ID E1- Derm & Infestations

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66 Terms

1
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Staph or Strep:

Catalase positive

Staph

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Staph or Strep:

Catalase negative

Strep

3
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What pathogen is the MCC of folliculitis?

Staph

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What pathogen causes Hot tub folliculitis?

Pseudomonas A.

5
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What abx are used to treat folliculitis?

Topical - Mupirocin, Clindamycin

6
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What is the treatment for folliculitis caused by pseudomonas?

Good hygeine, Cipro if severe

7
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What is an abscess?

circumscribed collection of pus appearing as an acute or chronic localized infection with tissue destruction

8
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What is a furuncle?

acute, deep-seated, red, hot, tender nodule or abscess that evolves from a staphylococcal folliculitis

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What is a carbuncle?

deeper infection composed of interconnecting abscesses usually arising in several contiguous hair follicles

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What are boils?

furuncles

11
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What is the treatment for furuncles?

Warm compress, I&D, Abx if >2cm

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What is the treatment for carbuncles?

Swab for culture, I&D PLUS ABX

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When is IV therapy/admission necessary for treatment of carbuncles?

systemic signs of toxicity, surrounding cellulitis, Immunocompromised, Unable to tolerate or failure of oral abx, Abscess is close to catheter

14
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What are the preferred oral agents for treatment of skin/soft tissue infections due to MRSA?

Bactrim, Clindamycin, Doxycycline, Minocycline

15
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What age range is impetigo most common in?

2-5 y/o

16
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What pathogens cause nonbullous impetigo?

Staph aureus, GABHS

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What pathogens cause bullous impetigo?

primarily staph aureus

18
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How does Impetigo present?

pustules that progress to erosions covered by honey-colored crusts; painless

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What is the treatment for mild/localized non-bullous impetigo?

Topical Mupirocin, Warm compress, Cephalexin or Docloxacillin

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What is the treatment for bullous impetigo/extensive disease?

Same as non-bullous

PLUS Doxy/Bactrim/Clindamycin

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What is Ecythyma?

ulcerative form of impetigo

22
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How does Ecthyma present?

"Punched-out" ulcers covered with yellow crust surrounded by raised violaceous margins

23
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Bullous impetigo can progress to what disease?

SSSS

24
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What pathogens most commonly cause cellulitis?

Staph (MRSA/MSSA), Group A strep

25
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What pathogen causes cellulitis due to meat/fish exposure?

Erysipelothrix rhusiopathiae

26
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What pathogen causes cellulitis after saltwater exposure?

Vibrio vulnificus

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In patients with cellulitis, you should NEVER take a culture from what area?

Intact skin; only from abscess or bullae

28
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What IV therapy is used for cellulitis?

Vancomycin

29
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What is another name for SSSS?

Ritter's disease

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What age group is affected by SSSS?

Infants & children <6 y/o

31
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Which disease would have a positive Nikolsky's sign?

SSSS

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What is the only way to differentiate SSSS from SJS/TEN?

Skin biopsy

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What is the treatment of SSSS?

ICU admission, IVF, IV abx directed towards staph aureus

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What pathogen is the MCC of toxic shock syndrome?

Staph aureus (MSSA)

35
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What is Toxic shock syndrome associated with?

tampon use, nasal packing, or wound packing

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What are some symptoms of toxic shock syndrome?

Fatigue, Abdominal pain, Rash, HA, Sore throat, Hypotension, Orthostatic dizziness/syncope

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How does Toxic shock syndrome present?

diffuse, red, macular rash with bullae formation resembling a sunburn, INVOLVING PALMS/SOLES, followed by desquamation

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How many organ systems must be involved in order to dx TSS?

≥3

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What is the MC complication of toxic shock syndrome?

Prolonged hypovolemic shock

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What is the treatment for toxic shock syndrome?

IV abx: clindamycin + vancomycin + beta lactam

(need MRSA/MSSA coverage)

41
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What pathogen is the MCC of erysipelas?

GABHS (S. pyogenes)

42
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How does Erysipelas present?

butterfly pattern involving both cheeks/spread across the nose

43
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How is strep throat transmitted?

Direct person to person contact

44
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What is the first line treatment for strep throat?

PCN V po

45
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What is Scarlet fever?

complication of strep pharyngitis that presents with strawberry tongue & rash

46
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Where does the "sandpaper" rash associated with scarlet fever typically begin? Does it affect the palms & soles?

Axillae, groin, neck; spares palms and soles

47
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How does Scarlet fever present?

fine, papular or punctate lesions that has a coarse, sandpaper texture + pastia lines

48
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5 major manifestations of rheumatic fever

Carditis

CNS involvement (ie chorea)

Erythema marginatum

Polyarthritis (large joints)

Subcutaneous nodules

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4 minor manifestations of rheumatic fever

Arthralgia

Fever > 100.4F

Elevated ESR/CRP

Prolonged PR interval (>0.2 secs)

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Jones criteria for rheumatic fever

Initial episode with evidence of preceding GAS infection, PLUS:

Two major manifestations, OR

One major + two minor manifestations

51
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What is the treatment for eradication of GAS for rheumatic fever?

IM PCN G

52
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What is another name for Erythema infectiosum?

"Fifth disease"

53
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What virus causes erythema infectiosum?

Parvovirus B19

54
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How does Erythema infectiosum present?

"Slapped cheek" appearance with lace-like rash on body and circumoral pallor

55
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Whats another name for Roseola?

"Sixth disease"

56
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What is Pediculosis capitis?

Head lice

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What is Pediculosis corporis?

Body lice

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What is Pediculosis pubis?

Pubic lice/"crabs"

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What is the drug of choice for treatment of pediculosis?

Permethrin

60
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What causes the itching associated with Scabies?

delayed type IV hypersensitivity reaction to mites

61
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How does Scabies present?

nocturnal pruritus, elevated S-shaped tracks on the skin at clothing lines

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What is the treatment for scabies?

Permethrin cream; Remove by shower/bath after 8-14 hours, Repeat in 1-2 weeks

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What are the two bedbug species that MC affect humans?

C. lectularius, C. hemipterus

64
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When does peak activity of bedbugs occur?

Just before dawn

65
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What type of infestation produces a peculiar pungent odor, and commonly affects environments that are in disarray?

Bedbugs

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What is the treatment for bedbug bites?

Usually self-limiting; may use steroid cream or oral antihistamine