Integumentary 5

Question 1

RMSF is caused by

Answer 1

the bite of a dog tick/wood tick that is infected with the parasite Rickettsia rickettsii

Question 2

first line treatment for RMFS

Answer 2

doxy

Question 3

RMSF definitive dx is based on

Answer 3

antibody titers to R. rickettsii (by indirect fluorescent IgG antibodies or IFA assay)

Question 4

what rash suggests RMSF

Answer 4

red spot like rash that starts on hands, palms, and feets/soles

Question 5

RMSF classic symptoms
4

Answer 5

rash that starts on hands/palms and feet/soles
fever
HA
myalgia

Question 6

after removing the tick, clean the area with
3

Answer 6

rubbing alcohol, iodine scrubs, or soap and water

Question 7

light skinned adult or older patient that c/o small acne-like papules and pustules around nose, mouth, and chin; telangiectasias on nasal are and cheeks

Answer 7

rosacea

Question 8

rosacea mild to mod disease tx
3

Answer 8

topical metronidazole, azelaic acid, or ivermectin

Question 9

rosacea mod to severe disease tx

Answer 9

oral tetracycline or minocycline 4-12 weeks

Question 10

pruritic rash located in the interdigital webs of the hands, axillae, breasts, buttock folds, waist, scrotum, and penis; severe itching at night

Answer 10

scabies

Question 11

scabies lab

Answer 11

scrape burrow or scales with glass slide; use coverslip (wet mount) to look for mites or eggs

Question 12

scabies tx

Answer 12

permethrin - wear for 8-14 hours, can repeat in 7 daysc

Question 13

crusted scabies tx

Answer 13

combo permethrin and ivermectin

Question 14

scabies - persons in the same household tx

Answer 14

treat everyone at the same time; any clothes/bedding used 3 days before and during tx should be washed and dried on hot settings

Question 15

scabies - treat itching with

Answer 15

benadryl and topical steroids; can last up to 2-4 weeks

Question 16

oral candidiasis - patient c/o

Answer 16

severe sore throat with white adherent plaques with a red base and hard to dislodge on the pharynx

Question 17

thrush in healthy adults who are not on abx may signal what

Answer 17

immunodeficient condition

Question 18

yeast infection - for skin infections do what in skin folds

Answer 18

nystatin powder and/or cream BID

Question 19

yeast infection - OTC topical antifungals include
2

Answer 19

miconazole
clotrimazole

Question 20

for mod to severe thrush or recurrent disease, what is preferred tx

Answer 20

oral fluconzaole systemic antifungal agent

Question 21

tinea versicolor - KOH slide will show

Answer 21

hyphae and spores

Question 22

lab test for tinea versicolor

Answer 22

KOH slide

Question 23

tinea versicolor meds

Answer 23

topical selenium sulfide
topical azole antifungals like ketoconazole or terbinafine BID

Question 24

fever, pharyngitis, malaise, then rash that starts on head and face then spreads to trunk, pruritis

Answer 24

chickenpox/varicella

Question 25

elderly with papules and vesicles on red base that rupture and become crusted, pain and burning

Answer 25

shingles

Question 26

shingles - cover lesions?

Answer 26

yes

Question 27

the most sensitive test for VZV is

Answer 27

polymerase chain reaction PCR

Question 28

varicella/chickenpox - antiviral therapy is recommended in who

Answer 28

immunocompetent individuals and pregnant patients

Question 29

uncomplicated herpes zoster virus med

Answer 29

acyclovir 800 mg 5 x day or valacyclovir 1000 mg TID x 7 days

Question 30

herpes zoster PHN - meds
3

Answer 30

tricyclic antidepressants
anticonvulsants
gabapentin

Question 31

varicella vaccine age

Answer 31

2 dose
12-15 months
4-6 years