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Specialty Medicine > Infectious Derm II > Flashcards

Infectious Derm II Flashcards

1
Q

What are the three major variants of impetigo?

A
  • Non-bullous
  • Bullous
  • Ecthyma
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2
Q

What are the top two causes of impetigo in order?

A

S. aureus

S. Pyogenes

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3
Q

What is the age range that is generally affected with impetigo?

A

2-5 years

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4
Q

What is the treatment for impetigo?

A

Topical abx

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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
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6
Q

punched out ulcers surrounded by raised margins, covered with yellow crust = ?

A

Ecthyma

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7
Q

Where on the body does ecthyma usually occur?

A

Distal extremities, with regional LAD present

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8
Q

What are the preventative measures for impetigo?

A

Good handwashing

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9
Q

What is the oral treatment for impetigo? Topical?

A

oral abx like dicloxacillin or cephalexin

Topical mupirocin

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10
Q

Hot tub folliculitis = ?

A

Pseudomonas

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11
Q

What is the usual infectious agent that cause folliculitis?

A

Staph aureus

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12
Q

What is the treatment for folliculitis?

A

cleanse 3x/day and oral anti staph

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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

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14
Q

What is the treatment for a furuncle?

A

I and D

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15
Q

What are carbuncles?

A

Coalesced furuncles–large abscesses that are usually of staph orign

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16
Q

What is the treatment for a carbuncle?

A

I and D, maybe oral abx

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17
Q

What is hidradenitis suppurativa?

A

Chronic suppurative infection of apocrine sweat glands, most often d/t staph
-Leads to recurrent abscesses

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18
Q

What is the treatment for hidradenitis suppurativa?

A

Moist compresses and I and D

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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

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20
Q

Where on the body is cellulitis usually found?

A

Legs

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21
Q

What are the associated signs of cellulitis?

A

Lymph streaking

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22
Q

What is characteristics of cellulitis if caused by strep?

A

Bullous lesions may form

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23
Q

spreading, red, nonfluctuant, TTP, plaque, that has a poorly defined border = ?

A

Cellulitis

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24
Q

What are the risk factors for cellulitis?

A

Preexisting skin infection or trauma

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25
Q

What usually causes cellulitis?

A

Gram positive organisms

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26
Q

What is the causative agent of animal bite and human bite cellulitis?

A 
Animal = pasteurella multocida
Human = Eikenella Corrodens
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27
Q

What is the treatment for purulent vs nonpurulent cellulitis?

A 
Purulent = treat for MRSA
Non-purulent = GAS
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28
Q

What are the causes of HA-MRSA? (3)

A
  • Abx use
  • Surgical site infection
  • ICU
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29
Q

What are the causes of CA-MRSA? (3)

A
  • proximity to others with MRSA
  • Skin trauma
  • Shaving
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30
Q

What causes erysipelas, and where does it tend to occur?

A

GAS

Legs or face

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31
Q

What, generally, is erysipelas?

A

Superficial cellulitis with marked dermal lymphatic involvement

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32
Q

What are the systemic symptoms of erysipelas?

A

Fevers
Leukocytosis
HA
Emesis

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33
Q

What is the major difference between cellulitis and erysipelas?

A

Erysipelas is sharply demarcated, while cellulitis is not

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34
Q

What causes the rash with scarlet fever?

A

Strep exotoxin

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35
Q

Where does the rash begin with scarlet fever? How does it progress?

A
  • Face
  • Neck
  • Upper chest
  • Progresses downward
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36
Q

What are the oral findings of scarlet fever? (2)

A
  • Strawberry tongue

- Perioral pallor

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37
Q

What are the palpable characteristics of the rash with scarlet fever?

A

Feels like sandpaper

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38
Q

What are the pastia’s lines that can be seen with scarlet fever?

A

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

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39
Q

Does the rash with scarlet fever blanch?

A

Yes

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40
Q

What areas are spared with scarlet fever?

A

Peri-oral area

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41
Q

Where is the rash accentuated with scarlet fever?

A

Antecubital areas

Axillary folds

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42
Q

What happens to the scarlet fever rash?

A

After 4 days, there is extensive desquamation of the skin

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43
Q

What is the treatment for scarlet fever?

A

PCN

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44
Q

What is Ritter’s disease?

A

SSSS

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45
Q

What causes SSSS?

A

Exfoliative exotoxin of staph aureus

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46
Q

What is SSSS called in neonates?

A

Pemphigus neonatorum

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47
Q

What is the progression of the rash with SSSS?

A

Within 24 hours, large clear bullae develop which gradually shed, leaving a red, denuded base

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48
Q

What causes toxic shock syndrome?

A

one or more exotoxins of staph aureus

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49
Q

What are the s/sx of toxic shock syndrome?

A
  • n/v
  • Hyperemia of the oral
  • Kidney failure
  • Hepatitis
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50
Q

True or false: bacteremia is not a feature of toxic shock syndrome

A

True

51
Q

What is the treatment for toxic shock syndrome?

A

Abx, but more so aggressive supportive therapy

52
Q

What part of the skin is affected with necrotizing fasciitis?

A

Fascia just above the muscle

53
Q

What is the appearance of the skin with necrotizing fasciitis?

A

Rapidly expanding dusky, edematous, red plaques with blue discoloration.

54
Q

Expanding dusky, edematous, red plaques with blue discoloration. = ?

A

Necrotizing fasciitis

55
Q

What are the symptoms of nec fash?

A

Anesthesia of the skin

56
Q

What is the treatment for nec fash?

A

WIdespread debridement and broad spectrum abx

57
Q

What are types I - III of Necrotizing fasciitis?

A

Type I = poly microbial
Type II = GAS
Type III = Gas gangrene or Clostridial

58
Q

What is Fournier’s gangrene?

A

Necrotizing fasciitis of the perineum and scrotum

59
Q

What are the x-ray findings that may be present with Necrotizing fasciitis?

A

gas

60
Q

What area of the body is particularly bad for Necrotizing fasciitis?

A

Abdomen

61
Q

Over what age is a bad prognostic factor for Necrotizing fasciitis?

A

50

62
Q

What diseases are bad prognostic signs for Necrotizing fasciitis? (2)

A
  • Atherosclerosis

- DM

63
Q

Which neisseria meningitidis strain is there no vaccine available for?

A

B

64
Q

What is the rash that is seen with meningococcemia?

A

Erythematous macules, with brown stained appearance. Later lesions become purpuric with an irregular edge

65
Q

True or false: the petechia with meningococcemia always spares the conjunctiva?

A

False-it can

66
Q

What is the treatment for meningococcemia?

A

PCN

67
Q

True or false: there is meningococcus in the rash with meningococcemia

A

True–don’t touch it

68
Q

What are the three types of fungi, based on their location/source?

A

Geophilic
Zoophilic
Anthrophilic

69
Q

What are the three major genera of fungi that infect humans?

A
  • Epidermophyton
  • Microsporum
  • Trichophyton
70
Q

What area of the body do dermatophytes infect? What allow them to infect this area?

A
  • Keratinized tissue

- Have keratinase that allows them to live there

71
Q

Yeasts are more likely to infect what parts of the body?

A

Deep skin or mucous membranes

72
Q

What is the cause of tinea versicolor? What is the appearance with KOH prep?

A

Malassezia furfur

Spaghetti and meatballs

73
Q

What is the causative agent of tinea pedis?

A

Trichophyton rubrum or mentagrophytes

74
Q

What are the three major clinical patterns of tinea pedis? Which is most common?

A
  • Interdigital
  • Moccasin
  • Vesiculobullous
75
Q

What is the moccasin type of tinea associated with?

A

Onychomycosis

76
Q

What are the findings of tinea manus?

A

Whiteness in the creases of the hand

77
Q

What are the characteristics of the vesiculobullous type of tinea?

A

Grouped, 2-3 mm vesicles, often on the arch of the instep of the foot

78
Q

What are the topical agents for tinea?

A

Azoles

Terbinafine

79
Q

What is the best way to diagnose tinea?

A

KOH prep

80
Q

What are the characteristics of tinea corporis?

A

Sharply marginated annular plaque with central clearing and scaling at the edges

81
Q

Sharply marginated annular plaque with central clearing and scaling at the edges

A

Tinea corporis

82
Q

Where in the lesion of tinea corporis is the fungi most active, and thus where you should take a sample from for dx?

A

Margins

83
Q

What should always be assessed for with tinea corporis?

A

Tinea pedis

84
Q

What is the usual fungi involved with tinea corporis?

A

Trichophyton rubrum

85
Q

What are the usual fungi involved with tinea cruris? (2)

A

Epidermophyton floccosum

Trichophyton rubrum

86
Q

What is the treatment for tinea corporis? When is systemic therapy indicated?

A

Topical antifungals

-systematic if poor response to topical, or large surface area

87
Q

What are the two types of tinea on the face? How does each appear?

A
  • Tinea faciei = corporis on the face

- Tinea barbae = multiple pustules around hair follicles

88
Q

What is the fungus usually responsible for tinea barbae?

A

Trichophyton mentagrophytes

89
Q

What is the usual presentation of tinea capitis?

A

Patch of alopecia with black dots, which are hairs that have broken off at the skin

90
Q

What are the fungi that cause tinea capitis?

A

Microsporum canis, audouninii

91
Q

Who usually gets tinea capitis?

A

School aged children

92
Q

What is a kerion?

A

Pustules of the hair shaft with tinea capitis develop, forming an inflammatory nodule

93
Q

What is the treatment for tinea capitis?

A

Topical agents not effective–oral griseofulvin

94
Q

What is the treatment for onychomycosis?

A

Oral terbinafine x 12 weeks

95
Q

What is the usual presentation of tinea versicolor?

A

Well demarcated hyper and hypopigmentation

96
Q

What is the treatment for tinea versicolor?

A

Selenium shampoos, ketoconazole

97
Q

What is the appearance of intertrigo?

A

Sharply defined red plaques involving skin folds with surrounding satellite macules

98
Q

What is the usual cause of diaper dermatitis, and what does it look like?

A
  • Beefy red plaques with white scales

- Candida

99
Q

Is a diaper rash does not improve with barrier creams like Zn oxide, what pathogen should be suspected?

A

candida

100
Q

What is the treatment for candidal diaper rashes?

A

Nystatin

101
Q

Cradle cap in infants = ?

A

Seborrheic dermatitis

102
Q

What causes seborrheic dermatitis?

A

Increased sebaceous gland activity causes an inflammatory reaction to malassezia species

103
Q

What does seborrheic dermatitis look like?

A

Ranges from fine white scale to erythematous patches and plaques with greasy yellow scales

104
Q

What is the fungal infection commonly seen with PD?

A

Seborrheic dermatitis

105
Q

What is the treatment for seborrheic dermatitis?

A

Ketoconazole

106
Q

What are the symptoms of candidal vulvovaginitis?

A

Creamy white d/c with pruritis

107
Q

What is candidal paronychia? What is the risk that this presents?

A

Fungal infection of the nail folds

secondary infection with bacteria

108
Q

What is the lepromatous form of TB?

A

Infiltrative cutaneous lesions will ill-defined borders

109
Q

What is the tuberculoid leprosy?

A

Benign course, but with cutaneous lesions that are frequently erythematous with elevated border

110
Q

What is the treatment for lepromatous and tuberculoid leprosy?

A
  • lepromatous = Dapsone, RIPE

- tuberculoid = excise +systemic therapy

111
Q

What is the parasite that causes pediculosis (lice)?

A

Pediculus humanus

112
Q

Where is the most common place to find head lice on the head?

A

retroauricular and occipital scalp

113
Q

What is the treatment for head lice?

A

Permethrin or malathion

114
Q

What is the usual presentation of scabies?

A

Multiple erythematous papules on trunk, extremities, and genitals

Burrows are pathognomonic

115
Q

What is the best way to diagnose scabies?

A

skin scrapings and microscopy

116
Q

What is the treatment for scabies?

A

Oral ivermectin

117
Q

What is Norwegian scabies?

A

Scabies + hyperkeratosis

118
Q

What is pediculosis pubis? Treatment?

A

Pubic lice

Ivermectin

119
Q

What is the usual presentation of bed bugs?

A

Clusters of Pruritic, erythematous and edematous papules

120
Q

What is the parasite that causes bed bugs?

A

Cimex lectuularis

121
Q

What is the treatment for bed bugs?

A

Topical steroids and antihistamines

Burn everything

122
Q

What causes rocky mountain spotted fever? Presentation?

A

Rickettsia rickettsii

ILI + centipedal rash

123
Q

What are the lab abnormalities that may be seen with RMSF?

A

Hyponatremia and thrombocytopenia

Specialty Medicine (36 decks)

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