WorksheetsDerm Exam 1 - Insect Bites Stings Pediculosis
Total questions: 52
Worksheet time: 39mins
Insect bites
are very common to individuals who spend time outdoors
may cause mild location reactions
release anticoagulant saliva to take blood from their host
won't have any irritation or reaction
What are some characteristics related to mosquitos
found worldwide, particularly in warm, humid climates
breed in standing water
transmits Malaria, West Nile Virus, Yellow Fever, Zika Virus
breed in moving water
What are some characteristics of fleas
tiny, blood sucking, wingless
can multiply without food for several weeks
bites occur primarily on ankles and legs
will die as soon as it runs out of food supply
What are some characteristics of scabies
contagious parasitic skin infection spread from skin-skin contact
mites burrow into skin to start new life cycle
common infestation sites - within skin folds
common infestation sites - on smooth skin
causes inflammation and intense itching
What are some characteristics of bedbugs
hide during daytime, active at night
live and deposit eggs in crevices of walls, floors, picture frames, bedding, & furniture
can survive up to 6 months without blood feedings
bite reactions may range from mild irritation to small dermal hemorrhaging
they burrow into the skin
What are some characteristics of chigger "redbugs"
live in shrubbery, trees, and grass
only chigger larvae bite
small red papule
dangerous
intensely itchy bites
What are some characteristics of spiders
approx 60 spider species in the US can bite humans
most cause only local reactions
only larve can bite
most dangerous: black widow, brown recluse, hobo
What are some characteristics of ticks
feed on both the blood of humans and wild/domesticated animals
remains attached to the host for up to 10 days
remove with fine tweezers
transmits various tick-borne illnesses
feeds only on humans and domesticated animals
Should you use mineral oil, petrolatum, and other irritants to aid the removal of a tick
Yes, it makes it easier to get the tick out
No, it irritates the skin and makes it harder to remove the tick
What are some characteristics of Lyme Disease
caused by the bacteria Borrelia burgdorferi
spread by the brown-legged deer tick
spread by any tick
caused by Corynebacterium diphtheriae
What are some acute symptoms of Lyme Disease
"bull's-eye" skin rash
rash from 3-30 days after bite
flu-like symptoms
neurologic symptoms
What are some long term symptoms of Lyme Disease
cardiac
rheumatic
neurologic
partial paralysis
full paralysis
What medications can be used for Lyme Disease
doxycycline
amoxicillin
cefuroxime
ceftriaxone
spirochete
What are some tick-borne illnesses
Ehrlichiosis
Rocky Mountain Spotted Fever
Lyme Disease
Rickets
What are some complications of insect bites
secondary bacterial infections
impetigo infections
How do you get secondary bacterial infections from insect bites
promoted during scratching of the skin
transferred over from a bandage used to cover bite
ointment trapped bacteria
What are characteristics of impetigo infections
yellow crusting
purulent drainage
redness and swelling
white ring
How to you avoid insect bites
cover skin as much as possible
avoid swamps & dense woods
remove standing water
insect repellents
kill them
Does DEET kill insects?
Yes
No
How does DEET repel insects
releases vapors to discourage approach of insects
releases vapors that kills nearby insects
releases vapors that distract insects
releases vapors that confuse insects and cause them to leave
DEET is available in
sprays
solutions
creams
wipes
oral tablets
What is the smallest % of DEET must you use to prevent tick bites
20%
30%
40%
50-100%
What is the maximum % of DEET recommended for children
20%
30%
40%
50-100%
What are some adverse effects of DEET
skin irritation
CNS reactions w/ overdose/improper use
can not use sunscreen + DEET products
improper use causes a higher attraction for insect bites
What are some characteristics of Picaridin
concentration ranges from 7-20%
colorless odorless insect repellent
used as an alternative to DEET
cloudy and pungent insect repellent
What is the goal of treating insect bites
relieve symptoms
prevent secondary bacterial infections
keep area moist
isolate insect for studying
What are some general approaches for insect bite treatments
ice pack
apply external analgesic
avoid scratching skin
trim fingernails in children
heat pack
When should you self treat an insect bite
reaction is localized
patient is older than 2
patient is younger than 2
reaction is spread
What are some exclusions for self treatment for an insect bite
hypersensitivity to insect bites
< 2 yrs old
history of tick bite & systemic effects - possible infection
severe spider bites
signs of secondary infection
What are some pharmacologic therapies for insect bites
local anesthetics
topical antihistamines
hydrocortisone
counterirritants
antibiotics
How much should local anesthetic, antihistamine, counterirritants, and hydrocortisone be applied
3-4 times daily
4-5 times daily
MAX duration 7 days
MAX duration 14 days
What is the most effective insect repellant
DEET 7-100%
Picaridin 7-20%
Permethrin 0.5%
Citronella
Lemon eucalyptus oil
What can cause an insect sting
bees
wasps
hornets
yellow jackets
fire ants
What are signs of a nonallergic reaction to an insect sting
pain
itching
irritation
hives
What are signs of anaphylaxis from an insect sting
hives/itching
swelling
burning sensation of the skin
decreased blood pressure
bronchial tree constriction
What are some general treatment approaches for insect stings
immediate removal of the stinger
application of local anesthetic, skin protectant, antiseptic, or counterirritant
application of an ice pack (10 min intervals)
children <2 should get medically evaluated
go to the ER
How do you avoid insect stings
avoid perfume/scented lotions
control odor in picnic and garbage areas
wear shoes outdoors
avoid wearing brightly colored clothes
What are the treatment goals of insect bites
relieve itching/pain of cutaneous symptoms through self treatment
refer to PCP for evaluation in an allergic reaction
use epinephrine in an emergency allergic reaction
do nothing and wait for it to go away
What is the emergency treatment of allergic reactions
epinephrine
one dose every 10-20 mins of travel time to a emergency medical facility
benadryl
one dose will hold pt stable to travel to emergency medical facility
What are the different types of pediculosis
head lice
body lice ("cooties")
public lice ("crabs")
hair lice
What are characteristics of head lice
most common
10-12 million Americans affected annually
all socioeconomic groups are affected
controlled by appropriate hygiene
What are some characteristics of body lice ("cooties")
live, hide and lay their eggs in clothing
can attack body areas for feedings
controlled by appropriate hygiene
most common lice
What are characteristics of pubic lice
spread by sexual contact, toilet seats, shared undergarments, or bedding
found in pubic area, armpits, eyelashes, mustaches, bears, and eyebrows
controlled by appropriate hygiene
10-12 million Americans affected annually
How can you prevent spread of or re-infestation of lice
avoid direct physical contact, do not share combs, brushes, towels, caps, etc
Wash bedding in HOT water & dry clothes in dryer
seal contaminated items in a bag for 2 wks
shaving head
louse combs
What are some non-pharmacologic therapies for lice
AIRALLE
Nuvo Method
Dimethicone
Pyrethrins
What is AIRALLE, how does it treat lice, who can operate it
FDA approved medical device
applies airflow and heat to dehydrate and kill lice; no chemicals or medications required
requires trained technician to operate
applies water and heat to hydrate and drown lice; no chemicals or medications required
What is the Nuvo Method to remove lice
Cetaphil gentle skin cleanser applies to hair and tried with a hairdryer
"shrink wraps" lice to suffocate them
requires 2nd treatment 7-10 days later
"shrink wraps" lice to chemically burn them
How does Dimethicone treat lice and how many treatments is needed
coats and immobilizes lice
coats and kills lice
one treatment will suffice
may require 2nd treatment 7-10 days later
What are some exclusions for self-treatment of pediculosis
hypersensitivity to chrysanthemums, ragweed, or pediculicide ingredients
< 2 yrs of age for pyrethrins; < 2 mo of age for permethrins
secondary skin infection in area of lice infestation
lice infestation of eyelids or eyebrows
pregnancy/breastfeeding or presence of active tumors
What order should you apply sunscreen and DEET if you are using both together
DEET then suncreen
sunscreen then DEET
mix them together and put them on at the same time
Which medication used for pediculosis is dosed based upon hair length?
Benzyl Alcohol
Permethrin
synergized pyrethrins
topical ivermectin
What is the first line treatment for pediculosis
Benzyl Alcohol
Permethrin
synergized pyrethrins
topical ivermectin
