
79
What is the best way to diagnose tinea?
KOH prep
80
What are the characteristics of tinea corporis?
Sharply marginated annular plaque with central clearing and scaling at the edges
81
Sharply marginated annular plaque with central clearing and scaling at the edges
Tinea corporis
82
Where in the lesion of tinea corporis is the fungi most active, and thus where you should take a sample from for dx?
Margins
83
What should always be assessed for with tinea corporis?
Tinea pedis
84
What is the usual fungi involved with tinea corporis?
Trichophyton rubrum
85
What are the usual fungi involved with tinea cruris? (2)
Epidermophyton floccosum
| Trichophyton rubrum
86
What is the treatment for tinea corporis? When is systemic therapy indicated?
Topical antifungals
| -systematic if poor response to topical, or large surface area
87
What are the two types of tinea on the face? How does each appear?
- Tinea faciei = corporis on the face
| - Tinea barbae = multiple pustules around hair follicles
88
What is the fungus usually responsible for tinea barbae?
Trichophyton mentagrophytes
89
What is the usual presentation of tinea capitis?
Patch of alopecia with black dots, which are hairs that have broken off at the skin
90
What are the fungi that cause tinea capitis?
Microsporum canis, audouninii
91
Who usually gets tinea capitis?
School aged children
92
What is a kerion?
Pustules of the hair shaft with tinea capitis develop, forming an inflammatory nodule
93
What is the treatment for tinea capitis?
Topical agents not effective--oral griseofulvin
94
What is the treatment for onychomycosis?
Oral terbinafine x 12 weeks
95
What is the usual presentation of tinea versicolor?
Well demarcated hyper and hypopigmentation
96
What is the treatment for tinea versicolor?
Selenium shampoos, ketoconazole
97
What is the appearance of intertrigo?
Sharply defined red plaques involving skin folds with surrounding satellite macules
98
What is the usual cause of diaper dermatitis, and what does it look like?
- Beefy red plaques with white scales
| - Candida
99
Is a diaper rash does not improve with barrier creams like Zn oxide, what pathogen should be suspected?
candida
100
What is the treatment for candidal diaper rashes?
Nystatin
101
Cradle cap in infants = ?
Seborrheic dermatitis
102
What causes seborrheic dermatitis?
Increased sebaceous gland activity causes an inflammatory reaction to malassezia species
103
What does seborrheic dermatitis look like?
Ranges from fine white scale to erythematous patches and plaques with greasy yellow scales
104
What is the fungal infection commonly seen with PD?
Seborrheic dermatitis
105
What is the treatment for seborrheic dermatitis?
Ketoconazole
106
What are the symptoms of candidal vulvovaginitis?
Creamy white d/c with pruritis
107
What is candidal paronychia? What is the risk that this presents?
Fungal infection of the nail folds
secondary infection with bacteria
108
What is the lepromatous form of TB?
Infiltrative cutaneous lesions will ill-defined borders
109
What is the tuberculoid leprosy?
Benign course, but with cutaneous lesions that are frequently erythematous with elevated border
110
What is the treatment for lepromatous and tuberculoid leprosy?
- lepromatous = Dapsone, RIPE
| - tuberculoid = excise +systemic therapy
111
What is the parasite that causes pediculosis (lice)?
Pediculus humanus
112
Where is the most common place to find head lice on the head?
retroauricular and occipital scalp
113
What is the treatment for head lice?
Permethrin or malathion
114
What is the usual presentation of scabies?
Multiple erythematous papules on trunk, extremities, and genitals
Burrows are pathognomonic
115
What is the best way to diagnose scabies?
skin scrapings and microscopy
116
What is the treatment for scabies?
Oral ivermectin
117
What is Norwegian scabies?
Scabies + hyperkeratosis
118
What is pediculosis pubis? Treatment?
Pubic lice
| Ivermectin
119
What is the usual presentation of bed bugs?
Clusters of Pruritic, erythematous and edematous papules
120
What is the parasite that causes bed bugs?
Cimex lectuularis
121
What is the treatment for bed bugs?
Topical steroids and antihistamines
Burn everything
122
What causes rocky mountain spotted fever? Presentation?
Rickettsia rickettsii
| ILI + centipedal rash
123
What are the lab abnormalities that may be seen with RMSF?
Hyponatremia and thrombocytopenia
