Final Exam Q & A - NR511 / NR 511 (Latest 2025) :
Differential Diagnosis & Primary Care Practicum -
Chamberlain
Impetigo caused by .....ANSWER.....Staph aureus
Group Streptococcus (GAS)
Occasional MRSA
Most commonly seen in 2-5 years of age population. Easily
spread in close environments.
Risk Factors: Poverty, crowding, poor hygiene, and underlying
scabies
Nonbullous impetigo .....ANSWER.....papulues that progress to
vesicles and pustules rupture and become encrusted sores.
Golden honey appearance.
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Involving face and extremities
Bullous impetigo .....ANSWER.....Vesicles enlarge to form a faccid
bullae with clear yellow fluid, leaving a thin brown crust. Trunk is
more frequently affected.
If an adult w/ appropriate demographic risk factors should
prompt an HIV investigation.
Ecthyma .....ANSWER.....Group A beta-hemolytic streptococci-
GAS
ulcerative form in which the lesions extend through the epidermis
and deep into the dermis.
"punched out" ulcers, with yellow crust.
Poststreptococcal glomerulonephritis (PSGN)
.....ANSWER.....Nephritic syndrome that arises after group A
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beta-hemolytic streptococcal infection of the skin (impetigo) or
pharynx.
Edema, HTN, Fever, and Hematuria
Must treat with oral antibiotic
Treatment for Impetigo .....ANSWER.....Limited skin involvement
Mupirocin (Bactroban) TID
Retapamulin BID
Patient's with numerous affected areas (Tx: S.Aureus and GAS)
Dicloxacillin seven days
Cephalexin seven days
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if is only only GAS then Penicillin is preferred
MRSA impetigo tx .....ANSWER.....mupirocin - inhibits bacterial
protein synthesis
Doxycycline, clindamycin, or tiimethoprim-sulfamethoxazole
(Bactrim)
Staphylococcal Scalded Skin Syndrome (SSSS)
.....ANSWER.....Staphylococcus aureus, epidermal necrosis caused
by bacterial exotoxins. Epithelial layer peeling off in large
sheetlike pieces. Mimics scalded-skin thermal burn.
More common in children. Found in places where skin rubs
together.
Cellulitis .....ANSWER.....an acute, diffuse inflammation of the skin
and subcutaneous tissue characterized by local heat, redness,
pain, and swelling.