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M&M Test 4 > B6-029 CBCL Skin Infections and Rashes > Flashcards

B6-029 CBCL Skin Infections and Rashes Flashcards

1
Q

a patient with adult onset eczema should raise suspicion for […]

A

T cell lymphoma

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2
Q

[…] proven allergy indicates atopic dermatitis

A

IgE

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3
Q

flat lesion <1 cm with well circumscribed change in skin color

A

macule

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4
Q

macule > 1 cm

A

patch

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5
Q

elevated solid skin lesion < 1cm

A

papule

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6
Q

papule > 1 cm

A

plaque

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7
Q

small fluid containing blister < 1cm

A

vesicle

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8
Q

large fluid containing blister > 1 cm

A

bulla

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9
Q

vesicle containing pus

A

pustule

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10
Q

transient smooth papule or plaque

A

wheal

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11
Q

flaking of stratum corneum

A

scale

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12
Q

dry exudate

A

crust

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13
Q

epidermal accumulation of edematous fluid in intercellular spaces

A

spongiosis

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14
Q

maculopapular -> ulcerative rash with mucocutaneous involvement

A

SJS

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15
Q

more severe form of SJS
presents with fever, macules, bullae, necrosis, anemia

A

TEN

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16
Q

extensive maculopapular rash with multi-organ involvement, eosinophilia, and lymphadenopathy

A

DRESS

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17
Q

T cell mediated hypersensitivity that can cause AKI, liver damage, SOB, and cardiac involment

A

DRESS

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18
Q

what gene is associated with eczema?

A

filaggrin

**more filaggrin is better

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19
Q

VZV/HSV produce

A

vesicles

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20
Q

umbilicated papule

A

molluscum

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21
Q

labs for suspected fungal infection [2]

A

fungal blood culture
fungal serologic testing

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22
Q

large area of extending erythema with some scaling

A

cellulitis

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23
Q

presents in skin creases with erythema or hyperpigmentation with associated satellite lesions

A

candidiasis

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24
Q

contact dermatitis would typically present with what skin finding?

A

vesicles

(i.e. from a plant)

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25
Q

starts with a maculopapular rash
multi-organ involvement
eosinophilia

A

DRESS

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26
Q

SJS with > 10% body surface involvement

A

TEN

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27
Q

type I hypersensitivity is […] mediated

A

IgE

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28
Q

urticaria
angioedema
pruritis

all examples of skin involvement of […] hypersensitivity reactions

A

type I

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29
Q

[…] is characteristic of DRESS and occurs in 95% of cases

A

eosinophilia

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30
Q

organ involvement in DRESS most classically affects what two organs?

A

liver
kidney

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31
Q

pruritis with scaling

A

eczema

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32
Q

sandpaper like rash characteristic of drug eruption

A

maculopapular rash

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33
Q

urticarial symptoms associated with explosive diarrhea and cramping abdominal pain
often presents after dinner (at night)

A

alpha-gal allergy (from tick bite)

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34
Q

autoimmune causes of systemic urticaria [4]

A

lupus
RA
autoimmune thyroid disease
vasculitis

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35
Q

cold induced urticaria is associated with

A

Hep C

*cryoglobulinemia

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36
Q

malignancies that can cause systemic urticaria [2]

A

multiple myeloma
lymphoma

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37
Q

mutation in NLRP3 gene
inflammation causes multi-organ damage [2]

A

Muckle-Wells (Neonatal Multisystem Inflammatory Disorder)
Familial Cold Autoinflammatory Syndrome

NLRP3 activates capsase 1 which cleaves IL-1B
mutation results in excessive activation of this pathway
Can be treated with IL-1 inhibitors (anakinra)

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38
Q

treatment for dishydrotic eczema

A

topical corticosteroid

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39
Q

rash is worse in summertime due to excessive sweating

A

dishydrotic eczema

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40
Q

most common cause of flares of atopic dermatitis

A

non-adherence, is reviewed at every visit

41
Q

urticaria associated with weight gain, constipation, and hair loss could be attributed to

A

autoimmune thyroid disease

42
Q

help with decolonization of the skin in infected eczema patients

A

bleach baths

43
Q

testing for delayed T cell mediated hypersensitivites

A

patch testing

44
Q

pathogens that can cause skin infections in immunocompromised invididuals

A

mold
dimorphic fungi
yeast
nocardia
syphilis
mycobacteria
parasites

45
Q

what sort of testing is done for hives that are due to airborne causes?

A

skin prick testing

46
Q

what sort of testing would be performed on someone who has a rash every time they wear costume jewelry?

A

patch testing

47
Q

warning signs of systemic disease with chronic urticaria

A

weight changes
lymphadenopathy
arthralgias
myalgias
fevers
chills
night sweats

48
Q

adult onset eczema should raise suspicion of

A

cutaneous T cell lymphoma

49
Q

highly contagious skin infection involving superficial epidermis
honey colored crusting

A

impetigo

50
Q

impetigo is usually caused by [2]

A

S. aureus
S. pyogenes

51
Q

infection involving upper dermis and superficial lymphatics, usually from S. pyogenes
present with well defined raised demarcation between infected and normal skin

A

erysipelas

52
Q

acute, painful spreading infection of deeper dermis and subcutaneous tissues
usually caused by S. aureus, S. pyogenes

A

cellulitis

53
Q

umbilicated papules caused by a poxvirus

A

molluscum contagiosum

54
Q

chracterized by fever, bullae formation, and necrosis
sloughing of skin at DEJ

A

SJS

55
Q

often associated with asthma and allergic rhinitis

A

atopic eczema

56
Q

filaggrin is associated with

A

eczema

57
Q

[allergic or irritant contact dermatitis]
in response to dyes, fragrances, medications, metals, plants, synthetic compounds

A

allergic contact dermatitis

58
Q

[allergic or irritant contact dermatitis]
delayed T cell dependent immune reponse

A

allergic contact dermatitis

59
Q

[allergic or irritant contact dermatitis]
causes pruritis

A

allergic contact dermatitis

60
Q

[allergic or irritant contact dermatitis]
requires sensitization before elicitation
occurs 24-72 hours after exposure

A

allergic contact dermatitis

61
Q

[allergic or irritant contact dermatitis]
patch test positive

A

allergic contact dermatitis

62
Q

[allergic or irritant contact dermatitis]
due to irritants or “wet workers”

A

irritant contact dermatitis

63
Q

[allergic or irritant contact dermatitis]
non-immunologic; caused by direct cytotoxicity

A

irritant contact dermatitis

64
Q

[allergic or irritant contact dermatitis]
burning, pain, maybe pruritis

A

irritant contact dermatitis

65
Q

[allergic or irritant contact dermatitis]
may appear after first contact
can occur minutes to weeks after exposure

A

irritant contact dermatitis

66
Q

[allergic or irritant contact dermatitis]
patch testing negative

A

irritant contact dermatitis

67
Q

[acute/subacute/chronic atopic dermatitis]
intensely pruritic, erythematous papules, excoriations, vesiculations, and serous exudate

A

acute atopic dermatitis

68
Q

[acute/subacute/chronic atopic dermatitis]
erythematous, excoriated, scaling papules

A

subacute atopic dermatitis

69
Q

[acute/subacute/chronic atopic dermatitis]
thickened skin with lichenification and fibrotic papules

A

chronic atopic dermatitis

70
Q

complicating feature of atopic dermatitis that can cause corneal scarring and visual impairment

A

atopic keratoconjunctivitis

71
Q

occupational disability caused by repeated hand washing, hand sanitizing

A

hand dermatitis

72
Q

dermatitis increases susceptibility to colonization with

A

S. aureus

73
Q

treatment of molluscum contagiosum

A

destruction
cryotherapy
laser
imiquimod

74
Q

“soak and seal” therapy is a mainstay of atopic dermatitis treatment and involves [3]

A

hydration and topical creams
bleach baths for infections
wet wraps

75
Q

first line therapy for xerosis (dry skin)

A

topical moisturizers/emollients

76
Q

topical calcineurin inhibitors are equivalent to […] potency steroids

A

mid-potency

Calcineurin inhibitors inhibit the production of IL-2, resulting in decreased activation of T cells

77
Q

med option for adults with moderate to severe AD/CD who fail other therapies

A

PUVA

78
Q

IL4-Ra antagonist approved for use in AD down to infants 6 months of age

A

dupilumab

**all others are only approved in 12 y/o+

79
Q

first line therapy in AD if greater than 20% body surface area is involved

A

systemic corticosteroids

80
Q

most common cause of IgE mediated urticaria

A

beta-lactam antibiotics

(penicillins, cephalosporins)

81
Q

most common cause of T cell mediated rash

A

sulfa based antibiotics

(Trimethoprim-Sulfamethoxazole, sulfasalazine)

82
Q

urticaria with anaphylaxis and angioedema can result from

A

insect sting

83
Q

serum sickness and transfusion reactions cause […] mediated urticaria

A

complement mediated

84
Q

progesterone can cause urticaria via direct […]

A

mast cell activation

85
Q

vancomycin flushing syndrome is caused by direct […]

A

mast cell activation (Type 1 HS)

86
Q

rare autosomal dominant disease that causes the oversecretion of IL-1B [2]

A

familial cold auto inflammatory syndrome
muckle wells

87
Q

treatment of familial cold auto inflammatory syndrome

A

anakinra

Like Muckle Wells, this is also caused by a mutation in NLRP3

88
Q

common in children, generally not pruritic
fixed maculopapular rash that persists for days
associated with viral infection

A

viral exanthems

(i.e. measles, rubella, roseola)

89
Q

recurrent painful inflammatory papules and plaques associated with fever, arthralgias, and peripheral leukocytosis in adults

may have a hx of febrile illness in past 1-3 weeks

A

Sweet’s syndrome

Amboss: An inflammatory skin condition that manifests with sudden-onset fever and painful skin lesions (erythematous papules, plaques, and nodules). Associated with infections (e.g., upper respiratory, gastrointestinal), malignancy (e.g., acute myeloid leukemia), inflammatory bowel disease, pregnancy, and certain medications (e.g., granulocyte-colony stimulating factor).

90
Q

round/oval sharply demarcated pink lesions of adults in chest, neck, back
lasts for days to weeks
“Herald patch”, can have scale or central clearing of lesions

A

pityriasis rosea

91
Q

FDA approved for the treatment of chronic idiopathic urticaria
works for almost all patients with chronic urticaria

A

omalizumab

92
Q

anti-IgE therapy

A

omalizumab

93
Q

what laboratory test can help evaluate for vasculitis in chronic urticaria?

A

C4

94
Q

what laboratory test can help evaluate for thyroid abnormality in chronic urticaria? [3]

A

TSH, anti-TG, anti-TPO

95
Q

what laboratory test can help evaluate for food or aeroallergens in chronic urticaria?

A

skin testing
IgE testing

96
Q

what laboratory test can help evaluate for systemic disease in chronic urticaria? [5]

A

ANA
TSH
cryoglobulins
Hep B and C
SPEP

97
Q

used to rule out vasculitis in chronic urticarial lesions lasting >48 hours or that are painful, ecchymotic, petechiae

A

4 mm punch biopsy

98
Q

chronic urticaria with prolonged, purpuric lesions that are not as pruritic

A

urticarial vasculitis

99
Q

cryoglobulinemia with chronic urticaria is associated with

A

Hep C

M&M Test 4 (14 decks)

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