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PEDS 7500 > CLIPP 32 > Flashcards

CLIPP 32 Flashcards

1
Q

wheals vs petichiae/purpura, and purpura vs petichiae

A

wheals blanch and purpura/petechiae don’t..

purpora are larger than petchiae

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2
Q

what is a wheal

A

blanching, edematous, thin erythematous papule or plaque, often with a rim of hypopigmentation
May be white to pale red and often appear and disappear over a period of hours

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3
Q

atopic triad

A

asthma, eczema (atopic dermatitis), allergies (allergic rhinitis/hay fever)

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4
Q

Roseola

A

A viral exanthem that classically follows 3-5 days of a febrile illness.
As the fever resolves, patients develop a pink, maculopapular rash that starts on the trunk and may spread to the face and extremities.
Caused by human herpes virus-6 (HHV-6

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5
Q

Erythema infectiosum (Fifth Disease)

A

another viral exanthem - Rash starts on the face with a “slapped”-cheek appearance followed by a reticular (lacy) erythematous rash on the trunk and extremities.
Caused by parvovirus B19.

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6
Q

erythema migrans

A

Lesion associated with early localized Lyme disease.
Starts as a red papule at the site of a tick bite.
Expands to form a large erythematous, annular patch.

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7
Q

urticaria is due to

A

type 1 hypersensitvity

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8
Q

classic urticaria lesion

A

very pruritic (bc histamine release from mast cells), erythematous, edematous wheal often w/ central pallor/hypopig. these lesions continually change with new ones appearing as old ones disappear and individual lesions don’t last more than 12- 24 hours. trigger sometime can be ID’d. usually asymmetric

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9
Q

papular urticaria

A

common pediatric condition due to insect bites (i.e. kid will likely be outdoors a lot in hx) and is pruruitic, can be recurrent/chronic. lesions are 3-10mm

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10
Q

rash in streptococcal infection

A

often scarlet fever, which is fine red sandpapery rash worst at creases; can cause ~ to uriticarial rash

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11
Q

Erythema multiforme

A

symmetric, acute hypersensitivity reaction. dusky red macules become wheals become target lesions. lesions stay for 1-3 weeks and does not come and go. typically assoc w/ herpes.

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12
Q

drug eruption

A

often urticarial, can be type 1 HS but could also be non-immuno triggers

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13
Q

hives aka

A

acute urticaria, often caused by histamine release triggered by food etc or other common allergens

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14
Q

tx acute urticaria/hives

A

anti histamines, cool and calm patient (not hot bath).

-oral pred rarely used if anti histamines don’t work. topical steroids not used bc area is typically large

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15
Q

“cradle cap”

A

seborrheic dermatitis - eryhtematous plaques w/ red/yellow scale, typically on scalp but also on diaper area, ears or neck.

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16
Q

3 clues pointing to eczema

A

atopic diathesis, posterior scalp, extensor surfaces

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17
Q

candidal rash

A

7-10months old, diaper dermatitis, eryhtematous plaques w/ SATELLITE LESIONS

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18
Q

psoriasis of scalp

A

thicker and less waxy scale than seborrheic dermatitis and more defined. may or may nor be pruriitc. may have family hx of this, may have other areas on body affected too.

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19
Q

what causes seborrheic dermatitis in older people

A

malazzeia

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20
Q

tx of seborrheic dermatitis in infants and adults

A

adults = ketoconazole cream

infants =baby oil, baby shampoo or maybe ketoconazole shampoo, and / or mild topical steroid

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21
Q

blackheads vs whiteheads

A

blackheads = open comedones, whiteheads = closed comedones

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22
Q

staph folliculitis, furunculitis

A

often waist or groin area, can be similar to cystic or nodular acne

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23
Q

hidrenitis suppuritiva

A

pustular lesion causing occlusion of apocrine (vs pilosebascious in acne) and often co-infected w/ staph or strep. often affects axilla/groin areas unlike acne.

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24
Q

rosacea

A

often in adults tho early form seen in adol. no comedones. worse w/ stress, spicy food, alcohol. impacts malar and nasal areas. tx w/ metro topically

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25
Q

perioral dermaitits

A

adolescent variant of roscea w/ erhema, papules pustules but still NO comedones. not just perioral, also around eyes/nose

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26
Q

psueodfollicutusi

A

papules, not pustules thus distinct from acne due to this. often in beard area w/ papules near hair follicles and occurs when hair shaved close grows back into folilcle

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27
Q

eryhtema nodosum

A

Hypersensitivity reaction presenting as red, tender, nodular lesions on pretibial surface of the legs.
Many possible etiologies, a few of which include infections, drugs, and inflammatory bowel disease.
Primary lesions are nodules, not pustules.

28
Q

3 things known to exacerbate acne

A

mechanical (manipulation, or occlusion i.e. from helmet), make up, overzealous cleaning

29
Q

tx for mild vs mod vs severe acne

A

mild: BPO, retinoids
mod: abx topically or orally, bcp
severe: derm referral, isotretinoin

30
Q

4 key facts about retinoid timing

A

Retinoids need to be used at night, because they can cause photosensitization and lead to a significant sunburn.
Tretinoin is also inactivated by oxidation of BPO (so the BPO cream should be applied in the morning).
Tretinoin also must be applied to bone-dry skin or it may be significantly irritating.
It is important to make sure teens know that retinoids can make acne transiently look worse.

31
Q

doxycycline side effects (5)

A

photosensitivity, dental staining in children under age 9, teratogenicity, esophagitis i.e. stay upright for 30 min after taking, and pseudotumor cerebri

32
Q

dimethylglyoxime test

A

home test for nickel

33
Q

chronic contant dermatitis type of rxn

A

is delayed t4 hypersensitivity, takes 24-72h from start of contact and can occur even w prior tolerance. resolves w/i days to weeks of avoidance

34
Q

tx contact dermaitits

A

emollient lkike vaseline, aquaphor. remoev offending agent. can try medium potency topical steroid

35
Q

chronic vs acute contact dermaitist

A

acute will have vesicles, edema and erythema w/ itching

36
Q

toxicodendron/rhus genus

A

poison ivy, oak, sumac contain urshiol which is active in all seasons and on pets/objects

37
Q

is urshiol tranfersed by blister fluid?

A

NO

38
Q

tx urshiol exposure

A

wash hands w/i 30 min w/ soap/water or detergent, topical steroids/oral antihistamines if severe rash and itching. use oral steroids if widespread or increasing in size, for 10-14d

39
Q

impetigo

A

weeping honey colored crusts often below the nares, due to strep or staph

40
Q

tx impetigo

A

mupircoin. but b/c of mrsa, watch for abscess formation

41
Q

4 key steroid side effects

A

hypopig, telangiectasia, suppression HPA axis, skin breakdown/atrophy

42
Q

classes of steroids and their potency, and an example of each

A 
mild - class 7,6 (hydrocortisone acetate)
med - class 5,4 (triamcinolone acetonide)
potent - class 3,2 (betamethasone propionate)
super potent - class 1 (clobetazol)
-1000x diff between mild and super potent
43
Q

a reason infants absorb more steroid

A

bc of occlusive dressings like diapers

44
Q

pediculosis capitis

A

head lice

45
Q

tx of lice prophyalctically and missing school

A

can’t tx proph.

otherwise healthy child shouldn’t miss school due to nits (i.e. lice ova)

46
Q

current rx for lice

A

permethrin - repeated applications 2-3x in weekly intervals
benzyl alcohol if kid is older than 6 mos
malthion - if kid is older than 2y. use malthion or benzyl alcohol if failed permethrin/pyrethin or if resistance to it. also should wet comb w/ fine comb regardless.

47
Q

Lindane

A

former lice tx but can –> neurotoxicity

48
Q

scabies sx

A

itching, wosrt at night, often fingers toes wrists and elbows. often see linear lesions, can ultimately –>impetigo or even cellulitis

49
Q

scabies tx and after its gone

A

two applications of permethrin 5% cream, one week apart, for all affected household members. (oral ivermectin if allergic to permethrin)

can get post scabetic itch due to inflammation of infestation for a few weeks

50
Q

ringworm aka

A

tinea corporis, a superficial fungal infxn

51
Q

classic ringworm lesion and its dx

A

annular w/ raised borders and scaly, pururitc, w hypo pig in middle or brown.
dx w/ koh, see branches and rod shaped septated hyphae

52
Q

tinea versicolor - what iti s, predispose by, tx

A

aka malazeia.
predispose by sweat, sun, humidity
tx = selium sulfide shampoo

53
Q

which type of tine requires systemic tx, and w what

A

tine capitis - griseofulvin 6-8weeks - i.e. any involvement of scalp w/ tines –>systemic tx

54
Q

kerion

A

allergic response occurring in tine capitits - weepy boggy lesion requring oral steroids that goes away once fungus infection is controlled

55
Q

what can make tine worse

A

if misdiag as eczema and tx w/ steroid

56
Q

nummular eczema

A

coin shaped lesions on butt and legs

57
Q

pityriasis alba vs roesa

A

alba: hypo pig (due to fewer melanocytes/emlanosomes) on face, neck, upper trunk, prox extremities and assoc w/ sun exposure. don’t confuse w/ versicolor!
rosea: crhistmas tree distinction on back and trunk, upper thighs and groin. has herald patch

58
Q

christmass tree skin lesion

A

pityriasis rosea

59
Q

herald patch

A

pityriasis roesa

60
Q

home tx of warts and molluscum that works best

A

salicylic acid

61
Q

3 causes diaper rash

A

irritant is most common and spares intertrigenous creases and tx w/ barrier cream like zinc oxide, bactieral (strep perianal group a) may sees bloody streaks in stool, tx w/ oral abx, candida has satellite lesions and tx w/ nystatins, maybe azoles

62
Q

certain __ conditions can present w diaper rash

A

infalmmatory conditions - all have alarm sx of irritability, poor growth, fever etc
-examples include zinc/nutrition deficiency, malabsorption, langerhans histiocytosis (crusty weepy bloody diaper reash lesions)

63
Q

key sx that can be seen in atopic dermatitis

A

licehnification in skin flexures

64
Q

psoriaris pathophys

A

hyperprolif of keratinocytes

65
Q

type of virus that is the molluscum virus

A

poxviurs

PEDS 7500 (32 decks)

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