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
