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AANP Study Cards > Derm > Flashcards

Derm Flashcards

1
Q

Characterized by acute onset of flushing, hives, angioedema, dyspnea, wheezing, tachycardia/bradycardia, hypotension hypoxia or cardiac arrest is

A

Anaphylaxis

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2
Q

What its the immediate treatment for anaphylaxis

A

epinephrine 1mg/mL 0.3-0.5mg IM

repeats q5-15 minutes if response is poor

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3
Q

Abrupt onset of fever, chills, severe headache, nausea, vomiting, photophobia, myalgia, arthraliga, and a rash that erupts 2-5 days after the onset of fever

Rash is petechial that erupts on wrists, forearms, ankles and sometimes palms and soles then to the trunk

A

RMSF

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4
Q

What is 1st line treatments of RMSF

A

Doxycycline

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5
Q

Honey-colored crusts, fragile bullae and pruritic

A

Impetigo

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6
Q

Small white round spots on the head of a red base on the buccal mucosa by the rear molars and appear 2-3 days before symptoms.

A

Koplik spots

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7
Q

Very pruritic, serpiginous rash on interdigital webs, waist, axilla and penis

A

Scabies

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8
Q

Sandpare rash with sore throat

A

Scarlet fever or scarletina

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9
Q

Hypopigmented round to oval macular rashes

A

Tinea versicolor

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10
Q

Herald patch followed by a christmas tree patterned rash

A

Pityriasis rosacea

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11
Q

Smooth papules 2-5mm in size that are dome shaped with central umbilication with a white plug

A

Molluscum contagiosum

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12
Q

Red target like lesion that grows in size, some central clearing

A

Early lyme or Erythema migrans

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13
Q

Purple to dark red painful skin lesions all over the body, acute onset of high fever, headache, changes in LOC

A

Meningococcemia

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14
Q

Swollen tender and red then blisters center of the lesion may form a purple to black eschar which becomes an ulcer when sloughed off

A

Brown recluse spinder

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15
Q

What are the sx of brown recluse spider bite

A
  • fever
  • chills
  • nausea
  • vomiting
  • bitten area becomes swollen, red, tender, and blisters appear within 24-48 hours
  • Central area becomes necrotic when this area sloughs off it leaves an ulcer
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16
Q

Dark colored moles with uneven texture, variegated colors, irregular borders with a diameter of 6mm of larger

A

Melanoma

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17
Q

Pearly or waxy skin lesaions with an atropic or ulcerated center that does not heal. May be white, light pink, brown or flesh colored, may easily bleed with trauma

A

BCC

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18
Q

Dry round, red colored lesions with a rough texture that doe not heal, in sun exposed areas are

A

Actinic Keratosis

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19
Q

What are triggers for Steven-Johnson-Syndrome

A

-meds: Allopurinol, anticonvulsants, sulfonamides, NSAISs

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20
Q

What are risk factors for Steven-Johnson-Syndrome

A
  • HIV
  • Genetics
  • Lupus
  • Malignancy
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21
Q

Acral means

A

Distal portion of the limbs

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22
Q

Annular means

A

ring shaped

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23
Q

Exanthem means

A

Cutaneous ras

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24
Q

Extensor means

A

Skin area outside of the joint

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25
Q

Flexor means

A

Area of skin on top of the joint with skin folds

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26
Q

Flexural means

A

Skin flexures are body folds

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27
Q

Intertriginous means

A

Area where 2 skin areas touch or rub together

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28
Q

Maculopapular rash means

A

Rash with color and small raised bumps

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29
Q

Morbiliform rash means

A

Rash that resembles measles (pink rash with texture)

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30
Q

Xerosis means

A

dry skin

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31
Q

Verrucous means

A

Wart like

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32
Q

Nummular means

A

Coin shaped, round

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33
Q

Serpiginous means

A

snake like

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34
Q

ABCDEs of melanoma

A 
Asymmetry
Borders irregular
Colors multiple
Diameter >6mm
Enlargement or change in size
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35
Q

Macule

A

-flat non palpable lesion <1cm

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36
Q

Papule

A

-elevated solid lesion = 0.5cm in diameter

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37
Q

Plaque

A

Flattened, elevated lesion >1cm in siz

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38
Q

Bulla

A

Elevated superficial blister filled with serous fluid >1cm in size

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39
Q

Vesicle

A

Elevated superficial skin lesion <1cm in diameter

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40
Q

Pustule

A

Elevated superficial skin lesion <1cm in size filled with purulent flud

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41
Q

Erythematous and raised skin lesions with discrete borders that are irregular, oval or round. They enlarge over minutes to hours then disappear

A

Urticaria

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42
Q

Soft wartlike fleshy growths that look pasted on the skin that range from light tan to black

A

Seborrheic Keratosis

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43
Q

Raised and yellow colored soft plaques that are usually located under the brow or upper and lower lids of the eyes on the nasal side

A

Xanthelasma

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44
Q

Bilateral brown to tan colored stains on the upper cheek, malar area, forehead and chin in pregnancy or pts on OCP

A

Melasma

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45
Q

A loss of epidermal melanocytes resulting in white patches of hyperpigmentation with irregular shapes that gradually develop and coalesce over time. Chronic and progressive

A

Vitiligo

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46
Q

What are risk factors for vitiligo

A
  • graves, hashimotos
  • RA
  • Psoriasis
  • Pernicious anemia
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47
Q

Benign small smooth round papules that are bright red. These lesions are due to a nest of malformed arterioles

A

Cherry angioma

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48
Q

Soft fatty cystic tumors that are painless and located in the subcutaneous layer of skin

A

Lipoma

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49
Q

Round macules to papules that range in color from tan to dark brown

A

nevi

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50
Q

Diffuse velvety thickening of the skin that is usually located behind the neck and the axilla it is associated with

A

Acanthosis nigricans

-associated with DM, Metabolic syndrome, Obesity, GI cancer

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51
Q

What are acrochordon

A

Skin tags

-painless and peduncultated outgrowths of skin

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52
Q

Class I Topical Steroids are ____ potency and an example is ____

A

Super high potency Halobetasol propionate 0.5%

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53
Q

Class II Topical Steroids are ____ potency and an example is ____

A

High Potency

Halcinoide 0.1%

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54
Q

Class III Topical Steroids are ____ potency and an example is ____

A

Medium High Potency

Triamcinolon acetonide

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55
Q

Class IV Topical Steroids are ____ potency and an example is ____

A

Medium

Mometasone Furate

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56
Q

Class V Topical Steroids are ____ potency and an example is ____

A

Low Medium

Desonide 0.05%

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57
Q

Class VI Topical Steroids are ____ potency and an example is ____

A

Low

Fluocinolone acetonide

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58
Q

Class VII Topical Steroids are ____ potency and an example is ____

A

Hydrocortisone 1%

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59
Q

Super high potency topical steroids are recommended for

A

severe dermatoses on non facial and nonintertriginous areas for 2 weeks

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60
Q

Medium high potency topical steroids are recommended for

A

Use on mild to moderate non facial and nonintertriginous areas

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61
Q

Low potency topical steroids are recommended for

A

use on eyes, genital area for limited duration

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62
Q

Low-medium potency topical steroids can be used on

A

Larger areas that need treatment

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63
Q

An inherited skin disorder in which squamous epithelial cells undergo rapid mitotic division and abnormal maturation

A

Psoriasis

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64
Q

New psoriatic plaque forms over areas of skin trauma

A

Koebner phenomenon

65
Q

Pinpoint areas of bleeding in the skin when psoriatic plaques are removed

A

Auspitzs sign

66
Q

What is the classic presentation of Psoriasis

A

-pruritic, erythematous plaques covered with fine silvery white scales along with pitted fingernails and toenails

67
Q

What is the medications indicated in psoriasis

A
  • topical steroids
  • Topical retinoids
  • Tar
  • Methotrexate
  • Cyclosporine
  • Biologics
68
Q

Guttate psoriasis is

A

severe form of psoriasis r/t beta hemolytic strep infection

69
Q

What is a black box warning for topical tacrolimus

A

-malignancy

70
Q

What is the treatment plan for actinic keratosis

A
  • Biopsy

- Tx options: cryo, 5-FU crea,

71
Q

What is the medications indicated in tinea versicolor

A

-topical selenium sulfid and topical azole antifungals

72
Q

Chronic inherited skin disorder marked by extermely pruritic rashes that are located on the hands, flexural folds and neck. Exacerbated by stress and environmental factors

A

Atopic dermatitis

73
Q

What is considered 1st line in the treatment of atopic dermatitis

A
  • topical steroids and emolliants
  • mild disease: Class V (Hydrocortisone 2.5%)
  • Moderate Class IV Triamcinolone
74
Q

Acute onset of 1 to multiple bright red pruritic lesions that evolve into bullous or vesicular lesions, easily rupture, leave bright red moist areas that are painful. May experience burning or stinging. When dried it becomes crusted, pruritic and lichenified , may follow a patter or shape

A

Contact dermatitis

75
Q

What is the management of contact dermatitis

A
  • stop exposure to the substance
  • topical steroids for 1-2 weeks
  • consider high potency if: skin is lichenified or does not involve face/flexural areas
76
Q

What are environmental factors that promote overgrowth of yeast

A
  • warmth
  • humidity
  • friction
  • obesity
  • diabetes
  • decreased immunity
77
Q

Bright red shiny lesions that itch or burn located in the intertriginous areas, may have satellite lesion

A

Candidiasis

78
Q

Severe sore throat with white adherent plaques with a red base that are hard to dislodge on the pharynx

79
Q

What is the treatment plan for thrush

A
  • Clotrimazole troches or miconazole buccal tablets

- Nystatin oral suspension

80
Q

For moderate to severe cases of candidiasis, first line is

A

-oral fluconazole

81
Q

What is the treatment for external candidiasis

A
  • OTC miconazole/clotrimazole

- Terconzole or ciclopirox as prescription

82
Q

What are point of entry for cellulitis

A
  • skin breaks
  • insect bites
  • abrasions
  • pre-exisitng skin infections
83
Q

Vibro vulnificus is usually related to

A

Exposure of a wound to brackish water or saltwater or eating raw oysters/clams

84
Q

Puncture wounds of the foot may be at risk for what bacteria

A

Pseudomonas aeruginosa

85
Q

Dog bites: most common bacteria

A

P. multocida, p canis, capnocytophag

86
Q

Cat bites: most common bacteria

A

Pasteurella Multocida (gram negative)

87
Q

Purulent forms of cellulitis are often caused by

88
Q

These people should avoid eating raw or undercooked oysters or clams due to the possibility of vibri vulnificus

A
  • Pregnant
  • liver disease
  • immunocompromised
89
Q

Acute onset of diffused pink to red skin that is poorly demarcated with advancing margins, the lesion feels warm to touch, may become abscessed or fluctuant.

May have lymphadenopathy, may have systemic sx.

A

Cellulitis

90
Q

Where is the most common location for cellulitis

A

lower limb

91
Q

Clenched-fist injuries have a high risk of

92
Q

Reddish to purple colored lesions that increase rapidly in size, may have bullae, appear induated with complains of severe pain on affected site

A

Necrotizing fasciitis

93
Q

Folliculitis

A

infection of the hair follicile

94
Q

What is the tx for folliculitis

A

-Mupirocin

95
Q

For small boils (furuncles) the management is

A

use warm compresses BID

96
Q

If a furuncle is >2cm you should consider

A

-draining +/- empiric antibiotic treatment

97
Q

If a furuncle is located over a joint what should you do

A

-refer to ED for x-ray to rule out osteomyelitis

98
Q

The treatment for nonpurulent cellulitis is

A 
Dicloxacillin QID x 10 days
or
Cephalexin QID 
or
Clindamycin TID
99
Q

If a patient has a penicllin allergy and non purulent cellulitis consider

A

Azithromycin x 5 days

100
Q

If you have MRSA the treatment is

A

Bactrim
Clinda
Doxycycline

101
Q

Patients with cellulitis being treated with antibiotics should show improvement in ____ hours

102
Q

A subtype of cellulitis involving the upper dermis and superficial lymphatics caused by group A strep

A

Erysipelas

103
Q

What are the sx of erysipelas

A
  • sudden onset of 1 large hot and indurated red skin lesion with clear demarcated margins
  • usually located on the lower legs or cheeks
  • accompanied by fever or chills
104
Q

What is the treatment plan for bites

A
  • Augmentin (Doxy or Bactrim flagyl or clinda if pen allergic)
  • irrigate with saline
  • wound C&S
  • tetanus prophylaxis
105
Q

You should consider a rabies shot if

A

patient has a bite from a:

-bat, racoon, skunk, fox, coyote, dogs (if not recently immunized )

106
Q

Chronic and recurrent inflammatory disorder of the apocrine glands that result in painful nodules, abscesses and pustules in locations like the axillae, mammary glands, perianal areas, groin

A

Hidradenitis suppurativa

107
Q

What are risk factors for hidradenitis suppurativa

A
  • Women
  • smoking
  • obesity
108
Q

What is the treatment plan for hidradenitis suppurativa

A
  • avoid high glycemic foods and dairy
  • smoking cessation
  • weight loss if obese
  • Topical antibiotics or oral antibiotics
109
Q

Acute onset of itchy pink to red lesions which evolve into vesiculopustules that rupture when serous fluid dries up it looks like lesions covered with honey colored crusts

110
Q

What are the treatment options for impetigo

A
  • bactroban

- severe cases: Keflex or dicloxacillin; azithro or clinda if pen allergic

111
Q

Close contacts in regards to meningitis is defined as

A
  • close proximity to a patient (<3 feet) who has had prolonged contact (>8 hours)
  • Or direct exposure to oral secretions going back 7 days before the onset of a patients sx
112
Q

The CDC recommends MCV4 vaccination for

A
  • college students living in dorms
  • military
  • persons with asplenia
  • sickle cell
  • routinely for preteens and teens (first dose at 11 and booster at 16)
113
Q

Erythema migrans is

A

a skin lesion caused by the bite of a tick infected with borrelia burgdorferi, results in a bulleye appearing lesion

114
Q

What is the test for lyme disease

A
  • 2 step testing
  • 1st step is EIA (enzyme immunoassay) if the 1st step is positive or indeterminate the second step is the IFA or western blot if both are positive the patient has lyme
115
Q

What is the treatment for early lyme

A

Doxycycline BID x 10 days

116
Q

What are complications of lyme

A

Neuropathy
Lyme arthritis
Chronic fatigue
Impaired memory

117
Q

Rocky mountain spotted fever is caused by

A

-caused by the bite of a dog tick (wood tick) that is infected with the parasite Rickettsia rickettsii

118
Q

Treatment for RMSF is most effective if started in the 1st ____ days of symptoms

119
Q

What is the diagnostic test for RMSF

A

-Antibody titres to R. rickettsii

120
Q

What is first-line treatment for RMSF

A

-Doxycycline 100mg x 7 days

121
Q

When is chickenpox and shingles contagious

A

Chicken pox: 1-2 days before onset of rash and until all lesions have crusted over

Shingles: Contagious with onset of rash until all lesions have crusted

122
Q

Prodrome of fever, pharyngitis and malaise that is followed by eruption of pruritic vesicular lesions in different stages of development over a 4 day period

A

-Chickenpox

123
Q

Acute onset of groups of papules and vesicles on a red base that ruptures and become crusted following a dermatomal patter on one side of the body.

May have a prodrome with severe pain/burning at site before the breakout

124
Q

Although history and physical alone are usually enough to make a diagnosis, The gold standard test for chicken pox or shingles is

A

Polymerase chain reaction

125
Q

What is the treatment of shingles

A

Acyclovir 5x/day or valacyclovir BID x 10 days

126
Q

Post herpatic neuralgia is best reated with

A

TCAs or Gabapentin

127
Q

Triad of ipsilateral facial paralysis, ear pain and vesicles in the ear canal

A

Ramsay Hunt Syndrome

128
Q

Herpes Zoster Ophtalmicus can result in

A

Corneal blindness so refer to opthalmology

129
Q

Woman should wait ___ to get pregnant after a varicella immunization

130
Q

Shingles vaccine is recommended as a 1 dose shot for people age

131
Q

CI to the shingles vaccine include

A

AIDS
Chronic high dose steroids
Chemo/Radiation
Immunocompromised state

132
Q

Acute onset of extremely painful red bumps and small blisters on the sides of the finger, the cuticle area or the terminal phalanx of 1 or more fingers

A

Herpetic whitlow

133
Q

Patient education regarding herpetic whitlow

A

-Cover skin lesions until they heal

134
Q

An acute local bacterial skin injection of the proximal or lateral nail folds that resolves after the abscess drains. Associated with picking a hangnail, trimming cuticle

A

Paronychia

135
Q

What are causative agents for paronychia

A
  • Staph
  • Strep
  • Pseudomonas
136
Q

What is the treatment plan for paronychia

A
  • warm water soaks

- topical antibiotic

137
Q

What is the management of pityriasis rosacea

A

-self limiting usually takes 6-8 weeks to resolve

138
Q

A pruritic rash located in the interdigital webs of hands axillae, breast, buttocks, waist, scrotum and penis. Rash appears like serpiginous or linear burrows

139
Q

What is the treatment plan for scabies

A
  • Permethrin cream
  • Treat close contacts
  • Pruritus can last up to 2-4 weeks treat itch with benadryl/topical steroids
  • Wash clothes and bedding in hot water and dry on hot setting
140
Q

KOH slid microscopy tests for

A

Tinea infections

141
Q

Black dot tinea capitis gold standard treatmemtn is

A

Griseoulvin

142
Q

What is kerion

A

Inflammatory and indurated lesions that permanently damage hair follicles causing patchy alopecia

143
Q

What is the first line treatment for mild acne

A

Topical retinoids

144
Q

If no improvement with topical retinoids add

A

Oral antibiotics Tetracyclines

145
Q

When can tetracyclines be given

A

13 years and up

146
Q

These OCP are indicated in acne

A

Desogen and Yaz

147
Q

First line management of rosacea is aimed at

A

symptom control and avoidance of triggers (spicy foods, alcohol, sunlight, toners, AHA, strong soaps)

148
Q

Small acne like papules. and pustules around nose, mouth and chin, telangiectasis may be present on the nasal area and cheeks, flushing, chronic blepharitis

149
Q

What mediations are indicated in the management of rosacea

A
  • Metrogel
  • Azelaic acid
  • Low dose Tetracyclines orally
150
Q

Dome shaped papules iwth central umbilication

A

Molluscum contagiosum

151
Q

Minor burn criteria includes

A
  • Partial thickness burns <10% of TBSA in patients 10-50 and <5% of TBSA in patients <10 and >50
  • Full thickness burns <2% of TBSA

Above plus:

  • may not involve face, hands, perineum, feet,
  • may not cross major joints
  • may not be circumferential
  • no suspicion of inhalation injury
  • no suspicion of high voltage injury
152
Q

First degree burns and management

A
  • erythema only (no blisters)
  • Cleanse with soap and water or saline
  • Ice packs x 24-48 hours
  • OTC benzocaine or aloe vera PRN
153
Q

Partial thickness or second degree burns and management

A
  • red colored with superficial blisters
  • cleanse with mild soap/water or saline
  • treat with silvadene or triple anitbiotic ointments
154
Q

Full thickness burns (3rd degree burns) and management

A
  • pain less

- involve entire skin layer, subcutaneous area and soft tissue fascia

155
Q

Rule of 9’s adult

A

arm/head: 9% each

legs/trunk: 18% each

156
Q

Rule of 9’s in child

A

arms: 9%
legs: 14%
Trunk: 18% each anterior and posteriror

157
Q

Anthrax prophylaxis is

A

Doxycyline 100mg BID x 60 days

158
Q

Use of lidocaine with epi is contraindicated on areas with high risk of ischemia

A

-tip of nose, ears, fingertips, toes and penis

159
Q

Suture removal is indicated

A

Face: 5-7 days
Scalp: 7-10 days
Upper extremities: 7 to 10 days
Lower extremities: 10-14 days

AANP Study Cards (20 decks)

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