Sarah Michelle FNP Review (AANP)
1. Rocky Mountain Spotted Fever: Tick bite, infection by Rickettsia rickettsi
North Carolina, rash first appears with small spots on wrists and ankles, spreads to trunk
and slowly reaches palms/soles
Initial symptoms: fever, muscle pain, h/a, n/v
Rash appears 3-5 days later
2. Rocky Mountain Spotted Fever treatment: Doxycycline ALWAYS
3. Lyme Disease: Called Erythema Migrans (rash at site of tick bit, legs, arms, groin,
trunk)
Tick bite & infection by Borrelia burgdorferi
Bull Eye's: erythematous spot with central clearing, expanding
Can have fever, h/a, fatigue, joint pain
4. Lyme Disease treatment: Doxycycline
Amoxicillin in pregnancy
5. Measles: MeasLes = RubeoLa = KopLik spots
3 C's: cough, congestion (coryza),
conjunctivitis Fever 1st, then 3 C's, rash
3-5 days later
Appearance of Koplik spots: tiny grains of white sand surrounded by erythematous
hallow/base on buccal mucosa Can lead to pneumonia or encephalitis
Contagious 1 wk before symptoms, resolves in aprox. 1 month
6. Measles treatment: Symptomatic treatment
Prevent w/ MMR vaccine (can only give after 12 months old- live vaccine)
7. Mumps: Parotid gland swelling (salivary gland in front of ears- may mention cheek
swelling and pain down to jaw bone, difficulty chewing/swallowing)
Can be be unilateral or bilateral
,Resolves on its own, contagious via droplet
MMR vaccine (2 doses)
8. Rubella: German Measles (3-day measles)
Rash that started on face and spread across body
Mild fever, cervical lymphadenopathy
Distinguishing factors: milder symptoms, pink rash, swollen lymph nodes
Symptomatic treatment
Highly contagious
DO NOT want pregnant women to get this
9. Roseola: High fever, rash developed after fever broke
Rose pink rash that started on trunk, blanches w/ palpation, spreading to
neck, arms, and face Cervical lymphadenopathy
No longer contagious after rash appears
10. Fifth Disease: Erythema Infectiosum (parvovirus b19)
Starts w/ fever and leads to slapped cheek rash and lacy net-like rash
across body, mildly itchy Viral infection, rash appears after virus is gone
so no longer contagious Self-limiting
Avoid pregnant women can cause miscarriage if they
are not immune
11. Hand Foot & Mouth Disease: Coxsackie virus
Fever, sore throat, painful sores in mouth, now rash of hands and feet
Rash has little vesicles, skin around toes are starting to peel
12. Enterobiasis: Pinworms
Anal/genital itching
Scotch-tape test early in morning
Treat w/ Medendazole or albendazole
, 13. Anthrax: Black, painless ulceration
Cattle farmers
Treat w/ Fluoroquinolones (ciprofloxacin)
14. Erysipelas: Superficial cellulitis, superficial layers of skin
Rash w/ well-demarcated borders, superficial and red
Treat w/ Penicillin or Cephalexin (also treats non-purulent cellulitis)
15. Purulent Cellulitis Treatment: B, C, D
Bactrim, Clindamycin, Doxycycline
16. Lichen Planus: Reddish/purple flag bumps, intensely pruritic, lacy/white
appearance on mucous membranes (Wickham striae)
self limiting, treat w/ steroids, resolves in 6 months
Associated w/ ulcerative colitis, vitiligo, & MS; Exacerbated by stress and infection
17. Lichen Simplex Chronicus: Skin becomes leathery and rubbery due
scratching/itching Eczema can lead to this
Treat w/ topical steroids & antihistamines
18 Lichen Sclerosis: White, lacy and normally appears on genitalia (vulva)
Due to overactive immune system
Intensely pruritic, painful intercourse, tearing, bleeding
Recurrent
Treat w/ potent topical steroids: Clobetasol is #1 choice
19. 1st Degree Burn: Superficial, sunburn
Only involves epidermis
Treat w/ aloe
20. 2nd Degree Burn: Partial-thickness burn, involves epidermis and dermis
Red, blistered, painful (do not pop blisters)
Treat w/ silver sulfadiazine cream or abx ointment
1. Rocky Mountain Spotted Fever: Tick bite, infection by Rickettsia rickettsi
North Carolina, rash first appears with small spots on wrists and ankles, spreads to trunk
and slowly reaches palms/soles
Initial symptoms: fever, muscle pain, h/a, n/v
Rash appears 3-5 days later
2. Rocky Mountain Spotted Fever treatment: Doxycycline ALWAYS
3. Lyme Disease: Called Erythema Migrans (rash at site of tick bit, legs, arms, groin,
trunk)
Tick bite & infection by Borrelia burgdorferi
Bull Eye's: erythematous spot with central clearing, expanding
Can have fever, h/a, fatigue, joint pain
4. Lyme Disease treatment: Doxycycline
Amoxicillin in pregnancy
5. Measles: MeasLes = RubeoLa = KopLik spots
3 C's: cough, congestion (coryza),
conjunctivitis Fever 1st, then 3 C's, rash
3-5 days later
Appearance of Koplik spots: tiny grains of white sand surrounded by erythematous
hallow/base on buccal mucosa Can lead to pneumonia or encephalitis
Contagious 1 wk before symptoms, resolves in aprox. 1 month
6. Measles treatment: Symptomatic treatment
Prevent w/ MMR vaccine (can only give after 12 months old- live vaccine)
7. Mumps: Parotid gland swelling (salivary gland in front of ears- may mention cheek
swelling and pain down to jaw bone, difficulty chewing/swallowing)
Can be be unilateral or bilateral
,Resolves on its own, contagious via droplet
MMR vaccine (2 doses)
8. Rubella: German Measles (3-day measles)
Rash that started on face and spread across body
Mild fever, cervical lymphadenopathy
Distinguishing factors: milder symptoms, pink rash, swollen lymph nodes
Symptomatic treatment
Highly contagious
DO NOT want pregnant women to get this
9. Roseola: High fever, rash developed after fever broke
Rose pink rash that started on trunk, blanches w/ palpation, spreading to
neck, arms, and face Cervical lymphadenopathy
No longer contagious after rash appears
10. Fifth Disease: Erythema Infectiosum (parvovirus b19)
Starts w/ fever and leads to slapped cheek rash and lacy net-like rash
across body, mildly itchy Viral infection, rash appears after virus is gone
so no longer contagious Self-limiting
Avoid pregnant women can cause miscarriage if they
are not immune
11. Hand Foot & Mouth Disease: Coxsackie virus
Fever, sore throat, painful sores in mouth, now rash of hands and feet
Rash has little vesicles, skin around toes are starting to peel
12. Enterobiasis: Pinworms
Anal/genital itching
Scotch-tape test early in morning
Treat w/ Medendazole or albendazole
, 13. Anthrax: Black, painless ulceration
Cattle farmers
Treat w/ Fluoroquinolones (ciprofloxacin)
14. Erysipelas: Superficial cellulitis, superficial layers of skin
Rash w/ well-demarcated borders, superficial and red
Treat w/ Penicillin or Cephalexin (also treats non-purulent cellulitis)
15. Purulent Cellulitis Treatment: B, C, D
Bactrim, Clindamycin, Doxycycline
16. Lichen Planus: Reddish/purple flag bumps, intensely pruritic, lacy/white
appearance on mucous membranes (Wickham striae)
self limiting, treat w/ steroids, resolves in 6 months
Associated w/ ulcerative colitis, vitiligo, & MS; Exacerbated by stress and infection
17. Lichen Simplex Chronicus: Skin becomes leathery and rubbery due
scratching/itching Eczema can lead to this
Treat w/ topical steroids & antihistamines
18 Lichen Sclerosis: White, lacy and normally appears on genitalia (vulva)
Due to overactive immune system
Intensely pruritic, painful intercourse, tearing, bleeding
Recurrent
Treat w/ potent topical steroids: Clobetasol is #1 choice
19. 1st Degree Burn: Superficial, sunburn
Only involves epidermis
Treat w/ aloe
20. 2nd Degree Burn: Partial-thickness burn, involves epidermis and dermis
Red, blistered, painful (do not pop blisters)
Treat w/ silver sulfadiazine cream or abx ointment
