Pathophysiology Management Quiz

Study Notes

Tinea Manuum (Fungal Infection of the Hand)
- Acute stage: blisters on red areas of hands.
- Chronic stage: dry scaly patches.
- Associated with "1 hand 2 feet" syndrome, often linked to tinea pedis.
Management of Tinea
- Terbinafine (Lamisil) 250 mg once daily for 6 weeks for fingernails, 12 weeks for toenails.
- Pulse itraconazole (Sporanox) 200 mg twice daily for 7 days, followed by 3 weeks off (2 pulses for fingernails, 3 for toenails).

Skin Conditions Misdiagnosed as Fungal Infections
- Dyshidrotic dermatitis
- Allergic contact dermatitis (primarily on dorsum/heel)
- Atopic dermatitis
- Erythrasma and intertrigo (interdigital)
- Psoriasis (can occur on soles or interdigital spaces)
Other Conditions to Consider
- Lichen planus
- Trauma to skin

Causative Agent: Candida albicans, normally found in mouth, vagina, and lower GIT.
Infection Characteristics:
- Affects only outer layers of skin/mucous membranes.
- Presentation: red, macerated patches with a glistening surface and scaling at the border.
- Notable feature: presence of ‘satellite’ pustules beyond the main infection.

Non-Bullous Impetigo
- Most common form, presents with yellow crusts and erosions.
- Contagious, transmitted through skin contact, especially in children.
Bullous Impetigo
- Caused exclusively by Staphylococcus Aureus.
- Characterized by mildly irritating blisters that erode rapidly.
Ulcerative Lesions
- Most commonly observed in Aboriginal communities, distinguishes with significant crusting and ulceration.

Cellulitis
- Bacterial infection of dermis and subcutaneous tissues.
- Common organisms: Staphylococcus Aureus and Group A Streptococcus.
- Symptoms: painful, raised erythematous areas with possible blistering.
Abscesses
- Superficial infections of hair follicles leading to boils (furuncles) or carbuncles (cluster of boils).

Definition: A medical emergency requiring radical debridement.
Causes: Group A Streptococcus, Staphylococcus Aureus, Vibrio, Clostridium.
Symptoms: Brownish-red inflammatory areas, rapidly expanding margins, and systemic toxicity.

Leprosy: Affects skin and nerves, presenting in tuberculoid and lepromatous forms.

Jaundice: Caused by elevated bilirubin, yellow breakdown product of heme catabolism.
Symptoms: Yellowing of skin and eyes, brown color in feces.

Types of Fractures:
- Open (compound) and closed fractures, dislocations, and associated neurovascular compromise.
Splinting: Reduces pain, bleeding, and risk of further injury.

Von Willebrand’s Deficiency: Characterized by inadequate vWF leading to poor platelet plug formation.
Clinical Signs: Bruising, easy bleeding, and heavy bleeding.

Blood Tests: Elevated free hemoglobin, hematological findings including hemoglobinemia, and hemoglobinuria.
Liver Function Tests: Elevated bilirubin and decreased haptoglobins indicate hemolytic anemia.