A backpacker returns from Thailand claiming to have been bitten by a dog in Bangkok the week before. There is a healing wound with scab on the right forearm ulnar aspect of the extensor surface. She cannot remember her vaccination status. Which statement is most correct
1.You should give 250U TIG, 0.5mL of ADT, commence oral antibiotic and refer back to the GP for further care – complete ADT vaccinations B. There is a strong risk that cellulitis due to pasturella multocida will develop in the next week
2.There is a strong risk that cellulitis due to pasturella multocida will develop in the next week
3.ADT is contraindicated if she is either haemophilliac or pregnant
4.You should give 250U TIG, 0.5mL of ADT 3 x in the next 3 months, 20U/kg RIG once and 0.1mL HDCV 5 times in the next month
How many days it take a wound to reach 100% of its original tensile strength?
1. 40
2.100
3.150
4.250
Human bites to what area have the highest rate of infection?
1.face
2.shin
3.back
4.hand
If a patient presents with DIC after dog bite the likely organism would be
1. Pseudomonas Aeruginosa
2.Staphylococcus Aureus
3.Streptococcus Viridans
4. Capnocytophaga Caniniosus
Which antibiotic regimen is recommended in antibiotic guidelines for bites with a high risk of infection?
1.augmentin duo forte
2.penicillin
3.ampicillin
4.cephalexin
Which imaging modality is most successful at detecting suspected foreign bodies in wounds?
1.normal plain xray
2.plain xray ‘soft tissue view’
3.ultrasound
4.CT
Which is not associated with erythema nodosum?
1.crohns disease
2.salmonella
3.leukemia
4.hep
Which is not true of antiviral medications if given within 72 hours of vesicle formation in herpes zoster?
1.it decreases time to healing
2.it decreases new lesion formation
3. it decreases recurrence
4.it possibly decreases pain
Which of the following is not associated with poor wound healing
1. Lower limb lacerations in the elderly
2.Broad based flap lacerations
3.Long flap lacerations
4. Haematoma beneath a flap laceration
Which wound does not require antibiotic prohylaxis upon discharge (assuming seen within 3 hours and appropriate wound care applied)?
1.complicated dog bites
2.complicated human bites
3.all cat bites
4.xillary
All of the following statements about erythroderma are true EXCEPT
1.There is > 90% body surface involvement
2.It is more common in males .
3.The most common cause is drug reaction
4.High output cardiac failure is a recognised sequelae
At which distance should two point discrimination be possible?
1. A. 2mm
2.5mm
3.7.5mm
4. 10mm
Erythema Nodosum is an example of
1.Panniculitis
2.Vasculitis
3.Serum sickness
4.Erythroderma
Geographic tongue is caused by
1. Kawasaki disease
2.Syphilis
3.Acromegaly
4.None of These
In what dermatological condition is a Tsanck smear used to aid diagnosis?
1.Skin lesions of meningococcus
2.Herpes vesicular lesions
3.Secondary syphilis
4.Urticaria
Regarding bites which is false?
1.all hand bites (animal and human) should be managed by delayed primary closure or secondary intention
2. primary wound closure to the head and neck is acceptable after appropriate wound irrigation
3.wounds less than1-2 cm have a lower rate of infection and can be safely treated with primary closure
4.infection with pasturella multicodia is specific to cat bites
The feature you would NOT expect to find in a case of erythema multiforme after cefaclor use is
1. Itch
2.Target lesions
3.No cross sensitivity with cefotaxime
4. Complete resolution in 2-3 weeks, without sequelae
The toxic reaction you would least expect with bupivocaive is
1. Anaphylaxis
2.Sense of impending doom
3.Fitting
4.Arrythmia
When antibiotics are given for a wound with a high risk of infection, how should they be given in the ED?
1.orally prior to wound manipulation, with discharge prescription
2.iv prior to wound manipulation, with discharge prescription
3.a prescription to be filled on discharge
4.both A and B give the same result
Which dose not tend to produce palpable purpura?
1. meningococcus
2.vasculitis
3.SLE, rheumatoid arthritis
4.Clotting disorders
Which drug is not likely to cause toxic epidermal necrolysis?
1.penicillin
2.trimethoprim
3.carbamazepine
4.cimetidine
Which infectious erythema is purely caused by toxin alone and not from the infectious process as well?
1.toxic shock syndrome
2.scarlet fever
3.streptococcal toxic shock syndrome
4.staphylococcal scalded skin syndrome
Which is false regarding staples?
1.they have a higher rate of infection than sutures
2.they are cheaper than sutures
3.they are quicker to insert than sutures
4.they are more painful to remove than sutures
Which is not a possible cause of a blistered patient?
1.molluscum contagiosum
2.hand, foot and mouth disease
3. eczema herpeticum
4.allergic contact dermatitis
Which is not associated with pyoderma gangrenosum?
1.Rheumatoid arthritis
2.Leukemia
3.salmonella
4.myeloma
Which is not one of the five criteria other then fever required to make the diagnosis of Kawasakis disease?
1.cervical LN
2. peripheral changes. Eg erythema and oedema
3.polymorphous rash
4.pustular tonsillitis
Which is not readily seen on Xray?
1. all glass greater than 2mm
2.gravel
3.teeth
4. fish bone
Which is not true of erythema multiforme?
1.less than 30% of the skin must be blistered to make this diagnosis B. D. E.
2. classically there are target lesions, especially on the periphery
3.it settles within 7-10 days if left untreated
4.steroids orally quicken the recovery
Which is not true of henoch schonlein purpura?
1.purpura are classically on the lower limbs
2.abdominal pain and malena are documented
3.renal disease is a potentially serious complication
4.steroids diminish the likelihood of renal complications
Which is not true of measles?
1.Koplicks spots are seen a few days after the onset of rash
2.The rash appears a few days after the prodrome, starting at the head and moving downwards
3.Unimmunised contacts should be given MMR within 72 hours if over 6 months of age
4. If greater than 72 hours immunoglobulin should be given i.m.
Which is NOT TRUE of pemphigus and pemphigoid?
1. the prognosis of pemphigoid is better
2.pemphigous lesions are intra dermal where as the lesions in pemphigoid are subdermal C. mucosa is more often involved in pemhigous D. clinically the two can be usually differentiated with a good exa
3.mucosa is more often involved in pemhigous
4. clinically the two can be usually differentiated with a good examination
Which is not true of scarlet fever?
1.the erythema appears very early after the prodrome begins
2.the rash does not blanche
3.there is circumoral pallor
4.there is often pharyngotonsillitis
Which is NOT TRUE of staphylococcal scalded skin syndrome?
1.it tends to be less severe than toxic epidermal necrolysis
2. it is toxin mediatied
3.there is no mucosal invovement
4.None of these
Which is the best irrigation fluid for most wounds?
1.normal saline
2.povodine – iodine
3.aquesous chlorhexidine
4.chlorhexidine with cetramide
Which is the correct regimen for wound irrigation?
1.21 gauge needle, 50 ml syringe
2. 21 gauge needle, 20 ml syringe .
3.19 gauge needle, 50 ml syringe
4.19 gauge needle, 20 ml syringe
Which is the usual causative organism in toxic shock syndrome?
1.staph aureus
2.e coli
3.pneumococcus
4.strep pyogenes
Which medication does not commonly cause photosensitivity eruptions?
1. thiazide diuretics
2.spironolactone
3.loop diuretics
4.amioderone
Which of the following features is consistent with scarlet fever
1.Punctate rash on neck and truck
2. Perioral erythema
3.Geographic tongue
4.Resolution without desquamation
Which of the following is associated with a lower incidence of wound infection (given adequately cleanedwounds)
1.Steristrips
2.Staples
3.Histoacryl
4.All of the above
Which rash is not characteristically found on the hands?
1.secondary syphilis
2.erythema multiforme
3.gonococcus
4. herpes simplex
Which rash is not usually itchy?
1.urticaria
2.eczema
3.scabies
4. scarlet fever
Which suture should be used for wounds at risk of infection?
1.monofilament, natural
2.monafilament, synthetic
3.multifilament, natural
4.multifilament, synthetic
Which wound is most likely to produce tetanus?
1. A. Intraoral laceration
2. scalp laceration with underlying skull fracture
3.crush injury to distal phalynx
4.puncture wounds