MTB 2 Flashcards
Presentation of perianal abscess
Anal pain
Tender erythematous bulge at anal verge
Superior to anus over coccyx in midline
Erysipelas pathophys
Strep infxn (sometimes staph)
Invades dermal lymphatics
Bacteremia, leukocytosis, fever, chills
Presentation of Erysipelas
Bright, red hot swollen lesion on face
Leukocytosis
TX for Erysipelas, Cellulitis, Folliculitis, Furuncles, Carbuncles - MILD Dz
Oral
Dicloxacillin, cephalexin, cefadroxyl
PCN Allergic: Erythromycin, Clarithromycin, Clindamycin
MRSA: Doxycycline, Clindamycin, TMP/SMZ
Presentation of perianal fistula
Chronic and crypt infxn of Crohns
External/cutaneous opening drains purulent material
Win 3 cm of anal margin
TX for Erysipelas, Cellulitis, Folliculitis, Furuncles, Carbuncles - SEVERE Dz
IV Oxacillin, nafcillin, cefazolin PCN Allergic: Clindamycin, Vanco MRSA: Vanco, Linezolid, Daptomycin, Tigecycline Anaerobes - Imipenem
What are the Antistaph PCNs
OX
CLOX
DICLOX
NAF
Presentation of Cellulitis
Skin - warm, red, swollen, tender
Community Acquired MRSA Cellulitis Presentation
Purulence = Pus
Abscess
Contact sports, prisoners, Native Americans
Mupirocin MOA
Inhibits protein synthesis by reversibly binding to t-RNA synthetase in Staph Auereus and strep
What is molluscum contagiosum
Pox Virus
Umbilicated, flesh colored, dome shaped papules on trunk, limbs, anogenital areas
Transmission for molluscum contagiosum
Skin to skin
Sexual contact
Presentation of tinea corporis
Ring-shaped scaly patches
Central clearing
Distinct bordres
Itching
MCC Tinea corporis
Trichophyton rubrum
Presentation of Tinea Versicolor
Multiple macules
Vary in color - white to brown, pink
Chest, neck, abdomen, face
Tinea Versicolor cause
Malassezia furfur
Malassezia furfur on KOH prep
Spaghetti and meatball
TX Malassezia furfur
Topical selenium sulfide
Ketoconazole
Clotrimazole
Oral itraconazole
Presentation of Vibrio vulnificans
Fisherman, Gulf of Mexico
Poorly controlled DM
Cirrhosis
Dark, bullous lesions, wound infxn -> Septicemia
TX for Vibrio vulnificans
3rd G Cephalosporins Ceftriaxone Cefotaxime Cefalexin Ceftazidime AND Doxycycline Cipro
Best initial test for Fungal skin infxn
KOH prep
Most accurate test for fungal skin infxn
Fungal Culture
Best initial TX for fungal skin infxn
Topical antifungal
Best intial Tx for hair and nail
Terbinafine
AE of Ketoconazole
Antiandrogenic - gynecomastia
Hepatotoxic
Best initial test for Candida
KOH
Most accurate test for Candida
Fungal Cultue
Best next step in Candida Infxn
Topical antifungal
AE of terbinafine
Hepatotoxic
Presentation of morbilliform rash
Generalized maculopapular rash that blanches with pressure
Presentation of Erythema Multiforme (EM Minor)
Widespread, small, target lesions Palms and soles No mucous membrane involved Sudden onset MC after HSV Infxn
Presentation of Steven-Johnson Syndrome (EM Major)
Involves mucous membranes
Sloughs off resp epithelium -> resp failure
TX for Steven-Johnson Syndrome
IVIG
Presentation of Toxic Epidermal Necrosis
Rash with mucous membrane involvement
Nikolsky sign +
MCC of death w TEN
Sepsis
TX for TEN
IVIG
Presentation of Staph scalded skin syndrome
Similar to TEN
Presentation of Toxic Shock Syndrome
Skin involvement like SSSS HypoTN Renal Dysfnc (Hi BUN/Cr) Liver Dysfunc CNS involved Fever Rash - desquamative Vomiting
Management of SSSS and TSS
Supportive care - IVF, Pressors (Dopamine) Antistaph ABX - Oxacillin or Nafcillin - Cefazolin MRSA - Vanco -Linezolid
TX for Mild Acne
- Benzoyl peroxide
2. Topical Abx = Clindamycin, Erythromycin
Presentation of Acne
Pustules
Cysts
Comedones
TX for Moderate Acne
Add Topical Vit A derivatives
Oral Abx- minocycline, tetracycline
TX for Severe Acne
Add Oral Vit A derivatives
Isotretinoin
AE of Isotretinoin
Hyperlipidemia
Teratogenic
