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Step III

Step III - Derm 2

QuestionAnswer
Rx tx for cellulites Start w/ PO Antibx if severe (septic) then IV ox/naf/cefazolin
Etio of cellulites Staph and strep
Tx for folliculitis Topical mupirocin
Tx for furuncle/carbuncle Systemic diclox/cefadroxyl\
Pt w/ DM c/o bullae on skin, high fever, extreme pain, and palpable crepitus under skin Necrotizing fasciitis
MCC Necrotizing fasciitis Clostridia and strep (staph
Diagnostic studies for Necrotizing fasciitis XR, CT, MRI
Most accurate test and tx for necrx fasciitis Surgical debridement
BEST INITIAL STEP for Necrotizing fasciitis Surgery (not radiologic studies)
Name the different beta lactam and beta lactamase combos used to treat Necrotizing fasciitis Amp/sulbactam; ticar/clavul; piper/tazobac
If cx grow strep pyo for necrx fasciitis then rx tx Clinda + PCN
What is the tx for paronychia Incision + anti-staph antibx
What is the best initial test for HSV and what does it show Tzanck smear; multinucleated giant cells
Most accurate test for HSV Viral cx (1-2 days)
Tx acyclovir resistant HSV Foscarnet
When should chicken pox be treated w/ anti-virals Immunocompromised kid or infx occurs in adulthood
What are the sequelae of varicella PNA, hepatx, disseminated dz
In what pts would you expect shingles to erupt Elderly, HIV, leukemia, lymphoma, pt on steroids
What is the best initial test for herpes zoster Tzanck
Most accurate test for herpes zoster Viral cx
Tx for elderly w/ severe pain from herpes zoster shingles Steroids
Tx that is best efficacy for preventing post herpetic neuralgia Rapid admin Acyclovir
most effective tx for post herpetic neuralgia from shingles Gabapentin
other rx tx for post herpetic neuralgia TCA, topical capsaicin
non immunized adults should also receive what in addition to rx tx for varicella Varicella Ig w/i 96hrs exposure
What is the best initial test for warts None done routinely
Painless tx for warts Imiquimod
Which wart tx is teratogenic Podophyllin
What is the best initial tx for 1 and 2 syphilis IM PCN
Tx for 1 and 2 syphilis if PCN allergy PO doxy x2wks
What is the best initial test for 1 syphilis Dark field microscopy
Generalized copper colored rash mostly intense on palms and soles. Mucous pathc, alopecia areata, condyloma lata. Dx 2 syphilis
Most sensitive test for 2 syphilis RPR and VDRL
Itchiness in web spaces of hand as well as penis and breast Scabies
Norwegian scabies mostly occurs in what type of pts HIV
Most accurate test for scabies Mineral oil to area and scrape out bug
Tx for scabies Permethrin
Tx for Norwegian scabies PO ivermectin
Tx for pediculosis Permethrin or OTC pyrethins
Difference b/t pediculosis and lice Larger and rust colored (eating blood)
What is the rash like in Lyme dz CENTRAL clearing bulls eye and > 5cm diameter
Tx for Lyme PO doxy, amox, or cefuroxime
If pt w/ Lyme not tx then what is most likely sequelae Joint dz >> neuro > cardio
Pt w/ nasal packing, retained sutures, tampon use. Fever >102, desquamating rash, systolic BP <90, vomiting, involvement mucous membranes eye, mouth, genitals TSS
Dz where  creatinine,  CPK, low platelets, CNS involvement, rash, fever >102 TSS
Tx for TSS IVF, pressors (dopa), ox/naf/cefazolin +/- vanc/linezolid
(+) Nikolsky, nL BP, no organ involvement, epidermal layer only, not triggered by drugs SSSS
Tx for SSSS Transfer to burn unit; give ox/naf or other anti-staph rx
Contact w/ livestock, wool sorter, bioterrorism. Papule that turns in central necrotic lesion Anthrax
Most accurate test for anthrax Gram stain and cx
Tx for anthrax Cipro or doxy
Tx of melanoma Excision full thickness
Tx to reduce recurrence of melanoma IFN
Tx fo SK Liquid nitro or curettage
What is the best initial tx for AK Sunscreen
Tx for SK 5-FU, imiquimod, topical retinoic acid, curettage
Most accurate test for squamous cell CA bx
Tx for sq cell CA removal
Shiny pearly most common skin CA basal cell
Most accurate test for basal cell Punch or shave bx
At what CD count would you expect Kaposi’s sarcoma to erupt in HIV pt < 100
Created by: DrINFJ