Integumentary 3

Question 1

carbuncles are

Answer 1

several boils that coalesce to form a large boil or abscess

Question 2

several boils that coalesce to form a large boil or abscess

Answer 2

carbuncle

Question 3

carbuncles are usually treated with what

Answer 3

systemic abx

Question 4

purulent cellulitis organism

Answer 4

S. aureus (gram positive)

Question 5

non-purulent form of cellulitis is usually due to ____ but may also be ____

Answer 5

streptococci; staphylococcal

Question 6

people with liver disease, immunocompromised status, or those who are pregnant should avoid eating what

Answer 6

raw or undercooked oysters or clams d/t to possibility of Vibrio vulnificus infection

Question 7

cellulitis classic case

Answer 7

acute onset of diffused pink to red colored skin that is poorly demarcated with advancing margins

Question 8

cellulitis - abscess (boils) are usually due to

Answer 8

staphylococcus or MRSA

Question 9

cellulitis labs
2

Answer 9

C&S
CBC if fever or signs of systemic illness (refer to ED)

Question 10

non-purulent cellulitis tx options with no risk factors for MRSA
4

Answer 10

dicloxacillin
flucloxacillin
cephalexin
cefadroxil

Question 11

purulent cellulitis tx w/o severe sepsis but with risk factors for MRSA
3

Answer 11

trimethoprim-sulfamethoxazole
amoxicillin w/ doxycycline
linezolid

Question 12

for immunocompetent patients with purulent cellulitis w/o severe sepsis but with a risk factor for MRSA, give what

Answer 12

trimethoprim-sulfamethoxazole

Question 13

atopic dermatitis/eczema mild to moderate disease - what are first line tx
2

Answer 13

topical steroids
emollients

Question 14

eczema mild disease topical steroids
2

Answer 14

low potency - classes V and VI (e.g. hydrocortisone)

Question 15

eczema mod disease steroid potency

Answer 15

classes III and IV (e.g. triamcinolone)

Question 16

eczema - face and skin folds tx

Answer 16

recommend topical calcineurin inhibitors, which are at higher risk for skin atrophy

Question 17

eczema of ear canal tx

Answer 17

corticosteroid based ophthalmic solutions

Question 18

contact dermatitis tx

Answer 18

topical steroids 1-2 x day for 1-2 weeks; use high potency steroid (triamcinolone, halcinonide), calamine lotion, or oatmeal baths

Question 19

tinea infections - labs
2

Answer 19

fungal culture of scales/hair/nails or skin lesions
potassium hydroxide KOH slide microscopy reveals pseudohyphae and spores

Question 20

tinea capitis tx

Answer 20

systemic tx only - topicals are not effective

Question 21

asymptomatic scaly patch that gradually enlarges; hairs inside the patch break off easily by the roots =

Answer 21

tinea capitis

Question 22

tinea capitis - LFTs

Answer 22

determine baseline LFTs and repeat 2 weeks after initiating systemic antifungal treatment

Question 23

tinea capitis gold standard tx

Answer 23

oral antifungal therapy with griseofluvin, terbinafine, fluconzaole, and itraconazole

Question 24

early lyme disease two step testing

Answer 24

1. first step is enzyme immunoassay EIA; if negative no further testing
2. if positive the second test is the indirect immunofluorescence assay (IFA, or western blot test)

Question 25

EIA and IFA are to

Answer 25

lyme disease tests

Question 26

western blot test aka

Answer 26

IFA

Question 27

lyme disease - if what two things are positive, patient likely has lyme disease

Answer 27

both EIA and IFA

Question 28

treatment - early lyme disease only
3

Answer 28

doxy BID x 10 days (first line)
amoxicillin 500 mg TID or feuroxime axetil 500 mg BID x 14 days (alternative)

Question 29

erysipelas

Answer 29

a subtype of cellulitis involving the upper dermis and superficial lymphatics that is usually caused by group A streptococcus

Question 30

sudden onset of one large, hot, indurated red skin lesions that has clear demarcated margins; accompanied by fever, chills, severe malaise, and HA

Answer 30

erysipelas