Clin Med Final - Derm Flashcards
1
Q
papillomatosis is descriptive of
A
warts (verruca)
2
Q
rule of 9s
A
head - 9 trunk - 36 legs - 36 (18 each) arms - 18 (9 each) genitals - 1
3
Q
impetigo organism
A
S aureus, streptococci
4
Q
white scaly rash of symmetrical extensor surfaces a/w stress, AI, etc
A
psoriasis
5
Q
sensitized CD4 accumulate in epidermis and dec skin turnover rate from 23 to 5d.. dx is
A
psoriasis
6
Q
Ausptiz skin
A
tortous dialated blood vessels cause bleeding when scale lifted
7
Q
MC skin cancer
A
BCC
8
Q
solitary opalescent nodule on face w/ telangectasia
A
BCC
9
Q
how to tell freckle v lentigo
A
lentigo unresponsive to sun
10
Q
bullous form of impetigo usually affects
A
trunk/skin folds
11
Q
skin abx to cover MRSA
A
mupirocin (bactroban) TOPICAL
clinda or doxy SYSTEMIC
12
Q
painful warm red plaques w/ demarcated borders, +/- fever. affects dermis + SC
A
erispelas
13
Q
MC erispelas organism
A
GAS, S. aureus
14
Q
tender warm red area, usually UE, + fever/chills, fuzzy borders
A
cellulitis
15
Q
hot tub folliculitis organism
A
pseudomonas
…but MC folliculitis is S. aureus
16
Q
paronychia MC organism
A
S. aureus
17
Q
pediculosis means…
A
lice
18
Q
dx lice (aka pediculosis)
A
finding viable (brown) eggs or SINGLE louse
19
Q
tx lice
A
permethrin (Nix)
20
Q
intense itching of flexor wrists/hands, felt pen + alcohol reveals “path”
A
scabies
21
Q
scabies tx
A
permethrin 5% cream
tx close contacts – asym carriers
22
Q
breakfast, lunch, dinner streak
A
bed bugs
23
Q
bed bug tx
A
steroids, antihistamine, professional decontamination
24
Q
brown recluse tx
A
wash wound, TDAP
25
painless bite (violin marking on insect), becomes pink, then violaecous, then central necrosis
brown recluse bite
26
prodrome illness w/ herald salmon patch, then more patches appear along langher lines
pityriasis rosea
27
pityriasis rosea dx
exclusion...
| KOH (neg), RPR (neg)
28
pityriasis rosea tx
resolves 4-10w, priuritis relief+UVB if desired
29
Pt has lichen planus, you should consider screening them for
HCV
30
Lesion that has "6 Ps" w/ lacy Wickham striae, MC on flexor surface
lichen planus
31
Lichen planus tx
topical/injected/systemic corticosteroid, or wait it out if d/t offending agent
more concerned if oral/genital (SCC risk)
32
priuiritic "iris lesions" (dark center, w/ concentric pink, red border) following viral prodrome on dorsal hand, extensor extremities. a/w herp
erythema multiforme
33
erythema multiforme tx
tx underlying cause (HSV etc), steroid/immunosup if it's really bad
34
tinea corporis (ringworm) MC organism
T. rubrum
35
tinea versicolor (aka pityriasis versicolor) MC organism
M. furfur
36
spaghetti and meatballs KOB
tinea versicolor
37
trunk rash w/ many discrete lesions after strep
guttate psoriasis
38
how many episodes/yr for ppx HSV
6
39
treat HSV within
72h onset pain
40
"lacinating pain," Tzanck smear
HSV
41
umbilicated papules
Molluscum contagiusom
42
dx HPV
acetic acid, colposcopy
43
pt has HPV, important to tell them to do this lifestyle mod
quit smoking
44
isotretinoin actions
- dec follicular hyperkeratinization
- shrink sebaceous gland, less sebum
- inhibit p. acnes
- dec. inflam
45
what testing do you need before/during Accutane
2 neg pg tests
2 forms BC
monthly pg test
46
persistent redness of central face w/ stinging for >3mo
rosacea
47
rosacea tx
topical brimonidine + oxymetazline, moisturize+spf, laser vessel reduction, avoid triggers
48
obese smoker w/ malodor, drainage, deep painful nodules in axillary fold
hidradentis suppurativa
49
hidradentis suppurativa tx
prevention (no smoking, loose clothes), topical clinda, po tetracyclines, punch debridement..... if really bad immunosup
50
normal hairs to shed daily
100
51
90% of hairs on head are in this phase
anagen
52
circular bald patches on scalp <30 yo, w/ exclamation pt hairs
alopecia areata
53
alopecia areata tx
intralesional steroids
54
bitemporal hair loss after stress on body (emotional, surgery, childbirth, etc)
telogen effluvium
55
telogen effluvium tx
tx underlying cause, +/- minoxidil, usually resolves in <1y
56
androgenetic alopecia (male baldness) tx
minoxidil (inc anagen phase), finasteride (dec. DHT)
57
female baldness tx
minoxidul, spironolactone
58
scaly patches of alopecia
tinea capitus, tx w/ antifungal
59
onhomycosis tx length
up to 48weeks
60
topical formulation w highest ABSORBANCY (don't use it in intertriginous areas)
ointment
61
where would you general you a high POTENCY topical
palms/soles
62
eczema must be dx before age
11
63
eczema management
moisturize, steroid for flare, calcineurin inhib for refractory
64
can IgEs be positive w/ no clinical food allergy
yes
65
type I hypersensitivity rxn usually occurs within what time frame after drug is given
10 min
66
when are IgE test useful
predict PCN hypersensitivity rxn
67
what drug are you worried about given Han Chinese d/t potential SJS
allopurinol
68
typical timeline for EXANTHEMOUS skin rash a/w meds
starts 8-11d following drug, stops 2-3w after stopping
69
facial edema + rash after med
DIHS/DRESS
70
pt w/ suspected DRESS/DIHS, labs to get
CBC and LFT
| elevated lymphs, eison, AST
71
typical timeline for DIHS/DRESS
3 week after med start
72
"SATAN" meds a/w SJS/TEN
```
Sulfa abx
Allopurinol
Tetracyclines, thiacetazone
Anticonvuslant
NSAID, nevirpine
```
73
dusky purpuric macules that coalesce to flaccid blisters
SJS/TENS
74
pt w/ TENS >20 BSA should be admitted to
burn unit
75
SJS/TEN tx
STOP offending agent, hydration, vaginal dialator, monitor for ocular involvement
NO STEROIDS or PPX abx!!!
76
URI type prodrome, then bullae that easily shear leaving flaky scalded appearance
SSSS (staph scalded skin syndrome), d/t Staph's enterotoxin
77
SSSS tx
bafcillin, oxacillin, or vanco
78
CHRONIC painful flaccid bullae preceeded by mouth blisters in mid-age person, "TOMBSTONE" on bx
pemiphigus vulgaris (autoimmune)
79
PV tx
corticosteroid, IVIG, rituximab ...
80
fever, pain out of proportion w/ localized edema, +/- crepitus
necrotizing fasciitis
81
necrotizing fasciitis tx
carbapenem, fluids, surgery... serial debridements
82
systemically ill person w/ painful purpura beginning distally
purpura fulminans
83
purpura fulminans a w/ what biomarker
low protein C/S
84
MC melanoma
superficial spreading
85
rete ridges "test tube" appearance histology
psoriasis
86
psoriasis management
sea baths, UV light, emollients, OTC "Tar"
87
psoriasis flare tx
steroids or calcineurin inhib, vit D analog, retinoid.... if severe immunosup
88
calcineuin inhib watch for this SE
lymphoma/skin Ca
89
Koebner's phenomenon
when you get lesions at sites that experience trauma regularly
90
get worried if you see more than this many Cafe Au Lait Lesions
6
