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Quarter 2 > Clin Med > Flashcards

Clin Med Flashcards

Exam 1

1
Q

Griseofulvin 6-12 weeks, systemic antifungal

A

Tinea Capitis

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2
Q

Kerion & Favus appear in more severe cases

A

Tinea Capitis

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3
Q

Associated sx: Cervical adenopathy, dermatophytid rxn, erythema nodosum (rare)

A

Tinea capitis

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4
Q

Caregivers of child affected by tinea capitis, athletes w skin to skin, immunocomp

A

Tinea Corporis “ringworm”

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5
Q

Itchy, annular, erythematous plaque

A

Tinea Corporis “ringworm”

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6
Q

raised advancing border

A

Tinea Corporis “ringworm”

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7
Q

DO NOT USE STEROID, can atrophy skin & alter appearance of rash

A

Tinea Corporis “ringworm”

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8
Q

Tinea Cruris “jock itch”

A

well marginated, scaly, annular plaque w/ raised border

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9
Q

Scrotum spared, pruritis & pain, starts @ inguinal fold & extend to inner thigh

A

Tinea Crurus “jock itch”

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10
Q

Most common dermatophytosis in the world

A

Tinea Pedis

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11
Q

Itchy, painful vesicles/bula following sweating

A

Tinea Pedis

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12
Q

Secondary staph infection is common d/t scratching & de-roofing vesicle

A

Tinea Pedis

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13
Q

“Moccasin Ringworm” sharp demarcation & accumulation of scales in skin crease is a chronic version of what

A

Tinea Pedis

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14
Q

“Tinea Manuum”

A

version of Tinea Pedis: 2 feet & 1 hand (the scratcher hand)

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15
Q

Tx of Tinea Pedis

A

LONGER. Clotrimazole for 4 weeks & Wet Burow’s dressing

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16
Q

Onychomycosis

A

Tx depends on type
Dermato: Oral Terbinafine
NonDermato: Itraconazole

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17
Q

Tx of Onychomycosis

A

fingernails 6 wks

toenails 12 wks

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18
Q

Most common type of onychomycosis

A

Distal subungual

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19
Q

Candidal Intertrigo

A

skin fold disease!

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20
Q

Candidal Intertrigo

A

Tx: Nystatin (topical) &

Fluconazole (systemic)

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21
Q

Erythematous, macerated (soggy) plaques and erosions in skin folds
Satellite pustules/papules
Fine, peripheral scaling

A

Candidal Intertrigo

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22
Q

Tinea Versicolor AKA Pityriasis Versicolor

A

Etio: Malassezia Furfur. Normal skin flora –> mycelial form

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23
Q

Tinea Versicolor tx:

A

Topical Antifungal: CLotrimazole, Selenium sulfide shampoo/lotion/foam, Zinc pyrithione shampoo OR
Systemic Itraconazole

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24
Q

Tinea Versicolor

A

tropical climate, teens/ young adults. NOT CONTAGIOUS

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25
Q

Macules/patches on trunk & arms, can coalesce, often have fine scale. Asymptomatic other than mildly pruritic

A

Tinea Versicolor

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26
Q

Burrow is pathognomic

A

Scabies

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27
Q

insect w/ 30 day lifespan. Eggs hatch in 10 days

A

Scabies

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28
Q

Tx of Scabies

A 
Permethrin Cream 5% (again 10-14 days later) &
Oral Ivermectin (again 14 days later)
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29
Q

Pubic Lice

A

Permethrin 1% cream

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30
Q

Acne Vulgaris

A

4 main factors: follicular hyperkeratinization, increased sebum production, cutibactreium acnes w/in follicle, inflammation

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31
Q

Rapid appearance of this w/virilization suggests underlying problem- work up for adrenal or ovarian tumer or hyperandrogenism

A

Acne Vulgaris (be cautious with rapid appearance)

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32
Q

Comedonal (non inflammatory) acne vulgaris

A

Topical Retinoid (Tretinoin cream)

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33
Q

Mild PP & mixed acne

A

Topical Retinoid, Benzoyl Peroxide, +/- Topical Abx (Erythromycin, Clindamycin)

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34
Q

Moderate PP & mixed acne

A

Topical Retinoid, Benzoyl Peroxide, and Oral Abx (Tetracycline)

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35
Q

Severe acne

A

Topical Retinoid, Benzoyl Peroxide, and Oral Abx OR Oral Isotretinoin Monotherapy

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36
Q

Tx for Acne Vulgaris in Pregnancy

A

Topical Clindamycin, Topical Azelaic acid, Oral Erythromycin (DO NOT use peroxide)

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37
Q

Erythematotelangiectactic Rosacea

A

telangiectasis.
1st line tx: behavior mod
2nd line tx: Laser light therapy, Topical Brimonidine

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38
Q

Papulopustular Rosacea

A

NO COMEDONES

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39
Q

Papulopustular Rosacea

A

1st and 2nd line: Topical

Mod-severe: Tetracyclines (doxy, mino, tetra) & Macrolides (___mycin)

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40
Q

Phymatous Rosacea (hypertrophy)

A

Tx: Early: Isotretinoin
Advanced: Surgical debulking, laser ablation

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41
Q

Ocular Rosacea

A

dry eyes, pain, itchy, blurry vision, sensitive, blepharitis, conjunctivitis, stye

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42
Q

tx for Ocular Rosacea

A

Topical abs & Cyclosporin, Oral Abx REFER OUT

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43
Q

venom includes neurotoxin causing hyperexcitability and excessive neuromuscular activity

A

scorpion sting

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44
Q

tx for Scorpion sting

A

symptomatic, Tetanus, observation

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45
Q

Do not give ____ with Antivenom

A

Benzos!

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46
Q

Local rxn bee sting

A

swelling & erythema for hours-2 days

tx: cold compress

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47
Q

Large local rxn- bee sting

A

exag erythema & swelling, getting bigger over time. lasts 5-10 days
tx: cold compress, Prednisone, Antihistamine, NSAID

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48
Q

Secondary bacterial inf d/t bee sting

A

worsenign over 3-5 days, fever

tx: abx

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49
Q

Anaphylaxis

A

IM Epinephrine

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50
Q

Widow Spider Bite- if no venom is injected

A

blanched circular patch with surrounding red perimer, central punctum

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51
Q

Widow Spider Bite- if venom is actually injected

A

Catecholamine release- intmt radiating pain, abd pain, CP, back pain, muscle spasm, local/regional sweating, hA, N/V
tx: sx, Tetanus, Muscle relaxer, Antivenom if severe

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52
Q

Recluse Spider BIte

A

Necrotic Bite! in severe cases

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53
Q

Recluse spider

A

6 eyes

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54
Q

Recluse spider bite- minor case

A

painless at first –> increase over 2-8 hrs
red plaque or papule w/ central pallow (may see bite marks)
vesiculation can occcur

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55
Q

Recluse Spider Bite- NECROTIC severe

A

dark depressed center after 1-2 days w/ chills, HA, fever and rarely- renal failure, anemia, hypotension, DIC, Rhabdomyolosis

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56
Q

Vitiligo

A

autoimmune against melanocytes. mild, white macules with homogenous depigmentation. well defined borders

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57
Q

Tx for Vitiligo

A 
Topical & systemic corticosteroids
Calcineurin inhibitor
UV phototherapy
Skin graft
Sunscreen, make up, screen for stress
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58
Q

Hidradenitis Suppurativa “Acne Inversa”

A

chronic inflammatory condition involving the hair follicle
common places: Axillary, Inguinal, Anogenital
F>M

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59
Q

Hidradenitis Suppurativa “Acne Inversa”

A

starts w/ single deep seated inflammatory nodule

Follicular occlusion –> rupture –> immune response

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60
Q

Hidradenitis Supp “Acne Inversa”

A

Purulent drainage, sinus tract, comedones, scarring

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61
Q

Tx for “Acne Inversa”

A

Local: Clinda & Intralesional Corticosteroid
Anti-androgenic agents
Systemic: Doxy or Mino
Surgery: Punch Deb or Wide Exc
Severe: TNH inhibitor & Oral Retinoid

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62
Q

Atopic Eczema

A

chronic, non contagious, inflammatory skin disease

FLG gene mutation, Type I hypersensitivity IgE mediated

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63
Q

Atopic Eczema

A

ill defined, erythematous, scaling patches –> edematous papules & vesicles

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64
Q

Complication assoc w/ Atopic Eczema

A

Eczema Herpeticum- viral infection of HSV 1

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65
Q

Tx of Atopic Eczema

A

Topical/Oral steroids
Calc Inhibitors (Pimecrolimus Elidel cream & Tacrolimus Protopic ointment)
+/- Antihistamine
Gold standard: Petroleum vaseline

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66
Q

Lichen Simplex Chronicus

A

AKA Neurodermatitis

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67
Q

Neurodermatitis/ Lichen Simplex Chronicus

A

caused by excessive itching. Leathery appearance, pigmentation, exagg skin marking
tx: STOP itching, high potency topical steroid, moist, antidepressant, antihistamine

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68
Q

Dyshidrotic Eczema/ Dyshydrosis/ Pompholyx

A

Tapioca, VERY ITCHY, vesicles coalesce & rupture

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69
Q

Dyshidrotic Eczema

A

worse with stress and hot weather

tx: Reassurance, Burow’s dressing (Domebror solution) topical steroids

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70
Q

Tx for Keratosis Pilaris

A

Topical retinoid (only adults), Urea, Salicylic acid, Alpha-hydroxy acids, cream, exf scrubs

71
Q

Allergic Contact Dermatitis

A 
Poison Ivy "uroshiol oil"
delayed type hypersensitivity 
main sx: ITCHY
Hands, Face, eyelids
Red, papular, with NONDISTINCT margins. blisters and edema
72
Q

Tx for Allergic Contact Dermatitis (Poison ivy)

A

Topical steroids 1-2x daily for 7-14 days

consider Oral steroids (Prednisone) if involving face or >20% BSA

73
Q

Exanthematous Drug Eruption- Type 4

A

Most common
“Morbilliform” or “Rubelliform”
NO mucosal involvement
Note: underlying viral condiitons can affect rxn to drug (i.e. Mono)

74
Q

Common causes of Exanthematous Drug Eruption Type 4

A

Penicillin & Sulfa

75
Q

Type I Drug Rxn

A

Urticaria (Hives)/ Angioedema

Hives- circumscribed, raised, red eruptions with central pallor

76
Q

Type I Drug Rxn

A

IgE mediated, can become more sever with repeated exposure

Common culprits: Cephalosporin & Sulfa

77
Q

Drug Induced Hypersens Synd (DIHS)

A

Common Culprits: Antiepileptic, Allopurinol, Sulfa, Minocycline, Vancomycin, Dapsone, Sulfa

fever, face swelling, morbilliform rash, lymphadenopathy, blood abn, visceral involvement

78
Q

Common causes of SJS/TEN

A 
Allopurinol
Anticonvulsant (Phenobarbital, Carbamazepine, Lamotrigine)
Sulfa
NSAIDS
Mycoplasma Pnemunae
79
Q

Common secondary comp of SJS/TEN

A

SEPSIS (Staph aureus & P. aeruginosa)

80
Q

Solar Lentigo

A

“Age spot” “senile freckle”

81
Q

Local proliferation of melanocytes, well circumscribed brown macule, BENIGN

A

Solar Lentigo

82
Q

SK Seborrheic Keratosis

A

Brown, Warty, Waxy, Stuck on appearance

83
Q

Seborrheic Keratosis SK

A

proliferation of immature keratinocytes “Barnacles of aging”

can increase to Irritated SK

84
Q

Sudden onset of SK with inflammatory base + skin tags + acanthosis nigricans

A

“Leser Trelat Sign” work up further bc this is assoc with GI and Lung CA

85
Q

Rapid growth over 6-8 wks, round flesh colored nodule w/ central keratin plug

A

Keratocanthoma

considered benign, but biopsy to be safe. some consider a less aggressive form of SCC

86
Q

AK Actinic Keratosis

A

Pre Cancer, SandPaper

“oooh-kay”

87
Q

AK Actinic Keratosis

A

Topical Fluorouracil cream is preferred. can also do: cryotherapy, photodynamic therapy, Imiquimod (aldara) cream

88
Q

AK lesion >6mm

A

consider SCC in situ

89
Q

SCC

A

2nd most common skin CA. originates from Keratinocytes

90
Q

SCC

A

funny looking growth. SCALY EXOPHYTIC, Indurated, and/or FRIABLE papule, plaque, or nodule. pink, red, or skin colored. may be itchy or tender. WARTY looking

91
Q

SCC tx

A

Wide Excision! margin based on risk.
Mohs for high risk/cosmetic
Non surgical: radiation, Imiquimod cream, Flurocil cream 5%, Photodynamic therapy

f/u every 3-6 months

Rare metastatic potential: 5%

92
Q

BCC

A

nodular, flesh colored, pearly, with TELANGECTASIA

central ulceration with rolled border

93
Q

BCC tx

A

Surgery preffered: Curettage & dessication, excision with 4mm margin, Mohs for high risk/cosmetic

94
Q

BCC tx

A

non surgical: radiation, imiquimod cream, 5% fluoric cream, photodynamic therapy

f/u every 6-12 months

95
Q

Malignant Melanoma

A

ABCDES. sneaky. superficial spreading is most common type. deep growth is most dangerous

96
Q

Malignant Melanoma

A

pigmented plaque, nodule, or papule

97
Q

Lentigo Maligna

A

a type of malignant melanoma in elderly with chronic sun exposure

98
Q

Malignant Melanoma Tx

A

Gold standard: wide surgical excision w/ 2 cm CLEAR MARGIN

f/u every 3 mo

99
Q

Measles

A

etio: Paramyxovirus

100
Q

Measles

A

3 Cs: cough, coryza, conjunctivitis

101
Q

Measles

A

“Koplik spots” tiny white spots inside mouth

102
Q

Subacute Sclerosing Panencephalitis SSPE

A

a rare complication from Measles. can occur 2-10 years after rash dissapears! death within 1-3 year

103
Q

Tx for Measles

A

sx, Vitamin A, Ribavirin?, Vaccinate!!

104
Q

Erythema Infectiosum

A 
Fifth Disease
Etio: Parvovirus B19
"SLAPPED CHEEK"
Lacy Rash!
Pain & Inf of Joints

Comp: Transient Aplastic Crisis & Pregnant Hydrops

No vaccine

105
Q

Rubella

A 
Congenital Rubella Syndrome
-Blueberry Muffin baby!
-hearing loss
-mental retardation
-cardio & eye defects
-death
85% chance of having fetal damage if mother gets infected by this
106
Q

Rubella

A

“German Measles”
3 Day Measles
Pinpoint, pink, maculopapules

107
Q

Roseola Infantum

A

DIFFERENT SPREADING PATTERN: start @ Trunk/neck —–> face/extremities

108
Q

Roseola Infantum

A

High fever –> gone –> blanching pink/red mac-pap rash

109
Q

Hand, foot, & Mouth

A

Coxsackie virus

110
Q

Molluscum Contagiosum

A 
Poxvirus
Autoinoculation
Tx: self limiting but very conagous 
resolve in 6-12 mo
Tx recommended in genital region: Podophyll cream, cryotherapy, curretage, cantharidin
111
Q

Condyloma Acuminata HPV

A

Genital warts
“cauliflower”
Tx: topical Podophyll cream, Immunotherapy, surgery-electrocautery, laser, cryotherapy, excision

112
Q

Verucca Vulgaris

A

Plantar warts
common warts
Resolve on own in 1-2 yrs but recurrence often
Seeds: tiny pigmented thrombosed capillaries

113
Q

Tx of Verucca Vulgaris

A

Salicylic acid, Cryotherapy, Electrodessication, snip or shave biopsy

114
Q

Varicella

A

“Chicken pox”
different stages: papule, ulcer, blister

rare comp: group A strep, encephalitis, Reye synd

Acyclovir (antiviral) given in immunocomp

115
Q

Herpes Zoster

A

“shingles”
elderly & immunocomp
grouped vesicles on erythematous base

Chronic comp: PHN and HZO

116
Q

PHN

A

Post Herpetic Neuralgia- lancinating pain that can last mo-yrs after lesions of shingles leave

117
Q

HZO

A

Herpes Zoster Opthalmicus- eye involvement
“Hutchinson Sign” - lesions on nose.
vision threatening linked to trigeminal ganglion activatoin

118
Q

Tx for Herpes Zoster “Shingles”

A 
Start early!!
"FAV" antivirals
Famciclover (Famvir)
Acyclovir (Zovirax)
Valacyclovir (Valtrex)
x 7 days

Chronic pain: Gabapentin (Neurontin) & Pregabalin (Lyrica)

119
Q

HSV II “Genital Herpes” tx

A

“FAV” antiviral meds
Famciclovir (Famvir)
Acyclovir (Zovirax)
Valacyclovir (Valtrex)

120
Q

Epidermal Inclusion Cyst

A

soft, mobile, fluctuant, central punctum

tx: maybe nothing, could resolve on own
Uninfected: Kenalog injection, I&D, excision
Infected: I&D, abx

121
Q

Seborrheic Dermatitis

A

yellow, greasy scale
“Cradle cap”
“Seborrheic Blepharitis”

Tx: antifungal & topical steroid

blepharitis & cradle cap: olive oil, baby shampoo, warm compress

122
Q

Pityriasis Rosea

A

“Herald Patch”
CHRISTMASS TREE rash- raised, fine scaled pink oval papules & plaques, may have “cigarette paper”

often confused with tinea- do KOH prep!

spring/fall time. teens/young adults

123
Q

Pityriasis Rosea

A

suspected cause: HHV-6/7

124
Q

Pityriasis Rosea tx

A

will go away on own in 6-8 wks
Oral Antihistamine prn
Medium strength topical corticosteorid
Sun exposure

125
Q

Lichen Planus

A

“The Four P’s!” Pruritic, purple, polygonal, papules/plaque

126
Q

Lichen Planus

A

The four Ps! “WHICKAM STRIAE” tiny white lines running through papules

WRIST, ANKLES, skin, back, penis, mouth 50%

autoimmune (T cells)

127
Q

Lichen Planus

A

“Koebner Phenomenon” develop of lesions in sites of trauma

self limited but can last 1-2 years (SO LONG, pts do not want to hear this)

128
Q

Tx Lichen Planus

A 
Topical corticoteriods
Intralesional Tramcinolone
High potency on trunk/ext
2nd line: oral steroids, phototherapy, oral Retinoid
other: cyclosporine (immunosuppresssant)
129
Q

Psoriasis

A

red plaque covered with SILVERY WHITE SCALE

130
Q

Psoriasis

A

hyperproliferation of keratinocytes

131
Q

Psoriasis

A

Koebner phenomenon- new spots at sites of lesions

Auspitz sign- scrap off scale and see tiny blood vessels

132
Q

Two types of Psoriasis that can be lethal

A

Pustular

Erythrodermic

133
Q

Tx of Psoriasis

A

Do not use oral steroids!!

134
Q

Tx of Psoriasis

A

Sunshine, bath, emolliant, occlusive dressing, rest
Group I or II corticosteroids topical
Vitamin D, coal tar, topical Retinoid, Topical Calc Inhib
Limited disease <5% BSA- Super high potency steroids
Phototherapy
Systemic therapy

135
Q

Psoriasis

A

greater than or equal to 5% BSA- needs phototherapy or systemic and refer to DERM

136
Q

PsA Psoriatic Arthritis

A

often Asymmetric joint line tenderness/effusion
Lab: ESR- Elevated Sedimentation Rate & Leukocytosis (revealing inflammation)

“Sausage digit” Dactylitis

137
Q

Tx of PsA

A

NSAIDS, DMARDS- disease modifying anti-rheumatic, Methotrexate, TNF inhibitor, Humira

138
Q

Lymphangitis

A

Red streaking extending proximally
Inflammation of LYMPHATIC channels d/t inflammation or infection
Tender

139
Q

Folliculitis

A

inflammation of hair, itching, occasional pain
Papules/ Pustules
Usually infectious- S. Aureus is most common

140
Q

Hot Tub Folliculitis

A

Gram negatie bacteria

diff type of tx: Ciprofloxacin

141
Q

S. Aureus Folliculitis

A

Tx:
Topical: Mupirocin
Oral: Cephalexin/Keflex

142
Q

MRSA tx

A

Oral Sulfa, Clindamycin, Doxycycline

143
Q

Impetigo

A

“honey colored crusting”

contagious superficial bacterial infection-common in children (auto-inoculation)

144
Q

Impetigo

A

3 types: Bullous, Non bullous, Ecthyma

145
Q

Bullous Impetigo

A 
vesicles enlarge and become flaccid bulla
Etiology: Staph Aureus
Tx: 
Topical: Mupirocin
Oral Dicloxicillin, Cephalexin
146
Q

Non Bullous Impetigo

A 
most common "honey colored crusting"
Etiology: Staph Aureus
Tx: 
Topical: Mupirocin 
Oral: Dicloxicillin, Cephalexin
147
Q

Ecthyma

A

“punched out” cigarette burn looking
Etio: Strep
Tx:
Always Oral: Dicloxicillin, Cephalexin

148
Q

No pus Cellulitis

A

usually caused by STREP
tx: Empiric
Oral: Cephalexin
IV: Cefazolin

149
Q

Pus Cellulitis

A

usually caused by STAP AUREUS

150
Q

Erysipelas (nonpurulent)

A

ELDERLY, dangerous
Sharply demarcated border with well defined margin
Cheeks & lower ext
Aggressive tx: IV or IM Cefazolin, Ceftriaxone

151
Q

Abscess (purulent cellulitis)

A

Staph Aureus
Painful, fluctuant, erythematous nodule
“Ripe? Fluid filled? Bounce back effect? ready to be drained

152
Q

Abscess tx

A

I&D w/ C&S,

+/- Abx: Trimethoprim-Sulfamethoxazole (Bactrim), Doxycycline, Clindamycin

153
Q

Purulent Cellulitis (same abx as Abscess)

A

Empiric abx with MRSA coverage

Trimethoprim-Sulfamethoxazole (Bactrim), Doxycycline, Clindamycin

154
Q

High Risk pt with MRSA

A

IV Vancomycin

155
Q

SLE- Systemic Lupus Erytematosus

A

Malar Butterfly Rash 50%- on cheeks, nasolabial folds spared

Discoid Lupus 15-30%- annular, red, scaly plaque

156
Q

Lupus tx

A

avoid sun
Topical or intralesional steroid
Hydroxychloroquine vs other systemic meds
Consider “Drug induced Lupus” *Always check med list

157
Q

Erythema Multiforme (EM)

A

“Target Lesions”
Most common etio: Herpes Simplex**
Most cases self limited w/in 2 weeks

Tx if not resolved:
\+/- topical steroids
oral antihistamine
anesthetic mouthwash
maybe Antiviral but ONLY for chronic cases (bc acute will resolve on own)
Oral steroid for severe case
158
Q

Dermatitis Herpetiformis

A

Assoc w/ Gluten Sensitivity & Celiac Disease
Very ITCHY
Herpetiform pattern- vesicles on erythematous base
Dx gold standard: DIF- Direct Immunoflourescence
Tx: Dapsone & See a dietician to learn new ways to eat

159
Q

Pemphigus Vulgaris

A

SUPERFICIAL blistering disorder
Secondary infection is leading cause of death
Flaccid bullae- rupture easily
Oral cavity most common- can spread to skin
“NIKOLSKY SIGN”
dx: DIF gold standard
Tends to be chronic recurring issue
Tx: systemic corticosteroids
Immunosupp agents
Topical Lidocaine & Dental pase w/triamcinolone acetonide 0.1% for mouth
Antibiotics

160
Q

Bullous Pemphigoid

A

DEEP, sub epithelial
not as serious as other Bullous condition
Tense blisters, do not rupture as easily
Starts w pruritis like eczema, papules or hives, progress to –> urticarial red plaques and blisters on trunk & extremities, +/- mucosal involvement
Tx: topical/systemic corticosteroids
Derm referral
maybe immunosupp agents

161
Q

Melasma/Chloasma

A

“mask of pregnancy”
cause: sun, birth control
usually goes away on its own
tx if desired: skin lightening agents, chemical peels, avoid sun

162
Q

Acanthosis Nigricans

A

hyperpigmented, velvety plaques assoc w/insulin resistance

163
Q

Hirsutism

A

hair growth in females

many causes

164
Q

Cushing disease

A

Adrenal Excess
Cushing is TOO MUCH cortisol
Acne, stretch marks-striae, skin thinning

165
Q

Addison’s Disease

A

Addison does not have enough
low cortisol
Dark, bronze skin and GUMS
affects melanin

166
Q

Hyperthyroidism

A

“Orange peel appearance” to skin assoc w/ Grave’s disease- non pitting, scaly, thickening skin
Pretibial Myxedema
warm, wet, sweaty skin

167
Q

Porphyria Cutanea Tarda

A

Painless, sub-epidermal blistering of sun exposed areas
Heme synth problem
Not enough UROD leads to EXCESS PORPHYRINS
dx: look for elev porphyrins in urine and serum. look for elev iron

Tx: Phlebotomy to reduce iron levels, discontinue & treat potential cause

168
Q

Pressure Ulcer

A

4 phases:

  1. intact skin w/localized redness (transparent film for protection)
  2. partial thickness skin loss w/exposed dermis (dressing that maintains moist environ. as long as it’s not infected)
  3. full thickness skin loss WITH ADIPOSE visible, eschar maybe visible
  4. full thickness skin loss WITH exposed MUSCLE< TENDON, BONE, or FASCIA. eschar and rolled edges visible. look for tunneling (Debridement of nectrotic tissue, appropriate dressing, +/- abx)
169
Q

Lyme Disease

A

tick attached for at least 36 hours
Etio: Borrelia Burgdorferi
Rash: ERYTHEMA MIGRANS- Bullseye rash!!
Rash occur w/in 7-14 days
Sx progress to cardiac, arthritis, neurologic
Bell’s dx: consider Lyme disease in ddx
After 36 hours, option of single dose of Doxycycline to reduce risk of chronic comp

170
Q

Rocky Mountain Spotted Fever

A

only takes 6 hours of tick attachment!!
Etio: Rickettsia rickettsia
Usually rash (90%) within 3-5 days
Macular–> PETECHIAL lesions. ANKLES, WRISTS, PALMS, & SOLES, and then trunk
Treat if you have any suspicion!! 10% never get rash and this can be potentially lethal
Tx with Doxycycline

171
Q

Lichen Planus

A

“Whickam’s striae” tin white lines running through purple papules
“Koebner Phenomenon” new lesions in areas of trauma

172
Q

Psoriasis

A

“Koebner Phenomenon” new lesions in areas of trauma

“Auspitz sign” punctate spots of bleeding when plaque removed

173
Q

Koplik spots

A

Measles

174
Q

Pink, pinpoint maculopapules

Arthralgia is common in adults

A

Rubella

Quarter 2 (16 decks)

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