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Urgent Care Guide > Skin 7 > Flashcards

Skin 7 Flashcards

1
Q

local allergic reation occurs where

A

occurs at a single site

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2
Q

systemic allergic reaction may involve

A

may involve multiple organ systems - may be life threatening

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3
Q

local allergic reaction - pt presents w/
4

A
  1. itching
  2. redness
  3. swelling
  4. +/- pain at site of exposure
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4
Q

systemic allergic reaction - pt presents w/
10

A

may vary
1. diffuse rash
2. urticaria (hives)
3. facial swelling
4. mucosal membrane swelling
5. hoarse voice
6. SOB
7. wheezing
8. vomiting
9. abd pain
10. diarrhea

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5
Q

allergic reaction - always evaluate for
2

A

hypotension
hypoxia

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6
Q

local allergic reaction - during PE, assess skin for
4

A
  1. erythema
  2. swelling
  3. warmth
  4. itching
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7
Q

systemic allergic reaction - during PE, assess skin for
3

A
  1. diffuse maculopapular rash
  2. urticaria
  3. itching
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8
Q

allergic reaction - during PE, assess HEENT for
4

A
  1. facial swelling
  2. angioedema
    3 lingual or sublingual swelling
  3. hoarse voice
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9
Q

allergic reaction - during PE, assess lungs for
3

A

dyspnea
wheezing
stridor

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10
Q

allergic reaction - img/testing

A

none usually req

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11
Q

local allergic reaction - tx
4

A
  1. remove stinger if present
  2. ice
  3. antihistamines - diphenhydramine 25-50 mg PO and famotidine 20 mg PO)
  4. analgesics
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12
Q

why famotidine for local allergic reaction

A

normally used for heart burn but it is an H2 antihistamine and help relieve allergic symptoms such as itching, hives, and more

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13
Q

local allergic reaction - abx?

A

not indicated

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14
Q

systemic allergic reaction tx
3

A
  1. autoinjector or epi IM - adult max dose 0.5 mg
    ped max dose 0.3 mg (0.01 mg/kg
  2. may repeat q5-15 mins if needed
  3. consider antihistamines and steroids
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15
Q

allergic reaction - when to send to Er

A
  1. all pts receiving epi for anaphylaxis
  2. unstable VS
  3. airway compromise
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16
Q

thrombophlebitis

A

inflammatory condition where a thrombus forms in a superficial vein

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17
Q

DVT

A

formation of a blood clot in the deep veins of the body

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18
Q

arterial occlusion

A

in the acute setting, refers to the obstruction of an artery resulting in distal ischemia

19
Q

thrombophlebitis - pt presents with
4

A
  1. localized pain
  2. swelling
  3. warmth
  4. redness
20
Q

DVT - pt presents with
3

A
  1. pain
  2. swelling
  3. redness
21
Q

arterial occlusion - pt presents w/
5

A
  1. pain
  2. discoloration
  3. mottled
  4. cool skin
  5. decreased/absent pulse
22
Q

thrombophlebitis - PE findings
3

A
  1. redness
  2. swelling
  3. palpable “cord” may be present
23
Q

DVT - PE findings
3

A
  1. unilateral swelling of extremities
  2. tenderness to affected extremity
  3. erythema
24
Q

arterial occlusion - PE findings
6

A

P’s
pain
pallor
poikilothermia
paresthesia
pulselessness
paralysis

25
Q

thrombophlebitis - img/testing
2

A

clinical dx
consider US

26
Q

DVT - img/testing

A

US

27
Q

arterial occlusion - img/testing
3

A
  1. ankle brachial index <0.9 is abnormal
  2. US
  3. CT angiography
28
Q

thrombophlebitis tx
4

A
  1. NSAIDs
  2. warm compress
  3. elevation
  4. compression stockings
29
Q

thrombophlebitis f/u

A

refer to PCP

30
Q

DVT tx and f/u
2

A
  1. consider oral anticoags
  2. refer to ED or PCP..?
31
Q

thrombophlebitis/DVT/arterial occlusion - when to refer to ER

A
  1. arterial occlusion
  2. DVT w/ sx concerning for PE
  3. concern for f/u or compliance
32
Q

scabies spreads how

A

direct skin to skin contact

33
Q

scabie mites burrow where

A

just below the surface of the skin and lay eggs

34
Q

scabies sx

A
  1. relentless itching that worse at night
35
Q

pediculosis/lice is spread by

A

direct head to head contact and indirect transmission via fomites (brushes, combs, bedding etc)

36
Q

head lice - most common in who

A

school children ages 3-12

37
Q

pubic lice - consider
2

A

STI
in children may be sign of abuse

38
Q

body lice is known to transmit disease such as
3

A
  1. epidemic typhus
  2. trench fever
  3. epidemic relapsing fever
39
Q

scabies - PE finding
3

A

pruritis rash
essential lesions - small erythematous papules
burrows - thin lines, slightly raised,

40
Q

scabies burrows are most often where

A

web spaces of fingers and toes, flexor surfaces of wrist, axillary fold, groin

41
Q

scabies/lice - img/testing

A

none

42
Q

scabies tx and disposition
6

A
  1. oral antihistamine for itching
  2. permethrin 5% cream - apply to entire body, sparing the head and leave on 8-10 hours (do at night)
  3. may require 2nd tx 1-2 weeks later
  4. itching may last several weeks after tx
  5. all household members should be treated
  6. wash all items worn in last 3-4 days and linens in hot water and dry on high heat or seal in large plastic bags for 3-5 days
43
Q

scabies cream

A

permethrin 5% cream

44
Q

pediculosis/lice tx
4

A
  1. permethrin 1% cream rinse - saturate hair and scalp, wash off at 10 mins
  2. wet comb to remove nits
  3. launder clothing - seal non washables in plastic bags for 2 weeks
  4. treat all direct contacts

Urgent Care Guide (38 decks)

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