1
Q
- An expanding red rash with central clearing that resembles a target.
- Has a “Bulls-Eye” appearance that usually appears with 7 to 14 days after a deer tick bite (ranges from 3 to 30 days).
- Accompanied by “flu-like” symptoms
- Rash feels hot to touch with a rough texture
- The rash/lesions spontaneously resolve in a few weeks.
- This is more common in NorthEastern regions of the U.S
A
- Erythema Migrans (Early Lime Disease)
2
Q
- Where are the common sites/locations of “Early Lime Disease/Erythema Migrans” ?
A
- Belt Line/Waist
- Axillary area
- Behind the knees
- Groin area
3
Q
- Numerous round, dry, red-colored lesions with a rough texture.
- Most often found on elderly, fair-skinned adults, with light-colored eyes.
- It is a PRECANCEROUS lesion of “squamous cell carcinoma.
- Patients with early childhood history of severe sunburn are at higher risk for squamous cell carcinoma, basal cell carcinoma, and melanoma.
A
- Actinic Keratosis
4
Q
- Common sites for Actinic Keratosis include:
A
- Sun exposed areas such as:
- Cheeks
- Nose
- Face
- Neck
- Arms
- Back
5
Q
- This is most common type of melanoma in African Americans and Asians.
- It is a subtype of melanoma
- Dark brown to black lesions are located on the nailbeds (subungal), palmar, and plantar surfaces.
- Subungal melanomas look like longitudinal brown to black bands on the nailbeds.
A
- Acral Lentiginous Melanoma
6
Q
- This rash looks like small red spots (petechiae) and starts to erupt on both the hands and palms, feet and soles, rapidly progressing toward the trunk, until it become generalized.
- The rashes appear on the 3rd day after the onset of a high fever (103 to 105 degree) accompanied by a severe headache and myalgia, conjunctival injection, nausea and vomiting, and arthralgia.
A
- Rocky Mountain Spotted Fever
7
Q
- The highest incidence of Rocky Mountain Spotted Fever occur where?
A
- Southeastern and South central areas
* During the spring and early summer seasons.
8
Q
- How is meningococcemia spread?
A
- Aerosol droplet
9
Q
- Risk factors of Melanoma include:
A
- Family history
- Extensive/Intensive sunlight exposure
- Blistering sunburn in childhood
- Tanning beds
- High Nevi/Nevus count or Atypical Nevi/Nevus
- Fair skinned and Light Eyes
10
Q
Which drugs are associated with Steven Johnson Syndrome?
A
- Penicillin
- Sulfas
- Barbiturates
- Phenytoin (Dilantin)
- ** HIV patients have a 40-fold increased risk of SJS due to Bactrim, compared with the general population.***
11
Q
- A bacterial infections of the sebaceous glands of the axilla (or groin) by “Staphyllococcus Aerus” (which is gram-positive) that frequently becomes chronic.
- It is marked by flare ups and resolutions.
- Usually both axillae are involved.
- The chronic infections usually leaves sinus tracks and scars.
A
- Hidradenitis Suppurativa
12
Q
- Treatment for Hidradenitis Suppurativa includes:
A
- Augmentin (Amoxicillin/Clavulanate) p.o BID x 10days, or…
- Dicloxacillin p.o TID x 10 days.
- Use antibacterial soap on axillae and groin areas.
- Avoid underarm deodorant during acute phase
13
Q
- Acute superficial skin infection caused by gram-positive bacteria such as strep pyogenes or S. Aureus.
- VERY CONTAGIOUS
- Maculopapular lesions with yellow serous fluid and HONEY COLORED crusts
- More common in children and teens
A
- Impetigo/Pyoderma
14
Q
- Treatment for Impetigo includes:
A
- Keflex (Cephalexin) QID or Dicloxacillin QID x 10 days
* PCN allergy: Macrolide (Azithromycin 250mg x 5 days), or clindamycin x 10 days.
15
Q
- 1st line pharmacological treatment for Rocky Mountain Spotted Fever is?
A
- Doxycycline (a tetracycline)
16
Q
- Acute local bacterial infection of the proximal or lateral nail folds (cuticle) that resolves after abscess drainage.
- Most common locations are index finger and thumb.
- Usually reports a history of a hang nail.
A
- Paronychia
17
Q
- The causative agents of Paronychia include:
A
- Staph Aureus
- Sreptococci
- Pseudomonas
18
Q
- Oval lesions, with fine scales that follow skin lines (cleavage lines) of the trunk or a “Christmas Tree” pattern.
- Salmon-pink color in Caucasians/Whites.
- A “HERALDS PATCH” is the 1st lesion to appear and the largest in size. (it appears 2 weeks before full breakout).
- It is self-limited and the cause is unknown.
A
- Pityriasis Rosea
19
Q
- Tinea Pedis is known as
A
- Athletes Foot
20
Q
- Ring-like pruritic rashes with collarette of fine scales that slowly enlarge with some central clearing.
A
- Tinea Corporis (Ringworm of the body)
21
Q
- Peri-anal and groin area area pruritic red rashes with fine scales.
- May be mistaken for candida infection (beefy, bright red rashes with satellite lesions)
A
- Tinea Cruris (Jock Itch)
22
Q
- Inflammation and infection of the sebaceous glands.
- Found mostly on the face, shoulders, chest, and back.
- Highest incidence during puberty and adolescence.
- Has multifactorial causes: High androgen levels, bacterial infections, and/or genetic influences.
A
- Acne Vulgaris (Common Acne)
23
Q
- Mild Acne Vulgaris such as blackheads, small papules, and small pustules are treated with:
A
- Topical Retin-A 0.25% (a topical isotretinoin)
- Benzoyl peroxide with erythromycin
- Clindamycin topical cream
24
Q
- Treatment for Moderate Acne Vulgaris includes:
A
- Same as mild acne, but switch antibiotics to Tetracyclines.
- Topical Retin-A (Retonic Acid 0.25%)
- Benzamycin (Benzoyl peroxide with erythromycin)
- Tetracycline
25
* The most common type in America is "Black Dot"
* African American children are at a higher risk.
* Spread by close contact and/or fomites.
* Scaly patch in the scalp that gradually enlarges.
* Tinea Capitis (Ringworm of the Scalp)
26
* Koplik spots = small white round spots on a red base on the buccal mucosa by the rear molars.
* These represent
* Measles
27
* Very pruritic, especially at night.
| * Serpenginous rash on interdigital webs, waist, axilla, and penis.
* Scabies
28
* Hypopigmented round to oval macular rashes.
* Most lesions on upper shoulders/back.
* Non-pruritic
Tinea versicolor
29
* Smooth papules that are dome-shaped with central umbilication, with a cheesy-white plug
* Molluscum Contagiosum
30
* These are known as 2nd degree burns.
* Red-colored skin with blisters/bullae (Painful)
* Usually from hot water or oil scalds, or fire
* Partial Thickness Burns
31
* Treatment for "Partial Thickness" or "2nd Degree" burns include:
* Mild soap and water, or...
* Normal saline to cleanse broken skin
* **NEVER HYDROGEN PEROXIDE OR FULL STRENGTH BETADINE***
32
* In the "Rule of Nines" body surface area, what is the percentage for the arms and head?
* Each arm is 9%
| * The head is 9%
33
* When the entire skin layer, subcutaneous area, and soft tissue fascia is destroyed.
* Must rule out airway and breathing compromise 1st.
* Also known as 3rd degree burns
* Full Thickness Burns
34
* In the "Rule of Nines", each leg, the anterior trunk, and the posterior trunk are considered
* 18% each.
35
* Chronic inherited skin disorder marked by extremely pruritic rashes that are located on the hands, flexural folds, and neck.
* Rashes are exacerbated by stress and environmental factors.
* Associated with a history of asthma, allergic rhinitis, and multiple allergies
* Atopic Dermatitis (ECZEMA)
36
* What is the GOLD standard lab for Varicella infections:
* Viral Culture, polymerase chain reaction (PCR) for ZDV
37
* The preferred antibiotic for human, cat, or dog bites is:
* Augmentin (Amoxicillin/Clavulanate) p.o x 10 days
38
* A skin infection, involving the "upper dermis and superficial lymphatics" that is usually caused by "Group A Strep.
* Acute onset of one large "HOT & INDURATED" red skin lesion that has clear demarcated margins.
* Usually located in lower legs or the cheeks.
* Accompanied by fever and chills (systemic symptoms)
* Erysipelas (A sub-type of cellulitis)
39
* A skin infection involving the "DEEP DERMIS" and underlying tissue.
* Usually caused by a Gram-positive bacteria
* Point of entry is usually through breaks in skin, by insect bites, abrasions, and surgical wounds.
* Has 2 forms: Purulent and Non-purulent.
* Patient may be barefoot
* Acute Cellulitis
40
* Infected follicles that are filled with pus.
| * Red-round bump that is hot and tender to touch.
* Furnicles/Boils
41
* Pruritic erythematous plaques covered with fine silvery white scales, along with pitted fingernails and toenails.
* Plaques are distributed in the scalp, elbows, knees, sacrum, and intergluteal folds.
* Psoriasis
42
* Nail becomes yellowed, thickened, and opaque with debris.
* Nail may separate from nail-bed.
* Great toe is the most common location.
* Commonly a FUNGAL INFECTION
* Onychomycosis
43
* Treatment for Onychomycosis is
* Oral Fluconazole 150mg - 300mg weekly
* Get baseline LFTs
* Watch for hepatotoxicity and drug-drug interactions
44
* Inflammatory skin reaction due to contact with an irritating external substance.
* Acute onset of one to multiple bright red pruritic lesions that evolve into bullous or vesicular lesions.
* Lesions are easily ruptured, leaving moist, painful areas.
* Lesions are UNILATERAL/ASYMMETRICAL in shape.
* The shape of the lesion may follow a pattern
* Contact Dermatitis
45
* Treatment for "ATOPIC DERMATITIS" includes:
* Topical Steroids (1st line treatment)
| * Hydrocortisone 1% to 2.5%
46
* Treatment for "CONTACT DERMATITIS" includes:
* Removal from offending agent
* Calamine lotion
* Topical Steroids
47
* Treatment for MRSA Cellulitis includes:
* Batrim DS daily x 10 days, or...
* Doxycyline BID x 10 days
* ****Follow up in 48 hours*****
48
* Treatment for Non-MRSA Cellulitis includes:
* Dicloxacillin Q.I.D x 10 days, or..
* Cephalexin (Keflex) QID x 10 days
* Cefadroxil (Duricef) QID x 10 days
* ******Follow up in 48 hours*******
49
* Sudden onset of groups of small vesicles on a red base that become crusted.
* Mainly found in Elderly patients
* Crusted lesions follow a dermatomal pattern on one side of the body.
* Can be very painful
* CONTAGIOUS WITH THE ONSET OF RASHES UNTIL ALL LESIONS HAVE CRUSTED OVER.
* Herpes Zoster (SHINGLES)
50
* Treatment for Herpes Zoster includes:
* Antivirals (Acyclovir 5 per day, or Valacyclovir BID x 10 days)
* Most effective when started within 48 to 72 hours of when rash appears.
51
* Treatment for Shingles related Post-Herpetic Neuralgia includes:
* Tricyclic Antidepressant (Amitriptylline/Elavil)
* Gabapentin/Neurontin
* Pregablin/Lyrica
* Capsaicin cream
52
* Viral skin infection of the fingers.
* Caused by HERPES SIMPLEX VIRUS (1 or 2)
* It is from direct contact with either a cold sore or genital herpes lesion.
* Acute onset of extremely painful red bumps and small blisters on sides of fingers or cuticles or terminal phalanx
* Herpetic Whitlow
53
* Treatment for Herpetic Whitlow includes:
* Self Limiting (Analgesics and NSAIDs)
54
* Chronic skin inflammatory disorder that has relapsing.
* Commonly seen in Irish, Scottish, or English decent people.
* Chronic small acne like papules and pustules around the nose, mouth, and chin.
* THERE IS NO CURE
* Rosacea (Acne Rosacea)
55
* Treatment for Rosacea includes:
* Metronidazole Gel
56
* What precautions should females use when using Isotretinoin (Accutane)
* Use 2 forms of birth control
57
* What is the preferred treatment for Psoriasis?
* Topical Steroids
* Topical Retinoids (Tazorotene)
* Tar preparations
58
* Flattened elevated lesions with variable shape that is >1cm in diameter.
* An example is Psoriatic lesions
* Plaque
59
* Elevated superficial blister filled with serous fluid and > 1cm in size.
* An example is Impetigo, 2nd degree burns with blisters, and Steven Johnson Syndrome
* Bulla
60
* Pinpoint areas of bleeding remain in the skin when a plaque is removed.
* Associated with Psoriasis
* Auspitz Sign
FNP: Systems Review
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