NUR 611 1 - EXAM 1 - REVIEWER QUESTIONS AND ANSWERS

NUR 611 1 - EXAM 1 - REVIEWER QUESTIONS AND ANSWERS
Dermatology

SkinqwandqwSoftqwTissueqwInfections:qw(SSTI)

● 2qwmostqwcommonqwbacteriaqwthatqwcauseqwskinqwinfections:qwS.qwAureusqw&qwS.qwpyogenes
○ Gramqw(+)qw-qwStaphqw-qwmostqwcommonqw-qwcanqwcauseqwMRSA
○ Gramqw(-)qw-qwpresentqwinqwwoundqwinfectionsqwcausedqwby:
■ animalqwbites
■ traumaqworqwsurgery
■ exposedqwtoqwinfectedqwwaterqw(E.coli,qwpseudomonasqwaeruginosa,qwp
roteusqwmirabilis)
● Skinqwinfectionsqwcanqwbeqwnon-purulentqworqwpurulent

Folliculitis,qwFuruncle,qwCarbuncle
● MostqwcommonlyqwcausedqwbyqwS.qwAureusqw-qwMRSA
● Commonqwinqwathletes,qwshaving,qwwaxing,qwhotqwtubs
● Occursqwinqwareasqwwithqwcoarseqwhair

➔ Presentation:
◆ Pustulesqwinqwhairqwshaft
◆ Tendernessqwandqwredness
◆ Ifqwrecurrentqw-qwaskqwifqwptqwhasqwDM
◆ Noqwdiagnostics/labsqwneededqw-qwusually
● Ifqwrecurrentqwfurunclesqwandqwcarbuncles
○ Culture
● IfqwMRSAqwsuspected
○ Cultureqwnaresqwandqwaxilla
➔ Treatments:
◆ Hygiene
◆ Warm,qwmoistqwcompress
◆ Betadine/Hibiclensqwwashqw(Antisepticqwwash)

➔ TreatmentqwforqwFolliculitis
◆ BenzoylqwPeroxideqw5%,qwBactrobanqwTID
◆ Clindamycinqwgel

➔ TreatmentqwforqwPurulentqwSSTI
◆ 1stqwlineqw-qwIncisionqw&qwDrainageqw(I&D)
◆ C&S

, ➔ TreatmentsqwforqwFuruncleqwandqwCarbuncleqw(PO)
◆ Keflexqw500mgqw(Cephalosporinqw1stqwGen)qwq12qwxqw10-14qwdays
◆ MRSA
● BactrimqwDSqwODqw(Sulfonamide)qwxqw10qw-14qwdays
● Clindamycinqw300qwmgqwq6hqwxqw14qwdays

Cellulitis
● MostqwcausedqwbyqwMRSA,qwStrep,qwH.qwFlu
● DifferentialqwDX:
○ Gout
○ Dermatitis
○ HerpesqwZoster

➔ Presentation:
◆ Erythema
◆ Warmth
◆ Pain
◆ Lymphedema
◆ Fissuring
◆ Abscess

➔ Diagnosticqwtest/Labs:
◆ C&S
◆ CBCqw(Leukocytosis)
◆ BloodqwCX,qwESR
◆ Imagingqwtoqwr/oqwOM

➔ Management:
◆ Hygiene,qwelevation,qwmoistqwheat
◆ Pharma:
● Uncomplicated/nonsystematic:
○ PCNqw500qwmgqwq6
○ Keflexqw500qwmgqwq12qwxqw10-14qwdays
◆ IDSAqw-qwrxqwminqw5qwdays,qwextendqwifqwnoqwimprovement
○ MRSA:
◆ BactrimqwDSqwODqwxqw10-14qwdays
◆ Clindamycinqw300qwmgqwq6h

, ◆ Ptqww/qwcomorbidity:qwDM/HF
● Non-ulcer
○ Amoxicillin/Clavulanateqw500qwmgqwq12hqwxqw7-10qwdays
○ Quinoloneqw-qwCiproqw500-750qwmgqwq12hqwxqw7-14qwdays
◆ Gramqw(-)qwandqwanaerobicqwcoverage
● Mildqwulcer
○ Ciproqw+qwClindamycin

◆ Followqwup:qw48qwHOURS!!!

➔ ReferqwtoqwIDqw/Hospitalizeqwptsqwif:
◆ Immunocompromisedqwptqw=qwHOSPITALqwALWAYS!
◆ S/sqwofqwtoxicity
● Tqw>100.5
● Hypotension
● Sustainedqwtachycardia
◆ Rapidqwprogressionqwofqwerythema
◆ Rapidqwprogressionqwofqwclinicalqwfindingsqwafterqw48hrsqwofqwantibxqwtx
◆ Inabilityqwtoqwtolerateqworalqwtherapy
◆ Proximityqwofqwtheqwlesionqwtoqwanqwindwellingqwmedicalqwdeviceqw(prostet
hicqwjtqworqwvascularqwgraft)
◆ Periorbitalqwcellulitisqw=qwINPATIENTqwTX/qwREFERqwALWAYS!
◆ ReferqwtoqwID:qwhandqwinfection,qwinfectionqwfromqwbitesqw(considerqwadmission)

Dermatitis:
● ContactqwDermatitis
○ Allergic
■ Causes:qwNickelqw(jewelry),qwmedicationsqw(topicalqwcream/ointments),qwp
oisonqwoaks,qwpersonalqwproducts
■ Location:qwexposedqwareas,qwusuallyqwhands
■ Symptoms:qwpredominantlyqwpruritus
■ Surfaceqwappearance:qwvesiclesqwandqwbullae
■ Lesionqwborders:qwdistinctqwangles,qwline,qwandqwborders
○ Irritant
■ Causes:qwsolvents,qwbleach,qwalcohol,qwchemicalsqwinqwpersonalqwproducts
■ Location:qwusuallyqwhands
■ Symptoms:qwburning,qwpruritus,qwpain
■ Surfaceqwappearance:qwdryqwfissuredqwskin
■ Lesionqwborders:qwlessqwdistinct