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Derm Infxns 1

Infections Part I

QuestionAnswer
What vaccines should not be given to an HIV-positive pt? Live vaccines (except for MMR under certain conditions): VZV, intranasal flu, oral polio. Also yellow fever, BCG, anthrax, oral typhoid, small pox
What is the tx for TTP? Large-volume plasmapheresis, steroids
Compare the serum iron, ferritin, and transferrin levels in iron defic anemia to anemia of chronic dz. IDA: low serum iron, low ferritin, high transferrin. AOCD: low serum iron, high ferritin, low transferin
Flat spot <1cm macule
flat spon >1cm patch
solid, elevated lesion <1cm papule
same as papule but >1cm and flat-topped plaque
palpable, solid lesion >1cm and not flat topped nodule
elevated, circumscribed lesion <5mm containing clear fluid (small blister) vesicle
same as vesicle but >5mm (large blister) bulla
itchy, transiently edematous area wheal
Name the different abx regimens to treat a skin abscess with presumed MRSA. How long to treat? Combo of bactrim, clinda, mino or doxycycline + rifampin. OR linezolid by itself. Treat for 10-14d.
Pt admitted to the ICU for fluid resusc and monitoring following trauma w/sig blood loss. The skin around the central line placed in the ER days ago is now red and warm. Pt has fever and wt ct. What is the cause? Central line infxn caused by staph cellulitis
A 44yo AAW is in the office for eval of an area of inflammation in her L axilla. Initially area was itchy but is now painful. On exam, area has 6 papules and nodules that are erythem, indurated, and warm. Skin is fluctuant, and drainage is noted. Tx? Abx and surgical I&D. Pt has hidradenitis.
When should abx be used in the tx of skin abscesses? Abscesses >5cm and high risk of complications
What are the characteristic features of necrotizing faciitis? Excruciating pain in absence of or beyond the bounds of cellulitis, crepitus, redness with blisters or bulla, and diabetic with foot cellulitis
What is the tx for dry gangrene? For wet gangrene? Dry: autoampuation. Wet: debridement and possible guillotine amputation
A 66yo man w/long-standing poorly-controlled diabetes arrives at ER c/o a horrid smell coming from his L foot. Denies pain, but lost sensation years ago. Open would btwn 1st and 2nd toe on L foot +pus drainage and crepitus. Pt is tachy and febrile. Tx? Emergent surgical debridement with possible amputation. Pt has wet gangrene.
A 7yo boy is brought to the county clinic with a rash. The mother denies that the child has acted ill. The exam is unremarkable besides perioral honey-crusted lesions and regional lymphadenopathy. What can be used to tx this pt? Washing area. Muprircin (topical abx)
Created by: sarah3148