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S Michelle > SM Dermatology > Flashcards

SM Dermatology Flashcards

1
Q

A patient presents with cold sores. Is this HSV 1 or HSV 2?

A

HSV 1

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2
Q

When must HSV 1 be treated with antivirals?

A

Within 48-72 hours of sx onset

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3
Q

What is an antiviral used to treat HSV 1?

A

Acyclovir

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4
Q

Chronic ulcerative stomatitis
-characteristics
-how long does it take to resolve?
-resistant to what?

A

-autoimmune; large size, many sores/ulcers in mouth
-weeks to months
-topical steroids

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5
Q

Chronic ulcerative stomatitis
-treatment of choice after topical applications fail

A

hydroxychloroquine (Plaqueril)

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6
Q

what derm issue is seen mainly in children - bumps on skin?

A

keratosis pilaris

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7
Q

treatment for keratosis pilaris

A

emollients, moisturizers

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8
Q

what are the two types of impetigo?

A

Bollous and nonbollous

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9
Q

what are the characteristics of bollous impetigo?

A

no honey crust; bullae erupt

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10
Q

what are the characteristics of nonbollous impetigo?

A

more common; honey crusted

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11
Q

what is the treatment for nonbollous impetigo?

A

mupirocin ointment (bactroban)

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12
Q

what is the treatment for bollous impetigo?

A

oral abx based on underlying bacteria
-typically cephalexin or dicloxacillin
-if underlying bacteria is MRSA, treat with doxy

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13
Q

what two main types of bacteria are responsible for impetigo?

A
  1. strep pyogenes
  2. staph aureus
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14
Q

what characteristics describe pityriasis rosea?

A

-starts with herald patch, then full distribution of “rash” (usually to back or abd)

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15
Q

what is a herald patch? what disease is this a sx of?

A

-scaly, oval, or round skin patch that appears before a widespread rash known as pityriasis rosea

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16
Q

tx for pityriasis rosea?

A

goes away on its own; can last weeks to months before resolving

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17
Q

how long does it take for pityriasis rosea to resolve?

A

weeks to months

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18
Q

what are the characteristics of a brown recluse spider bite?

A

spot is tender, turned deep purple in color; possible white halo around it
-possible systemic symptoms

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19
Q

what two diagnoses can occur from tick bite?

A
  1. rocky mountain spotted fever
  2. Lyme disease (erythema migrans)
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20
Q

what sx occur with rocky mountain spotted fever?

A

rash 3-5 days after sx onset; rash on palms of hands and soles of feet initially

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21
Q

what is the biggest issue with rocky mountain spotted fever?

A

high mortality rate if untreated!

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22
Q

what is the treatment for rocky mountain spotted fever?

A

doxy
-no matter what - doesn’t matter age or if pregnant; benefit outweighs risk

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23
Q

sx of lyme disease

A

tick bite can have bullseye/target lesion (erythema migrans)

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24
Q

the rash of lyme disease is called what early on?

A

erythema migrans

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25
Q

tx for lyme disease

A

-doxycycline, no matter the age
-amox if pregnant

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26
Q

sx of measles

A

fever, cough, congestion, conjunctivitis; eventual rash (3-5 days after initial sx)

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27
Q

when does the rash occur with measles?

A

3-5 days after initial sx

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28
Q

what is another name for measles?

A

rubeola

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29
Q

what is a common/well-known symptoms of measles?

A

Koplik spots (in mouth)
-tiny grain-like lesions (of white sand) surrounded by erythematous halo on buccal mucosa

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30
Q

how to prevent measles?

A

MMR vaccine

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31
Q

when is MMR vaccine given to children? why?

A

12MO; live vaccine
-normally receive passive immunity in utero

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32
Q

when do you give MMR vaccine early?

A

when infant is traveling internationally and under 12MO

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33
Q

what is the most well-known symptom of mumps?

A

noticeable parotid gland swelling

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34
Q

what diseases have the characteristic sx of swollen parotid glands?

A

mumps
bulimia nervosa d/t repetitive vomiting

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35
Q

what is the dx for a mass under chin that occurs whenever pt eats any sort of meal?

A

salivary gland stone

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36
Q

what is another name for salivary gland stone?

A

sialolithiasis

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37
Q

tx for sialolithiasis?

A

surgical removal if stone is present

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38
Q

sx of actinic keratosis

A

dry scaly lesions on sun-exposed area; pink/yellow/tan/pale/brown

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39
Q

treatment for actinic keratosis

A

topical 5-FU or cryotherapy

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40
Q

should AK be treated right away or is it okay to wait?

A

yes, right away

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41
Q

why should AK be treated right away?

A

precursor to squamous cell carcinoma

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42
Q

squamous cell carcinoma sx
-how is it dx?

A

-slow growing, scaly ulceration that is very red and bleeds easily
*cancer
-biopsy

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43
Q

-characteristics of cafe au lait spots?
-benign or tx needed?

A

-hyperpigmentation of skin
-benign, no further intervention; however; >6, may indicate underlying disorder: neurofibromatosis

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44
Q

if patient has >6 cafe au lait spots, what are they at risk for?

A

neurofibromatosis

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45
Q

what is intertrigo?

A

rash present in skin folds (under breasts, abd folds)

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46
Q

treatment for intertrigo

A

minimize moisture and friction to area + antifungal (one of the azoles) (+ occasionally topical steroids)

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47
Q

ABCDEs of malignant melanoma

A

A - asymmetry
B - border irregularity
C - color variation
D - diameter >6mm
E - evolution of lesion

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48
Q

what does a brown or black line under fingernail w/o trauma indicate?

A

melanoma or splinter hemorrhage (associated with endocarditits)

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49
Q

treatment for brown or black line under fingernail

A

REFER (possibly melanoma)

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50
Q

sx of seborrheic keratosis

A

pasted on lesions; “stuck on”

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51
Q

do we treat seborrheic keratosis?

A

No, benign; does not need removal

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52
Q

basal cell carcinoma sx

A

lesion is shiny, waxy or pearly + telangiectasias

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53
Q

what are telangiectasis and what skin condition is this sx usually found in?

A

visible blood vessels across the lesion; basal cell carcinoma

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54
Q

what is the most common type of skin cancer?

A

basal cell carcinoma

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55
Q

how is basal cell carcinoma diagnosed?

A

biopsy

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56
Q

treatment for basal cell carcinoma?

A

REFER to derm before removal

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57
Q

what skin condition is usually located on flexor surfaces (creases) of body?

A

atopic dermatitis (eczema)

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58
Q

sx of atopic dermatitis

A

pruritic –> itch, scratch, itch cycle; usually located on flexor surfaces (creases) of the body

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59
Q

what are the three A’s?

A
  1. atopic dermatitis
  2. asthma
  3. allergies
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60
Q

treatment for atopic dermatitis

A

emollients, topical steroids

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61
Q

what is nummular eczema?

A

simple, round-shaped eczema lesion often resembling a coin

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62
Q

where is nummular eczema usually found on the body?

A

arms and legs

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63
Q

what is nummular eczema typically related to?

A

underlying atopic dermatitis, but can be idiopathic

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64
Q

treatment for nummular eczema and for how long?

A

high-potency steroids for several weeks

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65
Q

sx of plaque psoriasis

A

thick, silvery scales

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66
Q

tx of plaque psoriasis (within primary care)

A

topical steroids, emollients or coal tar can be used as adjunct therapy

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67
Q

tx of plaque psoriasis when not controlled within primary care setting

A

REFER to derm

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68
Q

what are the two signs to be aware of related to plaque psoriasis?

A
  1. auspite sign
  2. koebner phenomenon
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69
Q

what is the auspite sign?
-what disease is this related to?

A

-plaques are scratched or removed, and pinpoint bleeding occurs
-plaque psoriasis

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70
Q

what is the koebner phenomenon?
-what disease is this related to?

A

-trauma to the skin which leads to a plaque forming
-plaque psoriasis

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71
Q

sx of contact dermatitis

A

immediate rxn to irritant; typically linear pattern; localized

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72
Q

tx of contact dermatitis

A

topical steroids and avoid irritant

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73
Q

sx of shingles

A

vesicular, follows a dermatome

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74
Q

what is shingles proceeded by?

A

burning, tingling at site before rash appears; new pain on one side of body

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75
Q

how is singles prevented?

A

vaccine - shingrix

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76
Q

at what age is shingrix given?

A

age 50; though, adults 18yrs and older may receive shingrix if immunocompromised

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77
Q

is shingrix vaccine activated or inactivated?

A

inactivated

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78
Q

can patients receive antivirals with shingles dx? if so, when?

A

-yes
-within 48 hours of sx onset

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79
Q

when must a shingles patient be referred?

A

if shingles rash is close to eye(s)
-ophthalmology

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80
Q

if shingles rash gets too close to eye, what is patient at risk for?

A

permanent corneal scarring and blindness

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81
Q

what are the characteristics of pressure injuries stage I?

A

intact, non-blanchable

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82
Q

what is the treatment for stage I pressure ulcer?

A

foam dressings to prevent further damage; use of pressure relief ankle foot orthosis (PRAFO) boot; frequent position changes

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83
Q

what is considered an unstageable pressure injury?

A

cannot see wound bed d/t presence of slough (unstageable until we can see the wound bed)

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84
Q

should a stable eschar be removed/soaked?

A

NO - seals out bacteria

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85
Q

characteristics of scabies

A

intensely pruritic; occurs btw fingers/toes; others in household have similar sx

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86
Q

tx for scabies

A

permethrin cream and wash everything in HOT water
-usually treat these patients twice

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87
Q

how would you describe the rash associated with varicella?

A

rash presenting in various stages of healing

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88
Q

when can varicella vaccine be given to children?

A

> 12MO; live vaccine

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89
Q

when can children return to school/daycare after chicken pox diagnosis?

A

when all lesions have crusted over

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90
Q

sx of lice

A

incessant pruritis of scalp; contagious; occurs at any age

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91
Q

treatment for lice

A

permethrin = Nix
-only kills live lice; must comb out knits/eggs; may need second tx + wash everything in HOT water

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92
Q

sx of molluscum contagiousum

A

umbilicated lesion/dimpling; flush colored and highly contagious

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93
Q

tx of molluscum contagiosum

A

usually resolve on their own over time

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94
Q

sx of skin anthrax lesion

A

ulcerated, black lesion; painless (w/o systemic involvement)

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95
Q

common population who acquire skin anthrax?

A

cattle farmers

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96
Q

tx for skin anthrax lesions w/o signs of systemic involvement

A
  1. fluoroquinolone, typically ciprofloxacin
  2. tetracycline, typically doxycycline as alternative tx
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97
Q

sx of hidradenitis suppurativa

A

recurrent issue; comes and goes frequently
-can lead to several noudles, pustules, or even abscesses in the sweat glands
-often affects groin, thights, axilla, and under the breasts

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98
Q

R/F of hidradenitis suppurativa

A

-obesity
-smoking

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99
Q

is hidradenitis suppurativa related to poor hygiene?

A

NO; closely linked to genetics

100
Q

tx for hidradenitis suppurativa

A

NSAIDs for pain management initially
-mild cases: skin compresses (wamr), skin care, topical clindamycin
-severe cases: I&D, wound culture; typically requires abx for long term (>couple of weeks)

101
Q

is hidradenitis suppurativa an acute or chronic condition?

A

chronic condition

102
Q

what conditions may require an I&D?

A

cysts
boils (furuncle)
hidradenitis suppurativa

103
Q

sx of folliculitis

A

skin infection of hair follicles and surrounding tissues

104
Q

does folliculitis resolve on its own?

A

usually, yes; warm compresses help

105
Q

tx of folliculitis

A

mupirocin (similar tx as impetigo)
-if severe, oral abx: PCN or cephalexin (Keflex)

106
Q

what oral antibiotics are commonly used for skin infections?

A

-PCN
-Cephalexin (Keflex)

107
Q

sx associated with rosacea

A

erythematous facial rash that doesn’t spare the nose or nasolabial folds

108
Q

what skin condition is an erythematous facial rash that doesn’t spare the nose or nasolabial folds?

A

rosacea

109
Q

tx for mild rosacea

A

behavioral modification ie sun protection measures

110
Q

tx for rosacea (pharmacological measures)

A

metronidazole or Flagyl gel (most helpful for inflammatory type of rosacea that consists of papules or pustules)

111
Q

sx of lupus (SLE)

A

rash that does spare nasolabial folds = malar rash (“butterfly rash”)

112
Q

what skin condition is an erythematous facial rash that spares the nasolabial folds?

A

lupus (SLE)

113
Q

what is a malar rash? what skin condition is it associated with?

A

-“butterfly rash”; rash that spares nasolabial folds
-lupus (SLE) and Sjogren’s syndrome

114
Q

sx of Sjogren’s syndrome (that differentiate it from lupus)

A

-very dry eyes, very dry mouth
-also has malar rash

115
Q

what two skin conditions present with malar rash?

A

SLE
Sjogren’s syndrome

116
Q

sx of erysipelas

A

sharply defined, well demarcated borders; superficial and red = superficial cellulitis

117
Q

tx for erysipelas

A

PCN or cephalexin

118
Q

what are the two types of cellulitis?

A
  1. purulent
  2. non-purulent
119
Q

treatment for purulent cellulitis

A

BCD (esp with possibility of MRSA)
bactrim
clindamycin
doxycycline

120
Q

treatment for non-purulent cellulitis

A

keflex or PCN

121
Q

first line tx for acne

A

topical applications - tries to dry excess oil/bacteria
-benzoyl peroxide wash or cream

122
Q

second line tx for acne

A

topical abx (clindamycin) OR tretinoin (retinoic acid) - helps skin cells turn over while helping to keep pores open/stops clogging up

123
Q

third line tx for acne

A

oral abx
-doxycycline –> educate against sun exposure

124
Q

last case scenario for acne tx

A

referral to derm
-may prescribe isotretinoin (Accutane)

125
Q

what is the BBW for accutane associated with?

A

teratogenic to pregnancy

126
Q

what must patients do who take accutane?

A

have two forms of birth control

127
Q

can any provider prescribe accutane?

A

NO; federally regulated and need special certification

128
Q

what brings about geographic tongue sx?

A

spicy or hot foods tend to proceed geographic tongue

129
Q

is geographic tongue bad?

A

NO, benign

130
Q

sx of leukoplakia

A

hairy tongue; cannot scape off

131
Q

tx of leukoplakia

A

REFER to dentist - seen in pts with HIV (immunocompromised population); detrimental to enamel

132
Q

oral candidiasis - can you scape off tongue?

A

YES

133
Q

sx of fifth disease

A

slapped-cheek rash; lacy net-like rash

134
Q

what causes fifth disease?

A

viral infection

135
Q

sx of fifth disease?

A

starts with fever, leads to slapped-cheek rash/very reddened cheeks as well as lacy net-like rash across body

136
Q

when does fifth disease stop being contagious?

A

when rash appears (slapped-cheek rash; lacy net-like rash)

137
Q

tx for fifth disease

A

self-limiting

138
Q

who should patients with fifth disease stay away from?

A

those who are pregnant; can cause miscarriage

139
Q

what is the preferred medication class for fungal infections?

A

antifungals; typically fluconazole

140
Q

how do you decide topical vs oral in fungal infections?

A

based on severity

141
Q

when to use oral antifungal

A

severe, recurrent, unresolved yeast infections or vaginal yeast infection

142
Q

what diseases are treated with fluconazole?

A

tinea
intertrigo

143
Q

how to treat tinea vesicolor

A

antifungal creams, lotions, shampoos

144
Q

sx of enterobiasis

A

genital area is intensely pruritic at night

145
Q

what is enterobiasis

A

pinworm

146
Q

how to diagnose enterobiasis

A

scotch tape test early in AM

147
Q

tx of enterobiasis

A

mebendazole or albendazole

148
Q

what is mebendazole or albendazole used to treat?

A

enterobiasis (pinworm)

149
Q

what oral abx is used to treat dog/cat bite?

A

Augmentin

150
Q

do we suture a dog bite?

A

NO; do not use dermabond either - increases risk for infection

151
Q

what disease is linked to chronic ulcerative stomatitis?

A

lichen planus

152
Q

what other immune disorders can be associated with lichen planus?

A

UC, vitiligo, myasthenia gravis, alopecia areata

153
Q

what can exacerbate lichen planus?

A

stress, infection

154
Q

where on the body does lichen planus occur?

A

flexor surfaces of the limbs, but also mouth, sin, genitals

155
Q

how does lichen planus present?

A

red/purple flat top bumps, intensely pruritic
-some lesions are lacy/white when located on mucous membranes = wickham striae

156
Q

what is wickham striae?

A

seen in lichen planus
-lesions that are more lacy/white when located on mucous membranes

157
Q

how long does it take for lichen planus to resolve?

A

about 6MO; self-limiting

158
Q

tx for lichen planus (mild)

A

simple topical steroids; antihistamines

159
Q

where is lichen simplex chronicus seen on the body?

A

arms, legs, neck, upper trunk, genital region

160
Q

what does lichenification mean?

A

skin becomes leathery/rubbery in appearance d/t repetitive scratching/rubbing

161
Q

what can lead to lichenification?

A

atopic dermatitis (allergies, asthma)

162
Q

tx for lichen simplex chronicus

A

topical steroids; antihistamines
-utilize moisturizers to help with prevention

163
Q

how does lichen sclerosus appear on the skin?

A

almost always white in appearance

164
Q

where is lichen sclerosus typically found?

A

genitalia; on postmenopausal women, typically locaed on vulva

165
Q

what population is most commonly diagnosed with lichen sclerosus?

A

postmenopausal women

166
Q

is lichen sclerosus contagious?

A

NO

167
Q

sx of lichen sclerosus

A

very itchy; painful intercourse, tearing and bleeding; tends to reoccur often

168
Q

treatment for lichen sclerosus

A

topical steroids –> potent topical steroids
**this is the only dx that warrants potent topical steroids on genitalia
-clobetasol

169
Q

patients diagnosed with lichen sclerosus are at higher risk to develop what?

A

squamous cell carcinoma

170
Q

-what layer of skin is impacted by first degree burn?
-does it blister as SE?
-tx

A

-epidermis
-no
-OTC aloe vera

171
Q

-what layer of skin is impacted by second degree burn?
-sx
-tx

A

-epidermis and dermis
-red, blistered, painful (educate pt not to pop blisters)
-topical applications of silver sulfadiazine cream or abx ointment if concerned about infection

172
Q

what is silver sulfadiazine used to treat?

A

2nd degree skin burn

173
Q

-what kind of burn occurs in 3rd and 4th degree burns?
-emergency or can treat in primary care?
-what must be completed during initial assessment?

A

-full thickness burn; involves full epidermis and dermis
-need emergency care
-initial assessment must include airway assessment in relation to smoke inhalation

174
Q

Rule of 9’s: Adult
percent of BSA - head and neck

A

9%

175
Q

Rule of 9’s: Adult
percent of BSA - upper limbs

A

9% each (front and back = 9%)

176
Q

Rule of 9’s: Adult
percent of BSA - trunk

A

36%

177
Q

Rule of 9’s: Adult
percent of BSA - chest above navel

A

9%

178
Q

Rule of 9’s: Adult
percent of BSA - upper back

A

9%

179
Q

Rule of 9’s: Adult
percent of BSA - stomach/abd

A

9%

180
Q

Rule of 9’s: Adult
percent of BSA - lower back

A

9%

181
Q

when do you refer a burn patient to the ED?

A

-when burned BSA is >10%
-burn involves face, hands, genitals, feet
-any electrical or chemical burns
-any burn >2nd degree

182
Q

Rule of 9’s: Child
percent of BSA - head

A

18% (front and back)

183
Q

Rule of 9’s: Child
percent of BSA - anterior trunk

A

18%

184
Q

Rule of 9’s: Child
percent of BSA - posterior trunk

A

18%

185
Q

Rule of 9’s: Child
percent of BSA - arm

A

9%

186
Q

Rule of 9’s: Child
percent of BSA - leg

A

14%

187
Q

Guess this exanthem:
high fever, cough, nasal congestion, pink/watery eyes, white spots in mouth + rash

A

rubeola (measles)

188
Q

what are koplik spots?

A

sx of rubeola (measles)
-white cluster spots on gums, small; present 2-3d after measle sx start
-present on buccal mucosa, near molars specifically
-seen/presents before measles rash occurs

189
Q

what are the 3 C’s of sx associated with rubeola?

A

cough
congestion (coryza)
conjunctivitis

190
Q

-is rubeola contagious?
-does it lead to serious complications?
-tx

A

-very contagious
-yes: pneumonia and encephalitis
-symptomatic tx; MMR vaccine prevents

191
Q

timeline of rubeola virus

A
  1. exposure
  2. 1 wk later = contagious
  3. Day 10: sx start (3 C’s, fever)
  4. Day 12-13: koplic spots (before rash)
  5. Day 15: fever subsides; rash appears
  6. Day 22-24: rash resolves; measles resolves
192
Q

when are patients contagious with rubeola?

A

3-4d before rash starts until 4d after rash appears; expect high fever, 3 C’s

193
Q

what is the hallmark sx of measles (rubeola)?

A

rash; starts on face and spreads downward and outward to rest of body

194
Q

what are the two types of measles?

A

rubeola
rubella

195
Q

Guess this exanthem:
4YO girl; fever, bilateral swelling on face just in front of ears for last 2d
-bilateral swelling of face just in front of ears

A

Mumps
-parotic gland swelling

196
Q

-is mumps contagious?
-how is it transmitted/spread?
-sx

A

-Yes, very contagious
-respiratory droplets, direct contact, contaminated clothes, furniture (usually spread by individuals living in close contact ie college dorms)
-fever, HA, malaise, swelling of parotid glands

197
Q

Guess this exanthem:
Rash for 2d, mild fever, cervical lymphadenopathy; child seems well overall
-rash started on face and spread across rest of body

A

Rubella (German Measles)
-more mild than rubeola

198
Q

what other “nickname” does rubella have?

A

“3 day measles”

199
Q

-do patients have complications with/after rubella?
-distinguishing sx
-tx

A

-far fewer complications
-mild sx; pink rash; lymphadenopathy
-symptomatic tx: hydration, rest, OTC Motrin/Tyl.; MMR vaccine prevents!

200
Q

-are we concerned if a pregnant woman is exposed to rubeola?
-are we concerned if a pregnant woman is exposed to rubella?

A

-no
-yes

201
Q

at what age can MMR vaccine be given? why?
-who can this vaccine not be given to?

A

12MO; live attenuated vaccine
-pregnant women; immunocompromised
*do not get pregnant w/i 4 weeks of receiving this vaccine

202
Q

Guess this exanthem:
high fever (103F) for 3-4d; fever broke this AM but new rash appeared
-rash is rose/pink in appearance and started on trunk
-blanchable rash; spreading to neck, arms, face, legs

A

Roseola

203
Q

what is another name for roseola?

A

sixth disease

204
Q

what is roseola commonly caused by?

A

2 strains of human herpes virus or adnovirus (among others)

205
Q

in roseola, what comes first - rash or fever?

A

fever, then rash

206
Q

distinguishing sx of roseola

A

rose colored, blanchable papule rash
-high fever, then rash appears (typically starts on trunk)

207
Q

when does roseola stop being contagious?

A

once rash appears

208
Q

-tx for roseola
-is there a vaccine?

A

-symptomatic tx
-no

209
Q

Guess this exanthem:
Mild cold sx for few days; after 1 wk from sx onset, patient developed rash on cheeks
-across trunk, developed lacy and net-like rash that continue to spread
-rash is mildly itchy, esp at soles of feet

A

Fifths disease

210
Q

What is another name for Fifths disease?

A

erythema infectiosum

211
Q

what is Fifths disease caused by? (what virus)

A

strain of parvovirus B19

212
Q

what are the distinguishing sx of Fifths disease?

A

“slapped cheeks,” lacy, net like appearance to the rash

213
Q

-Tx for Fifths Disease
-any long-term complications?
-concerned if pregnant patient exposed?

A

-symptomatic tx
-not typically long term complications
-yes, can cause pregnancy complications –> severe anemia in fetus (order titer if pt has been exposed)
*many people are immune d/t previous exposure

214
Q

Guess this exanthem:
Fever for 1-2d, sore throat, painful sores started in mouth
-rash now on hands and feet as well
-some spots are vesicles; skin on top of toes is starting to peel

A

HFM

215
Q

-what virus causes HFM?
-where does rash start on the body?
-tx
-is there a vaccine?

A

-coxsackie virus
-mouth and spreads to hands/feet; can see peeling after rash has occurred
-symptomatic tx
-no

216
Q

what is the order of potency in topical steroids?

A

ointments
creams
lotions
solutions

217
Q

does potency = level os absorption into the skin?

A

no

218
Q

what type of topical steroid medium is best absorbed by skin?

A

cream

219
Q

what is the most commonly prescribed potency topical steroid prescribed in primary care?

A

-class III
-class IV

220
Q

can we prescribe class I topical steroid in primary care?

A

NO
-can lead to adrenal suppression, smother other SE

221
Q

what potency topical steroid can be used on the face?

A

low potency or none

222
Q

what potency topical steroid can be used on arms/legs/trunk?

A

medium potency

223
Q

what potency topical steroid can be used on hands/feet?

A

high potency

224
Q

can you apply topical steroid to genitalia?

A

Overall no, except in Lichen Sclerosis –> use high potency for short term (clobetasol)

225
Q

what is the most important factor to consider when prescribing topical steroid?

A

potency (and area of body steroid will go)

226
Q

Mupirocin
-what is this the primary tx for?
-effective against gram + or - bacteria?
-when should improvement be seen with use?
-if no improvement, then what?

A

-nonbollous impetigo
-gram + bacteria ie staph aureus and strep pyogenes
-in 3-5 days
-if lingering, reassess pt

227
Q

Antivirals
-what are antivirals used to tx?
-what routes are antiviral medications?
-what do these medications end in?

A

-shingles, HSV1 and HSV2
-oral, topical, etc.
-“-cyclovir” –> acyclovir (zovirax), valacyclovir (valtrex)

228
Q

Antivirals
-what organ system do antivirals impact? what can it lead to? how can the patient avoid this?
-when must these medications be started to be effective?

A

-kidneys; can lead to AKI; stay hydrated
-started w/i 48 hours; can wait up to 72hrs, but not as effective

229
Q

Antivirals
-what are sx of viral skin infections?
-are these used as spot tx or maintenance tx?

A

-burning, tingling at site prior to lesion
-can be utilized as spot tx or maintenance therapy doses

230
Q

Triazoles
-what kind of medication class is this?
-what is this used to treat?
-what do these medications end in?

A

-antifungal
-vaginal yeast, tinea versicolor, ringworm
-“-azoles”

231
Q

Triazoles
-are these medications fungistatic or fungicidal?
-are these medications teratogenic?
-what organ system can these medications negatively impact?

A

-fungistatic: limits ability of fungus to reproduce
-yes
-liver

232
Q

Selenium sulfide
-what type of medication is this?
-what makes this medication helpful?
-what is this medication used for?

A

-antifungal and antiinfective
-it is in shampoo form and OTC; slows growth of yeast
-tx of tinea versicolor, tinea capitis, common dandruff of scalp

233
Q

What is used to treat pinworms?

A

Mebendazole (Vermox) or Albendazole (Albenza)

234
Q

what is the medication regiment for pinworm treatment?

A

prescribe 1 dose at diagnosis, the 1 dose 2 weeks later (mebendazole or albendazole)

235
Q

-are pinworms contagious?
-what is the significance of prior question?

A

-yes
-must treat everyone in household

236
Q

what is the OTC medication option to tx pinworms?

A

Pyrantel Pamoate (not as effective)

237
Q

Terbinafine
-what kind of medication is this?
-what does this treat?
-length of time for treatment
-what organ system should be monitored?

A

-antifungal
-tinea capitis and fungal infection of nail beds (onychomycosis)
-tinea capitis = 2-4 wk; onychomycosis = 6-12 wks
-monitor liver prior to prescribing

238
Q

Griseofulvin
-what kind of medication is this?
-what does this treat?
-length of time for treatment
-how should this medication be taken?

A

-antifungal
-tinea capitis (slightly more effective than terbinafine, but comparable)
-6-8 week tx
-take with fatty meal

239
Q

what two medications can be used to treat tinea capitis?

A
  1. Terbinafine
  2. Griseofulvin (slightly more effective, but comparable)
240
Q

what is permethrin (elimite) used to treat?

A

lice, scabies, ticks, mites, fleas

241
Q

how to use permethrin (elimite) to treat scabies

A

-apply to entire body from neck down before bedtime; wash off 12 hours later
-repeat in 1 week
-daily showers and laundering (hot water) decrease recurrence

242
Q

how to use permethrin (elimite) to treat lice

A

-apply to head and remove immediately after
-kills active lice, but not unhatched eggs = needs second tx; knits need to be combed out of hair

243
Q

Acne Tx
-initial treatment
-solo tx or adjunct tx?
-how does it work?

A

-benzoyl peroxide (salicylic acid prior)
-solo tx or adjunct tx
-dries and peels skin on face so acne bacteria will be shed off; kills bacteria under skin and cleans out pores

244
Q

Acne Tx
-secondary tx
-how does it work?
-example of topical retinoid and how it works

A

-topical retinoids and/or abx cream
-stops overgrowing of bacteria on skin
-tretinoin (Retin-A); irritate skin = dissolves old/dead skin = pores unclog; skin heals itself

245
Q

Acne Tx
-tertiary tx

A

oral abx
-tetracyclines (start thinking of referring to derm)

246
Q

Acne Tx
-fourth option for tx

A

Accutane (isotretinoin)
-prescribed by derm
-need reliable form of birth control; med can cause numerous birth defects

S Michelle (18 decks)

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