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Clin Med > Clin Med Final - Derm > Flashcards

Clin Med Final - Derm Flashcards

1
Q

papillomatosis is descriptive of

A

warts (verruca)

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2
Q

rule of 9s

A 
head - 9
trunk - 36
legs - 36 (18 each)
arms - 18 (9 each)
genitals - 1
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3
Q

impetigo organism

A

S aureus, streptococci

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4
Q

white scaly rash of symmetrical extensor surfaces a/w stress, AI, etc

A

psoriasis

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5
Q

sensitized CD4 accumulate in epidermis and dec skin turnover rate from 23 to 5d.. dx is

A

psoriasis

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6
Q

Ausptiz skin

A

tortous dialated blood vessels cause bleeding when scale lifted

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7
Q

MC skin cancer

A

BCC

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8
Q

solitary opalescent nodule on face w/ telangectasia

A

BCC

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9
Q

how to tell freckle v lentigo

A

lentigo unresponsive to sun

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10
Q

bullous form of impetigo usually affects

A

trunk/skin folds

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11
Q

skin abx to cover MRSA

A

mupirocin (bactroban) TOPICAL

clinda or doxy SYSTEMIC

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12
Q

painful warm red plaques w/ demarcated borders, +/- fever. affects dermis + SC

A

erispelas

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13
Q

MC erispelas organism

A

GAS, S. aureus

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14
Q

tender warm red area, usually UE, + fever/chills, fuzzy borders

A

cellulitis

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15
Q

hot tub folliculitis organism

A

pseudomonas

…but MC folliculitis is S. aureus

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16
Q

paronychia MC organism

A

S. aureus

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17
Q

pediculosis means…

A

lice

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18
Q

dx lice (aka pediculosis)

A

finding viable (brown) eggs or SINGLE louse

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19
Q

tx lice

A

permethrin (Nix)

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20
Q

intense itching of flexor wrists/hands, felt pen + alcohol reveals “path”

A

scabies

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21
Q

scabies tx

A

permethrin 5% cream

tx close contacts – asym carriers

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22
Q

breakfast, lunch, dinner streak

A

bed bugs

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23
Q

bed bug tx

A

steroids, antihistamine, professional decontamination

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24
Q

brown recluse tx

A

wash wound, TDAP

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25
Q

painless bite (violin marking on insect), becomes pink, then violaecous, then central necrosis

A

brown recluse bite

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26
Q

prodrome illness w/ herald salmon patch, then more patches appear along langher lines

A

pityriasis rosea

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27
Q

pityriasis rosea dx

A

exclusion…

KOH (neg), RPR (neg)

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28
Q

pityriasis rosea tx

A

resolves 4-10w, priuritis relief+UVB if desired

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29
Q

Pt has lichen planus, you should consider screening them for

A

HCV

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30
Q

Lesion that has “6 Ps” w/ lacy Wickham striae, MC on flexor surface

A

lichen planus

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31
Q

Lichen planus tx

A

topical/injected/systemic corticosteroid, or wait it out if d/t offending agent

more concerned if oral/genital (SCC risk)

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32
Q

priuiritic “iris lesions” (dark center, w/ concentric pink, red border) following viral prodrome on dorsal hand, extensor extremities. a/w herp

A

erythema multiforme

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33
Q

erythema multiforme tx

A

tx underlying cause (HSV etc), steroid/immunosup if it’s really bad

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34
Q

tinea corporis (ringworm) MC organism

A

T. rubrum

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35
Q

tinea versicolor (aka pityriasis versicolor) MC organism

A

M. furfur

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36
Q

spaghetti and meatballs KOB

A

tinea versicolor

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37
Q

trunk rash w/ many discrete lesions after strep

A

guttate psoriasis

38
Q

how many episodes/yr for ppx HSV

A

6

39
Q

treat HSV within

A

72h onset pain

40
Q

“lacinating pain,” Tzanck smear

A

HSV

41
Q

umbilicated papules

A

Molluscum contagiusom

42
Q

dx HPV

A

acetic acid, colposcopy

43
Q

pt has HPV, important to tell them to do this lifestyle mod

A

quit smoking

44
Q

isotretinoin actions

A
  • dec follicular hyperkeratinization
  • shrink sebaceous gland, less sebum
  • inhibit p. acnes
  • dec. inflam
45
Q

what testing do you need before/during Accutane

A

2 neg pg tests
2 forms BC
monthly pg test

46
Q

persistent redness of central face w/ stinging for >3mo

A

rosacea

47
Q

rosacea tx

A

topical brimonidine + oxymetazline, moisturize+spf, laser vessel reduction, avoid triggers

48
Q

obese smoker w/ malodor, drainage, deep painful nodules in axillary fold

A

hidradentis suppurativa

49
Q

hidradentis suppurativa tx

A

prevention (no smoking, loose clothes), topical clinda, po tetracyclines, punch debridement….. if really bad immunosup

50
Q

normal hairs to shed daily

A

100

51
Q

90% of hairs on head are in this phase

A

anagen

52
Q

circular bald patches on scalp <30 yo, w/ exclamation pt hairs

A

alopecia areata

53
Q

alopecia areata tx

A

intralesional steroids

54
Q

bitemporal hair loss after stress on body (emotional, surgery, childbirth, etc)

A

telogen effluvium

55
Q

telogen effluvium tx

A

tx underlying cause, +/- minoxidil, usually resolves in <1y

56
Q

androgenetic alopecia (male baldness) tx

A

minoxidil (inc anagen phase), finasteride (dec. DHT)

57
Q

female baldness tx

A

minoxidul, spironolactone

58
Q

scaly patches of alopecia

A

tinea capitus, tx w/ antifungal

59
Q

onhomycosis tx length

A

up to 48weeks

60
Q

topical formulation w highest ABSORBANCY (don’t use it in intertriginous areas)

A

ointment

61
Q

where would you general you a high POTENCY topical

A

palms/soles

62
Q

eczema must be dx before age

A

11

63
Q

eczema management

A

moisturize, steroid for flare, calcineurin inhib for refractory

64
Q

can IgEs be positive w/ no clinical food allergy

A

yes

65
Q

type I hypersensitivity rxn usually occurs within what time frame after drug is given

A

10 min

66
Q

when are IgE test useful

A

predict PCN hypersensitivity rxn

67
Q

what drug are you worried about given Han Chinese d/t potential SJS

A

allopurinol

68
Q

typical timeline for EXANTHEMOUS skin rash a/w meds

A

starts 8-11d following drug, stops 2-3w after stopping

69
Q

facial edema + rash after med

A

DIHS/DRESS

70
Q

pt w/ suspected DRESS/DIHS, labs to get

A

CBC and LFT

elevated lymphs, eison, AST

71
Q

typical timeline for DIHS/DRESS

A

3 week after med start

72
Q

“SATAN” meds a/w SJS/TEN

A 
Sulfa abx
Allopurinol
Tetracyclines, thiacetazone
Anticonvuslant
NSAID, nevirpine
73
Q

dusky purpuric macules that coalesce to flaccid blisters

A

SJS/TENS

74
Q

pt w/ TENS >20 BSA should be admitted to

A

burn unit

75
Q

SJS/TEN tx

A

STOP offending agent, hydration, vaginal dialator, monitor for ocular involvement

NO STEROIDS or PPX abx!!!

76
Q

URI type prodrome, then bullae that easily shear leaving flaky scalded appearance

A

SSSS (staph scalded skin syndrome), d/t Staph’s enterotoxin

77
Q

SSSS tx

A

bafcillin, oxacillin, or vanco

78
Q

CHRONIC painful flaccid bullae preceeded by mouth blisters in mid-age person, “TOMBSTONE” on bx

A

pemiphigus vulgaris (autoimmune)

79
Q

PV tx

A

corticosteroid, IVIG, rituximab …

80
Q

fever, pain out of proportion w/ localized edema, +/- crepitus

A

necrotizing fasciitis

81
Q

necrotizing fasciitis tx

A

carbapenem, fluids, surgery… serial debridements

82
Q

systemically ill person w/ painful purpura beginning distally

A

purpura fulminans

83
Q

purpura fulminans a w/ what biomarker

A

low protein C/S

84
Q

MC melanoma

A

superficial spreading

85
Q

rete ridges “test tube” appearance histology

A

psoriasis

86
Q

psoriasis management

A

sea baths, UV light, emollients, OTC “Tar”

87
Q

psoriasis flare tx

A

steroids or calcineurin inhib, vit D analog, retinoid…. if severe immunosup

88
Q

calcineuin inhib watch for this SE

A

lymphoma/skin Ca

89
Q

Koebner’s phenomenon

A

when you get lesions at sites that experience trauma regularly

90
Q

get worried if you see more than this many Cafe Au Lait Lesions

A

6

Clin Med (12 decks)

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