2 - Vasculitis, Skin Flashcards

1
Q

Temporal arteritis/Giant cell arteritis

  • who
  • what
  • testing to order
  • ocular
  • tx
A

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

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2
Q

Abnormal GCA blood work results

  • ESR
  • CRP
  • platelets
A

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

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3
Q

Granulomatosis with polyangiitis/Wegener’s

  • what
  • ocular
A

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
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4
Q

Gout

  • what
  • ocular
  • tx
A
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)
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5
Q

IgA deficiency

  • who
  • what
A

Most common primary inherited immunodeficiency

Tear film: keratinization of cornea
Mucosal: upper resp tract, breast milk

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6
Q

HIV/AIDS

  • what
  • screening
A

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

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7
Q

HIV/AIDS

-common opportunistic infections

A

Pneumocystic pneumonia (PCP, Pneumocystic jiroveci) = #1
Toxoplasmosis
TB
CMV
Herpes - incl Kaposi’s sarcoma (HHV-8, red-purple lesions on lid/conj)

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8
Q

Papilloma

A

HPV (human papilloma virus)
Finger- or cauliflower-like app
“Skin tags”

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9
Q

Xanthelasma

A

Age&raquo_space;> cholesterol
-most pts with have normal cholesterol

Usually medial eyelids

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10
Q

Molluscum contagiosum

A

DNA pox virus
Dome-shaped waxy umbilicated nodules
Multiple think HIV
Toxic follicular conjunctivitis

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11
Q

Acne rosacea

  • who
  • key words
  • tx
A

Idiopathic

Telangiectasia
Triggers - alcohol, spicy food, caffeine, sun exposure
Sebaceous inflammation (meib, zeiss), rhinophyma, flushing

Doxycycline, metronidazole

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12
Q

Allergic contact dermatitis

A

T4 delayed HS

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13
Q

Impetigo

A

Gram (+)

Honey-colored crusted lesions

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14
Q

Herpes simplex virus

A

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

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15
Q

Herpes zoster virus

A

VZV -> trigem -> HZV/O

<40 think immunocompromised

Pseudodentritic keratitis

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16
Q

Behcet’s

A

25yo M, Asian/Mid Eastern

Recurrent oral aphthous ulcers (chancre)

Acute recurrent hypopyon - ONLY systemic dz causing hypopyon (ocular causes bact/fung ulcer, endophth)

17
Q

Malignant melanoma

A

Melanocytes in basal layer

Superficial spreading is most common variant

18
Q

Sturge-Weber

A

Congenital facial capillary malformation (over-abundance)

Unilateral glaucoma - uncr EVP/obstructed outflow)
Heterochromia

19
Q

Tuberous sclerosis

A

Assoc with astrocytic hamartoma