Atopy

Question 1

What is healing by delayed primary intent?

Answer 1

Contaminated or devitalized tissue demarcates by 4 days

clean wound and repair

Question 2

What type of healing is done with wounds that have dehisced?

Answer 2

Secondary–surgical wounds

Question 3

What is the care for partial thickness wounds?

Answer 3

No closure, skin care only–will reepithelialize fine

Question 4

What is the major difference in the healing process between primary and secondary intent?

Answer 4

Primary has a much smaller plug than secondary

Question 5

How long is the inflammatory stage of wound healing?

Answer 5

6 days ish

Question 6

What are the three major stages of wound healing?

Answer 6

Inflammatory
Granulation/proliferation
Remodeling/maturation

Question 7

When does a wound reach its final strength?

Answer 7

12 weeks out

Question 8

Should you use abx with wounds? Why or why not?

Answer 8

No–just breeds resistance

Question 9

Why is smoking bad for wound healing?

Answer 9

Vasoconstriction

Question 10

Atopic dermatitis usually develops by what age, and resolves by what age?

Answer 10

Develops by 5 years, and resolves by adolescence

Question 11

What is the primary symptom of atopic dermatitis?

Answer 11

itch that rashes

Question 12

What are the skin findings with AD?

Answer 12

Erythematous papules, which then coalesce to form erythematous plaque that may weep

Question 13

Where is the rash commonly found with AD in infants and toddlers?

Answer 13

cheeks, forehead, and extensor surfaces

Question 14

Where is the rash commonly found with AD in older children and adolescents?

Answer 14

Lichenified rash in flexural areas of the neck, elbows, wrists, and ankles

Question 15

What does lichenified mean?

Answer 15

Plaque formation in reponse to chronic scratching

Question 16

Where is the rash commonly found with AD in adults?

Answer 16

Lichenified rash in flexural regions and in feet / face

Question 17

What is the common characteristics of AD rash in all ages?

Answer 17

Xerosis

Question 18

What percentage of children with atopic dermatitis also have or will develop asthma or allergic rhinitis?

Answer 18

50-80%

Question 19

What is the atopic triad?

Answer 19

Asthma
Atopic dermatitis
Allergic rhinitis

Question 20

What is samter’s triad?

Answer 20

Aspirin Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad or Aspirin Sensitive Asthma, is a chronic medical condition that consists of asthma, recurrent sinus disease with nasal polyps, and a sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).

Question 21

What are the factors that are thought to play a role in the development of atopic dermatitis? (4)

Answer 21

• Genetics
• Skin barrier dysfunction
• Impaired immune response
• Environment

Question 22

What is the treatment for atopy?

Answer 22

Gentle cleansing,. pat dry, and emollients

Question 23

What should be used for anti-inflammation with itching?

Answer 23

Mild steroid

Question 24

What should be used as an antipruritic for atopy?

Answer 24

Antihistamine

Question 25

What type of moisturizer should be used for itchy skin?

Answer 25

greasy without smells

Question 26

What abx should be used for itchy skin?

Answer 26

Anti staph

Question 27

What is the medium that should be used for mild steroids on the face?

Answer 27

hydrocortisone ointment

Question 28

What is filaggrin? What is its function, and role in atopy?

Answer 28

- protein found in the stratum granulosum cell layer of the epidermis - Retains water within keratinocytes - Mutations cause AD

Question 29

What is harlequin baby?

Answer 29

a severe genetic disorder that mainly affects the skin. Infants with this condition are born with very hard, thick skin covering most of their bodies. The skin forms large, diamond-shaped plates that are separated by deep cracks (fissures) lethal

Question 30

What is pityriasis alba?

Answer 30

Variant of atopic dermatitis that causes irregular, white patches

Question 31

What are the characteristics of pityriasis in the summer and winter?

Answer 31

``` Summer = hypopigmentation Winter = dry/scaly ```

Question 32

How do you differentiate pityriasis alba from fungi?

Answer 32

Woods lamp - and mycology -

Question 33

What is the treatment for pityriasis alba?

Answer 33

Emollients and mild steroid ointment

Question 34

What type of hypersensitivity reaction is allergic contact dermatitis?

Answer 34

Tpye IV

Question 35

What is the treatment for allergic contact dermatitis?

Answer 35

Topical steroids, oral antihistamine

Question 36

How long does it take for s/sx to appear with contact dermatitis?

Answer 36

12-48 hrs

Question 37

What is urticaria? What layer of the skin is affected?

Answer 37

a vascular reaction of the skin, characterized by wheals surrounded by a red halo or flare Swelling of the uppe dermis

Question 38

what is the cardinal symptom of urticaria?

Answer 38

Pruritis

Question 39

Wheal and flare = ?

Answer 39

Urticaria

Question 40

What, generally, is angioedema?

Answer 40

deep dermis and SQ swelling

Question 41

What are the s/sx of angioedema?

Answer 41

- Face edema | - Painful or burning, but NOT pruritic

Question 42

what is the appearance of angioedema?

Answer 42

Like water filled skin

Question 43

How fast does urticaria present?

Answer 43

Within minutes, and disappear within hours

Question 44

What is the difference between acute and chronic urticaria

Answer 44

- Acute = less than 6 weeks | - chronic = more than 6 weeks

Question 45

Do urticaria blanch?

Answer 45

Yes

Question 46

True or false: most urticaria is acute, and will resolve

Answer 46

true

Question 47

True or false: many patients with chronic urticaria have physical factors that contribute

Answer 47

True

Question 48

What is dermatographism?

Answer 48

fast development of urticaria following scratching

Question 49

What is the major effector cell in urticaria?

Answer 49

Mast cell

Question 50

What is immunologic urticaria?

Answer 50

Antigen binds to IgE on the mast cell surface, crosslinking it, and releasing histamine

Question 51

What is the pathogenesis of non-immunologic urticaria?

Answer 51

Drugs directly cause histamine release, no IgE crosslinking needed

Question 52

What are the three major forms of non-immunologic urticaria?

Answer 52

- Dermographism - Samter's triad - Morphine

Question 53

Morphine is a direct histamine releaser. How do you differentiate between histamine release d/t morphine, and an actual allergic reaction?

Answer 53

If distal to site of injection, then probably allergic rxn

Question 54

Does contact dermatitis have a wheal and flare rxn?

Answer 54

No--very superficial

Question 55

What is the role of allergy testing with chronic urticaria?

Answer 55

High false positive rate, and not that useful

Question 56

true or false: chronic urticaria is a continuous and lifelong disorder

Answer 56

False--episodic and limited

Question 57

What is the rate of spontaneous remission with chronic urticar at one year?

Answer 57

30-50%

Question 58

What is the treatment for chronic urticaria?

Answer 58

Oral antihistamines

Question 59

What is the inheritance pattern of C1 inhibitor deficiency?

Answer 59

AD

Question 60

What are the s/sx of angioedema?

Answer 60

Swelling of the hands, feet, and GI tract

Question 61

What is the treatment for angioedema?

Answer 61

FFP +

Question 62

True or false: angioedema is unresponsive to usual anaphylaxis treatment

Answer 62

True

Question 63

What is the type of swelling that is had with angioedema

Answer 63

Non pitting

Question 64

What antiepileptic drug is known for SJS?

Answer 64

Lamotrigine

Question 65

What are the s/sx of TEN/SJS?

Answer 65

bullous rash with sloughing off of the skin. Respiratory compromise from sloughing off of skin

Question 66

What is the treatment for TEN/SJS?

Answer 66

Admit to burn unit, and stop meds