2 - Vasculitis, Skin Flashcards
Temporal arteritis/Giant cell arteritis
- who
- what
- testing to order
- ocular
- tx
60yo F
Medium-large vessels
Jaw claudication, neck pain, anorexia
ESR, CRP, CBC w/ diff, Platelets, Biopsy (gold standard)
Occlusions of SPCAs -> AAION
Steroids + aspirin
Abnormal GCA blood work results
- ESR
- CRP
- platelets
ESR (mm/hr): elevated
- men: > age/2
- women: >(age+10)/2
CRP: elevated, >2.45mg/dL
Platelets: elevated, >400,000 cells/uL
*elevated ESR + CRP is 97% specific for GCA
Granulomatosis with polyangiitis/Wegener’s
- what
- ocular
Systemic vasculitis with URT, lungs, kidneys
60% ocular involvement Granulomatous sclerouveitis Retro-orbital mass lesion w/ proptosis Corneal ulceration Inflammation: conj, episclera, sclera, ciliary vessels
Gout
- what
- ocular
- tx
Incr uric acid levels -> red, hot joints Metatarsophalangeal joint (MTP, think men toe pain) aka podagra
Band keratopathy (Ca2+ deposits in Bowman’s)
Allopurinol Indomethacin (NSAID)
IgA deficiency
- who
- what
Most common primary inherited immunodeficiency
Tear film: keratinization of cornea
Mucosal: upper resp tract, breast milk
HIV/AIDS
- what
- screening
HIV = RNA virus
-uses reverse transcriptase (drugs inhibit)
ELISA
Western blot
CD4 count
-less than 200 = AIDS
-less than 50 = high risk for CMV retinitis (recall tx with ganciclovir, if fails foscarnet)
*(+) elisa and western blot is 99% chance
HIV/AIDS
-common opportunistic infections
Pneumocystic pneumonia (PCP, Pneumocystic jiroveci) = #1
Toxoplasmosis
TB
CMV
Herpes - incl Kaposi’s sarcoma (HHV-8, red-purple lesions on lid/conj)
Papilloma
HPV (human papilloma virus)
Finger- or cauliflower-like app
“Skin tags”
Xanthelasma
Age»_space;> cholesterol
-most pts with have normal cholesterol
Usually medial eyelids
Molluscum contagiosum
DNA pox virus
Dome-shaped waxy umbilicated nodules
Multiple think HIV
Toxic follicular conjunctivitis
Acne rosacea
- who
- key words
- tx
Idiopathic
Telangiectasia
Triggers - alcohol, spicy food, caffeine, sun exposure
Sebaceous inflammation (meib, zeiss), rhinophyma, flushing
Doxycycline, metronidazole
Allergic contact dermatitis
T4 delayed HS
Impetigo
Gram (+)
Honey-colored crusted lesions
Herpes simplex virus
DNA virus
1 significantly more common (98%)
- primary: bleph, acute unilateral follicular conjunctivitis
- secondary: dendritic k, neurotrophic k, interstitial k, disciform endotheliitis, ARN, ulcers
2 is most common cause of herpetic keratitis in neonates (from infected mother)
Tx: ganciclovir, trifluridine, acyclo/valcyclo/famciclovir
Herpes zoster virus
VZV -> trigem -> HZV/O
<40 think immunocompromised
Pseudodentritic keratitis