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Session 2 CM derm12

CM- Derm -12- Insect BItes and infestations

What are two methods that bugs cause cutaneous response they inject toxin or enzyme that direct inures tissue or produce a venom that contain inflammatory mediators
Who tneds to react more severely to toxins and superficial irritants and get secondary infection easier from scratching children
What age group react more severely to toxic venom but are less likely to develop hypersensitvity reactions the elderly
What is the problem with bug bites and the immunocompromised and or debilitated patients they react more extensively and extremely to toxins and venoms
Common lesion caused by bug bite or stings a discrete erythematous papule or wheal with central punctum could turn into hemorrhagic vesicobullous response
Where are you most likely to see flying insect bites on exposed surfaces
Where can you see crawling insect bites localized under clothing or areas of skin in contact with the ground
Classic sign of this insect is a burrow that tend to involve fingerwebs wrists axillary folds and genitalia scabies
Apart from the burrow what else will you see with scabies erythematous, excoriated papuples or papulovesicles with severe itching especially at night
Dx for scabies skin shaving for mite, egg and feces
how contagious are mites(scabies) extremely contagious
What is the Tx for scabies elamite, eurax or oral invermectin
How long can patient continue to have itching even after treatment and what does that mean they can continue to have itching for 3 weeks after treatment don't retreat unless they have reinfected them selves
What is the treatment for scabies that has been banned in california and is only approved by FDA for second line use Kwell (lindane)
What type of scabies presents a big problem in immunocompromised individuals where you get widespread scaling with itching. Generally infected with millions of mites as opposed to 11 on normal patient norwegian scabies
redbug or harvest mite bite show papulovesicle with central hemorrhagic punctum pruritic usually around the beltline, socks or on buttocks and thigh chigger bites
do chiggers burrow no make sure patient doesn't scratch or dig trying to get them out
What is tx for chiggers treat the pruritis
What is the bite pattern for ticks erythematous papule or wheal with a central punctum
Disease transmitted by ticks with 2 stages lyme disease
what is the 1st stage of lymes disease s/s include a rash with an evolving annular erythema, fatigue, flu like symptoms, and pain
What is the 2nd stage of lymes disease numbness and pain in arms and legs, meningitis, unilateral facial paralysis
What is the tx for lymes disease Abs
disease transmitted by ticks most cases in eastern US characterized by prodromal headache, malaise, anorexia, photophobia, chills, fever, arthralgia, and myalgia Rocky Mountain Spotted fever
What are the S/sx of rocky mountain fever that appear after prodromal symptoms fever, rash and hx of tick bite rash starts on cooler portions of body as macular and blanches then rash becomes petechial or purpuric
What is the Tx for rocky mountain spotted fever Abs and supportive care
What are the three types of pediculosis head, body and pubic lice
How do you dx pediculosis you will see the lice, nits on hair shafts, Head lice will often have excoriated papuples on scalp
What is the Tx for pediculosis Nix, Rid or any pyrethrins treatment Rx- ovide usually only for recalcitrant infestations
What is the second line treatment for pediculosis kwell shampoo
Typically cuase papules or wheals with central punctum secondary infection and excoriation are common can be vector or bubonic/pneumonic plague FLEAS
most notice blood on bedding or night clothing and grouped wheals with a central purpuric punctum on distal extremities face or upper chest Bed Bugs
What do you note if you crush a bed bug a distinctive unpleasant order
What is the Tx for bedbugs antihistamines for itching
How does a fire ant bite present generally devopls into a urticarial papule with a hemorrhagic punctum this may develop into a vesicopustule that may become necrotic. Very painful with burning and itching
what is the tx for fire ant bites use potent steroid gel on individual lesions and stronger sytsemic medication if generalized s/s
What is the positive to fire ant bites rarely get urticaria, erythema multifrome or anaphylaxis
What is the problem with bee stings how do they present they can cause anaphylaxis and present with localized pain, edema and erythema
what is the tx for bee stings use ice or for more severe pain use oral prednisone
Most common cause of pruritis ani dx by ova or worm specimen in stool very common in children pinworms
what is the tx for pinworms one dose of vermox or use antepar
A cutaneous disorder characterized by migratory linear or serpiginous lesions that cause bizarre patterns Creeping eruption larva migrans
What causes serpiginous pattern in creeping eruptions caused by migration of larvae of helminths or flies usually hookworm
What is the Tx for larva migrans oral thiabendazole but only with extensive infestations
venom is a potent neurotoxin composed of proteins, lipids, and carbohydrates affects sympathetic and parasympathetic nerves black widow
What are the s/sx of black widow bite sharp pinprick sensation followed by localized cramping, edema, weakness, diaphoresis, generalized muscle cramping, fever, paralysis. May have erythema or erythema nodosum
What is the untreated mortality rate in children with black widow bites 50%
Has dermatotoxic venom sphingomyelinase D Brown Recluse
What are the clincal outcome from a brown recluse bite range from inconsequential cutaneous rxns to full skin thickness necrosis but rarely death
what are the s/sx of brown recluse bite swelling, erythema, purpura with stinging. Characteristic trizonal response with a central blue gray area due to thrombosis
what is the major problem with mosquitoes there action as a vector for disease not necessarily any problem their bite may cause
Created by: smaxsmith