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62 Cards in this Set
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what is bacillary angiomatosis?
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1. aka peliosis hepatis
2. rash c/ red or purple vascular lesions 3. casued by Bartonella hensealae (cat-scratch dz) or Bartonella quintana 4. seen in HIV pts or phomeless population |
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what causes Bacillary angiomatosis?
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aka Peliosis Hepatis:
1. Bartonella henselae (cat-scratch dz) 2. Bartonell quintana (spread by lice) |
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What are si/sx of Bacillary Angiomatosis?
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aka Peliosis Hepatis:
1. wt loss, abd pain 2. rash c/ red or purple vascular lesions 3. from papule to hemangioma size 4. located anywhere on skin and idsseminated to any organ (bone, lymph node, liver) 5. ddx= Kaposi's sarcoma, cherry hemangioma 6. seen in HIV pts |
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What is the ddx for Bartonella spp?
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1. Bacillary Angiomatosis (peliosis hepatis)= rashwith red or prple vascular lesions seen in HIV pts
2. ddx=Kaposi's sarcoma, cherry hemangioma |
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what is the dx for Bacillary angiomatosis?
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(Peliosis Hepatis)
1. histopathology c/ silver stain 2. visualization of organisms in lesion 3. blood culture and PCR can be done |
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what is tx for Bacillary Angiomatosis?
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1. tx with erythromycin
2. px is excellent with tx, some pts require liefong suppressive tx |
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what causes cat-scratch dz?
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1. Bartonella henselae
2. transmitted by kitten scratches |
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what causes trench fever?
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1. Bartonella quintana
2. spread by lice |
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what is the classic rash of Lyme dz?
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1. erythema chronicum migrans= erythematous annular plques with a red migrating border, central clearing and induration
2. Borrelia burgdorferi |
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what are si/sx of Lyme dz?
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1. caused by Borrelia burgdorferi
2. fever, chills, HAs 3. lethargy, photophobia, meningitis 4. myocarditis, arthralgia, myalgias |
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what is classified by erythema chronicum migrans?
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1. Lyme dz (Borrelia burgdorferi)
2. erythematous annular plques c/ a red migrating border, central clearing and induration |
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what is the vector for Lyme dz?
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1. vector= tick Ixodes dammini, Ixodes pacificus
2. infected with spirochete Borrelia burgdorferi |
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what is dx for Lyme disease?
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1. PCR for Borrelia burgdorferi DNA
2. or skin Bx of migrating edge looking for causative spirochete |
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what is tx for Lyme dz?
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1. spray skin gna dclothes with DEET or permethrin
2. wear long pants in woods to prevent tick bites (Ixodes dammini, Ixodes pacificus) 3. once infected--give high-dose penicillin or ceftriaxone for 2-4 wks |
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what is the characteristic rash of Rocky Mt Spotted fever?
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1. erythematous maculopapular
2. starting on wrists and ankles 3. then moving toward plams, soles, and trunk |
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what causes the rash characterized by erythematous maculopapular, starting on wrists and ankles then moving toward plams, soles, and trunk?
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1. Rocky mt spotted fever
2. tick bite from vector Dermacentor spp. 3. serologies for Rickettsia rickettsii |
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how do you catch Rocky Mt spotted fever?
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1. the causative agent, Rickettsia rickettsii is transmitted to humans
2. by the bite of ticks, including the Dermacentor spp. |
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what are si/sx of Rocky Mt spotted fever?
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1. acute-onset fever, HA, myalgias
2. erythematous maculopapular rash 3. rash starting on wrists and ankles then moving toward palms, soles and trucnk 4. rash may lead to cutaneous necrosis b/c of DIC-induced occlusion of small cutaneous vessels c/ thrombi |
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what is dx of Rocky Mt. spotted fever?
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1. exposure to doutdoors or tick bit from Dermacentor spp.
2. serologies for Rickettsia rickettsi 3. skin Bx 4. tx c/ doxycycline or chloramphenicol |
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what is tx for Rocky Mt. spotted fever?
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1. doxycycline or
2. chloramphenicol (for pregnant women) |
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what is the classic rash of Scabies?
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1. erythematous, markedly pruritic papules
2. and burrows located in intertriginous areas (finger and toe webs, groin) 3. lesions are contagious |
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what are si/sx of scabies?
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1. erythematous, markedly pruritic papules and burrows located in intertriginous areas (finger and toe webs, groin)
2. lesions are contagious 3. microscopic ID of Sarcoptes scabiei mite in skin scrapings |
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what causes an erythematous, markedly pruritic rash with papules and burrows located in intertriginous areas (finger and toe webs, groin)?
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1. mite/parasite Sarcoptes scabiei
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what is the dx for scabies?
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1. microscopic ID of Sarcoptes scabiei mite in skin scrapings
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what is tx for scabies?
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1. for pt and all close contacts
2. apply Permethrin 5% cream to entire body for 8-10 hr 3. repeat in 1 wk 4. wash all bedding in hot water the same day 5. Lindane cream is less effective and a/c adverse effects in kids 6. sx relief of hypersensitivity rxn to dead mites may be tx c/ antihistamines and topical steroids |
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what is the best tx for scabies?
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1. permethrin 5% cream
2. effective and safe 3. single application for 8-12 hrs 4. can be repeated in 1 wk |
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what is characterized by:
1. ash leaf patches 2. shagreen spots 3. adenoma sebaceum of the face 4. seizures 5. mental retardation |
1. tuberous sclerosis
2. AD, chromosome 9 3. seizures and progressive psychomotor retardation |
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how does tuberous sclerosis present?
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1. ash leaf patches (hypopigmented macules)
2. Shagreen spots (leathery cutaneous thickening 3. adenoma sebaceum of the face (reddened nodules on the face) 4. seizures 5. mental retardation |
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what is the px of tuberous sclerosis?
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1. dz is slowly progressive and leads to increasing mental deterioration
2. no specific tx |
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what are si/sx of neurofibromatosis?
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1. cafe au lait spots
2. neurofibromas 3. meningiomas 4. acoustic neuromas 5. kyphoscoliosis 6. b/l acoustic neuromas with NF-2 |
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where do you find b/l acoustic neuromas and cafe-au-lait spots?
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1. neurofibromatosis-2
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name four neurocutaneous dz
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1. tuberous sclerosis
2. neurofibromatosis 3. sturge-weber sx 4. von Hippel-Lindau syndrome |
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what is NF-1 characterized by?
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1. type 1= Recklinghausen's dz
2. multiple hyperpigmented macules 3. neurofibromas 4. chromosome 17 |
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what is NF-2 characterized by?
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1. eighth nerve tumors (b/l acoustic neuromas)
2. chromsome 22 |
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what is Sturge-Weber sx characterized by?
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1. port wine hemangioma of face in CN V distribution
2. mental retardation 3. seizures |
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what should you check for with port wine hemangioma of face?
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1. sturge-weber syndrome
2. causes mental retardation and seizures |
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what is von Hippel-Lindau syndrome characterized by?
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1. multiple hemangiomas in various organs (retina, cerebellum, spinal cord)
2. increased frequency of renal cell CA and 3. polycythemia (increased erythropoietin secretion) 4. pheochromocytomas 5. AD inheritance |
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what are si/sx of pediculosis capitis?
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1. aka Head Louse
2. can be aSx, or pruritus and erythema of scalp noted 3. common in school-age children |
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what is dx of pediculosis capitis?
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head lice!!
1. microscope exam of hair shaft 2. nits may fluoresce c/ Wood's lamp |
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what is tx of pediculosis capitis?
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head lice!!!
1. permethrin shampoo or gel to scalp 2. may need to repeat |
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what is pediculosis pubis?
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"crabs"!!!
1. pruritic papules in pubic area 2. microscopic ID of lice 3. tx with Permethrin 5% shampoo |
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what are si/sx of "crabs"?
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Pediculosis pubis!!
1. very pruritic papules in pubic area, axilla, periumbilically in males, along eyelashes, eyebrows and buttocks |
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what is dx and tx for pediculosis pubis?
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1. dx= microscopic ID of lice, r/o other STDs
2. tx= permethrin 5% shampoo for 10 min, then repeat in 1 wk |
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what presents as erythematous, pruritic, erpigninous threadlike lesion marking a burrow?
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1. cutaneous Larva Migrans (creeping eruption)
2. hookworms: ancylostoma (dog and cat hookworms), necator, strongyloides |
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what are si/sx of cutaneous larva migrans (creeping eruption)?
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1. erythematous, pruritic, serpiginous threadlike lesions
2. marking burrow of migrating nematode larvae 3. often on back, hands, feet, buttocks 4. organism= hookworms: ancylostoma, necator, strongyloides |
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what causes cutaneous larva migrans?
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1. hookworms: ancylostoma, necator, strongyloides
2. hx of unprotected skin lying in moist soil or sand 3. moist sandy soil contaiminated by dog or cat feces 4. tx with ivermectin orally or thiabendazole topically |
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how do you tx cutaneous larva migrans?
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1. ivermectin orally
2. thiabenazole topically (may have toxic SEs) |
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what does Ancylostma spp causes?
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1. ancylostma= dog and cat hookworms
2. causes cutaneous larva migrans |
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what are si/sx of tinea?
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1. black dots seen on scalp of pts c/ tinea capitis
2. erythematous, pruritic scaly well-demarcated plaques 3. tinea pedis on feet |
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what is dx of all fungal cutaneous disorders?
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1. KOH prep:
tinea onychomycosis Tinea versicolor Candida |
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what is tx for tinea?
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1. topical antifungal
2. oral antifungal needed for tinea capitis |
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what are si/sx of onychomycosis?
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1. fingernails or toenails appear thickened, yellow, degenerating
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what is dx and tx for onychomycosis?
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1. dx= clinical or KOH prep
2. tx= PO itraconazole or fluconazole |
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what causes Tinea versicolor?
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1. pityrosporum ovale (aka Malassezia furfur)
2. seen as yeast and hyphae (spaghetti and meatballs) on KOH prep |
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what are si/sx of Tinea versicolor?
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1. caused by Pityrosporum ovale (aka Malassezia furfur)
2. Multiple sharply marginated hypopigmented macules on face and trunk noticed in summer b/c macules will not tan 3. on KOH prep--yeast and hyphae (spaghetti and meatballs) |
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what disease presents with yeast and hyphae (classic spaghetti and meatball appearance) on KOH prep?
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1. Tinea versicolor
2. caused by Pityrosporum ovale (aka Malassezia furfur) |
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how do you tx Pityrosporum ovale?
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1. causes the disease Tinea versicolor
2. tx with selenium sulfide 3. shampoo daily on affected areas for 7 days |
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what is seen on KOH prep with Candida?
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1. budding yeast and pseudohyphae
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what are si/sx of Candida?
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1. erythematous scaling plaques
2. often in intertriginous areas (groin, breast, buttocks, web of hands) 3. oral thrush= cottage-cheeselike white plaques on mucosal surface 4. can extend to esophagus and cause dysphagia and odynophagia |
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what fungal cutaneous disorder can extend to esophagus and cause dysphagia and odynophagia?
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1. Candida!!
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how do you tx Candida?
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1. topical Nystatin
2. oral fluconazole |
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what is KOH?
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potassium hydroxide
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