UW ped

Question 1

Sunburn - clinical manifestation

Answer 1

symptoms begin hours after exposure, resolbe by day 3-7
mild-moderate: erythema, tenderness
severe: as above + blistering and systemic symptoms (eg. fever, vomiting, headache)

Question 2

sunburn - treatment

Answer 2

mild - moderate: topical cool compressess, calamine lotion, alone vera, oral NSAID
severe: hospital, IV fluids and analgesia, wound care

Question 3

sun protection (if avoidance is impossible)

Answer 3

sunscreens with sun protection factor 15-30 or higher, applied 15-30 minutes before sun exposure to allow the formation of a protective film on the skin and reapplied at least every 2 hours
(because is washed off with swimming and sweating

Question 4

no in infants younger than 6 months

Answer 4

their skin and high surface area to body weight ration increases exposure to sunscreen chemicals

Question 5

dark vs light clothes on sunprotextion

Answer 5

althoug dark attract more, the protect more

Question 6

mongolian spot

Answer 6

aka congenital dermal melanocytosis

• benign, flat, blue-grey patches that are usually present over the lower back and buttocks (but can be anywhere)
• african, asian, hispanic, native american
• fades spontaneously during first decade

Question 7

mongolian spot vs abuse

Answer 7

in abuse, bruises are tender, fade quickly, more varied in color

Question 8

scabies - organism, route of transmission

Answer 8

• sarcoptes scabie mite

- person to person contact

Question 9

scabies - clinical features

Answer 9

• extremely pruritic burrows + small erythematous papuls

- rash on interdigital web spaces, flexor wrists, extensor elbows, axillae, umbulicus, genitalia

Question 10

scabies - treatment

Answer 10

topical 5% permethrin or oral ivermectin

Question 11

neonatal rashes - types

Answer 11

1. erythema toxicum neonatorum
2. neonatal HSV
3. neonatal varicella
4. staph scalded skin syndrome

Question 12

erythema toxicorym neonatorum clinical presentation / treatment

Answer 12

asymptomatic, scattered erythematous macules, papules + pustules throughout the body
- no treatment necessary (resolves within 2 weeks after birth)

Question 13

neonatal hsv - clinical manifestation / treatment

Answer 13

3 patterns
- vesicular clusters on skin, eyes + mucous membranes
- central nervous system infection
- fulminant disseminated multi-organ
ACYCLOVIR

Question 14

neonatal varicella - clinical manifestation / treatment

Answer 14

fever, ranges from vesicular clusters on skin to fulminant, disseminated disease
ACYCLOVIR

Question 15

staph scalded skin syndrome - clinical manifestation / treatment

Answer 15

fever, irritability + diffuse erythema followed by blistering + exfoliation, positive Nikolsky’s sign
treatment: oxacillin, nafcillin or vancon

Question 16

seberrheic dermatitis - clinical features

Answer 16

peaks in infancy + adulthood

• erythematous plaques +/or yellow, greasy scales
• located on scalp, face, (eg. eyebrows/eyelids, posterior ears, nasolabial folds), umbilicus, diaper area

Question 17

seberrheic dermatitis - treatment

Answer 17

1st line: emollients, nonmedicated shampoos

2nd line: topical antifungals or low potency glucocorticoids

Question 18

tinea corporis - RF

Answer 18

1. athletes with skin-skin contact
2. humid environment
3. contact with infected animals (eg. rodent)

Question 19

tinea corporis - presentation

Answer 19

• scaly erythematous pruritic patch with centrifugal spread

- subsequent central clearing with raised annular borders

Question 20

tinea corporis - treatment

Answer 20

1st line/localized: topical antifungals (eg. clotrimazole, terbinafine)
2nd line / extensive: oral antifungas (terbinafine, griseofulvin)

Question 21

tinea capitis - treatment

Answer 21

• oral grizeofulvin

- terbinafine

Question 22

pityriasis rosea - treatment

Answer 22

reassurance

anti-histamine if pruritus

Question 23

infectious complications of atopic dermatitis - types (and pathogens)

Answer 23

1. impetigo (S. aureus, S pyogenes)
2. Eczema herpeticum (HSV1)
3. Molluscum contagiosum (Poxvirus)
4. Tinea corporis (Trichphyton rubrum)

Question 24

infectious complications of atopic dermatitis - types and presentation

Answer 24

1. impetigo –> painful, non-pruritic pustuls with honey crusted adherent coating
2. Eczema herpeticum –> painful vesicular rash with punched out erosions + hemorrhagic crusting
3. Molluscum contagiosum –> fresh-colored papules with central umbilication
4. Tinea corporis –> pruritic circular patch with central clearing + raised, scaly border

Question 25

Perianal dermatoses - types (and epidemiology)

Answer 25

1. contact dermatitis (MC in infants)
2. Candida dermatitis (2nd MC in infants)
3. perianal Streptococcus

Question 26

Perianal dermatoses - types + appearance

Answer 26

1. contact dermatitis –> spares creases / skinfolds
2. Candida dermatitis –> beefy-red rash involving skinfolds with satellite lesions
3. perianal Streptococcus –> bright, sharply demarcated erythema over perianal / perianal area

Question 27

Perianal dermatoses - types + treatment

Answer 27

1. contact dermatitis –> topical barrier ointment or paste
2. Candida dermatitis –> topical anti-fungal therapy
3. perianal Streptococcus –> oral antibiotics

Question 28

irritant diaper dermatitis?

Answer 28

presents with erythema and skin breakdown in the diaper area due to prolonged exposure to urine or stool in the diaper, particularly in the setting of diarrhea

Question 29

deliberate scald injuries are characterised by

Answer 29

sharp lines of demarcation, uniform burn depth and spared flexor surfaces

Question 30

congenital melanocytic nevus

Answer 30

presents within the 1st few months of life as isolated hyperpigmented patches with an increased density of hair follicles

Question 31

compartment syndrome after burn?

Answer 31

the eschar results drom circumferential, full thickness (3rd degree) burn often leads to constriction of venous and lymphatic drainage, fluid accumulation –> acute compartment syndrome