Cumulative Final Flashcards
1
Q
need a fungal cultures for tinea capitis or unguium because
A
hard to treat, make sure you have the right organism
2
Q
atopic triad
A
Eczema, asthma and hay fever (allergic rhinitis)
3
Q
lichen simplex chronicus
A
due to constant itching of atopic dermatitis. scaly, well demarcated, rough plaques with exaggerated skin lines
4
Q
pityriasis rosea presentation and treatment
A
herald patch, then 2 weeks–>salmon colored macules in trunk and upper extremities in “christmas tree” pattern. NO TREATMENT NEEDED. its very itchy though so maybe topical steroids, po antihistamines
5
Q
what causes psoriasis
A
inflammatory/autoimmune (genetics). keratin hyperplasia (epidermal thickening/dermis is continually turning over) due to T cell activation
6
Q
what are you going to see for tinea versicolor on diagnostics (which diagnostic too)
A
KOH: “spaghetti and meatballs” hyphae and spores. ALSO yellow/green on wood’s lamp
7
Q
treat tinea versicolor
A
selenium sulfide lotion, oral fluconazole–>dont shower need to sweat it out to get to skin.
8
Q
seborrheic dermatitis occurs where
A
high sebaceous oversecretion–>scalp, face, eyebrows, body folds. fungal?
9
Q
treat psoriasis
A
-NEVER USE SYSTEMIC CORTICOSTEROID -phototherapy, high potency topical corticosteroid + Vitamin D analogs
10
Q
oval, fawn/salmon-colored, scaly plaques with collarette scale
A
Pityriasis Rosea
11
Q
seborrheic dermatitis treatment
A
-scalp: zinc pyrithione.selenium shampoo -facial and intertriginous: hydrocortisone
12
Q
what is this
A
erythema multiforme: classic target lesion 3 concentric zones of color change, found acrally on hands and feet
13
Q
benign, pruritic, TENSE blisters in flexural areas
A
bullous pemphigoid
14
Q
pruritic, VIOLACEOUS, flat-topped papules with fine white streaks; mucosal lacy lesions of buccal/vaginal mucosa; on flexural surfaces and trunk. starts at the WRIST
A
lichen planus, can develop into SCC
15
Q
burning or stinging (CNS); erythematous, dilated vessels on cheeks—telangiectasias; papules/pustules possible
A
rosacea, mc 30-50. avoid the triggers and treat with topical metronidazole or clindamycin
16
Q
rosacea vs ance?
A
neurovascular component of rosacea and comedones are in acne and absent in rosacea
17
Q
actinic keratosis
A
- prolonged sun exposure
“sandpaper pink macules/papules”
- Pre-malignant–>SCC
- treat with 5-FU/cryotherapy
–>can also get hypertrophic
18
Q
Basal cell vs SCC
A
Basal: pearly/waxy/arborizing vessels/telangestasias. mc, local infiltrating, doesnt met
SCC: more likely to met, often preceded by actinic keratosis
19
Q
A
20
Q
seborrheic keratosis
A
“stuck on” benign lesion of elderly people with sun exposure–velvety/warty
21
Q
extensor (elbows and knees) vs flexor (antecubital and knee fossa)
A
psoriasis–>extensor and nail pitting
atopic dermatitis–>flexor, atopic triad
22
Q
impetigo causative agents and treatment
A
s aureus, GAS
mupirocen
23
Q
erysipelas caused and DOC
A
group A streptococcus
(edematous hot raised circumscribed red area on *cheeks or leg)
Penicillin! (GAS)
24
Q
Edematous erythematous warm spreading plaque. chills, fever, malaise, lymphadenopathy
A
cellulitis. have to have a break in the skin (ex tinea pedis). treat with antibiotics 7-10 days. s aureus GAS common offenders.
25
treat folliculitis
mupirocin, s aureus mc. its a hair follicle infection
26
what do folliculitis and furuncle have in common
folliculitis is superficial infection of the hair follicle and furuncle/boil is deeper infection---tender nodule. i&d that shit.
27
scabies!
start in finger/toe webs/wrist.
intensely itchy
pain increases at night
scrape the skin for dx--see the mites and eggs
28
cough, coryza (runny nose), and conjunctivitis is the prodromal (pre-rash) of which viral xanthem?
rubeola/measles
29
koplik spots?
measles/rubeola, its part of the prodromal phase
30
etological agent of erythema infectiosum (5th's disease)
parvovirus B19 DNA virus
31
causative agent of rubella
rubivirus RNA virus
32
measles causative agent
paramyxoviridae
33
xanthem that could cause aplastic anemia
erythema infectiosum
34
cause of roseola
HHV 6
35
Chronic dacrostenosis presentation
yellow bacterial overgrowth from stagnant tears no other signs of infection. no swelling, redness, tenderness.
36
what may lead to a chalazion
internal hordeolum--\>memobian gland abscess. the chalazion is a chronic internal hordeolum.
37
two types of anterior blepharitis and differeniating features
staphalococcal and seborrheic (zeis and moll gland inflammation and associated eyelid skin and eyelashes
Staph: ULCERATIONS, burning sensation. bacitracin treat.
Seborreic: white skin flakes.
keep lids clean, warm cloth
38
posterior blepharitis assoc with which dermatologic condition
mebomian gland infection or dysfunction.
assoc with ROSACEA--telangectasias
if blocking the cornea or involved in the conjunctiva--\>antibiotics (tetracyclin) eye drop antis, corticosteroids topical short term
39
frothy oily tears assoc with
posterior blepharitis!
40
why do we worry about acute dacrocystitis
it could lead to preseptal or orbital cellulitis--\>systemic antibiotics
41
treat gonoccal conjunctivits
1 g IM ceftriaxone
42
chemical to the eye what are you worried about and what do you do
IRRIGATION within 5 min! alkaline cpds worse, get through cornea
43
thickening of conjunctiva with active BV growth
pteryguim and pingecula
44
white patch on cornea? and s/s
corneal ulcer, from infection, exposure keratitis, etc.
s/s: pain, redness, photophobia, tearing, reduction in vision
45
mc cause of bacterial keratitis
pseudomonas, water lovin, opaque cornea. treat with cipro drops
46
defining feature of chronic glaucoma
aka open angle glaucoma
BIALTERAL slow peripheral vision loss, "tunnel vision"
47
key defining features to postseptal orbital cellulitis--\>infection of the fat and ocular mm
decreased vision, pain with moving eyes--\>behind the septum and PROPTOSIS
preseptal wont have the vision changes or pain with eye movements
48
defining feature of dry "non exudative" macular degeneration
drusen bodies, retinal pigment dies, bilateral central vision lost GRADUALLY
49
Hallmark of wet macular degeneration
neovascularization. its more sudden vision loss.
do the anti-VEGF therapy to prevent the new blood vessel formation
50
ischemic optic neuropathy assoc with
giant cell arteritis, systemic steriods to save other eye
51
associated with multiple schlerosis
optic neuritis
52
s/s of optic neuritis
UNILATERAL vision loss over a few days, color first
central loss---central scotoma
pain with eye movements
relative afferent pupillary defect!
53
the result of increased intracranial pressure in the eye is called
papilledema: bilateral increase of blindspot
54
rapid loss of vision in 1 eye with curtain
retinal detachment
55
central and branch retinal vein occlusions
both sudden vision loss in 1 eye with no pain or redness
difference is the amount of hemorrhage
"flame shaped hemorrhages and cotton wool spots"
56
hallmark of diabetic retinopathy
macular edema, in proliferative or non proliferative
57
arteriovenous nicking and copper wiring assoc with
chronic HTN retinopathy
later stage malignant HTN gets the papilledema
58
manifest vs latent and cominant vs incominant strabismus
manifest: there, cant induce ; latent: cover uncover shows it
cominant: same in all gazes, incominant: can induce with H test
59
unequal red relfex in a kid could mean
retinoblastoma
60
strabismus can be tested with
corneal light relfex and cover/uncover
61
treatment line up for AOM in kid 1.2.3
1. amoxicillin (higher dose with single red flag like daycare)
2. augmentin (diarrhea)
3. 2nd, 3rd gen cephalosporin
62
3 mc organisms to cause OM
s pneumo, h flu, and m cat
ALSO THE SAME ONEs in Sinusitis
63
ototoxic meds
aminoglycosides, loop diuretic (furosemide), NSAIDs, acetominphen
64
when to treat OM after watchful waiting
1. kid under 2
2. symptoms \>48 hours
3. fever
4. severe pain even after analgesics
65
pseudomonas loves
otitis externa and contact lens!
66
what precipitates eustachian tube dysfunction or serous otitis media
URI or allergies---swelling/edema
"Symptoms include aural fullness, difficulty popping ears, intermittent sharp ear pain, hearing loss, tinnitus, and dysequilibrium"
67
what is this
tympanoschlerosis: recurrent inflammation from AOM or tubes.
conductive hearing loss
68
presbycusis is _____ Sensineural Hearing loss
high frequency, and speech discrimination in a crowded room
69
triad for menieres disease
episodic vertigo
tinnitus with aural fullness
fluctuating hearing loss
70
treat menieres
symptomatic
vertigo: vestibular suppressant like meclizine for the motion sickness
antiemetic for nausea
diuretics/salt restriction bc its a fluid problem, aural fullness
71
sudden and severe vertigo lasting days with associated hearing loss following URI
labrynthitis
treat with fluids, antiemetic, meclizine, and antibiotic if bacterial.
72
Best treatment for allergic rhinitis
intranasal corticosteroid (+antihistamines for immediate relief)
73
most commonly see nasal polyps in ______ rhinitis
allergic
74
lichen planus is what and can present where?
Lichen planus occurs when the immune system mistakenly attacks cells of the skin or mucous membranes.
skin or mucous membranes--\>lacy pattern on mucous membrane
75
glossitis vs glossodynia
glossitis is painless red shiny tongue assoc with nutritional deficiencies
glossodynia is "burning mouth syndrome" mc in post menopausal women. assoc with diabetes, tobacco and candida infections
76
cause of aphthous ulcer
HHV 6 and stress!
77
erythroplakia is indicative of
SCC / pre-malignancy
78
4 main things to dx pharyngitis (GAS throat)
1. fever
2. anterior cervical lymphadenopathy
3. sore throat
4. enlarged tonsils with exudate
79
treat strep throat to prevent
rheumatic fever and glomerularnephritis
80
neck masses are classified as \_\_\_\_, \_\_\_\_\_, \_\_\_\_
congenitial
inflammatory
neoplastic
81
midline neck masses
dermoid cyst vs thyroglossal duct cyst
dermoid cyst: teratoma, DOES NOT move with swallowing or tongue protrusion
thyroglossal duct cyst: moves with tongue elevation and protrusion
82
what is this
ranula. cystic lesion: block of the salivary gland, right next to frenulum
83
sialadenitis: what is it and how do you treat
bacterial inflammation of gland: parotid or submandibular
treat: massage gland, oral antibiotics, warm compress
dehydration, sjogrens contributes to the blockage and swelling
84
sialolithiasis most commonly in where
wharton duct (submandibular duct)
85
where does lugwig's angina come from
infected tooth
this is an emergency! airway obstruction!
secure airway, IV antibiotics
86
treat gonococcal in general
IM cephtriaxone
87
common causes of bacterial conjunctivitis
staph aureus, s pneumo, h flu, m cat
88
diagnostics for a corneal ulcer
fluorescein stain
89
what is this
acanthamoeba keratitis
90
what do behcets, chronhns, reactive arthritis, and psoriasis all have in common
uveitis!
mutton fat deposit/fibrin stuff and hypopyon
91
diagnostic tool for peptic ulcers
endoscopy, do biopsy too
92
PE and diagonsis of pyloric stenosis
PE: olive right after emesis
Diagnosis assisted with US
clinical picture of projectile vomit after eating as well
93
diagnostics for choledocholithiasis: common bile duct blockage (not infection)
Ultra sound and ERCP
treat: sphinterectomy and usually followed by cholecystectomy
94
treat acute cholecystitis
NPO
IV fluids
emetics
2nd gen cephalosporin
Cholecystectomy
95
charcot's triad of cholangitis?
what makes this Reynold's Triad?
jaundice, fever, RUQ pain
reynolds means its more septic: hypotension and altered mental status
96
calculating BMI (peds lecture)
weight in kg/height in meters squared
| (other is pounds/inches x 703)
97
at birth to 7 days babies lose \_\_\_\_\_\_% birth weight
at 2 weeks will be \_\_\_\_\_\_\_\_
5-10%
back to normal weight
98
0-6 mo needs _____ calories per day
110-120 cals/day
99
from 2-12 years calculate calories how
1000 + 100 cals/year
12 year old= 1000 + 100x12 = 2200
100
rule of 3's with which common pediatric problem
Colic
3/day
3 days/wk
\>3 weeks
peaks at 3 months!
101
triad for chronic pancreatitis
calcifications, steatorrhea and Diabetes Mellitus
102
erythemia infectiousum worst complication
aplastic anemia
103
if its waking you up at night it cant be IBS
has to be IBD
104
whole milk until age
2!
105
gestational age:
term for an infant
38-42 weeks
106
low birth weight is
very low birth weight is
\<2500
\<1500
107
polyhydramnios and oligohydramnios
| (normal is 1000-1500)
poly is \>2000cc and Oligo is \<500cc
108
2 newborn screenings
metabolic: PKU, galactosemia
hemoglobinopathies like sickle cell and thalasemia
109
treating chrohns UC
anti-inflamm like sulfasalazine (good for the arthritis too)
steroid
azathioprine/methotrexate
biologics
110
dx celiacs and treat
IGA blood test and bowel biopy--see flattening
gluten free, watch for TTG levels to go down
111
coffee ground hematemesis ddx
peptic ulcer, varices, gastritis, mallory weis tear (prob more normal blood), cancer
112
hemolytic uremic triad
hemolytic anemia
low platelets
acute kidney failure
113
what pediatric gut condition is suseptible to volulus
midgut malrotation.
s/s: bilous vomit, tender over area, foul stools.
MUST do an upper GI series with barium
114
sausage shaped mass
current jelly stool
sqautting
\< 2 years
intusseption
barium enema treats it!
115
\<10% is ok for weight loss early in breast fed baby.
how much does baby need to transfer per feeding?
40-60 ml
116
how much should a baby gain per day in ml
30 ml / 1 oz
117
elbow fx. what is most common for peds and adults?
1. peds supracondylar fx
2. adults is radial head fx
118
what fx is this
galeazzi.
radius fracture with distal ulnar dislocation
119
what fx is this
monteggia
proximal ulnar fracture and radius displaced at elbow
120
different injuries overhead throwing athletes get
1. SLAP labral tear
2. anterior shoulder dislocation
3. ulnar collateral ligament injury (valgus stress test)
121
colles
distal tip pointing in toward palm
122
this is demonstrating which ligament injury? treatment?
gamekeepers thumb: injury to ulnar collateral ligament
thumb can be abducted way farther
thumb spica cast 4 weeks
123
ulnar gutter splinting indicated for which common hand fracture?
boxer break (5th metacarpal)
124
this is for _______ when the DIP is hyperflexed----extensor tendon is ruptured
mallet finger, stack splint 6-8 wks
125
treat boutonniere deformity
splint finger in extension for 4-6 wks
126
Treat De Quervain's Tenosynovitis
thumb/ wrist splint
NSAIDs
steriod injections into the sheath
127
lateral epicondylitis is aggrevated by which two motions
extension and supination at the wrist
128
treat anklosing spondylitis
Options start with
1. NSAIDs
2. TNF inhibitors
3. Sulfasalazine
129
treat psoriatic arthritis
1. NSAIDs
2. MTX 10 mg 1 time per week
130
Back pain. Fill in the blanks.
1. In _______ pain is worse with extension
and
2. In ______ pain is worse with flexion
1. spinal stenosis: worse with prolonged standing/walking
2. herniated disk: sitting, lifting, coughing makes it worse
131
Risk _______ if you do not reduce a hip dislocation within 8 hours.
avascular necrosis. blood supply to femoral head.
132
potential for ______ nerve to be compromised in a posterior hip dislocation
sciatic. check for foot drop!
133
legg calve perthes
temporary AV necrosis to femoral head
egg shaped head
mc in 4-6 yo
painless limping at end of day
treat: leg braces for ABduction, eventual Total hip
134
what is the mortise view on x ray?
true AP of the ankle to see joint space, fractures
foot internally rotated
135
ottawa ankle rules on when to do an x ray
1. pain at the lateral or medial malleolus
2. ability to bear weight
3. pain at the base of the 5th metatarsal
136
three types of inflammatory arthritis
autoimmune
seronegative spondylarthropathies
erosive OA: gull wing central erosions
137
treat fibromyalgia
(characterized by trigger points, mm pain, sleep disturbances)
exercise, NSAIDs, relaxation, amitryptylline, gabapentin
138
treat acute gouty flares with
NSAIDS
Colchicine
Prednisone
139
1. characterized by pain in proximal muscles: hip and shoulder 2. common with what other condition
"can't brush hair, can't get out of chair"
1. polymyalgia rheumatica
2. \*common with giant cell arteritis\*
treat with daily prednisone
does not cause weakness like polymyositis
140
treat reiter's syndrome
1. NSAIDs
2. Sulfasalazine 1000 mg BID
141
soft tissue calcifications, gottrens papules, heliotrope rash, PAINLESS WEAKNESS
Dermatomyositis, polymyositis
high dose steriods then MTX / Azothioprine
142
common drugs to induce lupus
hydralazine, minocycline, procainamide, quinidine
143
antimalarial hydroxychloroquine to treat
lupus
144
treat raynauds
Ca channel blockers
145
treat clubfoot
plantarflexion, medial hindfoot, metatarsus adductus
passive manipulation and serial taping for 12 weeks
146
what is this and how do we treat
calcaneovalgus = intrauterine molding
stretching/passive manipulation
147
what is this and how do we treat
vertical talus
its associated with neuro symptoms: spina bifida
SURGERY ONLY
148
Torticollis highly associated with
congenital hip dysplasia
149
Intoeing
\_\_\_\_\_\_\_ common BEFORE 2
\_\_\_\_\_\_\_\_ common AFTER 2
internal tibial torsion common BEFORE 2 (intrauterine)
femoral anteversion common AFTER 2 (from W sitting\*)
150
Scoliosis degrees from cobb's measurements and what to do based on them
\<25 observe
25-45 brace
\>50 refer, surgery
151
mc breast cancer
and dx procedure of choice
infiltrating DUCTAL carcinoma, in situ is direct precursor
core needle biopsy guided by US
152
mc site for breast cancer (quadrant)
upper outer quadrant
