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infectious dz Flashcards

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Dermatology Board Prep flashcards
1
Q

two agents responsible for impetigo

A

strep pyogenes
staph aureus

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2
Q

starts as small vesicles, that rupture to expose red moist base with HONEY CRUSTED LESION; very contagious

A

impetigo

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3
Q

tx of impetigo? (2) if bullous or extensive non-bullous?

A

warm soapy washes with antibacterial or chlorhexadine
mupirocin 2% TID (or Retapamulin)
oral dicloxacillin or cephalexin if disseminated or bullous

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4
Q

most common form of impetigo also honey crusted

A

non-bullous

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5
Q

location of most bullous impetigo and most likely agent of bullous impetigo

A

trunk
s. aureus– the toxin forms the bullous

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6
Q

if an adult has bullous impetigo what should you test them for

A

HIV

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7
Q

if giving oral abx for impetigo and pt has PCN allergy, what should you give

A

erythromycin or clarithromycin
if MRSA– clindamycin, bactrim, doxycycline

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8
Q

if youre seeing redness and not sure if its cellulitis what can you do?

A

touch it— it will be hot!

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9
Q

non-necrotizing inflammation of the dermis and hypodermis related to acute infection that does not involve the fascia or muscles that starts from break in skin; also from impaired or occluded lymphatic drainage and edema (post mastectomy, vein harvest).

A

cellulitis

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10
Q

3 bacterial causes of cellulitits

A

Group A strep
S. aureus (adults)
HIB (kids)

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11
Q

4 descriptors of cellulitis; 3 sx they might have

A

redness, warmth, edema, pain
may have fever, leukocytosis, elevated ESR

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12
Q

3 abx for uncomplicated cellulitis

A

Cephalexin, Dicloxacillin, or Clindamycin

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13
Q

3 bacteria involved with dog bite cellulitis

A

PASTERURELLA CANIS, S aureus, or S pyogenes

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14
Q

abx for dog bite cellulitis? if allergic to PCN?

A

augmentin
PCN allergy: clinda + cipro

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15
Q

how is human and cat bite tx?

A

same as dog

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16
Q

2 bacterias that are involved in cat bite

A

PASTEURELLA MULTOCIDA
and pasturella septica

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17
Q

rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues

A

necrotizing fasciitis

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18
Q

cause of Type 1-3 necrotizing fasciitis

A

1: polymicrobial
2: group A strep
3: gas gangrene or clostridial myonecrosis

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19
Q

Ulcerations covered by adherent crusts, deeper form of impetigo d/t poor hygiene; preexisting tissue damage and immunocompromised;

A

ecthyma

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20
Q

which is more aggressive ecthyma or erysipelas

A

erysipelas

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21
Q

bacteria causing ecthyma

A

Group a strep (pyogenes) which gets contamined with s. aureus

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22
Q

An acute, inflammatory form of cellulitis, differing due to STREAKING from lymphatic involvement; More superficial than cellulitis, with better demarcation.

A

erysipelas

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23
Q

location of ecthyma vs erysipelas

A

ecthyma: usually <10 lesions on LE
erysipelas: lower legs, face, ears

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24
Q

bacteria responsible for erysipelas

A

group A strep on face
Non-group A strep on legs

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25
Q

facial erysipelas develops from ______

A

nasopharyngeal strep, as a result of recent strep pharyngitis

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26
Q

tx of localized ecythema

A

topical mupirocin ointment TID

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27
Q

tx of extensive ecythema (same as for erysipelas)

A

1 oral/iv PCN G or VK

cephalexin, dicloxacillin, clindamycin
Admit if its erysipelas

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28
Q

kiesselbach’s plexus and cranial cavity

A

in some ppl, some nasal veins join with sagittal sinus making potential pathway into cranial cavity

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29
Q

an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation; common complication of obesity and DM

A

Intertrigo

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30
Q

most common cause of intertrigo? what else can cause it?

A

Most common– candida
can also be bacterial or viral

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31
Q

2 tests to diagnose intertrigo

A

KOH— budding yeast with pseudohyphae
Wood’s lamp

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32
Q

“beefy red” macerated moist plaques and erosion with peripheral scaling and red satellite lesions; can be itchy; will have hx of moisture & friction area

A

intertrigo

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33
Q

3 tx of intertrigo & what to do if it doesnt go away?

A

correct causes– AC, absorbent powders etc
nyastin, miconazole, clotrimazole esp with class III to VI steroid for short duration
if no improvment then biopsy

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34
Q

a chronic superficial infection (stratum corneum) of the intertriginous areas of the skin

A

erythrasma

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35
Q

organism responsible for erythrasma

A

CORYNEBACTERIUM MINUTISSIMUM

36
Q

dx of erytherasma (2)

A

wood’s lamp CORAL RED
gram stain: G+ filamentous rods

37
Q

3 tx of erythrasma

A

ERYTHROMYCIN
clarithromycin
clinda or TCN

38
Q

groin tinea cruris vs cutaneous candidasis

A

tinea involves the folds but not the penis itself
cutaneous will be on penis but not folds

39
Q

groin tinea vs candida hx

A

tinea– heat sweat hx or coexisting low immunity or obesity
candida– generalized itchy with increased severity; warm and moist

40
Q

Symmetric red rash in the groin, red patches with central clearing in inguinal creases. Penis and scrotum spared (typically)

A

tinea cruris

41
Q

Satellite lesions are commonly found; Penis and scrotum affected and inguinal creases spared.

A

genital candida

42
Q

dx of tinea cruris and candida

A

tinea: KOH for hyphae, pseudohyphae or budding yeast
candida: KOH for fungal hyphae

43
Q

tx of groin tinea vs candida

A

tinea: topical terbinafine is best; PO if extensive
candida: expanded sprectrum azole– PO fluconazole or topical polyene (nystatin)

44
Q

Most common vector-borne illness in US, multisystem illness usually caused by spirocheteBorrelia burgdorferi

A

Lyme dz

45
Q

sx of lyme dz

A

Erythema migrans– rash bulls eye
flu like illness– fever, chills, malaise, myalgias, arthralgia, HA
tender local adenopathy

46
Q

risk of lyme dz is ____ if tick feeds for 72 hrs

A

25%

47
Q

tx if there is tick attachment only

A

doxycycline 200mg ONCE

48
Q

tx of early localized lyme dz (3) & duration

A

doxycycline 100mg BID
amoxicillin 500 mg TID
Cefuroxime 500 mg BID
all used 14-21 days

49
Q

how fast does EM appear after tick bite

A

7-14 days

50
Q

dx of early localized lyme (2)

A

dont do serology if there is EM
can get acute and covalescent Ig titers if cause of sx is unknown

51
Q

how to screen for lymes if no EM or they dont recall a tick bite

A

ELISA or EIA first; if its positive or equivocal, then to Western Blot to confirm

52
Q

how do you tx oter tick borne dz

A

PO doxycycline

53
Q

As a result of direct contact with infected person or pet; questionable if contracted from linens/cloths; Insidious onset followed by scratching, which destroys burrow removing mite. After 6-8 weeks can be wide spread

A

scabies

54
Q

nocturnal pruritis is characteristic of ______

A

scabies

55
Q

what is responsible for scabies

A

Sarcoptes scabiei hominis mite

56
Q

dx of scabies

A

skin scraping to a slide with saline (NOT KOH)

57
Q

how to differentiate scabies from dyshidrosis on fingers

A

dyshidrosis isnt really itchy

58
Q

2 tx for scabies that is pregnancy B and safe in over 2months old

A

Permethrin – synthetic pyrethrin
Lindane– gamma benzene hexachloride

59
Q

permetherin duration in adults vs kids

A

12 hours in adults, kids 8 hrs

60
Q

tx of scabies in large groups

A

ivermectin– antihelminitic used in healthy and HIV; pruritis is rapidly controlled

61
Q

tx of scabies in pts with thick, crusted lesions

A

Ivermectin + Permetherin

62
Q

tx of scabies that has a lower cure rate and used daily for 5 days

A

Crotamiton lotion

63
Q

who should you tx with scabies? (2)

A

all intimate contacts
family members

64
Q

Crusted lesions, grey scales and dystrophic nails HIV patients, cognitive impaired, elderly and/or immunocompromised individuals from Sarcoptes scabiei hominis

A

norwegian scabies

65
Q

Most contagious STI caused by Pthirus pubis; with itching as #1 complaint

A

Pediculosis pubis

66
Q

dx of lice (2)

A

complaints of itching & visualization of nits/eggs
wood lamp causes nits to fluorescence

67
Q

Infects the scalp more in kids; scratching causes inflammation and secondary bacterial infection; caused by Pediculus humanus capitis

A

Pediculosis capitits

68
Q

4 tx of lice

A

Lindane shampoos & lotions
Synergized pyrethrins shampoos & lotion
permethrin for head lice
nit removal

69
Q

duration of tx with lice

A

repeat in 7-10 days

70
Q

Lactrodectus mactans is the…

A

black widow

71
Q

neurotoxic; one of the most potent venoms secreted by an animal; sx start w/in 20 mins of bite

A

black widow bite

72
Q

Local pain, then localized or generalized severe muscle cramps, abd. pain, weakness, and tremor. Large muscle groups (such as shoulder or back) are often affected for 2-3 days.

A

minor black widow bite

73
Q

nausea, vomiting, fainting, dizziness, chest pain, respiratory difficulties, significant hypertension, and death

A

severe black widow bite

74
Q

bite that can mimic appendicitis, cholecystitis & MI

A

black widow

75
Q

3 tx of black widow envenomations

A

RICE & analgesics
Latrodectus Antivenin
Muscle relaxants

76
Q

tx of black widow bite that significantly shortens symptom duration, regardless of species; IM or IV; prepared in horse serum; requires call to state DoH to get it

A

Latrodectus Antivenin

77
Q

med for healthy 16-60 y/o to help with sxs

A

muscle relaxants– calcium gluconate or diazepam

78
Q

Loxosceles reclusa is

A

brown recluse spider; violin pattern on back

79
Q

cytotoxic & hemolytic; can be necrotic w/in 4 hrs

A

brown recluse bite

80
Q

Blue-gray halo, cyanotic bulla, irregular edges, increased pain after getting bitten; in severe cases RBC destruction, thrombocytopenia, blood clots, acute renal failure, coma

A

brown recluse spider bite

81
Q

tx of brown recluse (5)

A

RICE & analgesics
tetanus prophylaxis!
Dapsone w/in 48 hrs of bite
PO prednisone if necrosis >2cm
surgical debridement if central area of necrosis

82
Q

do not apply heat, steroids, suction, tourniquet with ____

A

brown recluse spider bites

83
Q

angular chelitis is caused by

A

yeast +/- bacterial

84
Q

tx of angular cheilitis

A

nyastin (maybe w steroid?)

85
Q

if worried about pseudomonas in shoe, what should you treat with

A

fluoroquinolone– ciprofloxacin

DERM (13 decks)

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