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Dermatology
Clinical Medicine Final Review
Question | Answer |
---|---|
Wood's light results for erythema, and pseudomonas, Microsporum, Tinea versicolor, vitiligo | E: coral/pink, P: pale blue M: yellow/green, Tinea: green/gold, vitiligo: white |
Multinucleated giant cells confirm herpes/varicella infection | Tzanck Smear |
Colored spores/hyphae//budding yeast to confirm fungal infection | KOH |
Bacterial Infections | Cellulitis, Erysipalis, Impetigo, TSS |
Fungal Infections | Candida, angular cheilitis, Tinea |
Fungus for Tineas | Trichophyton, Microsporum |
Sterile scalp infection | Kerion (part of tinea capitis) |
"Jock itch" | Tinea Cruis (Tiniea of the groin) |
Fungal hand infection | Tinea Manus |
5th's dz/slapped-cheek dz Virus and name | Erythema Infectiosum, Parovirus B19 |
Clinical features of Erythema Infectiosum | 4-14 days prodrome, followed by slapped cheek, then generalized rash (supportive tx) |
Clincal features of HFM dz snf virus | Coxsackie A 16 or evterovirus 71 4-6 incubation w/ vesicles->bullae->ulcers in those areas |
Grouped macules to painful vesicles, which erode to crusts | 1 infection of Herpes Simplex |
Lies dormant in the dorsal root ganglia | Herpes Simplex |
DDx for chest pain | Herpes Zoster (shingles) followed by red macules->papuals, vesicular, pustular, scabs |
Virus Molluscum Contagiosum and tx | Poxvirus, Tx: self-limiting, topical tretinoin |
Complications of Herpes Zoster | post-herpetic neuralgia, Ramsey-Hunt's syndrom, Opthalmicis, bell's palsy, cerebellitis |
Koplik spots(buccal mucosa) 3C's cough, coryza, conjunctivitis | Measles (Rubeola) Virus: paramyxovirus |
Red petechiae may occur on soft palate, Virus and name | Rubella (German measals) and Togavirus |
high fever each night, (101-104) w/ rash 3-4 days later | Roseola HHV 6/7 virus |
Types of warts | Common, Plane, Plantar, Mosaic |
Agent and CF's of Syphilis | Treponema pallidum, 1: painless chancre, 2: copper-tinted leisoins, rash, 3: effects the organs long term |
Dx of Syphilis | Spirochete on dark-field microscopy |
Virus and CF's of Chancroid | Haemophilus ducreyi, PAINFUL chancres, |
Genital Warsts | Condyloma Acuminata (HPV) |
Vaccine for HPV | Strains 6,11: Warts and 16,18 Cancers |
Erythema Migrans | Lyme Dz: MC tick borne illness |
Lyme Dz bacteria and transmission | Borrelia burgdorferi, Common deer tick |
3 stages of lyme dz | Early localized infection, early disseminated infection, persistent infection |
Bulls-eye rash with flu-like sxs | Ly Dz, LATE dz: arthritis and neuro sxs |
Lyme dz tx | Doxy 100mg X3wks |
Rocky Mt Spotted fever etiology and transmission | Rickettsia rickettsii, wood tick, dog tick |
Rash eruption for RMSF | starts day 4 around writsts and ankles, then within hrs to palms and soles, then generalized |
Pediculus humanus | lice |
Types and manifistations of Lice | Scalp: nits to hair shafts just above scalp Corporis: in seams, not on hairs, Pubis: plainly visible onto adjacent hairy areals-eyelashes |
Lice tx | Permethrin (shampoo) |
Classic Scabies, Crusted scabies | C: children and sexually active Crus: immunocomprimized and elderly |
Primary and secondary leisons for scabies | 1: 1-3mm erythematous papules/vesicles seen in adults, burrows. 2: scratching marks,excoriations eczema |
Latrodectus mactans | Black Widow: 1 hr systemic sxs: muslce cramping, N/V HA anxiety HTN and tachy |
Tx Black widow spider bites | Antivenom in preggos and limb threatning bites, opoiod for pain |
Loxoscelidae reclusus | Brown Recluse Spider, red margin around bite, blue-gray halo around puncture site |
tx Brown recluse spider | Usually supportive, may need Abx for severe bites |
Pasteurella species, strep, staph, moraxella, | Bacteria infecting dog/cat bites |
Tx cat dog bites | Tetanus, rabies if appropriate, abx, suture later |
Goals of wound care | Eliminate complication, restore fxn, reduce scaring |
Drugs that affect healing | Corticosteroids, NSAIDS, Pencillamine, BBs's, nicotine |
Toxic rxns to injectable anesthsia | Cardiovascular, excitatory CNS, vasovagal syncope (2 to pain/anxiety) |
Three types of Injectable anesthesia | Lidocaine short onset, short action, Mepivacaine, med onset/action but ^vasoconstriction no need for epi, Bupivacaine med onset LOOONG action, |
What is the cardinal rule with injectable anesthsia | DO NOT USE epi with terminal circulation, Fingers, toes, ears, penis, nose |
Time for "safe wound" to be sutured | 6-8hrs (some texts say up to 24) |
Use for tertiary closure (delayed closing) | Bite wounds, high bacteria count, abscesses, and other deep infections |
Follow what with suturing | Langer's lines |
Decreases inflammation and increases re-epithelization | Occlusive dry dressings |
Bite, Throw, know definitions for suturing | B; amount skin taken T: a pass through the skin, K: surgeon's know MC how stop slipping |
5 skin layers | Basale, spinosum, granulosum, lucidum, corneum |
Hypothermia Classifications | Mild: 35-36C, 95-97F, Moderate 30-35C, 86-93F Severe <30C <86F Do not rub pt. |
Ways to classify Frostbite | tecnetium 99m scan |
Types of Burns | Frostbite, inhalation, electrical, chemical, Scald, Flame, Flash, Contact |
Cataracts occure in 5-7% of pt's 1-2 yrs later | Electrical burn |
Dry w/o blisters, blanch w/ pressure, take 3-6 days to heal w/o scarring | Superficial burns 1st degree, sunburn, minor scalds |
Painful to temp, blister, moist, pink to red, wet and weepy, damages but does NOT destroy | Superficial Partial thickness burn (2nd degree) |
painful to pressure only, always blister, wet or waxy dry, do not blanch | Deep partial Thickness burn (2nd degree) confused w/ full thickness |
Painless, destroys all layers of skin, fat, muscle, or bone, waxy white or leathery gray, dry w/o blisters, inelastic | Full Thickness burn (3rd degree) very slow healing |
Types of Burns | Frostbite, inhalation, electrical, chemical, Scald, Flame, Flash, Contact |
Cataracts occure in 5-7% of pt's 1-2 yrs later | Electrical burn |
Dry w/o blisters, blanch w/ pressure, take 3-6 days to heal w/o scarring | Superficial burns 1st degree, sunburn, minor scalds |
Painful to temp, blister, moist, pink to red, wet and weepy, damages but does NOT destroy | Superficial Partial thickness burn (2nd degree) |
painful to pressure only, always blister, wet or waxy dry, do not blanch | Deep partial Thickness burn (2nd degree) confused w/ full thickness |
Painless, destroys all layers of skin, fat, muscle, or bone, waxy white or leathery gray, dry w/o blisters, inelastic | Full Thickness burn (3rd degree) very slow healing |