Podcast
Questions and Answers
What is the recommended therapeutic management for localized impetigo?
What is the recommended therapeutic management for localized impetigo?
- Mupirocin ointment for 7 to 10 days (correct)
- Oral antibiotics for extensive impetigo
- Two doses of oral ivermectin
- Retapamulin twice a day for 5 days
How is impetigo transmitted according to the text?
How is impetigo transmitted according to the text?
- Direct contact with lesions (correct)
- Indirect contact with lesions
- Inhaling respiratory droplets
- Ingesting contaminated food
What age group is impetigo most common in?
What age group is impetigo most common in?
- Children 2 through 5 years old (correct)
- Infants under 1 year old
- Adults over 30 years old
- Teenagers between 13 and 18
Which bacterial species can cause impetigo?
Which bacterial species can cause impetigo?
What is the incubation period for impetigo?
What is the incubation period for impetigo?
How long does it usually take for sores to appear after exposure to group A strep?
How long does it usually take for sores to appear after exposure to group A strep?
What is a sign of crusted scabies?
What is a sign of crusted scabies?
What is NOT a method to diagnose scabies?
What is NOT a method to diagnose scabies?
What can occur as a result of scratching the scabies rash?
What can occur as a result of scratching the scabies rash?
Where are scabicides typically applied?
Where are scabicides typically applied?
What is true about scabies in infants and young children?
What is true about scabies in infants and young children?
Why must scabicides be prescribed by a doctor?
Why must scabicides be prescribed by a doctor?
What is the main cause of mitral valve disorder?
What is the main cause of mitral valve disorder?
Who is more at risk of developing CHF during pregnancy due to mitral valve disorder?
Who is more at risk of developing CHF during pregnancy due to mitral valve disorder?
Which of these is not a place where scabies is common?
Which of these is not a place where scabies is common?
How long can scabies mites live off a person?
How long can scabies mites live off a person?
How is scabies infestation usually diagnosed?
How is scabies infestation usually diagnosed?
What treatment option is mentioned for children with mitral valve disorder?
What treatment option is mentioned for children with mitral valve disorder?
Which age group is most commonly affected by Rheumatic Fever?
Which age group is most commonly affected by Rheumatic Fever?
Which antibody is present in individuals with Rheumatic Fever?
Which antibody is present in individuals with Rheumatic Fever?
What is the cause of Rheumatic Fever?
What is the cause of Rheumatic Fever?
What is the most common symptom of Rheumatic Fever in the joints?
What is the most common symptom of Rheumatic Fever in the joints?
What medication is used to reduce inflammation and joint pain in Rheumatic Fever?
What medication is used to reduce inflammation and joint pain in Rheumatic Fever?
What is the prognosis for individuals with Rheumatic Fever?
What is the prognosis for individuals with Rheumatic Fever?
Which treatment requires a second application 7-9 days after the first treatment?
Which treatment requires a second application 7-9 days after the first treatment?
Which treatment is classified as an organophosphate?
Which treatment is classified as an organophosphate?
Which treatment is intended for use on persons as young as 6 months old?
Which treatment is intended for use on persons as young as 6 months old?
Which treatment does not require nit combing?
Which treatment does not require nit combing?
Which treatment is partially ovicidal, meaning it kills some lice eggs?
Which treatment is partially ovicidal, meaning it kills some lice eggs?
Study Notes
Impetigo
- Impetigo is a bacterial infection of the skin, most common in young children.
- Causative agents: Grp A Streptococcus, Staphylococcus aureus.
- Incubation period: 7-10 days.
- Period of communicability: From outbreak of lesions until lesions are healed.
- Mode of transmission: Direct contact with lesions.
- Immunity: None.
- Impetigo is most common in children 2 through 5 years old.
Signs and Symptoms of Impetigo
- Red, itchy sores that break open and leak a clear fluid or pus for a few days.
- A crusty yellow or “honeycolored” scab forms over the sore, which then heals without leaving a scar.
- Sores usually take 10 days to appear after exposure to group A strep.
Therapeutic Management of Impetigo
- Localized disease is treated with Mupirocin (Bactroban) ointment for 7 to 10 days or with Retapamulin (Altabax) for children over 9 months twice a day for 5 days.
- Oral antibiotics covering both staphylococcus and streptococcus are reserved for extensive impetigo.
Scabies
- Scabies is an infestation of the skin by the human female itch mite (Sarcoptes scabiei).
- Scabies is found worldwide and affects people of all races and social classes.
- Scabies can spread rapidly under crowded conditions where close body and skin contact is frequent.
Signs and Symptoms of Scabies
- Black burrow filled with mite feces, usually between fingers and toes, on palms, or in axilla or groin.
- Intense itching (pruritus), especially at night, and a pimple-like (papular) itchy rash.
- The rash also can include tiny blisters (vesicles) and scales.
- Scratching the rash can cause skin sores; sometimes these sores become infected by bacteria.
Treatment of Scabies
- Administer scabicides because they kill scabies mites; some also kill eggs.
- Scabicides to treat human scabies are available only with a doctor’s prescription; no “over-the-counter” (non-prescription) products have been tested and approved for humans.
Rheumatic Fever
- Rheumatic fever is an autoimmune disease, a reaction to grp A beta-hemolytic streptococcal infection.
- Inflammation from immune response leads to fibrin deposits, endocardium, and valves, especially mitral valves, as well as in the major body joints.
Assessment of Rheumatic Fever
- Heart involvement: systolic murmur from mitral insufficiency, prolonged P-R and Q-T intervals on ECG, reflecting inflammation and slowing of impulse conduction.
- Sydenham Chorea: sudden involuntary movement of the limbs, loss of involuntary movement, resulting in dysfunctional speech.
- Poor hand control, weak, and spasmodic contractions and relaxation, facial expression changes rapidly from “Cheshire cat” grin to flat, expressionless affect, or grimace.
- Erythema Marginatum: macular rash found predominantly on the trunk, subcutaneous nodules (painless lumps) on tendon sheaths by the joints, tender swollen large joints (polyarthritis) are frequent symptoms.
Laboratory Findings of Rheumatic Fever
- Presence of Antibody anti-streptococcal titer, elevated sedimentation rate, c-reactive protein levels.
Therapeutic Management of Rheumatic Fever
- Maintain bed rest during the acute phase of illness or until congestive heart disease is not present, ESR dec., C-reactive protein level and pulse rate return to normal.
- Penicillin therapy or a single IM injection of Benzathine penicillin to eliminate any grp A beta-hemolytic streptococci in the body.
- Oral ibuprofen or corticosteroid to reduce inflammation and joint pain.
- Phenobarbital and diazepam to reduce purposeless movement of chorea.
- If CHF is present, digoxin and diuretics.
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Description
Test your knowledge about Rheumatic Fever, an autoimmune disease triggered by a reaction to group A beta-hemolytic streptococcal infection. Learn about the symptoms, causes, and manifestations like fibrin deposits in the endocardium, valves, and major body joints. Understand how the presence of acetone on a test strip indicates fat being used for energy or potential acidosis.