Term
| what 2 lab tests do you do to check for inflammation? |
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Definition
ESR and CRP
(erythrocyte sed rate and c reactive protein) |
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Term
| What 4 lab tests could you do for a patient that itches? |
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Definition
- CMP
- Hepatic function panel
- Lipid panel
- Renal function |
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Term
| Before put someone on acutane should do a __ lab test. |
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Definition
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Term
| What 3 lab tests are for syphilis: |
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Definition
- RPR
- VDRL titer
- FTA-ABS |
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Term
| who would do an iron studies lab test for? |
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Definition
| for patients with concerns about hair growth/loss |
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Term
| If you want to give someone Dapsone, what lab test do you have to do first? |
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Definition
| G6PD Quantitative (if someone is G6PD deficient do NOT put them on dapsone) |
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Term
| Necessities for a scabies scraping: |
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Definition
- #15 blade
- glass slide
- mineral oil
- microscope |
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Term
| An H&E stain, direct immunofluroescence slide, and special stains all require a __. |
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Definition
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Term
| When are doing a skin scraping of a bullae, where do you scrape? |
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Definition
| edge of the bullae, get some normal, some abnormal skin with scrape |
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Term
| special stain for fungus: |
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Definition
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Term
| if there is a scaly rash do a __ _. |
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Definition
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Term
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Definition
Select a scaly lesion
Use sterile #15 blade or glass slide to take skin scrapings from representative lesion
Scrape the skin scales into a single compact pile
Add 1 drop of 10-20% KOH Solution or Chlorazol Black E, cover with cover slip
Heat gently over butane burner, not alcohol flame, avoid boiling
(if you don't heat it, you won't see the hyphae) |
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Term
| In my practice, I always do a test to screen for fungal organisms before treating a patient presenting with a fungal-like skin rash. The most useful test is the potassium hydroxide preparation (KOH prep) test. With this in-office test, you can quickly determine the presence or absence of fungal or yeast organisms. Although a culture (and 30 days’ time) is required to determine the exact genus and species of the organism, you can get a working diagnosis and establish a treatment plan in 5-10 minutes. |
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Definition
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Term
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Definition
DTM: dermatophyte medium
- orange medium turns red when there is fungus with a white cotton ball like wad of fungus |
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Term
| May take a sample of the scales of skin and or nail fragments (debris) from under the infected nail. If a sample of debris cannot be taken easily, a nail sample may be taken by lightly scraping the nail near the infected area or by using a small blade to shave off a piece of nail. |
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Definition
| Scrape right under nail> put on KOH prep or DTME or can clip nail and send it away for PAS stain. |
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Term
| when you do a KOH test you are looking for __ to confirm presence of fungus. |
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Definition
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Term
| With tinea versicolor you are looking for __ and __ on KOH prep. |
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Definition
| endospores and hyphae (spaghetti and meatballs) |
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Term
| A fungal culture, which can determine which type of fungus is present. Since fungi generally grow slowly, it can take 2- 4 weeks for a culture to produce test results. |
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Definition
| Prove its fungus b/c treatment can cause fulminant hepatitis, which is hard to recover from. |
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Term
| A fungal culture is often used as an adjunct to KOH for diagnosis. Fungal culture is more specific than KOH for detecting a dermatophyte infection; therefore, if the clinical suspicion is high yet the KOH result is negative, a fungal culture should be obtained. |
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Definition
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Term
Sabouraud agar containing neopeptone or polypeptone agar and glucose is often used for fungal culture. However, it does not contain antibiotics and may allow overgrowth of fungal and bacterial contaminants.
Mycosel, a commonly used agar, is similar to Sabouraud agar but has antibiotics.
Commonly, dermatophyte test medium (DTM) is used. It contains antibacterial (ie, gentamicin, chlortetracycline) and antifungal (ie, cycloheximide) solutions in a nutrient agar base. This combination isolates dermatophytes while suppressing other fungal and bacterial species that may contaminate the culture |
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Definition
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Term
| what turns DTM media red if there is fungus? |
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Definition
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Term
| DTM contains phenol red solution, which causes a color change from straw-yellow to bright-red under alkaline conditions, indicating a positive dermatophyte culture result. However, the color makes identification of culture morphology (particularly pigmentation) difficult. |
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Definition
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Term
| What two types of agars should be used to assess gross and microscopic colony appearance of fungus? |
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Definition
| Sabouraud or Mycosel agar |
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Term
If the KOH preparation and fungal culture do not show the presence of fungi but a fungal infection is still suspected, your health professional may remove a small piece of nail and look at it under a microscope (nail biopsy) with a special stain called PAS for fungal elements.
This is rarely done. |
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Definition
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