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Another name for atopic dermititis
Eczema
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scaly lesions and intense pruritis
Erythematous
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Dust mites
Trigger associated with exacerbation of atopid dermatitis
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Pets or animal dander
Trigger associated with exacerbation of atopid dermatitis
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pollens
Trigger associated with exacerbation of atopid dermatitis
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Soaps or detergents
Trigger associated with exacerbation of atopid dermatitis
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Food allergens
Trigger associated with exacerbation of atopid dermatitis
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Changes in climate and temperature
Trigger associated with exacerbation of atopid dermatitis
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sweating
Trigger associated with exacerbation of atopid dermatitis
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Infections
Trigger associated with exacerbation of atopid dermatitis
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Textiles
Trigger associated with exacerbation of atopid dermatitis
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emotional stressors
Trigger associated with exacerbation of atopid dermatitis
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Treatment of atopic dermatitis
Control of symptoms by relief of itching, hydration of the skin and minimization of inflammatory changes.
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Keep child fingernails short
Tx for atopic dermatitis
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Why shouldn't you use heat for treating atopic deteratitis?
Aggravates itching.
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Promote hydration of the skin
TX for atopic dermatitis
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Diphenhydramine (Benadryl)
oral antihistamine to treat atopic dermatitis
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daily bathing in warm water followed by application of an occlusive product such as a cream or ointment to seal in moisture.
Tx for atopic dermatitis
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Why shouldnt' use use lotion sfor atopic dermatitis?
Have a higher water content; however, they promote drying of the skin because of an evaporative effect.
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Most common prescribed treatment for atopic dermatitis and used to reduce inflammation
Topica corticosteroids
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what is most often used to tx mild to moderate atopic dermatitis?
1% hydrocortisone cream or ointment
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High potentcy steroids should be avoided in infants and young children for tx of atopic dermatitis?
Risk of increased absorption and systemic side effects such as growth suppression.
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Tx for severe or persistent atopic dermatitis
Wet wrap therapy, which enhance penetration of topical corticosteroids and may help relieve pruritis.
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Act specifically to suppress T cell activity, thereby inhibitin gthe inflammatory process involved in the development of atopic dermatitis
Eladil and Protopic
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S/E of corticosteroids that is not seen in Eladil and Protopic
Thinning of the skin, and therefore safe to be used on the face
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Worsening symptoms of atopic dermatitis may indicate...
secondary infection or contact dermatits
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Atopic dermatitis often resolves by...
adolescense
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Caused by contact with soaps, detergents, poison oak/ivy, fabric softener, and loations
Contact dermatitis
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Colonization of the skin by _______________ ________ is present in 90% of children with atopic dermatitis
Staphylococcus aureau
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Total serum IgE, Specific IgE antibodies and eosinophil counts are lab test useful in evaluating
atopic dermatitis
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Bullae or vescicles & pruritis are signs of
Contact dermatitis
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Erythamatous leasions signs of
contact dermatitis
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Tx of contact dermatitis
- Remove irritant
- Cool compress (burrows solution)
- -oatmeal soaks
- antihistamines
- Calamin loation
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Medication for severe diaper dermatitis
Hydrocortisone 1%
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Overgrowth of pityrosporum - yeast
Seborrheic dermatitis
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Scales, dandruff, yellow-red patches
seborheic dermatitis
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Tx of seborrheic dermatitis
Baby shampoo, emoillient x 20 minutes, gently brush and rinse
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Tx for adolescents in seborrheic dermatitis
Shampoo w. selsun. Head and shoulders, oatmeal or cream for body
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spongiosis
Inflammation of skin's spongy layer seen in seborrheic
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use of mineral oil left overnight 2- 4 weeks may aid in removing persistent scales
Tx of seborrheic dermatitis
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sensitization phase
Initial exposure to the antigen in contact dermatitis
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Elicitation phase
hypersensitivity response in contact dermatitis
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Topical retinoids to comodones only, in the evening
Treatment for comedomal acne
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Topical antibiotics to entire area, nnot just lesions
Tx for mild to moderate inflammatory acne
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Oral antibiotics
tx for acne, moderate to severe
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Oral isotrentinoin
For severe papulonodular acne
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Tx of severe papulonodular acne during menses
Norgestimate and ethinyl estradoil for flare-ups during menses
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Involves pilosebacceous follicles: pore, sebascious gland and tiny vellus
Acne vulgaris
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Inreased production of sebum and androgen
Acne vulgaris
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Comedones, non inflammatory lesions, may be open or claosed in
Acne vulgaris
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Precaution in females taking isotretinoin (accutane)
Need 2 negative pregancy tests prior to monthly and 1 month after treatment. Also need to use 2 forms of ctraceptives due to tertogenicity and adverse effects
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Use of noncomedogenics
Used as an alternative cosmetics and moisturizers in acne
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Don't PICK or Squeeze!
Acne teaching
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Tretinoin precaution
Used for acne, and should be applied at night due to inhibition when exposed to ultraviolet light.
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When using topical and oral medications that cause photsensitivty in acne, it is important to use
Sunscreen with SPF of 15
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Topicals used in acne may cause
erythema, peeling and itching
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Auto immune disease causing hair loss on scalp and body
Alopecia areata
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Highly contageous superficial bacterial skin enfection
Impetigo conagiosa
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characterized by local inflammation and infection in the peidermis
Impetigo contagiosa
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Vesicle with erythema surrounding that progresses to honey yellow crust
Impetigo contagiosa
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Tx for impetigo contagiosa
Crusts soaked. scrubbed off
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Bactroban/mupirocin is a topical antibiotic used for
Imetigo contagiosa
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oral and systemic antibiotics such as dicloxacillin or cephalexin (a cephalosporin aka Keflex) are considered appropriate cost effective therapy for
impetigo
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benign epithelial tumors
Papillovirus aka warts aka varuka
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Salyicic acids can be used for tx of
Papillovirus
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Cryotherapy can be used for
papillovirus
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Cautery or laser is a treatment for
paillovirus
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Fever blisters symptom/sign of
HSV1
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Ulcers>yellow exudate>crust
HSV1
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Tx for mild HSV1
Hydrates, analgesics
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Tx for severe recurrent oral acyclovir
Zovirax
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Can be fatal in immunocompromised child
HSV1
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Fungal infection in newborns
Oral candidiasis (Thrush)
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Fungal infection in children using inhalers
Oral candidiasis (Thrush)
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Fungal infection occuring with impaired immunity, or on antibiotics
Oral candidiasis (Thrush)
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White patche in mouth resemble coagulated milk
Oral candidiasis (Thrush)
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Pain with lesions
Oral candidiasis (Thrush)
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Tinea capitus
Dermatophytoses (ringworm)
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Tx for ringworm (dermatophytoses)
Griseofulvin po, 8 wks
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Griseofulvin po is treatment for
Dermatophytoses (ringworm)
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How long do you use griseofulvin po?
8wks
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Selenium sulfide shampoo used to tx
Ringworm / Dermatophytoses
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How long should you use selenium sulfide?
2-3 weeks, leave on for 10 mintutes
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Why are topicals innefective for dermatophytoses?
Can't penatrate the hair follicle
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2% ketocanozole used to tx
dermatophytoses (ringworm)
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Tinea Corporis
Body Ringworm
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annular expanding lesion
tinea coporis
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raised erythematous border, scaly clearning center
tinea corporis
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Washing the body with selenium sulfide shampoo is a tx for
tinea corporis
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tx for tinea pedis and length of time
4-6 weeks, antifungal
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tx of tinea cruris and length of time
lotrimin, 2-3 weeks
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Tx for pediculosis capitus
Pediculocidde (nix), removal with fine tooth comb
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What age should you not use Nix on a child? What is nix used for?
<2 years, pediculosis capitis
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Highly contagious
Scabies
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Female mite burrows under skin and lays eggs and feces in the path
scabies
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Itching noted for 1 month after infestation
Scabies
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Erythematous, papular rash
Scabies
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5% permethrin cream (Elimite) x 1 to whole body
Tx for Scabies
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Treat the entire family
Scabies
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Permethin is safe for what age children? Treatment for what?
Scabies, >2 mo old.
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Range for mild hypothermia
32-35 C
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Range for moderate hypothermia
29-32C
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Profound hypothermia
<28C
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Tx for profound hypothermia
- Gradual core body rewarming
- If immergened in water, CPR until body temp normal. Hypothermia may have preserved organs
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Volume expanders
tx for profound hypothermia
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Internal warming
tx for profound hypothermia
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Rectal probe for temp monitoring
tx for profound hypothermia
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Humidified, warm 02
tx for profound hypothermia
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Warmed IVFs
tx for profound hypothermia
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Warm packs to core circulation areas
tx for profound hypothermia
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Hemodialysis prn
tx for profound hypothermia
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Hypoglycemia = IV glucose, tx in
tx for profound hypothermia
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High risk areas for frostbite
ears, nose, cheeks.
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Immerse in warm water for 10-15 minutes
Tx for frostbite
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Narcotic alangesics used as treatment for
frostbite
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Warm fluids po
tx for profound hypothermia
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Amputation prn
tx for profound hypothermia
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Elevate prn to promote venous return
tx for profound hypothermia
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Who is at highest risk for animal bites?
<8years old
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Crushing lacerations
Dog bits
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Puncture wounds
Cat bites
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Cultures are obtained after what?
Animal bite
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Irrigate/debride after
animal bite
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use local anesthesia after
animal bites
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Antibiotic therapy after..
animal bites
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Tetanus a possible problem after
animal bites
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Tx for bites and stings
- remove stingers
- Cool, wet compresses
- Antihitamines (benedryl)
- Mild anagesics (acetaminophen)
- Oral steroids
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past of meat tenderizer and 1 tsp water to site
tx for bites and stings
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baking soda and water paste tx for
fire ants
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Systemic reacction
anaphylactic reaction
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tx for anaphylactic reaction
emergency epi kit
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Medical ID important for
anaphylactic reaction
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Systemic reaction can occur in what time frame?
5-30 minutes
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Mild erythematous, painful purple bull's eye macule; fever, chills, malaise >>edema, tissue necrosis; slow to heal
Brown recluse spider
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Keep area below heart
brown recluse
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cleanse; cool compresses, analgesics
Brown recluse
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If njo bullae, no further treatment and watch for secondary infection
Brown recluse
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Pain, edema, muscle cramps, crying
Black widow
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Systemic reaction to black widow bite in how long?
1-3 hours
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Malaise, vomiting, dizzyness, muscle ridgidity of abdomen
Systemic reaction to black widow
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Calcium gluconate IV
Emergency tx for black widow bite
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Anti venom
Emergency tx for black widow bite
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Antihistamines
Emergency tx for black widow bite
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hydrocortisone
Emergency tx for black widow bite
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Rare, tissue destroying bacteria
Necrotizing fascities
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Necrotizing fascities caused by
Strep
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Can be caused by minor wound, chicken pox, abraison, bruise
Necrotizing fascites
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Enters bloodstream
necrotizing facites
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Remove affected tissue or limb may stop progression
Tx for necrotizing fascites
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Meningococcinum is a deadly infection in what age group?
<5 years old
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Flu-like sx
Meningococcinum
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Large bruises with damage like 3rd degree burns
Meningococcinum
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Shock and respiratory failure
Meningococcinum
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Antibiotics treat infections and damage to tissues
Meningococcinum
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Fever and rash, seek medical attention immediately
Meningococcinum
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What bacteria are normally found on the skin?
Streptococcal and staphylococcal
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what causes epidermal inflammation and formation of visicles or warts?
viruses
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Characteristic rashes are present with communicable _____
viruses
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What causes fungal infections?
Dermatophytoses
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Affects the stratum corneum, hari and nails and are superficial and not in the skin.
Dermatophytoses
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How long does it take for nits to hatch?
7-10 days
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Life span of lice
1 month on host, 48 hours without host
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A small, superficial, elevated lesion containing serou fluid is called a
visicle
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A flat, nonpalpapable lesion
macule
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contains purulent fluid
pustule
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palpale lesion that is firm, such as a wart and does not contain fluid
papule
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Which of the following are manifestations of scabies?
Nits present
threadlike rash between fingers and other moist areas
Curcular rash on extremities
Pruritus
Eczematous eruption in infants
- threadlike rash between fingers and other moist areas
- Pruritus
- Eczematous eruption in infants
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Life cycle of lice eggs
14 days
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what tempt to wash clothes in contact with lice
130
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Imetigo caused by what kind of infection?
Bacterial
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Scabies caused by a
Caused by a burrowing mite
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Cold sore, and fever blister caused by what kind of infection?
Viral
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Ringworm is caused by what kind of infection
Fungal
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Should you wash off zinc oxide with each diaper change?
NO
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Constratch can be used to do what?
Reduce friction between diaper and skin
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Medications used for relief of itching
Claritin, atarax, and benadryl
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Acne may be genetically inheritied, T or F
T
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Acne more common in boys or girls?
males
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No association between stress and acne - true or false
true
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open comedones
blackheads
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closed comedones
whiteheads
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Red, inflamed skin
Diaper dermattis
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weeping, red vesicles and papules
infantile eczema
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Comedones or pustules are associated with
acne
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Thick and yellow scaly areas
Seborrheic dermatitiss
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Which of the following medications can be used for children with eczema?
Corticosteroids
Accutane
Peroxide
Antihistamines
Calamine lotion
- Corticosteroids
- Antihistamines
- Calamine lotion
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Where ies eczema usually seen on a 4 year old child?
AC, and politeal foassae in children 2-5
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A complication that may occur with acne and most types of dermatitis is...
cellulitis
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