infestations trigger Flashcards
lifespan of a louse
14-18 days
yellow, greasy and easy to remove
seborrheic dermatitis
what suggests an infestation of pediculosis capitis
pyoderma + occipital/cervical LAD
these are oval and tenacious and stay stuck to the hair shaft. not easily removed
nits for pediculosis capitis
what will microscopy show in a lice/nit infestation
oblong structures attached to hair at an acute angle with breathing apparatus at its superior end
what fluoresces under the woods lamp
nits
when is petrolatum used
eyelid involvement of pediculosis capitis
what is the name for louse that live in clothing
humanus corporis
pt presenting with pruritus of the skin. blue/gray macules and papules are found in armpits, between thighs, buttocks and in the creases of elbows and knees. what is the diagnosis and treatment
dx: pediculosis corporis
tx: treat clothing and fomites with extreme heat (washer or iron) or put in bag x 2 weeks. if SEVERE 5% permethrin cream or lotion head-toe for 8-14 hours
pt presents with widespread melanoderma that is worse in the creases of the elbows and knees, armpits and under his abdominal skin folds. He reports he has had repeated problems with macule/papule formation for 7 years. what is the diagnosis and treatment
dx: vagabond disease (body louse occuring for years)
tx: def severe so 5% permethrin cream or lotion head-toe for 8-14 hours
also hot water/iron all clothes/linens or put all things in bag x 2 weeks
how do you confirm pediculosis corporis? what may help with this diagnosis?
look in the clothes! use a woods lamp because they fluoresce yellow/green
typhus, relapsing fever and trench fever are all diseases that can be caused by what
Pediculus humanus corporis.
when do we use 5% permethrin cream vs 1% permethrin
1% - pediculosis capitis, pediculosis pubis
5% - pediculosis corporis (can use for capitis but its off label), scabies
can dogs/cats spread pediculosis pubis
noooooo
these louse adhere themselves to the terminal hair shaft with chitin
pediculosis pubis (phthirus pubis)
fibrous substance consisting of polysaccharides and forming major constituent in the exoskeleton of arthropods
chitin
in pediculosis pubis, how would you tell the difference between an empty nit shell and a nit with a nymph in it.
nymph present - brown and full in shape
empty nit - translucent and flat.
A patient presents with pruritus and erythema to her pubic area. She reports she has been noticing small amounts of bleeding on her underwear and on exam you find mild inguinal lymph node swelling. what diagnostics should be used? what is the treatment?
diagnostic: clinical PE, woods lamp, dermatoscopy.
tx: permethrin 1%, mousse containing pyrethrins!
this is a neurotoxin that results in repsiratory paralysis of a parasite.
permethrin
this is a neurotoxin/synergistic combo drug
pyrethrin/piperonyl butoxide
this canNOT be used with an allergy to ragweed or in children <2 y/o
pyrethrin/piperonyl butoxide
this medication is used for head lice and is flammable. it is CI in children under 6!
malathion
what are all the neurotoxic medications
permethrin
pyrethrin
malathion
lindane
this medication causes neurotoxicity, inducing seizures and death.
lindane
this has a BBW for neurotoxicity and cant be used in children, elderly, or people who are really light weight
lindane
Sarcoptes scabiei var. hominis is known for what disease
scabies
what layer of skin do mites burrow into for scabies
into the stratum corneum of the epidermis
a pt presents with itching in her elbow that has now become a rash. She said a friend of hers had a simliar rash about 2-6 weeks ago. At first it didnt bother her, but now the itching is worse at night and she is having trouble sleeping. on exam, what type of rash pattern will you see? what is the diagnosis and treatment?
rash pattern: fine, thread like line w tiny black speck at the end
dx: scabies
tx: permethrin 5%. treat all close physical contacts! lindane last resort. can also use oral ivermectin 2nd line.
if a woman has a itchy/papular rash on her areola what is a top dx on your ddx list?
scabies
if there are itchy papules on the scrotum and penis what dx should be top on your ddx list
scabies
a dermoscopy showing jetliner with a trail is suggestive of what diagnosis
scabies
a prisoner presents with crusted scabies. thousands to millions of mites are on him (DISGUSTING). what is the treatment
Topical Permethrin 5% overnight
+
Oral ivermectin x5 dosing (sometimes x7)
what diagnostics should you run for a suspected case of crusted scabies
scabies prep
KOH
what medication should you avoid using for treatment of crusted scabies
lindane (crust increases risk of neurotoxicity)
what type of venom does a black widow spider have?
alpha-latrotoxin (neurotoxic venom)
what is the result of neurotoxic spider venom
systemic symptoms relating to cholinergic and catecholamine excess!
which spider is from the loxosceles genus
recluse spiders
a bite with pain, swelling, bullae and ischemia developing minutes/hours later
recluse bites
a bite with clear fang marks and a halo around it
black widow
can lead to DIC (clumpy blood)
brown recluse bites
violin shaped figure on dorsal head and thorax
brown recluse
tegenaria agrestis
funnel-web spider
neurotoxic venom capable of produucing severe pain at bite and systemic symptoms that can be fatal within minutes
funnel-web spiders
theraphosphidae
tarantulas
these spiders have a painless bit but you can be allergic to their hair haha
tarantulas
if there is systemic involvement after this spider bite, you should check for evidence of hemolysis.
what spider and what labs?
brown recluse
hemoglobin and plasma free haptoglobin
what prophylactic treatment is sometimes indicated in venomous spider biets
tetanus
antivenom
yayyyyy youre done.
maybe rhys was hiding from a spider in this pic idk.
