Infectious Diseases of the Skin MLS

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100 Terms

1
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most skin pathologies occur in what layer of the skin?

epidermis

2
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folliculitis

inflammation of the hair follicles

3
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what are the 2 types of folliculitis?

pathogenic or inflammatory

4
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name 3 pathogens that cause pathogenic folliculitis

Staphylococcus or MRSA

Pseudomonas ("Hot Tub" folliculitis)

Pityrosporum yeast

5
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how does pathogenic folliculitis present and how do you differentiate what pathogen is the cause?

crops of red papules/pustules; bacterial culture

6
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inflammatory folliculitis

common in athletes in high sweet or fritiction areas

7
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your patient has a small patch of pathogenic folliculitis from bacteria, what are you prescribing?

mupirocin or clindamycin

8
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your patient has a large patch of pathogenic folliculitis from Staphylococcus bacteria, what are you prescribing?

cephalexin

9
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your patient has a large patch of pathogenic folliculitis from MRSA, what are you prescribing?

trimethoprim-suldamethoazole

10
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a patient comes in red papules/pustules and says she was just recently in a hot tube. what are you prescribing her?

ciprofloxacin (diagnosis: pathogenic folliculitis from pseudomonas bacteria)

11
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your patient has pathogenic folliculitis from pityrosporum. what treatment would you prescribe?

Topical antifungal (Ketoconazole, econazole, terbinafine (OTC- athletes foot))

Oral antifungal (Fluconazole, terbinafine)

12
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what could you prescribe for irritant/inflammatory folliculitis?

Topical corticosteroid (hydrocortisone, triamcinolone, betamethasone)

Oral corticosteroid (prednisone)

13
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Pseudobarbae Folliculitis

bread area

14
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Acne keloidalis nuchae

Occipital scalp

15
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what patient education should you give relating to folliculitis?

Shaving techniques (with the grain, electric razors)

Avoid waxing

Prevention: reduce irritants, drain hot tub water

16
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furuncle

boil; involves 1 hair follicle

17
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carbuncle

several coalescing furuncles developing in the adjacent hair follicles

18
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risk factors for furncles/carbuncles

Bacterial colonization (staph aureus, MRSA)

History of folliculitis

19
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what do furuncles/carbuncles look that?

tender, red, purulent nodule(s)

20
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how to you diagnosis furuncles/carbuncles?

clinical, bacterial culture

21
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whats the treatment for furuncles/carbuncles?

incision and draining (I and D)

antibiotics- cephalexin or TMP-SMX for MRSA

22
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whats the most common pathogen to cause impetigo?

S. Aureus

23
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whats the hallmark for impetigo?

honey colored crusting

24
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how do you diagnosis impetigo?

clinical, bacterial culture

25
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what are you prescribing for your patient with impetigo?

cephalosporin or TMP-SMX for MRSA

26
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herpes simplex virus is never cured t/f

true

1 multiple choice option

27
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what pathogen causes cold sores?

HSV-1

28
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oral HSV may reoccur _________

episodically

29
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symptoms of oral HSV

Local: burning/pain, itching

Prodromal itching or tingling

Constitutional: Fever, malaise (more common on 1st episode)

Gingivostomatitis/pharyngitis (lesions inside mouth)

30
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signs of oral HSV

Small grouped vesicles which rupture leaving ulcers

31
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how do you diagnosis oral HSV?

clinical, Tzanck smear: look for multi- nucleated giant cells

Viral culture

32
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whats the gold standard/best way to diagnosis oral HSV?

viral culture

33
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your patient comes in with recurring, painful cold sores. what are you prescribing?

acyclovir or valacyclovir

34
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what pathogen causes genital herpes?

HSV 2

35
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what are the symptoms of genital herpes?

Recurrent episodes

Small grouped vesicles on an erythematous base

Tender erosions

Vaginal discharge

Prodromal tingling or burning

36
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whats the best way to diagnosis genital herpes?

viral culture

37
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what are the two most common medications for genital herpes?

Acyclovir and Valacyclovir

38
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herpetic whitlow

Vesicles/erosions at the distal finger/junction of the nail bed and skin

39
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how to diagnose herpetic whitlow?

clinical, viral and bacterial cultures

40
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what do you treat herpetic whitlow with?

acyclovir/valacyclovir

41
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herpes zoster

shingles

42
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what pathogen causes herpes zoster?

Varicella zoster virus (VZV)

43
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what are the symptoms/appearance of herpes zoster?

Pain (extreme!) along one nerve route and dermatome (does NOT cross midline)

Pain frequently precedes rash

Grouped vesicles on erythematous base

Unilateral dermatome distribution

44
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a patient comes in with an extremely painful rash, painful eruption of the ear canal and TM, and ipsilateral facial paralysis. whats the diagnosis and what causes it?

Ramsey Hunt Syndrome -

Infection involving the sensory branch of the facial nerve (CN VII)

45
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zoster ophthalmicus/corneal lesions are from the infection of what nerve and what are 2 signs of this diagnosis?

V1 of trigeminal nerve; Dendritic lesion

Hutchinson sign (V2 involvement (nose))

46
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whats the treatment for herpes zoster?

Acyclovir/valacyclovir x 1 week

47
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what is a serious complication of herpes zoster?

Postherpetic Neuralgia

48
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how can herpes zoster be prevented?

Shingrix recombinant vaccine

49
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an immunocompromised patient comes in with red/purple cutaneous papules, plaques, and nodules. what are you doing to diagnosis this patient and how are you treating it?

biopsy; prescribe acyclovir, valacyclovir (diagnosis: Kaposi's sarcoma)

50
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Kaposi's sarcoma is the reactivation of what?

HHV-8

51
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decubitus ulcers

bed sores

prolonged pressure and vascular insufficiency at weight bearing sites in non ambulating patients leads to ischemia and cutaneous necrosis

52
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where do 70% of decubitus ulcers occur?

hip/buttock

53
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how would you grade a decubitus ulcers that extends to subcutaneous fat?

stage 3 (stage :1 skin is unbroken stage 2: skin is broke to epidermis or dermis stage 4: extends to muscle or bone)

54
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what are some risk factors decubitus ulcers?

Immobility

Decreased sensory perception (won't feel pain/discomfort)

Moisture (adult diapers)

Poor nutritional status

Friction

55
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what are the most common pathogens to cause decubitus ulcers?

Gram positives: Staph, strep

Gram negative rods

56
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what are the most effective ways to treat a decubitus ulcer?

debride, relieve pressure, antibiotics

57
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whats the best way to stop decubitus ulcers from happening?

Prevention!!!!!

Reduce pressure

Timely position changes

58
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Stasis ulcers

Patients with lower extremity edema have skin breakdown secondary to venous insufficiency

59
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typical or textbook location of stasis ulcers

medial aspect of ankle

60
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symptoms/signs of stasis ulcers

Mild erythema

Scaling

Erosion with well-demarcated borders

+/- pruritus

61
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what is the treatment for stasis ulcers?

Decrease edema by

(Compression stockings

Elevate limb)

Diuretics

Debride if indicated

Biopsy atypical lesions

Wound care

62
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why do diabetics get ulcers and not know they have them?

Peripheral neuropathy

63
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what are the main 2 pathogens for diabetic ulcers?

Staph

Gram negative rods

64
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treatment of diabetic ulcers

Educate, educate, educate

Prevention

Bed rest, topical antiseptics

Systemic antibiotics

Debridement

Hospitalization with ID consult

If untreated or treatment unsuccessful: surgery

65
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erysipelas

infection of the upper dermis and lymphatics

66
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where are erysipelas typically seen?

on the face or lower legs

67
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what pathogens cause erysipelas?

Group A strep, Streptococcus pyogenes

68
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you suspect a patient has erysipleas. whats signs and symptoms would you expect them to have?

Bright red, hot raised with sharply demarcated edges

Tense, pitting edema

Vesicles or bullae may develop

Progresses rapidly and painfully

Systemic symptoms

May have red streaking

69
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whats the most common way erysipelas is diagnosed?

clinical

70
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what are you prescribing for your patient with erysipleas?

Antibiotic-Penicillin, cephalosporin, macrolide, or clindamycin

71
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cellulitis

breaks in the skin allow infection to develop in the deeper dermis

72
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where does cellulitis typically occur?

lower extremity, almost always unilateral

73
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signs/symptoms of cellulitis

Pain/swelling

Hot

Fever

Erythema +/- streaking (borders non-demarcated)

Regional adenopathy

Malaise

74
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whats normally the pathogens for cellulitis?

Group A Strep, Staphylococcus aureus, or MRSA

75
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your patient comes in with a hot, painful, erythema rash with streaking. they said they were recently bitten by an animal. what pathogen to you think could of caused this?

Pasteurella

76
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how is cellulitis dianosed?

clinical

Blood cultures

+/- Wound bacterial culture

77
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what are you prescribing for your patient with cellulitis?

Penicillin, cephalosporin, clindamycin

If MRSA: Vancomycin

78
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what pathogen causes tinea?

Dermatophytes- Trichophyton rubrum

79
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where are tineas normally located, generically?

superficial

80
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Tinea versicolor

Noninflammatory dermatophyte infection

81
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what pathogen causes tinea versicolor?

Malassezia yeast

82
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where/what is tinea versicolor more common in?

hot climates, athletes

83
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what does tinea versicolor look like and where is it located?

Pink/brown or hypopigmented diffuse macules with fine scale (flat discolorations)

Located on trunk, proximal limbs, neck

84
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whats the pathogen for tinea corporis?

T. rubrum

85
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in what populations is tinea corporis common in?

children and athletes

86
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explain how tinea corporis presents

Erythematous, scaly, annular plaque

Expands in size with central clearing

Raised "active" border

87
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whats the main pathogen for tinea cruris?

T. rubrum

88
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in what population is tinea cruris more common in?

males

89
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describe how tinea cruris presents

Erythema/scaly plaque with expanding active border

Begins in groin crease, spreads to thigh/abdomen

Pruritus/burning

90
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what pathogen causes tinea capitis?

Trichophyton tonsurans

91
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who is the most likely to get tinea capitis?

children and darker ethnicities (black skin)

92
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describe how tinea capitis presents

Erythematous plaque surrounding hair shaft

Gradually enlarges in annular pattern

Hair shafts frequently break/hair loss

93
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kerion

deep severely inflamed form of T.Capitis

94
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what pathogen causes tinea pedis?

T. rubrum

95
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interdigital tinea pedis

scaling/maceration in toe web spaces

96
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moccasin tinea pedis

scaling/erythema on lateral foot surfaces

97
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whats the pathogen for tinea unguium?

T. rubrum

98
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describe how tinea unguium presents

Yellow, thickened nails with onycholysis

Superficial white discoloration

99
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how could you diagnosis tinea?

Fungal Culture

KOH of fine scale

100
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name some topical and oral antifungals that could be used to treat tinea

Topical

-Clotrimazole (OTC)

-Terbinafine (Lamisil) (OTC)

-Tolnaftate (Tinactin) (OTC)

-Naftifine (Lotrimin) (OTC)

E-conazole (Spectazole)

-Ketoconazole (Nizoral)

-Ciclopirox (Loprox, Penlac)

Oral

-Fluconazole

-Terbinafine

-Griseofulvin

-Itraconazole