OTC 2 Flashcards
most common causes of impetigo and cellulitis
GAS (pyogenes), staph aureus
2 types of impetigo
non bullous- small blisters on face and extremeties. Bullous- very large flaccid blisters. See honey colored crusting lesions as they break and yellowish exudate dries
how to treat impetigo
-can be anywhere on body. Before topical AB (mupirocin, fucidin- sparingly tid for 7-10 days or until all lesions healed), remove crusts with warm water or saline compress for 10-15 min tid-qid (clean compress each time).
how impetigo spreads
lesion/fluid contact. As adult, immune system usually can fight off
when to refer impetigo
large area, very fatigued or fevered, no sig improvement with 48hr topical treatment
what systemic AB are recommended for impetigo? carbuncle?
cephalexin, cloxacillin, amox/clav if widespread, immunocompromised, valvular heart disease, systemic infection symptoms, no improvement with topical therapy tid for 48 hrs. Carbuncle- ceph, clox
when are impetigo lesions no longer infectious?
48 hours after initiating treatment
usual first lines for cellulitis
cephalexin. 2nd= clox, clinda, eryth
how to treat folliculitis
saline compress or warm washcloth, AB if persistent (mup, fucidin- tid f7d until all lesions healed)
what are exanthemas and what are they usually associated with and in whom? What accompanies them
widespread rashes, kids, viral infections. Accompanied by fever, pruritus, pain, sedation, etc.
symptoms of scarlet fever (second disease)
fever, sore throat, bright red strawberry tongue, flushing, classic scarlatiform rash (small, papular lesions like sandpaper)- skin will often peel in 7-10 days following onset of rash
how is ringworm spread
person to person, contact with infected skin cells
name the 4 types of ringworm and where they are located
corporis (smooth areas or trunk and limbs), cruris (groin, jock itch), capitis (scalp hair follicles), pedis (athletes foot)
how to treat tinea capitis
oral always, maybe selenium sulfide as adjunct. Terbinafine, itraconazole, griseofulvin
which antifungal accumulates in skin, nails and fat?
terbinafine
itraconazole/terbinafine is a substrate for
3a4/2d6
how to treat tinea corporis
topical antifungal for minimum 2-3weeks and at least one week after visual resolution. Apply 2cm beyond visible edge
how to treat tinea cruris
minimum 3 weeks, dry feet last (often spread from here), topical antifungal
how to treat tinea pedis
dry scaly lesions? topical antifungals onto washed, dried feet. wet macerated? dry with astringents and powders, use topical antifungals and antibiotics. Both for minimum 4 weeks and 2 weeks after condition clears. Toenail involvement requires oral
T/F- launder clothes and linens separately if have fungal infection
T
what is tinactin
tolnaftate- blocks cholesterol synthesis in cells, not for c albicans, good for mild scaly forms of dermatophytosis, well tolerated, can be first line for fungal infections with antifungals
a rash that worsens with steroid use may be
fungal
when should substantial improvement in topical fungal infections be seen
one week
when should symptoms of a vaginal yeast infection start to clear, when eradicated?
clear- 3 days improvement, eradicated at 7. If persist beyond 7 days despite treatment see doc
what virus causes chicken pox
varicella zoster
how is chicken pox spread, and how long does the rash take to develop? How long are they contagious?
direct ontact, drops or air-rash 11-21 days. Contagious from 2 days before rash appears until all vesicles scab
when to refer with chicken pox
signs of encephalitis; dizzy, stiff neck, lethargy, other CNS probs. OR 2’ bacterial infection, preg, immunocompromised
what do you treat in chicken pox and how
fever and itching- baths (lukewarm pat dry, add otameal), lotions, antihistamines, astringents (burrow’s solution), fingernails short, cool cloth
what virus causes shingles
herpes zoster
how long does it take most people to recover from shingles (what complications might happen)
4-5 weeks- but rash may become infected, and damage to sight/hearing may happen if near eyes/ears, post herpetic neuralgia (severe pain after rash gone)
how soon should shingles therapy be initiated and what are the benefits
within 3 days, reduces viral rep, limits nerve damage and inflam, decreases duration and severity of pain
benefit of getting vaccine after shingles
none for pain/duration once you have it
how to treat frostbite
immerse in warm water for 10-30 min (do not rub-friction can increase tissue damage), elevate to minimize edema, sterile dressing and analgesics
how does an epi pen work
alpha receptor agonist (adrenaline) that counteracts vasodilation and increases BP, reduces vascular perm (decrease inflam), agonist at bronical beta receptors (relaxes), increases heart rate
epipen doses
less than 30kg or child is 0.15, greater than 30kg 0.3
T/F-increased deet concentration means better efficacy?
F- just works longer
what happens when sunscreen and deet are applied together
efficacy of SPF reduced- reapply sunscreen frequently (no limit) an deet sparingly and 30 minutes after sunscreen
deet in pregnancy and lactation
appears safe
limits for deet
less than 6 mnths- none (physical barriers only), 6-24 mnth one application of less than 10% per day, 2-12 years 3 applications of less than 10% per day, over 12 up to 30% deet and as much as need. Recall stored in fatty tissues up to 1-2 months when absorbed and can result in neuro sx if too much
NSAIDs in pregnancy
avoid near term (over 30 weeks)- premature closure of ductus arteriosus and increased bleed risk.
