Mehlman skin fungal/scabies/lice/candida 11-14 (1) Flashcards

1
Q

M. Malassezia fur fur (tinea versicolor) is extremely HY!!!
Definition?

A

Clasically causes hypopigmentation+hyperpigmentation on the trunk, back, shoulders. This is caused by fatty acid breakdown in the skin.
Skin findings get prominent after sun-exposure or tanning.

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2
Q

M. Malassezia/ extremely HY Tx?

A

Topical selenium

Also: topical ketoconazole, terbinafine

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3
Q

M. Tinea capitis. Tx?

A

griseofulvin for PATIENT ONLY

one Q: Tx for patient or patient+ contact
A: ONLY FOR PATIENT

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4
Q

M. Tinea capitis. best way to prevent infection. Use shampoo vs avoid sharing of hat?

A

AVOID SHARING

anti-fungal shampoo doesnt matter

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5
Q

M. Tx for tinea corporis (ring-worm)?

A

topical miconazole or clotrimazole

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6
Q

M. Tx for tinea pedis (athletes foot)?

A

topical terbinafine or topical -azoles.

usmle wont list both as options.

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7
Q

Tx topical miconazole or clotrimazole?

A

Tx for tinea corporis (ring-worm)

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8
Q

Tx topical terbinafine or topical -azoles?

A

Tx for tinea pedis (athletes foot)

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9
Q

Tx griseofulvin for PATIENT ONLY?

A

Tx for tinea corporis

also prevention - avoid hat sharing

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10
Q

M. Tx for onychomycosis (fungal nail infection)?

A

ORAL terbinafine (6 weeks for fingernail; 12 weeks for toenails)
usmle won’t as duration, just interesting fact

also (UW): itraconazole

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11
Q

Tx ORAL terbinafine?

A

Tx for onychomycosis (fungal nail infection)

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12
Q

M. Cutaneous candida. DM versus Obesity. what has higher risk?

A

!!!!!!DM is the biggest risk factor for cutaneous candida in comparision to obesity.

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13
Q

M. Cutaneous candida. DM versus Obesity. Case?

A

48F + BMI 67 + red, moist, 8x12 cm elipse under one of the breast. what is the biggest risk factor?
A: INSULIN RESISTANCE!!! exceedingly HY
wrong answer is obesity

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14
Q

M. both DM1 and DM2 have same risk for candida. they just commonly assess DM2 since it presents in obese people, and they want you to know that DM is more important than obesity for candida.

A

.

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15
Q

M/UW. Scabies. Scabies + lice (pediculosis) –> Tx?

A

Permethrin

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16
Q

M/UW. Scabies. Case
Homeless lives in shelter for 4 months + red dots on hand + topical fungals didnt work –> what next best Tx?

A

Permethrin

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17
Q

M/UW. Scabies. Scabies associated pyoderma (scabies + pus) –> what mcc?

A

infected by S. aureus or Group A Strep (S. pyogenes)

18
Q

M/UW. Lice.
Pediculosis capitis = head lice.
Pediculosis corporis = body lice.
Tx?

A

Permethrin

19
Q

UW table scabies. cause?

A

Sarcoptes scabiei mite infestation

20
Q

UW table scabies. pathogenesis?

A

mites burrow into the skin and lead to delay type IV hypersensitivity reaction to mite, feces eggs

21
Q

UW table scabies. spread?

A

direct person to person contact

22
Q

UW table scabies. diagnosis?

A

Light microscopy of skin scraping. It reveals mites, ova, feces

23
Q

UW table scabies. CP?

A

Extremely pruritic pathognomonic burrows and small, erythematous papules
Rash located on interdigital web spaces, flexor wrists, extensor elbows, axillae, umbilicus and genitalia

24
Q

UW table scabies. Tx? 2

A

topical 5 proc. permethrin
OR
Oral ivermectin

25
Q

UW table scabies. Also: bedding and clothing should be cleaned or placed in a plastic bag for >= 3 days.

A

.

26
Q

M. Chronic mucucutaneous candidasis. HY.
mechanism?

A

T cell dysfunction –> answer will be ,,defect in cell-mediated immunity”.

27
Q

M. Chronic mucucutaneous candidasis.
Case: 17F + Hx of cutaneous candidal infections since childhood + 1y HX autoimmune thyroiditis + 2 yr Hx of DM1; what mechanism of disease?

A

Defect in cell mediated immunity
OR
T cell (if they ask which cell if affected)

28
Q

M. Oropharyngeal candidasis –> Tx?

A

use nystatin mouthwash

29
Q

M. Chronic mucucutaneous candidasis.
USMLE like concept
,,Autoimmune disease go together”
and
,,autoimmune disease and immunodeficiencies fo together”

A

.

30
Q

M. Esophageal candidasis –> Tx?

A

oral azole
Odynophagia in immunocompromised patient is esophageal candidasis until proven otherwise.

31
Q

M. Vaginal candidasis –> Tx?

A

topical nystatin –> if it doesnt work, go to ORAL azole.

Nystatin is used first because the correct medicine is technically to do LFT’s before giving an oral azole, whereas nystatin has shown efficacy and can be given right away.

32
Q

UW. Tinea versicolor diagnostics?

A

KOH preparation shows hyphae and yeast cells in ,,spaghetti and meatballs” pattern

33
Q

UW. Tinea corporis cause?

A

Trichophyton rubrum

34
Q

UW. Tinea corporis 2nd line Tx?

A

if topical not effective, 2nd line ORAL antifungals, eg terbinafine, griseofulvine

35
Q

UW. Tinea corporis risk factors?

A

Athletes who have skin-to-skin contact; humid environment; contact to infected animals

36
Q

UW. tinea pedis, cause?

A

Trichophyton spp

37
Q

UW. tinea pedis, risk factors?

A

barefoot walking in public areas (pool, athletic venue)

38
Q

UW. tinea pedis, Tx?

A

1st - topical azoles or terbinafine
2nd - oral antifungal (eg fluconazole)
also: keep feet dry and get rid of old shoes

39
Q

UW. onychomycosis, risk factors?

A

Advanced age, tinea pedis, DM, peripheral vascular disease

40
Q

M. Scabies lesions can be defined as ….

A

linear burrows

41
Q

M. Scabies disseminated disease can occur in ……?
Tx = ?

A

in HIV
Tx = oral ivermectin

42
Q

M. Tinea vesicolor. What region, what patients?

A

Sub-tropical, eg Florida
patient goes surfing/to the beah