FNP- DERMATOLOGY – Flashcards
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Scabies itch mite name
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sarcoptes scabiei var. hominis
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scabies mode of transmission
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close personal contact. Highly contagious
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scabies characteristics
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scaly lesions at site of invasion- warty and encrusted intraepidermal burrow
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papule
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ex moles
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macule
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ex freckles
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wheal
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ex mosquito bite
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vesicle
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ex. herpes simplex
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Bulla
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vesicle larger than 1 cm. ex blister
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purpura
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does not blanch with pressure
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Scabies Treatment
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Permethrin 5% lotion first line for patient Antihistamines or topical steriods for itching Clean household and bedding with hot water and detergent Systemic: Ivermectin200mcg/kg
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topical medication dispensing
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prescribe enough to complete course of treatment!
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How many grams should you prescribe cream for Hands, head, face, anogenital region?
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2grams QD 4grams total for BID (2g x 2 dose) 28grams (BID x 7days)
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How many grams of cream should you prescribe for One arm, anterior or posterior trunk
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3gram for QD 6 grams for BID (3g x2 dose) 42 grams for BID for 1 week (6grams x 7 days)
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how many grams of cream should you prescribe for one leg?
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6 grams for QD 12 grams for BID (6x 2 dose) 320grams for BID for 1 week
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how many grams of cream are needed to cover entire body?
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30- 60 grams one dose 420-840 grams for BID x 1 day 60-120oz needed for 1 week BID dosing
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The less viscous the vehicle containing a medication, the less of the medication is absorbed. T or F
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True
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Which is better absorbed- lotion or ointment?
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Lotion
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Scabies symptoms
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Itching worse at night!
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How long is the incubation period for scabies on initial exposure/
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4-6 Weeks
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Common sites of scabies infestation in adults
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hands (90%), especially fingerwebs flexor aspects of the wrists Waistline Thighs Navel Intergluteal cleft Penis Aerola Axillary folds
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Permethrin 5% CREAM instructions
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Apply over entire body from neck down prior to going to bed. Cream left on overnight Remove cream by bathing in 8-14 hours Two applications about one week apart are recommended in order to kill all mites
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Should you treat all household members for scabies or just the infected person?
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ALL MEMBERS!
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How long should symptoms resolve in those treated for scabies?
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4 weeks
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Oral Candidiasis symptoms
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sore throat, dysphagia
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Oral candidiasis (thrush) treatment
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Nystatin oral suspension (100,000 units/ml) 5 ml swish and as long as possible before swallowing - QID x 5 days
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vaginal candidiasis symptoms
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burning, itching and irritation, either on the vulva or in both the vulva and vagina. Burning during intercourse, vaginal discharge with cottage-cheese texture
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penile (balanitis) candidiasis symptoms
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Balanitis-sexually active male with reddish rash and itching on glans penis. May have penile burning after intercourse. No burning with urination. Partner may be being treated for yeast infection
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balanitis candidiasis treatment
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For limited disease use nystatin cream, clotrimazole cream, or econazole cream BID for 10 days. Must use entire 10 days! For more extensive - oral fluconazole 150 mg PO once x 1 day
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interrogious candidiasis symptoms
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obese adult with red, itchy rash that is "weepy"and moist. May burn and is usually in the groin or perianal area or interdigital areas of feet or hands.
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interrogious candiadiasis treatment
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Ketoconazole 2% cream apply BID for 14 days instruct patient to wash and dry folds thouroughly
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nail (subungual) candidiasis symptoms
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Subungual- No pain or itching. Adult that reports several discolored nails for several weeks . Some nails are deformed or separate from the nail bed. History of excessive contact with water from dishwashing, bartending etc.
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what are Dermatophytoses
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skin infections caused by fungus
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What organism is candidiasis
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yeast
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what does the diagnosis of "tinea ----" refer to
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fungal infections
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Treatment for Tinea infections
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treat with an -azole cream
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Onychomycosis
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fungal infection of the nails
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onychomycosis
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May have for few weeks to years No pain Thick nails with cloudy, white-colored patches. May be yellow-to black coloration. May be partially detached from nail bed. Most likely failed otc topical therapy
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impetigo
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Honey-crusted, dirty looking is a pathognomonic sign and treatment can be started prior to receiving results from culture
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impetigo
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Pruritis Shallow erosions with moist honey-colored crusts Usually on face or extremities Spreading or getting larger in size Fever indicates deeper infection
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Treatment for Impetigo
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Dicloxacillin 500 mg QID x 7 days or Keflex 500 mg BID x 7 days
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Empiric treatment for uncomplicated cases of nonpurulent cellulitis in which MRSA is not suspected
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Keflex 500 mg po, every 6 hours for 5-7 days or Dicloxacillin 500 mg orally, every 6 hours for 5-7 days
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Empiric treatment for uncomplicated cases of nonpurulent cellulitis in which MRSA IS susptected
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Bactrim DS BID for 5-7 days
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Someone with Rosacea has comedons, true or false?
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false
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What triggers rosacea
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Sun, hot or cold weather, wind, overheating during exercise, excessive alcohol ingestion, hot beverages, spicy foods, aged products, cosmetics, stress, hot baths/saunas, smoking, caffeine and excessive washing of face.
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management of rosacea
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Avoid triggers Topical-metronidazole cream is main therapy but can take 6-8 weeks for response. If above is not effective topical clindamycin may be tried Systemic- antibiotics (tetracycline, ees) should be used for flare-ups or when initiating topical treatment but should then be discontinued.
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atopic dermatitis is otherwise known as.....
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eczema (another name for.....)
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atopic dermatitis (eczema) presentation
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Abnormally dry skin and lowered threshold for itching are hallmarks of the disease
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treatment for eczema
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Moisturizers are first line therapy for all ages with mild case and as an adjuvant for use in cases when involvement is more extensive and topic steroid therapy is needed
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pharmacologic treatment for eczema
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Triamcinalone 0.1% cream applied BID
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seborrheic dermatitis
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OTC dandruff shampoo for scalp-need to stay on scalp 5-7 minutes to be effective
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psoriasis peaks at what age?
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Peaks at teens to early 20's and late 50's to early 60's
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what blood level may be eleavated in someone with psoriasis
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serum uric acid
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psoriasis treatment
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Topical steroids, emollient creams Keratolytic to help with absorption Systemic only for severe disease if more then 20% of body covered with lesions. Referral to dermatologist for severe disease.
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what causes Actinic keratosis
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sun damage
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is Actinic keratosis cancerous?
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it is pre-cancerous Can progress to squamous cell, latency 10 years with only 20% of lesions progressing to cancer
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Most common form of skin cancer
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basal cell carcinoma
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What does ABCDE stand for when assessing a skin lesion for cancer?
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Asymmetry. One half doesn't match the appearance of the other half. Border irregularity. The edges are ragged, notched, or blurred. Color. The color (pigmentation) is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to a mottled appearance. Diameter. The size of the mole is greater than 1/4 inch (6 mm), about the size of a pencil eraser. Any growth of a mole should be evaluated. Evolution. There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color of a mole.
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which skin cancer is related to the highest incidence in death?
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melanoma
