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Nurp 423 Exam 3 > Week 10: Derm > Flashcards

Week 10: Derm Flashcards

1
Q

Bacterial infections of the skin usually caused by:

A 
Staph aureus or MRSA
Strep pyogenes (group A strep)
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2
Q

Nonpharm care of bacterial skin infections:

A

Good hygiene
Warm compresses
Elevation of lower extremity
If severe infections: I and D with culture

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3
Q

Topical antibiotics used for bacterial skin infections:

A

Mupriocin (Bactroban)

Gentamycin

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4
Q

What topical antibiotic is effective against S. Aureus and used to decolonize carriers?

A

Mupirocin (bactroban)

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5
Q

What topical antibiotic is used for group a strep, s. Aureus, and pseudomonas?

A

Gentamycin

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6
Q

Folliculitis is a superficial bacterial infection of hair follicle that is primarily caused by?

A

Staph aureus

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7
Q

Folliculitis in the groin could be caused by?

A

Candidiasis

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8
Q

Folliculitis from swimming pool/hot tub exposure is caused by?

A

Pseudomonas

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9
Q

Topical therapy for folliculitis?

A

Bactroban or clindamycin gel

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10
Q

If folliculitis is severe/diffuse how would you treat?

A

Cephalexin, keeled, or augmentin for staph

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11
Q

Antibiotics are recommended for abscesses associated with:

A

Severe or extensive disease(involving multiple sites)
Rapid progression in presence of associated cellulitis
Signs/symptoms of systemic illness
Associated comorbidities
Extremes of age
Abscess in area difficult to drain (face, hands, or genitalia)
Associated septic phlebitis
Lack of response to I and D alone

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12
Q

Antibiotic therapy for abscess:

A

1st line: broad-spectrum penicillin or first generation cephalosporins (cephalexin)

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13
Q

Second line antibiotic therapy for abscess:

A

2nd/3rd generation cephalosporins or fluoroquinolones (ciprofloxacin- good for pseudomonas)

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14
Q

Treatment for abrasion:

A

Clean, apply bacitracin, triple antibiotic ointment and cover until it’s healed

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15
Q

Treatment of abscess with CA-MRSA:

A 
I and D
Systemic antibiotics- if there is surrounding inflammation or induration:
-bactrim 
- mino /doxycycline 
- zyvox
- Vancomycin for serious infections
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16
Q

Treatment of mild acne:

A

BP or topical retinoids or combo of both

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17
Q

Treatment of moderate acne:

A

Combo of BP+ antibiotic or retinoid or oral antibiotic plus topical retinoid and BP

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18
Q

Pharmacological treatment for acne with comedolytics:

A

Topical retinoid - core of topical treatment but use at a different time then BP
Benzoyl Peroxide

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19
Q

Side effects of topical retinoids:

A

Dryness/peeling, erythema, photosensitivity, pregnancy class C

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20
Q

MOA of Azelex:

A

Interferes with DNA synthesis of P. Acnes, antibacterial and anti inflammatory

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21
Q

Caution with azelex:

A

Can cause pigment changes in dark skin

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22
Q

Topical antibiotics for acne treatment include:

A

Erythromycin and clindamycin

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23
Q

MOA of topical antibiotics and acne:

A

Reduce microbial colonization and decrease inflammatory response, best used in combo with a comedolytic

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24
Q

Oral antibiotics are used in what type of acne?

A

Moderate to severe

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25
Q

First line oral antibiotic in acne:

A

Tetracycline- educate of photosensitivty

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26
Q

Other oral antibiotic options in acne:

A

Erythromycin and bactrim

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27
Q

Adverse events of accurate:

A

Monitor for lipids, osteoporosis, depression
Dryness, itching of mucous membranes and skin
Muscle aches, corneal opacities
Teratogenic- pregnancy class x- must use 2 forms of birth control!

28
Q

Cutaneous vascular disorder of increased reaction of capillaries to heat that is present for at least 3 months and starts between the ages of 30-50.

A

Acne rosacea

29
Q

First line therapy for acne rosacea:

A

Topical:
Metronidazole gel/cream/lotion
Sodium sulfacetamide with sulfur
Azelaic acid

30
Q

Nonpharmacologic treatment of acute dermatitis:

A

Avoidance of perfumes, irritants such as smoke, detergent, soaps, and bubble bath
Decrease frequency of bathing, temp of water, and duration of shower/bath
Loose/cotton clothing

31
Q

Cornerstone of atopic dermatitis therapy:

A

Emollients- 1-4 times daily and after bathing with no alcohol or fragrance

32
Q

1st line pharmacologic treatment of atopic dermatitis:

A

Topical steroids: work on immune cells interfering with antigen processing and suppressing the release of proinflammatory cytokines

33
Q

Where to use low-potency topical steroids:

A

Face, mucous membranes, genitalia, intertriginous areas

34
Q

What type of steroids are needed in the palms and soles?

A

Potent

35
Q

Ointment and steroid vehicles is more or less potent?

A

More potent and good for dry rashes

36
Q

What vehicle for steroids is good for wet rashes?

A

Creams

37
Q

Second line therapy for atopic dermatitis?

A

Topical calcineurin inhibitors: elidel and protopic

38
Q

Calcineurin inhibitors can be used in ages:

A

Elidel: infant and up
Protopic: 2 and up (0.3%)

39
Q

Side effects of calcineurin inhibitors:

A

Viral infections such as HSV, Molly scum, varicella, warts
Flu-like symptoms, allergic reaction, asthma, cough, fever, headache
Pregnancy cat c

40
Q

Systemic treatment for atopic dermatitis:

A

Oral antihistamines

41
Q

Skin disorder caused by uncontrolled accelerated replication of the basal epidermal cells, causes redness, flaking, and thickened patches.

A

Psoriasis

42
Q

Treatment of psoriasis:

A 
Emollients
Topical steroids-cornerstone 
Topical immunosuppressives- elidel/protopic
Vitamin D derivatives- dovonex, sorilux 
Keratolytic agent- salicylic acid
43
Q

First line treatment in psoriasis:

A

Emollients

Topical steroids

44
Q

First line therapy in impetigo:

A

Mupirocin (Bactoban)

45
Q

What medication can be used to treatment inflammatory pustular acne?

A

Oral tetracycline

46
Q

If you treat a fungus with a steroid cream it will:

A

Get worse

47
Q

Oral antifungals should be reserved for:

A

Severe or extensive cases

48
Q

Oral antifungals can cause:

A

Significant hypoglycemia when a patient is on hypoglycemia meds

49
Q

Preferred agent for tinea capitis and tinea corporis of oral treatment is needed:

A

Griseofulvin- oral antifungal

50
Q

Yeast/tinea infection of the nails:

A

Onychomycosis

51
Q

Onychomycosis treatment:

A

Penlac 8% daily application for 48 weeks

52
Q

MOA of penlac:

A

Inhibits enzymes responsible for the breakdown of peroxidases within fungal cells,interrupts RNA/DNA synthesis, alternative to systemic treatment for onychomycosis

53
Q

MOA of topical retinoid:

A

Decreases the cohesion of epidermal and follicular cells

54
Q

Griseofulvin should be taken:

A

With fatty foods to increase absorption, liquid form is easiest for patients to find

55
Q

Topical antiviral agents:

A

Acyclovir and pencyclovir

56
Q

Topical antiviral moa:

A

Inhibiting viral DNA synthesis which decreases healing time

57
Q

Systemic antiviral agents:

A

Acyclovir, famciclovir, valacyclovir

58
Q

Systemic antivirals are contraindicated in:

A

Renal disease

59
Q

Side effects of systemic antivirals:

A

Headache, vertigo, depression, tremors

60
Q

Famciclovir dosing:

A

HSV: 250 TID x 7-10 days (initial); recurrent 1000mg BID for 1 day or 250mg twice a day

Zoster: 500 mg TID x 7 days

61
Q

Acyclovir dosing:

A

HSV: 200mg 5 times per day initial; recurrent 200 mg 5 times per day x 5 days

Zoster: 800 mg 5 times per day x 7 days

62
Q

Valacyclovir dosing:

A

HSV: initial 1000 mg bid for 10 days

Zoster: 1000 mg TID for 7 days

63
Q

First line therapy for warts:

A

Salicylic acid for 8 weeks if not resolved after 8 weeks- cryotherapy

64
Q

Therapy for genital warts:

A

Podofilox solution or gel
Imiquimod cream

Practitioner applied:
Cryotherapy
Podophyllin
Trichloroacetic acid

65
Q

Poison ivy therapy:

A

May need steroid burst or medrol pack

Nurp 423 Exam 3 (3 decks)

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