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MSK Biweekly Exam 1 > Al-Mehdi Dermatologic Drugs > Flashcards

Al-Mehdi Dermatologic Drugs Flashcards

1
Q

mild to severe skin condition that starts out as comedones then can become nodules (most severe)

A

Acne vulgaris

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2
Q

these increase number of cells that produce sebum

A

androgens

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3
Q

bacteria related to acne

A

Cutibacterium acnes
Propionibacterium acnes

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4
Q

what causes inflamed papule in acne

A

fatty acids

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5
Q

these block sebaceous gland and eventually form papule that can rupture in dermis and produce IL-8 that brings neutrophils to site (pustule)

A

keratinocytes

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6
Q

testosterone produced from 3 places

A

adrenal gland
ovaries
testes

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7
Q

what pathway forms hair follicles and can lead to acne

A

testosterone to dihydrotestosterone

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8
Q

initial treatment of acne

A

benzoyl peroxide

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9
Q

2nd stage treatment of acne

A

retinoid + topical Ab
OR
benzoyl peroxide
+ oral Ab

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10
Q

3rd stage of acne treatment

A

topical Ab, topical retinoid, oral Ab, benzoyl peroxide, and SULFACETAMIDE

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11
Q

most severe treatment of acne

A

Isotretinoin (systemic retinoid)

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12
Q

treatment for acne if isotetrinoin doesn’t work

A

oral contraptives
spironolactone

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13
Q

topical retinoid treatment for acne vulgaris

A

tetrinoin

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14
Q

systemic retinoid treatment for acne

A

isotetrinoin

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15
Q

ALL retinoids are what

A

teratogens

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16
Q

retinoid MoA

A

bind zinc finger proteins (RAR and RXR) and induce gene expression for new kertinocytes to be formed

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17
Q

so if acne, psoriasis, and ichthyosis are due to hyperkeratosis, why do retinoids work?

A

b/c they induce formation of new keratinocytes to replace the abnormal kerinocytes causing the diseases

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18
Q

a new drug for acne that is an androgen receptor antagonist

A

Flutamide

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19
Q

not acne at all b/c no comedones; facial flushing in response to heat and other stimuli

A

Acne Rosacea

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20
Q

overproduction of IgE

A

Atopy

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21
Q

this disease is due to overproduction of IgE, increased Th2 response, and decreased filaggrin

A

Atopic dermatitis (eczema)

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22
Q

abnormal skin barrier that leads to dry and itchy skin

A

eczema

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23
Q

adult comes in with plaques looking like eczema but “they have never had it”

A

not eczema, could be sign of some other cancer

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24
Q

patient itches skin and causes what in eczema

A

rash

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25
Q

monoclonal Ab used for eczema that blocks IL-4 and IL-25 (decrease in IgE production)

A

Dupilamab

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26
Q

what happens to location of eczematous lesions with age

A

they change location and start at face and scalp

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27
Q

what stage of dermatitis in eczema does spongiosis happen

A

acute

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28
Q

what stage of dermatitis in eczema does acanthosis or lichenification happen

A

chronic

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29
Q

thickened skin w/ increased markings

A

lichenification

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30
Q

2 genetic diseases that have eczema as a feature

A

Wiskott-Aldrich
Phenylketonuria

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31
Q

in general, what 2 things to treat eczema with

A

corticosteroids and immunosuppressants

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32
Q

cyclosporine and tacrolimus are what two drugs

A

drugs used to treat eczema and they inhibit calcineurin and therefore IL-2 production

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33
Q

main corticosteroid used to treat eczema

A

prednisone

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34
Q

longterm use of corticosteroids causes:

A

dermal atrophy

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35
Q

more proliferation of cells from stratum basale, normal dequamation leads to

A

psoriasis

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36
Q

decrease in desquamation leads to

A

acne, ichthyosis

37
Q

what produces lipid envelope that surrounds stratum corneum

A

stratum granulosum

38
Q

how to get corneocyte from granulocyte

A
  1. keratin and filaggrin help disintegrate nuclear envelope
  2. cell w/out nucleus is surrounded by protein
39
Q

caused by mutation in filaggrin

A

ichthyosis vulgaris

40
Q

caused by mutation in transglutaminase or ABCA12

A

lamellar ichthyosis

41
Q

patients with hyperkeratotic disorders are heat intolerant why?

A

because they have hypohidrosis and sweat glands are unable to make secretions

42
Q

to treat ichthyosis: (remember you want keratolysis to get rid of the dead cells in corneum layer)

A

salicylic acid

43
Q

these are moisturizers that decrease water loss

A

emollients

44
Q

increase water content in stratum corneum

A

humectants

45
Q

major complication of psoriasis

A

psoriatic arthritis

46
Q

2 cytokines that activate keratinocytes

A

TNFalpha and IL-17

47
Q

keratinocytes once they are activated make their own products that do what

A

make langerhans cells more active

48
Q

increased proliferation of keratinocytes causes what

A

psoriasis

49
Q

when T cell is being activated, what allows NFAT to be made

A

calcineurin

50
Q

when T cell is being activated, what transcription factor produces IL-2

A

NFAT

51
Q

drugs that inhibit IL-2 production

A

Cyclosporin and Tacrolimus

52
Q

drug that inactivates mTOR

A

Sirolimus

53
Q

traumatized areas often develop lesions of psoriasis

A

Koebner phenomenon

54
Q

remove scale and capillary bleeds (psoriasis)

A

Auspitz sign

55
Q

decoy TNFalpha receptor that inhibits TNFalpha from binding to keratinocyte

A

Etanercept

56
Q

Infliximab
Adalimumab
certolizumab

A

block TNFalpha
used to treat psoriasis

57
Q

Secukinumab

A

blocks IL-17
used to treat psoriasis

58
Q

Brodalumab

A

binds and blocks IL-17R
used to treat psoriasis

59
Q

IL-23 is involved in what T cell differentiation

A

Th17

60
Q

Ustekinumab

A

blocks IL-23 and stops T cell differentiation

61
Q

cytotoxic drugs that inhibit T cell clonal expansion

A

methotrexate
azathioprine

62
Q

what drugs block gene expression and used to decrease inflammation

A

glucocorticoids (-ONE)

63
Q

drug that is a decoy receptor of CD28, blocking binding of APC to naive T cell

A

Abatacept

64
Q

Tretinoin and Acitretin are retinoids used to treat what

A

psoriasis

65
Q

photochemotherapy used to treat psoriasis and vitiligo

A

PUVA (Psoralen + UVA)

66
Q

happens by Ab’s attacking collagen VII

A

Epidermolysis bullosa

67
Q

kill cells by inducing cytotoxic CD8+ T cells to release granulysin

A

SJS (stevens-johnson syndrome), TEN (Toxic Epidermal Necrolysis)

68
Q

variant of TEN (toxic epidermal necrolysis) that is Nikolsky’s sign positive

A

SJS (Stevens-Johnson syndrome

69
Q

blistering autoimmune disease associated in MG and thymoma

A

pemphigus

70
Q

to treat pemphigus

A

immunosuppressors and corticosteroids

71
Q

Staph scalded skin syndrome does NOT involve what

A

mucosa

72
Q

involved in mucosa and is full thickness epidermal necrosis

A

TEN

73
Q

EPIDERMAL inflammation due to infection

A

impetigo

74
Q

when impetigo dives deep to the dermis

A

Ecthyma

75
Q

topical ointment used to treat ecthyma (impetigo that extends to dermis and also treats mild skin abscesses)

A

Mupirocin

76
Q

Herpes zoster mandibular branch of CN V: stops at the midline! if it crosses midline, then what

A

NOT herpes

77
Q

site where herpes virus remains latent

A

sensory ganglia

78
Q

to treat molluscum contagiosum

A

Imiquimod cream

79
Q

drug that is an agonist for TLR7/8

A

Imiquimod

80
Q

Excessive horny tissue induced by ray of light; can develop into SCC

A

actinic keratosis

81
Q

defective enzyme in heme synthesis can cause abnormal enzyme in skin and when exposed to light, what happens

A

natural apoptosis

82
Q

Protoporphyrin IX is used in phototherapy treatment for what

A

actinic keratosis

83
Q

Tacrolimus MoA

A

blocks calcineurin and inhibits IL-2 production

84
Q

doping agent that increases muscle mass and can cause acne

A

androgens

85
Q

diagnosis?

A

acanthosis nigricans

86
Q

what does adult patient with acanthosis nigricans most likely have

A

GI carcinoma

87
Q

what does child with acanthosis nigricans most likely present with

A

obesity, diabetes

88
Q

topical ointment has what in it for itchiness

A

anti-histamines (hydroxyzine, diphenhydramine, cyclizine)

MSK Biweekly Exam 1 (11 decks)

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