Lice, Scabies, Spider Bites Flashcards Preview

Dermatology > Lice, Scabies, Spider Bites > Flashcards

Flashcards in Lice, Scabies, Spider Bites Deck (46)
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1
Q

Medical Term for Lice

A

Pediculosis

2
Q

Define Pediculosis

A

Ectoparasites that live on the body & feed on human blood after piercing the skin

3
Q

Clinical Presentation

A
Pururitis
Secondary cellulitis
Pubic lice: eval for other STIs
Pink eye
Swollen lymph nodes
4
Q

Diagnosis of Pediculosis

A
Eggs (nits)
Nymphs
Mature lice
Found behind ears & back of neck
Wood lamp of area
5
Q

Focus of Treatment of Pediculosis

A

Neurotoxicity
Suffocation via “coating”
Hyper-excitation & death by paralysis

6
Q

Treatment of Pediculosis

A

Permethrin 1% lotion (Nix)
Benzyl alcohol 5% lotion (Ulesfia)
Spinosad 0.9% (Natroba)
Environmental control

7
Q

Medical Term for Scabies

A

Sarcoptes Scabiei

8
Q

What is scabies?

A

Parasite that burrows under the host’s skin causing intense itching

9
Q

Transmission of Scabies

A

Objects
Direct skin to skin contact
Crowded conditions

10
Q

How long until patient’s become symptomatic?

A

2-6 weeks

11
Q

What causes the itching?

A

Allergic reaction to the mites
Worse with warmth
Usually worse at night
Watch for excoriation

12
Q

Diagnosis of Scabies

A

Scraping of skin

View under microscope

13
Q

Treatment for Scabies

A

Permethrin Cream 5%
Lindane Lotion 1%
Oral Ivermectin

14
Q

SE of Permethrin Cream 5%

A

Mild to moderate burning & stinging
Itching
Rash
Redness

15
Q

Education for Permethrin Cream 5%

A

Apply head to toe
Leave on 8-14 hours then wash with soap & water
Repeat in 7 days
Treat family members & sexual partners

16
Q

Other Treatment for Scabies

A

Wash clothing, bedding, towels in hot water & dry with hot temp
Pruritis: atarax (hydroxyzine), benadryl
Steroid cream

17
Q

Lindane Lotion 1% for Scabies

A

More neurotoxic

Head to toe

18
Q

Oral Ivermectin

A

More effective than Lindane
Less effective permethrin
Oral medication

19
Q

2 Spiders That are a Threat to Humans

A

Black widow

Brown recluse

20
Q

Insect Bites that Mimic Spider Bites

A
Ant bites
Bedbug bites
Flea bites
Fly bites
Reduviid bug bites
Mite bites
Tick bites
21
Q

Skin Disorders that Mimic Spider Bites

A
Erythema chronic migrans
Erythema nudism
Leukocytosclastic vasculitis
Sporotrichosis
Toxic epidermal necrolysis
22
Q

Infections that Mimic Spider Bites

A
Chronic herpes simplex
Cutaneous anthrax
Disseminated gonococcal infection
MRSA
Septic emboli in endocarditis or IVDU
23
Q

Trauma that Mimics Spider Bites

A

Self-inflicted injuries

Subcutaneous drug injection

24
Q

Location of Black Widow Spiders

A

Worldwide

25
Q

Location of Recluse Spiders

A

North & South America

26
Q

Acute Presentation of Spider Bites

A

Appears within minutes
Papule
Pustule
Wheal

27
Q

Recent History with Black Widow Spider Bites

A

Recent

28
Q

Symptoms of Black Widow Spider Bites

A
Muscle pain
Mild pain at site
Tremor
Weakness
Shaking of the extremity
Distressed & inconsolable (infants & children)
Refusing food & drink (infants & children)
Generalized erythema
29
Q

Physical Findings of Black Widow Spiders

A
VS normal (70%)
Intermittent muscle rigidity & tenderness adjacent to the bit
Weakness
Tremor
Myoclonus
Diaphoresis
Blanched circular patch
Surrounding red perimeter
Central puncture
Appears "target" lesions
30
Q

Diagnosis of Black Widow Spider Bite

A
S/S with Hx
Leukocytosis
Elevated creatinine, liver enzymes
EKGs (cardiac risk)
Cardiac enzymes (cardiac risk)
31
Q

PE Findings of Mild Envenomation from Black Widow Bites

A

Localized pain at bit

Normal VS

32
Q

PE Findings of Moderate Envenomation from Black Widow Bites

A

Muscular pain in area
Extension of muscular pain to chest or abdomen
Local diaphoresis at bite
Normal VS

33
Q

PE Findings of Severe Envenomation from Black Widow Bites

A
Generalized muscular pain in back, abdomen, & chest
Diffuse diaphoresis
ABnormal VS: tachycardia, tachypnea
N/V
Headache
34
Q

Treatment of Mild Envenomation of Black Widow Bites

A

Local: clean bite
Analgesia: acetaminophen, ibuprofen, oxycodone or hydrocodone
Muscle relaxers: Valium, methocarbamol (Robaxin)
Tetanus prophylaxis

35
Q

Treatment of Moderate to Severe Envenomation of Black Widow Spiders

A
Local wound care
Tetanus prophylaxis
Parenteral opioids, benzodiazepines
Antiemetic therapy
Antivenom administration
36
Q

Risk of Antivenom Administration

A

Anaphylactic reactions

37
Q

Pregnancy Category of Antivenom Administration

A

Category C

38
Q

Where are brown recluse bites normally?

A

Upper extremities
Thorax
Inner thigh

39
Q

Areas Where Brown Recluse Spiders are Located

A

South
West
Midwest

40
Q

Local Symptoms of a Brown Recluse Bite

A

Develop 2-8 hours after a bite
Painless initially
Minor burning
Severe pain at site after 4 hours

41
Q

Systemic Symptoms of a Brown Recluse Bite

A

Malaise
N/V
Fever
Myalgia

42
Q

Physical Findings of a Brown Recluse Bite

A
Initially: bite site mildly red
May reveal fang marks
Blistering
Necrosis of skin & subcutaneous fat
Severe destructive necrotic lesions with deep wide borders
43
Q

Diagnosis of a Brown Recluse Bite

A

History
Clinical Presentation
Definitive: spider seen, recovered, collected & identified

44
Q

Conditions Mistaken for a Brown Recluse Spider Bite

A
Bacterial
Deep fungal
Pseudomonas aeruginosa
Parasitic
Viral
Topical & exogenous causes
Venous
Neoplastic disease
Necrotizing vasculitis
Diabetic ulcers
45
Q

Treatment of Brown Recluse Bite

A

Local wound care
Pain management: NSAIDs or opioids
Tetanus prophylaxis
Dapsone to prevent progression to necrosis & reduce pain

46
Q

Local Wound Care of Brown Recluse Bites

A

Clean with mild soap & water
Apply cold packs
Maintain affected part in elevated or neutral position