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Criado por Jaimie Shah
quase 11 anos atrás
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Questão | Responda |
abs are produced against antigens in the IC spaces of epidermal cells. Causes are idopathic, ACE inhibitors, and Penicillamine | Pemphigus Vulgaris |
what disease have a positive nikolsky's sign | Pemphigus, Staph scalded skin, TEN |
tx of pemphigus | predisone, and if don't work add azathioprine, mycophenolate, cyclophosphamide |
Bullous pemphigoid defineing factors | can be caused by sulfa, thicker walled and less likely to rupture, no oral lesions, mortality lower |
tx of bullous pemphigoid | steroids, alt are tetracycline, and erythromycin with nicotinamide |
defining Pemphigus foliaceus | can be autoimmue as well as from ACE I and NSAIDs; more superficial and easily rupture, no oral lesions and treat with steroids |
Associations with porphyria cutanea tarda | ETOH, liver dz, hep C, OCP, hemochormatosis (PCT increases liver iron stores), diabetes |
patient with nonhealing blisters on sun exposed areas, hyperpigmentation, hypertricosis of face | porphyria cutanea tarda |
Dx of PCT | urinary porphyrins |
tx of PCT | stop drinking ETOH, stop all estrogen use, use barriers to sun, phlebotomy to remove iron and Deferoxamine, Chloroquine increases ext of porphyrins |
most common causes of urticaria | asa, nsaids, morphine, codeine, penicillin, phenytoin, quinolone, insect bites, peanuts, sellfish, tomatoes, strawberrys, emotions, latex |
assoc with chronic urticaria | dermatographism, cold, vibration |
tx of urticaria | benadryl, hydroxyzine, or cyproheptadine; if life threaten add systemic steroids; chronic therapy H2- loartadine, fexofenadine; desensitze if cant avoid trigger but stop BB prior to treatment if epi is needed |
mobiliform rash | lympohcytic so can be treated with antihistamines and rarely steroids. |
what causes Erythema multiforme | PCN, Phenytoin, NSAIDs, Sulfa, herpes simplex, mycoplasam (seen on palms and soles)--tx antihistamies and the condition |
medications that cause SJS/TEN | PCN, Sulfa, NSAIDs, Phenytoin, and phenobarb |
tx SJS and TEN | steroids and ABx no proven benefit; tx as burn patients with wound care and rehydration; IGs, cyclophosphamide, cyclosporine and thalidomide can be used |
fixed drug reaction | will happen in the same spot they preset with rexposure, look like large bruise almost; treated with topical steroids. |
painful red nodules on anterior shins, TTP, non ulcerating, last about 6 weeks | Erythema nodosum |
when is erythema nodosum seen | pregnancy, staph infection, coccidiodomycosis, histo, sarcoid, IBD, Syphilis, Hepatitis, Yersinia; treat with NSAIDs and analgesics and disease |
Onychomycosis or tinea capetus | need orals for long periods of time; terbinafine (hepatotox, check LfTs) and intraconazole; can use griseofulvin but less effective |
all other fungal infection not on hair or nails use? | topicals: ketoconazole, clotrimazole, Econazole, terbinafine, miconazole, sertaconazole, sulconazole, tolnaftate, naftifine |
ketoconazole SE | hepatotox and causes gynocymastia when used orally (fluconazole no topical form) |
tx of impetigo, erysipelas, cellulitus, folliculits, and carbuncles | dicloxacillin (IV oxacillin or nafcillin), cephalexin, ceadroxil (IV cefazolin); if PCN allergic use macrolides or floroquinolones (not cipro); if resistance or in hosp a while use IV vanc and change to oral linezolid or bactrim |
Impetigo can cause GN and rheumatic fever? | false can cause GN not Rheumatic fever (staph or group A strep (pyogenese)) |
tx impetigo | mupirocin or systemic abx |
Erysipelas basics | caused by strep pyogenes; used systemic abs mentioned before |
how do we treat cellulitis generally | treat emperically and give IV if showing signs of sepsis |
what bacteria causes furuncles, folliculits and carbuncles around hair follicules | usu staph, some follifulitis can be due to pseudomonas. |
tx of folliculitis | topical mupirocin |
furuncles and carbuncles tx | oral anti staph abx like dicloxacillin or cefadroxil |
patient presents with high fever, portal of entry into skin, pain out of proportion to appearance, bullae, crepitus | necrotizing fasciitis |
tx of necrotizing fasciitis | amp/sulbactam, ticarcillin/clavulanate, pip/tazo; if pyogenes then clinda + PCN |
dx testing for unclear dx of HSV | initially zanck smear, most accurate is viral culture |
best tx of HSV | oral acyclovir and if resistant use foscarnet |
when is VZV treated | if child is immunocompromised, or primary infection occurs in adults |
complications of VZV | PNA, hepatitis, Dissemination |
predispose to shingles | elderly, leukemia, lymphoma, HIV, steroids |
tx of vzv | acyclovir, gabapentin, tca, topical capsaicin; non immune adults need vaccine in 96hrs of exposure for effect |
tx HPV warts | cryotherapy, laser, trichloroacetic acid, or podophyllin (careful in preg); Imiquimod (longer but less damaging to skin) |
sen and spp of RPR and VDRL | in primary 75%, 25% false negative; in secondary 100%; latent positive serology and negative manifestation (early and late) |
tx of Pediculosis | same as scabes with permetherin and lindane |
clinical definition of TSS | fever>102, SBP<90, desquam rash, vomiting, involves MMM, inc Cre/CPK/LFT, lowers Plt cnt, confusion |
tx of TSS | fluids, pressors, abx oxacillin/nafcilllin/ cefaolin; if resistant vanco or linezolid |
anthrax dx and tx | gram stain and culture of lesions; cipro/doxy |
seborrheic Keratosis basics | stuck on apperance, removed with liquid nitrogen or curretage, no malig potential, and not related to other skin findings |
actinic keratosis | premalig lesions, tx lesions cryotherpathy,5FU, imiquimod, retinoic acid or curretage |
SCC occurence | less common than BCC except in ESRD patients the occurence is opposite |
BCC | shiny pearly appearance |
KS tx | start HAART, and Adriamycin and vinlbastine |
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