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62 Cards in this Set

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  • Back
what is bacillary angiomatosis?
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
what causes Bacillary angiomatosis?
aka Peliosis Hepatis:
1. Bartonella henselae (cat-scratch dz)
2. Bartonell quintana (spread by lice)
What are si/sx of Bacillary Angiomatosis?
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
What is the ddx for Bartonella spp?
1. Bacillary Angiomatosis (peliosis hepatis)= rashwith red or prple vascular lesions seen in HIV pts
2. ddx=Kaposi's sarcoma, cherry hemangioma
what is the dx for Bacillary angiomatosis?
(Peliosis Hepatis)
1. histopathology c/ silver stain
2. visualization of organisms in lesion
3. blood culture and PCR can be done
what is tx for Bacillary Angiomatosis?
1. tx with erythromycin
2. px is excellent with tx, some pts require liefong suppressive tx
what causes cat-scratch dz?
1. Bartonella henselae
2. transmitted by kitten scratches
what causes trench fever?
1. Bartonella quintana
2. spread by lice
what is the classic rash of Lyme dz?
1. erythema chronicum migrans= erythematous annular plques with a red migrating border, central clearing and induration
2. Borrelia burgdorferi
what are si/sx of Lyme dz?
1. caused by Borrelia burgdorferi
2. fever, chills, HAs
3. lethargy, photophobia, meningitis
4. myocarditis, arthralgia, myalgias
what is classified by erythema chronicum migrans?
1. Lyme dz (Borrelia burgdorferi)
2. erythematous annular plques c/ a red migrating border, central clearing and induration
what is the vector for Lyme dz?
1. vector= tick Ixodes dammini, Ixodes pacificus
2. infected with spirochete Borrelia burgdorferi
what is dx for Lyme disease?
1. PCR for Borrelia burgdorferi DNA
2. or skin Bx of migrating edge looking for causative spirochete
what is tx for Lyme dz?
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
what is the characteristic rash of Rocky Mt Spotted fever?
1. erythematous maculopapular
2. starting on wrists and ankles
3. then moving toward plams, soles, and trunk
what causes the rash characterized by erythematous maculopapular, starting on wrists and ankles then moving toward plams, soles, and trunk?
1. Rocky mt spotted fever
2. tick bite from vector Dermacentor spp.
3. serologies for Rickettsia rickettsii
how do you catch Rocky Mt spotted fever?
1. the causative agent, Rickettsia rickettsii is transmitted to humans
2. by the bite of ticks, including the Dermacentor spp.
what are si/sx of Rocky Mt spotted fever?
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
what is dx of Rocky Mt. spotted fever?
1. exposure to doutdoors or tick bit from Dermacentor spp.
2. serologies for Rickettsia rickettsi
3. skin Bx
4. tx c/ doxycycline or chloramphenicol
what is tx for Rocky Mt. spotted fever?
1. doxycycline or
2. chloramphenicol (for pregnant women)
what is the classic rash of Scabies?
1. erythematous, markedly pruritic papules
2. and burrows located in intertriginous areas (finger and toe webs, groin)
3. lesions are contagious
what are si/sx of scabies?
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
what causes an erythematous, markedly pruritic rash with papules and burrows located in intertriginous areas (finger and toe webs, groin)?
1. mite/parasite Sarcoptes scabiei
what is the dx for scabies?
1. microscopic ID of Sarcoptes scabiei mite in skin scrapings
what is tx for scabies?
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
what is the best tx for scabies?
1. permethrin 5% cream
2. effective and safe
3. single application for 8-12 hrs
4. can be repeated in 1 wk
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
how does tuberous sclerosis present?
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
what is the px of tuberous sclerosis?
1. dz is slowly progressive and leads to increasing mental deterioration
2. no specific tx
what are si/sx of neurofibromatosis?
1. cafe au lait spots
2. neurofibromas
3. meningiomas
4. acoustic neuromas
5. kyphoscoliosis
6. b/l acoustic neuromas with NF-2
where do you find b/l acoustic neuromas and cafe-au-lait spots?
1. neurofibromatosis-2
name four neurocutaneous dz
1. tuberous sclerosis
2. neurofibromatosis
3. sturge-weber sx
4. von Hippel-Lindau syndrome
what is NF-1 characterized by?
1. type 1= Recklinghausen's dz
2. multiple hyperpigmented macules
3. neurofibromas
4. chromosome 17
what is NF-2 characterized by?
1. eighth nerve tumors (b/l acoustic neuromas)
2. chromsome 22
what is Sturge-Weber sx characterized by?
1. port wine hemangioma of face in CN V distribution
2. mental retardation
3. seizures
what should you check for with port wine hemangioma of face?
1. sturge-weber syndrome
2. causes mental retardation and seizures
what is von Hippel-Lindau syndrome characterized by?
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
what are si/sx of pediculosis capitis?
1. aka Head Louse
2. can be aSx, or pruritus and erythema of scalp noted
3. common in school-age children
what is dx of pediculosis capitis?
head lice!!
1. microscope exam of hair shaft
2. nits may fluoresce c/ Wood's lamp
what is tx of pediculosis capitis?
head lice!!!
1. permethrin shampoo or gel to scalp
2. may need to repeat
what is pediculosis pubis?
1. pruritic papules in pubic area
2. microscopic ID of lice
3. tx with Permethrin 5% shampoo
what are si/sx of "crabs"?
Pediculosis pubis!!
1. very pruritic papules in pubic area, axilla, periumbilically in males, along eyelashes, eyebrows and buttocks
what is dx and tx for pediculosis pubis?
1. dx= microscopic ID of lice, r/o other STDs
2. tx= permethrin 5% shampoo for 10 min, then repeat in 1 wk
what presents as erythematous, pruritic, erpigninous threadlike lesion marking a burrow?
1. cutaneous Larva Migrans (creeping eruption)
2. hookworms: ancylostoma (dog and cat hookworms), necator, strongyloides
what are si/sx of cutaneous larva migrans (creeping eruption)?
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
what causes cutaneous larva migrans?
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
how do you tx cutaneous larva migrans?
1. ivermectin orally
2. thiabenazole topically (may have toxic SEs)
what does Ancylostma spp causes?
1. ancylostma= dog and cat hookworms
2. causes cutaneous larva migrans
what are si/sx of tinea?
1. black dots seen on scalp of pts c/ tinea capitis
2. erythematous, pruritic scaly well-demarcated plaques
3. tinea pedis on feet
what is dx of all fungal cutaneous disorders?
1. KOH prep:
Tinea versicolor
what is tx for tinea?
1. topical antifungal
2. oral antifungal needed for tinea capitis
what are si/sx of onychomycosis?
1. fingernails or toenails appear thickened, yellow, degenerating
what is dx and tx for onychomycosis?
1. dx= clinical or KOH prep
2. tx= PO itraconazole or fluconazole
what causes Tinea versicolor?
1. pityrosporum ovale (aka Malassezia furfur)
2. seen as yeast and hyphae (spaghetti and meatballs) on KOH prep
what are si/sx of Tinea versicolor?
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)
what disease presents with yeast and hyphae (classic spaghetti and meatball appearance) on KOH prep?
1. Tinea versicolor
2. caused by Pityrosporum ovale (aka Malassezia furfur)
how do you tx Pityrosporum ovale?
1. causes the disease Tinea versicolor
2. tx with selenium sulfide
3. shampoo daily on affected areas for 7 days
what is seen on KOH prep with Candida?
1. budding yeast and pseudohyphae
what are si/sx of Candida?
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
what fungal cutaneous disorder can extend to esophagus and cause dysphagia and odynophagia?
1. Candida!!
how do you tx Candida?
1. topical Nystatin
2. oral fluconazole
what is KOH?
potassium hydroxide