NURS 5463 UPDATED EXAMS TEST PAPER
QUESTIONS AND ANSWERS SURE A+
✔✔Pemphigus - ✔✔2 types:
- Vulgaris: Begins as oral lesions
- Foliaceous: no oral lesions, begins on face/scalp/chest/groin
Treat with steroids 2-3mg/kg/day (titrate down to lowest dose) and immunosuppressives
✔✔Bullous Pemphigoid - ✔✔- Most common bullous dermatosis
- Ages 60-80
- Blisters rupture less easily than pemphigus
- Diagnose with skin biopsy and flourescence
- Treat with Prednisone 50-100mg/day, can be used with immuran 150mg; Can use
tetracycline/doxycycline with nicotinomide
- Severe cases treated with plasmapheresis/IVIG
✔✔Pustular Psoriasis - ✔✔- Red erythema topped by pinpoint sterile yellow pustules in
clusters that spread over a few hours to cover the entire body
- Causes fever, malaise and elevated WBC count
- Cause the nails to lift and shed
- Cause the layers of the tongue to slough
, ✔✔Graft vs. Host Disease (GVHD) - ✔✔- Complication of bone marrow transplant
- Acute cutaneous GVHD is the earliest and most frequent reaction
- 10-30 days post bone marrow transplant
- Begins w/ faint itching and macules that progress to erythroderma or TEN
- Chronic cutaneous CVHD is > 60 days
✔✔Graft vs. Host Stages - ✔✔Stage I: Eruptions involving < 25% total BSA
Stage II: Eruptions involving 25% - 50% total BSA
Stage III: Erythroderma
Stage IV: Bulla
✔✔Graft vs. Host Other Signs & Symptoms - ✔✔Erosive stomatitis, oral and occular
sicca symptoms, fever, jaundice, nausea/vomiting, cramping, abd. pain, diarrhea,
serositis, elevated SGOT, elevated bilirubin, elevated alk. phos
✔✔Graft vs. Host Disease Treatment - ✔✔Topical steroids, PUVA, extracorporeal
photopheresis, methylprednisolone, tacrolimus, cellcept, etanercecpt, infliximab, CYA
✔✔Erysipelas & Cellulitis - ✔✔- In adults: Staph aureus or Group A strep
- In children: H. influenzae type B
- In the diabetic: Group B strep, E. coli, proteus, acinetobacter, enterobacter,
pseudomonas
- In dog & cat bites: Pasturella M.
✔✔Toxic Epidermal Necrolysis (TEN) - ✔✔- Necrotizing fascitis that covers >30% total
BSA
- A cytotoxic immune reaction aimed at destruction of keratinocytes expressing foreign
antigens
- Resembles *second degree burns*
✔✔Necrotizing Fascitis Types - ✔✔- Type I: Polymicrobial (After surgery or trauma,
often mistaken for cellulitis)
- Type II: Gas (AKA flesh-eating bacteria)
- Type III: Clostridial myonecrosis (gas gangrene)
- Type IV: Fungal
✔✔Staphylococcal Scalded-Skin Syndrome [SSSS] - ✔✔- Acute epidermolysis caused
by Staph toxin
- Infants and children most susceptible
- A diffuse, ill-defined erythema & fine, stippled, sandpaper appearing rash; within 24°
the erythema deepens and the involved skin becomes tender
- Treat with antibiotics, steroids not indicated
✔✔Toxic Shock Syndrome - ✔✔Rapid onset of fever, hypotension, rash
QUESTIONS AND ANSWERS SURE A+
✔✔Pemphigus - ✔✔2 types:
- Vulgaris: Begins as oral lesions
- Foliaceous: no oral lesions, begins on face/scalp/chest/groin
Treat with steroids 2-3mg/kg/day (titrate down to lowest dose) and immunosuppressives
✔✔Bullous Pemphigoid - ✔✔- Most common bullous dermatosis
- Ages 60-80
- Blisters rupture less easily than pemphigus
- Diagnose with skin biopsy and flourescence
- Treat with Prednisone 50-100mg/day, can be used with immuran 150mg; Can use
tetracycline/doxycycline with nicotinomide
- Severe cases treated with plasmapheresis/IVIG
✔✔Pustular Psoriasis - ✔✔- Red erythema topped by pinpoint sterile yellow pustules in
clusters that spread over a few hours to cover the entire body
- Causes fever, malaise and elevated WBC count
- Cause the nails to lift and shed
- Cause the layers of the tongue to slough
, ✔✔Graft vs. Host Disease (GVHD) - ✔✔- Complication of bone marrow transplant
- Acute cutaneous GVHD is the earliest and most frequent reaction
- 10-30 days post bone marrow transplant
- Begins w/ faint itching and macules that progress to erythroderma or TEN
- Chronic cutaneous CVHD is > 60 days
✔✔Graft vs. Host Stages - ✔✔Stage I: Eruptions involving < 25% total BSA
Stage II: Eruptions involving 25% - 50% total BSA
Stage III: Erythroderma
Stage IV: Bulla
✔✔Graft vs. Host Other Signs & Symptoms - ✔✔Erosive stomatitis, oral and occular
sicca symptoms, fever, jaundice, nausea/vomiting, cramping, abd. pain, diarrhea,
serositis, elevated SGOT, elevated bilirubin, elevated alk. phos
✔✔Graft vs. Host Disease Treatment - ✔✔Topical steroids, PUVA, extracorporeal
photopheresis, methylprednisolone, tacrolimus, cellcept, etanercecpt, infliximab, CYA
✔✔Erysipelas & Cellulitis - ✔✔- In adults: Staph aureus or Group A strep
- In children: H. influenzae type B
- In the diabetic: Group B strep, E. coli, proteus, acinetobacter, enterobacter,
pseudomonas
- In dog & cat bites: Pasturella M.
✔✔Toxic Epidermal Necrolysis (TEN) - ✔✔- Necrotizing fascitis that covers >30% total
BSA
- A cytotoxic immune reaction aimed at destruction of keratinocytes expressing foreign
antigens
- Resembles *second degree burns*
✔✔Necrotizing Fascitis Types - ✔✔- Type I: Polymicrobial (After surgery or trauma,
often mistaken for cellulitis)
- Type II: Gas (AKA flesh-eating bacteria)
- Type III: Clostridial myonecrosis (gas gangrene)
- Type IV: Fungal
✔✔Staphylococcal Scalded-Skin Syndrome [SSSS] - ✔✔- Acute epidermolysis caused
by Staph toxin
- Infants and children most susceptible
- A diffuse, ill-defined erythema & fine, stippled, sandpaper appearing rash; within 24°
the erythema deepens and the involved skin becomes tender
- Treat with antibiotics, steroids not indicated
✔✔Toxic Shock Syndrome - ✔✔Rapid onset of fever, hypotension, rash
