Lice and Scabies Flashcards

1
Q

Explain the life cycle of lice.

A

male + female louse–>egg–>nymph–>adult louse
-female lice survive for 1-3 months and lay 5-10 eggs per day
-nymphs emerge after 6-10 days
-nymphs undergo 3 molts over 10 days

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2
Q

In which group of people do we most commonly see lice?

A

young children

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3
Q

What are the most probable routes of lice transmission?

A

head-to-head contact (vast majority of cases)
beds
towels
hats
combs/brushes

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4
Q

True or false: lice jump to a new host

A

false
they dont have wings

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5
Q

True or false: lice prefer dirty hair, thus excessive shampooing will help prevent your child from getting lice

A

false
clean or dirty hair, lice dont care

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6
Q

True or false: it is highly unlikely to get lice from your pet or on the back of couches

A

true

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7
Q

Differentiate between nits and lice.

A

nits:
-the eggs
-immobile (glued to one spot)
-typically laid closely to the scalp for warmth
-they do not wash out (shampoo or combs will do niche)
lice:
-living
-little bugs

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8
Q

What are the symptoms of lice?

A

it can vary from nothing to itching
-itching typically occurs behind the ears or back of neck
because
-the nits like the warmth in these spots

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9
Q

What was the original insecticide used for lice?

A

GBH/lindane (original Kwellada)
-agricultural chemical

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10
Q

Why was GBH/lindane (original Kwellada) taken off the market?

A

it was totally safe for head lice but people overused it for scabies

head lice: used as a shampoo for 8 minutes to kill lice
scabies: Kwellada needed for 8-12hrs from head to toe, some
people used for months on end which caused
neurological disorders

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11
Q

List off all the lice treatments. (that are currently available)

A

pyrethrins/pb
permethrin
Nyda
isopropyl myristate
anista/coconut oil

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12
Q

List off characteristics of the pyrethrins/pb treatment.

A

apply to dry hair
shampoo for 10 minutes
repeat in 7 days
removes nits
resistance is possible

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13
Q

Where do pyrethrins come from?

A

chrysantheum plant extract

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14
Q

What is the point of adding piperonyl butoxide to the pyrethrin treatment?

A

pb is a potency enhancer, it helps pyrethrins last longer or get into the bodies of lice better

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15
Q

True or false: GBH is safer than pyrethrin

A

false

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16
Q

What are the side effects of the pyrethrin treatment?

A

almost none, maybe some local reactions
Jeff says he never discusses any side effects

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17
Q

What is one of the popular pyrethrin/pb treatments?

A

R & C

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18
Q

R & C II Spray is an insecticide that is promoted to kill lice on furniture, bedding, mattresses, etc. What do we make of this product?

A

not needed in the vast majority of lice cases
lice do not want to live on spots like the couch

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19
Q

How is permethrin made?

A

it is a synthetic pyrethroid made in the lab
relative of pyrethrins

20
Q

True or false: permethrin is not safe in children

A

false
very safe

21
Q

List off characteristics of the permethrin treatment.

A

wash hair with regular shampoo
add creme rinse for 10 minutes
rinse out
repeats not needed (though it cant hurt to repeat)
nit removal
resistance is possible

22
Q

What are the popular permethrin treatments?

A

Nix
Kwellada-P

23
Q

What are the pediculosides?

A

permethrin
pyrethrins/pb
lindane

24
Q

True or false: you should never use the word “pediculoside” when talking with a parent who needs lice treatment for their kid

A

true
this can scare the parent

25
Q

What are the physical agents for lice treatment?

A

SH-206 (Jeff said it was ahead of its time, wont see it)
isopropyl myristate (10 min, nit pick, repeat in 7d)
coconut/anise oil (15min, nit pick, repeat in 9d, not behind counter)
dimethicone (10min+nit comb time, nit pick, re-apply prn)

26
Q

True or false: the shampoo alone can get rid of nits

A

false
nit combing needed as well

27
Q

Which physical agent is probably a solid option to pick?

A

Nyda (dimethicone)

28
Q

List off some characteristics of Nyda.

A

contains dimethicone
penetrates lice/egg breathing system
death of lice and eggs within 58s
30 min of contact then start nit-combing with product still in hair
product will dry
then 8hr of contact
re-check in 8-10d

29
Q

What are the directions for use of Nyda?

A
  1. spray all over hair (dry hair)
  2. massage until hair is completely wet then let sit for 30min
  3. comb hair with nit comb and leave the product on for 8hrs
  4. after 8hrs wash with any regular shampoo
30
Q

What should be done if live lice are found in hair 24-48hrs after treatment?

A

we are suspecting insecticide resistance so try a different product
if its Nyda, try again

31
Q

What are some of the popular “other” treatments?

A

bug-busting:
-no medicated shampoo, just lice comb every 3d
-failure is high
heat:
-you would have to set your hair on fire
-wont work
electrocution:
-unsure about efficacy
-supposed to be like bug zappers at a cabin
tea tree oil:
-we arent sure the concentration to give
dry-on-suffocation using lotion:
-probably the pre-cursor to Nyda
ivermectin

32
Q

What are some things to expect with lice treatment?

A

the products arent that gross
the itch will stop in a few days
they work in ~10mins
kids can go back to school the next day

33
Q

What are a few things you can do to clothes, bedding, hats, cloths, and toys for home control?

A

hot water and dry in the laundry machine
ironing
dry cleaning
freezer (complete overkill)

34
Q

True or false: dipping a comb in vinegar will be enough to dissolve the glue on nits

A

false
you need the special combs

35
Q

When are nits considered to be cosmetic?

A

when they are >1/2 inch from the scalp

36
Q

True or false: body lice is not common in our part of the world

A

true

37
Q

Which treatment is officially indicated for pubic lice?

A

pyrethrins/pb
the others are probably fine but the company didnt indicate it

38
Q

What is suggested that you do if you have pubic lice?

A

shave
if shaved, no repeats of treatment are needed

39
Q

What is scabies?

A

bug burrowing in the skin and laying eggs

40
Q

What is the most common method of scabies transmission?

A

person-to-person contact

41
Q

What is the treatment for scabies?

A

permethrin 5% dermal cream/lotion
head-to-toe

42
Q

What is the main symptom of scabies?

A

itch
-the itch can persist for a few weeks after treatment

43
Q

True or false: blind treatment of close contacts for scabies is not necessary

A

false

44
Q

Which agent was probably the pre-cursor to many physical agents?

A

SH-206
-made up of essential oils, repeat every 2 days

45
Q

Which physical agent is not behind the counter?

A

coconut/anise oil

46
Q

Why should you not use a comb dipped in vinegar while using permethrin?

A

vinegar can neutralize the activity of permethrin

47
Q

Where are scabies pre-dominantly found?

A

between fingers and on wrist