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dermatology > D2 > Flashcards

D2 Flashcards

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Dermatology Board Prep flashcards
1
Q

Clinical manifestation of keratoacanthoma?

A

Rapidly growing nodule with ulceration and keratin plug
Often show spontaneous regression and resolution
Common in fair skin individual
Commonly involve UV exposure and trauma site

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2
Q

Clinical significance?

A

may resemble or progress to SSC

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3
Q

managment?

A

Excisional biopsy with complete mass removal

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4
Q

SCC-Ca risk?

A

UV light
Chronic skin ulcer
Scared/inflamed skin
If occur secondary to burn wound called Marjolein ulcer
radiotherapy and osteomyelitis site are also risk

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5
Q

visual assessment of a pigmented lesion for melanoma?

A 
AbCDE(>=1-2 from below)
Asymmetry
Border irregularity
Color variation
Diameter > 6 mm
Evolving appearance over time
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6
Q

other criteria(7 point checklist and Ugley duckling sign)?

A

7PC
>=1 major and >=3 minor criteria
MjC: Change in shape, size, or color
MiC:>7 mm size, local inflammation, crusting/bleeding, and sensory symptom
UDS
One lesion significantly different from other

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7
Q

Most important prognostic factor in melanoma?

A

Breslow depth(Distance from granular layer to the tumor depth point)

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8
Q

Nodular malignant melanoma caracterstich?

A

Grow vertically
nodular lesion on a sun-exposed area
Deeply rpigmented,asymmetric & uniform color
ABCD criteria are not good for assessment
suspect in case of .>1 from the following (Ugley duckling sign, elevation from around tissue, firm palpation, and continuous growth)

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9
Q

Basal cell carcinoma risk factor?

A

Sun/Uv light
fair/light skin
Ionizing radiation
Arsenic poisoning

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10
Q

CM?

A 
Slowly growing
Locally invasive
Rare metastasis
Pink/flesh-colored
Pearly papule
Translucent
Central Telagectasis
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11
Q

Diagnosis?

A

Narrow margin 2-3 mm excisional biopsy

In the cosmetic area Mohs micrographic surgery

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12
Q

Sample taking in melanoma?

A

Excisional biopsy
2-3 mm from normal tissue
Full-thickness
But in the face and another important area, an incisional biopsy can considerd

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13
Q

Risk of Hidradinitis superlativa?

A 
Smoking
Obesity
DM
Family history
Mechanical stress
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14
Q

pathogenesis of Hidradenitis suppurativa?

A

Chronic inflammation of pilosebaceous unit-disable keratinocyte shedding from follicular epithilium

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15
Q

CM?

A

Involve intertriginous /hair area
Solitary, Inflamed, Painful nodule
Chronic relapsing and remitting course
Can become purulent and drain serosangious fluid

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16
Q

Complication?

A

Scaring
Sinus
Comedone

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17
Q

Risk factor for pressure ulcers other than immobilization?

A

Malnutrition
Dementia
Decrease skin perfusion
Decrease sensation

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18
Q

Indication for imaging in diabetic foot ulcers for osteomyelitis suspicion?

A 
Deep wound
> 14-day stay
>2 cm
increase CRP/ESR
associated adjacent ST involvement
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19
Q

Burn wound infection sign?

A 
Sign of sepsis
Progression of wound stage
Loss of graft tissue
Confusion
Decrease urine output
Thrombocytopenia
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20
Q

The pattern of infection etiology?

A

Usually multi bacterial
<5 days: G+Ve–S.Aureus
>5 days: G-Ve –Pseudomonas

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21
Q

What to do?

A

Quantitative wound culture

Biopsy(To determine depth)

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22
Q

managment?

A

Broad-spectrum(carpapenem)+
Vancomycin(MRSA)
Pseudomonas should be covered(Aminoglycoside)
wound care and debridement

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23
Q

more common in?

A

wound >20 %

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24
Q

CM of pyoderma gangrenusum?

A 
Begin with papule and pustule
Rapidly progressive
Painful ulcer  
purulent base
Vioulacious border
Pathergy(precipitation at site of trauma)
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25
Q

Epidemiology of PG?

A

Common in age 40-60 and in women

Associated with: IBD.Other inflammatory Diseases (like RA) and malignancy

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26
Q

Diagnosis?

A

Is a diagnosis of exclusion

Biopsy: Neutrophilic infiltration

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27
Q

Management?

A

Topical/systemic corticosteroid

Surgical debridement should be avoided(pathergy)

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28
Q

CM of squamous carsinoma of skine?

A

Scaly nodule/plaque
+-hyperkeratosis/ulceration
Nurologic sign(if PN involvment)
SCC in situ:Red,slowley growing patch/plaque.
Involve below and lower Lip(At vermilion border)

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29
Q

Diagnosis?

A

Dysplastic/anaplastic keratinocyte with keratin pilare

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30
Q

Adverse prognosis sign?

A

Large size
Deep involvemnt
Regional LN involvment

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31
Q

Basal cell carcinoma fetcher in the biopsy?

A

Spindele cell surounded by pallaseding basal cell

32
Q

Which skin cancer have ealy nural invasion?

A

SCC

33
Q

Whay SCC have scaley lesion which blleed and ulcerate with peeling?

A

Due to high keratinization

34
Q

Epidermal inclusion cyst pathogenesis?

A

Due to epidemis is loged ito dermis due to trauma, comedons or denovo
Form mass filled with keratin and lipid with surounded by Squamous cell.

35
Q

CM(Mass caracter)?

A 
Dome shaped
freley moving
firm
nodule/cyst
central punctum
affect fece,neck and thrunk
36
Q

Prognosis ?

A

Usually reocur
But can raptured and form chessy dischrge
Inflamed and involve surounding tissue

37
Q

managment?

A

Observation

Drain if inflamed and form cyst

38
Q

Dermatofibroma CM?

A 
Firm
Hyperpigmented
Usually involve LE
Fibrous componenet
Central dimpling
39
Q

cause of angiosarcoma after brast ca treatment?

A

Radiation
Lymphedema due to LN disection
Lead to internal lining of LV/BV proliferation

40
Q

Lesion caracter?

A

4-8 year after treatment
echimotic
or purpuritic
papular lesion on breast,axilla and UE skin

41
Q

Prognosis?

A

More agresive than primary angiosarcoma

Surgical resection is curative

42
Q

Melanoma riisk factor?

A 
>=2 familiy history
Previous history
Fair skin
prior atypical nevi
numerous>100 nevi
sever burn history
43
Q

Pressure ulcer managment?

A

Superficial:Moist dressing
Deep:Complex dressing and debridement

44
Q

superficial BCC feucher?

A

redish pach,irritated area which can bleed

45
Q

erythema multiformis pathogenesis?

A 
T cell mediated rxn
caused by
Infection like HSV,M.Pnumonia
Drug like sulfonamide
Malignancy
Collagen vascular disease
46
Q

lesion caracter?

A 
Involve all area exept genitalia
Papular
central dusky
ring of pale lesion
pheripherial erythema
Involve mucosa if sever
47
Q

managment?

A 
resolve by itself
Symptomatic therapy(topical CS or antihistamin)
48
Q

Porphyria cutanea tarda CM?

A 
affect sun exposed area
bullea
blister
scaring and calcification
Hypo/Hyperpigmentation
Associated abdominal pai and nurophychiatric menifestation
49
Q

Risk factor?

A 
HIV
HCV
Exesive alcohol
Estrogen
Smoking
50
Q

Diagnostic testing?

A

Elevated urine/plasma porphyrine
Elevated TA
Iron overload

51
Q

Pathogenesis?

A

Urophyriphirogen decarboxylase deficiency—phyriphirogen accumulate iin skine–photosensetivity rxn

52
Q

managment?

A

Phelebotomy
hydroxychloroquine
HCV Tx

53
Q

Skine disease associated with HIV?

A

Recurent herpes zoster
Sudden onset sever psoriasis
Dissiminated molluscum contagiousum

54
Q

Psoriasis CM?

A 
involve extensor surface,scalp an sacrum
plaque
erythematous
scaly
autipitiz sign
55
Q

Extra skine menifestation?

A 
Psoriatic artheritis
Naile change(pitting)
Eye inflamation(conjectivitis and uvietus)
56
Q

Pricipitating factor?

A

Trauma(kohebner phenomina)
withdrawal of GC
drug(antimaleria,endometacine & propranolol)
Infection(HIV,streeptococal pharengitis)

57
Q

CM of vitiligo?

A

Hypopigmented
Pach
afect Acral, extensor surface and face

58
Q

Clinical course?

A

In majority progress
10-20 repigmentation
associated autoimmune disease(MCC: Hashimoto and graves)

59
Q

Treatment?

A

Minor: topical GC
Major: Oral GC/Topical calcineurin inhibitor and PUVA

60
Q

Pathogenesis?

A

Autoimmune melanocyte destruction

61
Q

Tinea cruris and candidia interigo D/C in lesion?

A

CI: Moist and macerated
TC: Dry and scaly similar to Tinea corporis

62
Q

TC CM?

A

spares scrotum
caused by trichophyton rubrum
moisture and sweating increase the risk

63
Q

Managment?

A

Mild:Topical azole
Resistant: oral azoles
keep perineum clean and dry
Treat another site Tinea infection

64
Q

nummular eczema CM?

A 
Circular
scaly
fissure
pruritic
intermittent exudation(yellowish discharge)
Mostly affect extremity
65
Q

pathogenesis?

A

Dry skin(poor lipid content)–Chronic inflammation

66
Q

Risk factor for dermatophyte infection?

A

Environmental factor

Patient factor

67
Q

Environmental factor?

A

Warm, Humid environment
Direct contact with infected fomite, person, and public shower
autoinoculation(from another site tinea infection)
IC(HIV, DM, and GC therapy)

68
Q

Common drug associated with photosensitivity?

A

AB:Tetracycline(doxycycline)
APS:Chlopromazine,prochlopromazine
Diuretics:Furosamide and HCT
other:amidadrone,prometazine and piroxicam

69
Q

Pathogenesis?

A

Drug metabolite reacts with UV—ROS–damage DNA and cell membrane

70
Q

lesion type?

A

Similar to sunburn(direct DNA damage) but more painful and redder.

71
Q

what about photoallergic rxn?

A

Due to hypersensitivity RXn to systemic or topical(sunscreen) medication
Eczematous lesion

72
Q

Liches planus clinical finding?

A 
5P
papular/plaque
Pruritic
purple/pink
polygonal
lacy, White network line(Wickham stria)--mucosa
flexural area(knee, wrist)
73
Q

disease-associated?

A

HCV

Thiazide and ACE

74
Q

natural history?

A

Chronic
Associated with trauma site(Kobbner phenomena)
resolve within 2 year

75
Q

treatment?

A

Mild: Topical CS
Disseminated: systemic GC /phototherapy

dermatology (4 decks)

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