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Derm Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the four types of tissue?

A

Muscle
Nervous
Epithelial
Connective

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2
Q

What type of tissue generates physical force to make the body structure move and is arranged in bundles

A

Muscle tissue

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3
Q

What tissue has the poorest capacity for renewal and initiates/transmits nerve impulses that coordinate body activities and maintain homeostasis

A

Nervous tissue

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4
Q

What tissue has the best capacity for renewal

A

Epithelial

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5
Q

What tissue covers body surface, lines body cavities, hollow organs and ducts and forms glands

A

Epithelial tissue

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6
Q

What tissue protects and supports the body and its organs as well as provides immunity

A

Connective tissue

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7
Q

What provides contact or adhesion between neighboring cells or between a cell and extracellular matrix. They also maintain paracellular barrier of epithelia and control transport of materials or signals between cells (paracellular transport)

A

Cell junctions

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8
Q

What forms a barrier against water and antigens passing between individual epithelial cells

A

Tight junctions

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9
Q

What are cell-cell adhesions continuously assembled and disassembled so cells can respond changes in their micro environment

A

Adherens junction

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10
Q

What forms stable adhesive junctions between cells

A

Desmosomes

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11
Q

What allows various molecules and electrical signals to pass freely between cells

A

Gap junctions

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12
Q

What facilitates the stable adhesion of basal epithelial cells to the underlying basement membrane

A

Hemidesmosomes

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13
Q

What are the two categories of epithelial tissue

A

Covering and lining epithelium
Glandular epithelium

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14
Q

What is the most superficial layer of cells in epithelial tissue anatomy

A

Apical layer

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15
Q

What is the deepest layer of cells in epithelial tissue anatomy

A

Basal layer

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16
Q

What layer helps bind and support the epithelium and is located between the epithelium and underlying connective tissue layer

A

Basement membrane

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17
Q

What are two ways to classify epithelial tissue

A

Morphology - based on shape
Stratification - number of layers

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18
Q

What are thin, flat shaped to allow rapid passage of substances through them and can be keratinized or non-keratinized, “wet” or “dry” depending on their location in the body

A

Squamous epithelium

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19
Q

What type of epithelium frequently has microvilli at apical surface

A

Cuboidal epithelium

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20
Q

Where is cuboid epithelium found

A

Found in areas such as salivary glands and thyroid follicles

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21
Q

What type of epithelium protect underlying tissues and the apical surfaces may have cilia or microvilli

A

Columnar epithelium

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22
Q

What type of epithelium is useful for organs such as the urinary bladder when it is stretching to a larger size

A

Transitional epithelium

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23
Q

What is a single layer of cells that functions in a diffusion, osmosis, filtration, secretion and absorption

A

Simple epithelium

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24
Q

What is a simple epithelium that appears be stratified because the cell nuclei lie at different levels and not all cells reach the apical surface

A

Pseudostratified epithelium - single layer
- one specialized type of pseudo stratified cell are goblet cells, which secrete mucus and are an integral part of mucous membranes

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25
Q

Cells that do extend to the apical surface may contain what

A

Cilia

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26
Q

In mammals, what helps remove contaminates or move move particles by movin fluids over the cell layers. For example, the lining of the nasopharyngeal and Trachea are covered in it to remove mucus, bacteria and other debris from the lungs as well as the Fallopian tubes

A

Cilia

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27
Q

What increases the surface area of a cell by multiplying the area from 2 dimensions to 3 dimensions

A

Microvilli

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28
Q

What is a highly-insoluble fibrous protein with water proofing qualities and high friction resistance

A

Keratin

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29
Q

What are epithelial cells infused with keratin in the stratum basale of the epidermis called

A

Keratinocytes

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30
Q

Where is non-keratinized stratified epithelium found at

A

Found on wet/inferior surfaces exposed to considerable wear and tear such as the lining of the mouth, tongue, pharynx, esophagus and vagina

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31
Q

What type of tissue is bone, blood, lymph and cartilage

A

Connective

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32
Q

What are the three components of connective tissue

A

Resident cells -grapes in jello
Extracellular matrix (ECM) - jello
Protein fibers

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33
Q

What is the most common cells in connective tissue and is a major component of the reparative capacity of the tissue

A

Fibroblasts

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34
Q

What are fat cells specialized for cytoplasmic storage of lipid as neutral fats or less commonly for production of heat

A

Adipocytes

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35
Q

What is a component of loose connective tissue often located near small blood vessels in the skin and its function is localized release of compounds important to inflammatory response, innate immunity and tissue repair

A

Mast cells

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36
Q

What is the most abundant connective fiber that is very strong and resistant to shear forces

A

Collagen fibers

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37
Q

What are the connective tissue fibers

A

Collagen
Elastic
Reticular

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38
Q

What connective fiber provides strength and support in the walls of the small blood vessels. Stroma supporting framework of many soft organs; most notably the immune system, liver, endocrine glands, spleen and lymph nodes

A

Reticular fibers

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39
Q

What lines the entire GI, respiratory, reproductive and much of the urinary system

A

Mucous membranes

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40
Q

What is the general function of mucous membranes

A

Prevent cavities from drying out

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41
Q

What membrane lines a body cacvity that doesn’t open directly to exterior and covers organs that lie within the cavity

A

Serous membrane

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42
Q

What type of membrane lines the joints and secretes fluid to reduce friction, lubricate and nourish cartilage and removes microbes/debris from the joint cavity

A

Synovial joints

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43
Q

What is the surface layer of the skin that is not alive and comprised of epithelial tissue

A

Epidermis

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44
Q

What lies inferior to the epidermis and comprised of connective tissue. (Is alive)

A

Dermis

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45
Q

What is the top layer of the epidermis where cells consist mostly of keratin and where cells are shed and replaced from below

A

Stratum corneum

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46
Q

What layer of the epidermis is found only on the palms and soles of the hands and feet

A

Stratum lucidum

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47
Q

What layer of the epidermis loses cell organelles and nuclei as well as infusion of waterproofing lipids

A

Stratum granulosum

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48
Q

What layer of the epidermis is where cells begin to look flattened

A

Stratum spinosum

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49
Q

What is the bottom layer of the epidermis which is the stem cell layer and new cells arise here

A

Stratum basale

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50
Q

What layer of the skin contains the terminal ending of capillaries, lymph vessels and sensory neurons

A

Dermis

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51
Q

What is within the reticular region of the dermis

A

Roots do the hair
Sebasceous glands
Sweat glands
Receptors
Nails
Blood vessels

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52
Q

What is specialized cells of the epidermis and hair follicle and its primary function is to synthesis and transfer melanin to adjacent keratinocytes

A

Melanocytes

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53
Q

What cells touch and pressure are sensed by four types of mechanoreceptors in the skin and are expanded dendritic endings in epidermis of glabrous skin that responds to sustained pressure and touch

A

Merkel cells

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54
Q

What cells are typically found within the stratum spinosum. These monocyte-derived cells represent a large part of the skins adaptive immunity

A

Dendritic cells

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55
Q

What glands release secretions directly into the bloodstream

A

Endocrine glands

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56
Q

What gland releases secretions onto a epithelial surface via a duct

A

Exocrine glands - major role in derm

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57
Q

What is an exocrine gland in the skin that opens into a hair follicle and secretes an oily/waxy sebum

A

Sebaceous glands - sebum lubricates the hair in humans and mammals

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58
Q

What gland covers nearly the entire body surface and is especially dense on the palms, soles, forehead and upper limbs. It also empty’s directly onto the skins surface but not from the hair follicles

A

Sudoiferous - Eccrine glands

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59
Q

What gland is largely confined to the axillae, perineum and the concentrated hairy areas. it is attached to the hair follicle and empties onto the skin via the follicle opening

A

Apocrine glands

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60
Q

Which gland becomes active at puberty and have a hormonal pattern

A

Apocrine glands

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61
Q

What is the whitish crescent at base of nail plate

A

Lunula

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62
Q

What is the function of the nails

A

Protects the distal phalanges and surrounding soft tissue from injuries. It also enhances precise and delicate finger movements by exerting counter pressure on the puls of the fingers when grasping and manipulating objects

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63
Q

What color will the skin turn with a lack of oxygen

A

Blue

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64
Q

What color will the skin turn due to a buildup of bilirubin

A

Jaundice/ yellow

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65
Q

What color will the skin turn due to an engorgement of capillaries in the dermis with blood

A

Red

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66
Q

What color will the skin turn if someone is in shock or has anemia

A

Pale

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67
Q

What are the three main pigments that influence skin pigmentation

A

Melanin
Carotene
Hemoglobin

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68
Q

What is the primary determinant of skin color, hair color and eye color

A

Melanin

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69
Q

True or false, melanocyte numbers are the same in everyone

A

True - melanin is different in everyone

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70
Q

What will cause carotenemia

A

Excessive intake of lipid-soluble compounds in red, orange, yellow and green vegetables and fruit

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71
Q

What stimulates melanin production

A

UV light

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72
Q

What is a genetic condition characterized by little or no melanin pigment in the eyes, skin or hair

A

Albinism

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73
Q

What is an acquired depigmentation of the skin characterized by a loss of melanocytes

A

Vitiligo - autoimmune disease

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74
Q

What is the function of melanin

A

Protects against damaging effects of UV light

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75
Q

What are the functions of the skin

A

Temperature regulation
Protection
Sensation
Excrete and absorb

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76
Q

What activates the absorption of vitamin D

A

Exposure to UV radiation
- vitamin D is concerted to Calcitriol which aides in the absorption of calcium and phosphorus

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77
Q

What are the five signs of inflammation

A

Localized hyperthermia
Erythema
Localized edema
Pain
Loss of function

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78
Q

What is the inevitable physiological changes of the sin that occur with time and are influenced by genetic and hormonal factors

A

Intrinsic aging

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79
Q

What is the preventable structural and functional changes of the skin that occur with exposure

A

Extrinsic

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80
Q

What are some extrinsic factors that influence aging

A

Environmental
Lifestyle - tobacco, ETOH, illicit drugs
Social
Extensive cosmetic surgery

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81
Q

What is the most preventable extrinsic aging cause

A

UV radiation exposure

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82
Q

What happens during the epidermal aging

A

Decreased wound renewal capacity
Overall thinning of the epidermis
Decreased melanocytes - increased risk of skin cancer
Reduced responsiveness of langerhans cells - weakened cutaneous immunity

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83
Q

What happens during dermal aging

A

Reduced collagen fiber
Reduced elastin fibers
Decreased skin hydration and characteristic elderly xerosis

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84
Q

What are the two processes of tissue repair

A

Regeneration and replacement

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85
Q

What happens with regeneration tissue repair

A

Damaged tissue is completely restored to its pre-injury/normal state via new growth.
- Regeneration can happen continuously

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86
Q

What happens during the replacement phase

A

Severely damaged or non-regenerable tissues s repaired by the laying down connective tissue, resulting in SCARRING

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87
Q

When does the inflammation phase occur and what occurs

A

1-3 days post injury
- secretes mainly to clear bacteria and debris demotion he wound and prepares wound and environment for repair

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88
Q

When does the proliferation phase occur and what is its purpose

A

2-10 days post injury
- purpose is to construct granulation tissue to fill the defect caused by the wound

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89
Q

When does the healing phase occur and what happens in this phase

A

2- 3 weeks post injury
- early remodel phase

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90
Q

When does the healing- late remodel stage occur

A

Months to > 1 year

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91
Q

What is an example of healing by primary intention

A

Relies on the dermal edges that are close together and easily approximated
- sutures, staples and dermal adhesive

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92
Q

What is healing by secondary intention

A

Natural healing
- relies on formation of granulation tissue to fill the space between the wound opening or edges

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93
Q

What is an exaggerated IgE-mediated immune response triggering a histamine response

A

Atopy

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94
Q

What are the components of a skin, hair and nail exam

A

Inspection
Palpation

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95
Q

What are the only essential tools needed for an examination of the skin

A

The IDC’s eyes and hands

96
Q

What is a quasi-objective metric amount of melanin pigment in the skin rated as I-VI on the scale

A

Fitzpatrick scale

97
Q

What is the size of skin lesions measured in

A

Always in mm or cm

98
Q

What is a ring shaped lesion with central clearing called

A

Annular

99
Q

What is an arc-shaped lesion often a result of incomplete formation of an annular lesion

A

Arcuate

100
Q

What is elevated, circumscribed, superficial fluid-filled and less than 1cm

A

Vesicle

101
Q

What is a vesicle greater than 1cm called

A

Bulla

102
Q

What is an overgrowth of scar tissue that remains confined to the site of initial injury and may be raised or flat

A

Hypertrophic scar

103
Q

What is an irregular shaped, elevated scar that grows beyond the boundaries of the initial injury or wound

A

Keloid

104
Q

What is the difference between a callus and wart

A

Dermatoglyphics are preserved over the surface in calluses and not in warts. Warts will also have thrombosed vessels that appear as black dots

105
Q

What is a bacterial infection around the nail

A

Paronychia

106
Q

What is the most common infectious etiology of folliculitis

A

S. Aureus (+/- MRSA)

HOT TUBS - pseudomonas

107
Q

What are the risk factors of folliculitis

A

Hair removal
Scratching a lot
Occlusive dressing or clothing
Diabetes
Immunosuppressive
Chronic antibiotic use
Tattoo recipient
Poor hygiene

108
Q

What is the clinical hallmark of folliculitis

A

Hair emanating from the center of the pustule

109
Q

What is the general treatment and prevention for folliculitis

A

Antiseptic and supportive care
Good hygiene
Wash hands frequently
Wash linens in hot water
Good hair removal practices
Use of witch hazel,ETOH or tend skin

110
Q

What ointment can be used as a therapeutic intervention of folliculitis

A

Mupirocin ointment TID for 10 days

Also:
Cephalexin 250-500mg
Dicoloxacin

111
Q

What medications can be prescribed for MRSA infections

A

Bactrim
Clindamycin
doxycycline

112
Q

For pseudomonas folliculitis what medication will be prescribed

A

Cirpofloxacin
High potent corticosteroid
Antihistamine to control the itching

113
Q

What is the instruction for pseudo folliculitis Barbae

A

Bupersinst 1000.22C

114
Q

What is a complication of PFB

A

Scarring and hyperpigmentation

115
Q

How long can a grooming standards waiver be granted for with PFB

A

60 days

116
Q

What is the most reliable approach for allowing return of grooming standards for PFB

A

Laser hair reduction

117
Q

When can treatment be counted as successful in someone with PFB

A

When symptoms improved enough to allow for comfortable shaving

118
Q

What is a contagious, superficial, intraepidermal infection occurring prominently on exposed areas of the face and extremities

A

Impetigo

119
Q

What is the most common cause of impetigo

A

S. Aureus

120
Q

What can result from neglected impetigo

A

Ecthymia - a deeper, ulcerated impetigo infection with lymphadentitis

121
Q

What are the two types of impetigo and how do they present

A

Bullous - crusting with a brown appearance

Non-bullous - most common, crusting with a golden/honeycomb appearance

122
Q

What are the risk factors of impetigo

A

Warm,humid environment
Tropical climate
Poor hygiene,poverty, crowding, wartime
Contact sports
Daycare

123
Q

What is the treatment for impetigo

A

Avoid infection spread
Mupirocin ointment - helps prevent spread
Remove crusts with gentle washing 2-3x daily and clean with antibacterial soap, chlorhexidine, or betadine

124
Q

If the impetigo is MRSA related what is the treatment

A

Clindamycin
Tetracycline
Trimethoprim-sulfamethoxazole (Bactrim)
Oral for 7 days

125
Q

What is the cause of cellulitis

A

Streptococci
Staphylococcus aureus

126
Q

What is the most common cause of lower leg cellulitis

A

Toe web intertrigo with figuring interdigital tinea pedis

127
Q

If someone presents with previous trauma as the portal of entry and pain/itching/burning with fever chills and malaise. there may also be regional lymphadenopathy

A

Cellulitis

128
Q

What is the treatment for cellulitis

A

(Decrease swelling and antibiotics)

Demarcate the area with sharpie
Tetanus if needed
Antibiotics
- NonMRSA = cephalexin
- purulent cellulitis(suspect MRSA) = Clindamycin, trimethoprim-sulfamethoxazole or doxy
- animal bites = amoxicillin and augmentin

129
Q

What is the DDX of cellulitis

A

Necrotizing fasciitis or DVT

130
Q

How does necrotizing fasciitis present

A

Most frequently occur in extremities
Initially pain, erythema, edema, cellulitis and high fever
Pain is out of proportion, severe and relentless

131
Q

What is the definitive treatment for necrotizing fasciitis

A

Prompt and wide surgical debridement is the cornerstone of treatment

132
Q

What is the treatment YOU will do for necrotizing fasciitis

A

Broad spectrum antibiotics -main adjunctive of treatment

133
Q

What is a well circumscribed, painful, suppurative inflammatory nodule at any site that contains hair follicles

A

Furuncle

134
Q

What is a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicle

A

Carbuncle

135
Q

Where does a carbuncle most commonly occur at on the body

A

Back of neck
Upper back
Lateral thighs

136
Q

What is the mainstay of treatment for a carbuncle, furuncle or an abscess

A

Incision and drainage

137
Q

Systemic antibiotics are needed for extensive cases of carbuncle, furuncle and abscess. what antibiotics are prescribed for MSSA

A

Dicloxacillian
Cephalexin
Amoxicillin and clavulanate (augmentin)

138
Q

What is the most common benign cutaneous cysts that can occur anywhere on the body

A

Epidermal cyst

139
Q

How does a stable epidermal cyst present

A

Firm or fluctuant flesh-to-yellow color solitary nodule 0.5 to 5cm in size and grows slowly overtime commonly on the face, neck, upper back, chest or if due to trauma on the buttocks, palms, or plantar side of feet

140
Q

How do inflamed epidermal cysts appear

A

Warm, red and boggy with tenderness to palpation. They present very similar to an abscess

141
Q

What is the treatment for epidermal cysts

A

Asymptomatic - do not require treatment

Remove if;
Inflamed/ruptured
Produces functional deficit
Cosmetic (derm or gen surg does this)
Infected, ruptured or inflamed epidermal cysts are treated like abscess with an extra step

142
Q

What must be removed from the cyst in order to prevent further infection

A

Remove the capsule

143
Q

What is the complications of epidermal cysts

A

Recurrence
May rupture creating an acute inflammatory nodule very similar to an abscess

144
Q

What is the most common benign mesenchymal neoplasm in adults and is comprised of mature white adipocytes. They commonly occur on the neck, trunk and extremities and are rarely symptomatic

A

Lipomas

145
Q

What is the treatment for a lipoma

A

Treatment is usually not required but may be excised by derm for cosmetic reasons, pain or impedance of duties

146
Q

What is an acute inflammatory process with or without abscess formation that involves the proximal and lateral folds of the nails and has been present for less than 6 weeks. Contributing factors of this include nail biting, thumb sucking, and picking at hang nails

A

Paronychia

147
Q

What is the most common causative agent of a Paronychia

A

Staph aureus

148
Q

What develops along the nail margins and pus accumulates behind the cuticle sometimes spreading to the nail folds

A

Paronychia

149
Q

What is the treatment for a Paronychia

A

Warm compress/soaks
Antibiotics if warranted
Bactrim/Septra DS if MRSA involved
Visible pus should be drained using scalpel blade inserted between the nail and nail fold

YOU ARE NOT MAKING A SKIN INCISION, YOURE SEPARATING THE NAIL FOLD

150
Q

A patient presents with a painful and swollen digital pulp space following a splinter injury. The patient reports severe pain, tenderness and a tense swelling of the distal digit with erythema. What is this?

A

Felon

151
Q

What is the treatment for a felon

A

Prompt incision and drainage with division of the fibrous septa to ensure adequate draining - this is performed by derm
IDC should TREAT WITH ANTIBIOTICS - dicloxacillin or keflex if non-MRSA
- manage the pain with NSAIDs/narcotics may be required

152
Q

What is the complications of a felon

A

Osteitis and osteomyelitis
- bone infection

153
Q

What are fungal infections caused by

A

Candida yeast

154
Q

Where does yeast grow best

A

Warm, moist environments so infection is often confined to mucous membranes

155
Q

A patient reports with a rash that is red, denuded, glistening surface with cigarette paper like scaling and advancing border near the groin and digital web-spaces. What might be the diagnosis

A

Candidiasis

156
Q

What is the treatment for candidiasis

A

Keep affected skin dry and exposed to air
Topical azole class antifungal

For vaginal candidiasis, sexual contact should be avoided until infection resolves and give clotrimazole

157
Q

What is lab diagnosis based on for candidiasis

A

Identification of yeast and PSEUDOHYPAE in potassium hydroxide wet mounts of scrapings from a lesion

158
Q

What is infection of crural folds and gluteal cleft

A

Tinea cruris - jock itch

159
Q

What is infection involving the face, trunk and or extremities often presenting with ring like lesions

A

Tinea corporis

160
Q

What is an infection of the scalp and hair and affected areas of the scalp can show characteristic black dots resulting from broken hairs

A

Tinea capitis

161
Q

What is the treatment for ring worm( tinea corporis)

A

Antifungal cream
- clotrimazole, miconazole, terbinfine for a minimum of two weeks and continue for at least one week after resolution of the infection

162
Q

What are bilateral lesions around the perineum and appear to be half moon shaped plaques with advancing boarders, and fine scaling. It does not involve the scrotum or the penis (unlike yeast infections)

A

Tinea cruris

163
Q

What is the treatment for jock itch

A

Topical antifungal
Absorbent powders to help control the moisture

164
Q

Patient reports with itching, burning and stinging of the interdigital web spaces as well as the plantar surface. Woods lamp does not fluorescence. What is the likely diagnosis

A

Tinea pedis (athletes foot)

165
Q

What is the treatment for tinea pedis

A

Open toe sandals
Wear shoes in the shower
Dry between the toes
Antifungal powders
Cotton socks
Powder to absorb excess moisture
Topical clotrimazole, miconazole, or terb

166
Q

A patient presents with a velvet tan, not raised patches of skin on the central upper back, chest, and proximal arms. Patient denies any itching, burning or pain with patching however notices they appear when exposed to excess heat or humidity.
KOH- Positive
Woods - Hypo-pigmented areas. Shows faint yellow-green fluorescence

A

Tinea versicolor

167
Q

What is the organism that causes tinea versicolor

A

Pityrosporum orbiculare - part of skins normal flora

168
Q

What is the treatment for tinea versicolor

A

Topical treatment
Selenium sulfide
Ketoconazole

  • oral treatment is used for patients with extensive disease and do not respond to the topical treatment. Oral ketoconazole or fluconazole will be used. Terb is not effective for this condition
169
Q

Patient presents with discoloration of the nail and he is in his 60’s. Splitting of the nail plate as well as nail plate destruction is noted at exam. What might be the diagnosis

A

Onychomycosis

170
Q

What is the treatment for onychomycosis

A

Confirmation of infection is required due to potential for liver toxicity of treatment with oral antifungals
- confirm with a postive KOH prep and fungal culture
ORAL ANTIFUNGAL IS CONSIDERED THE GOLD STANDARD OF TREATMENT

171
Q

A patient presents with intense itching of the wrists, sides of hands and feet and is losing sleep due to the itching being worse at night and now her partner is also experiencing similar symptoms. Upon inspection you notice some eczema present on the hands. What might be the cause

A

Scabies (sarcoptes scabiei)

172
Q

What test shows scabies burrow darker than the surrounding skin when performed

A

Ink test, because ink accumulates in the burrow after being wiped away

173
Q

What is the treatment for scabies

A

Kill scabies mites and remove infestation
Controlling the dermatitis and pruritus
- permethrin 5% or lindane 1% applied to the entire body
All clothes and bedding must be washed in HOT water or wrapped in plastic bags and set aside for 14 days

174
Q

What is the treatment for pediculus humans capitis (head lice)

A

Permethrin rinse (nix) 1%, permethrin 5% (elimite) or lindane
Treat sexual contacts and family members
Last resort - shave head.
Removing the nits is essential

175
Q

What is a home remedy for head lice

A

Vaseline to scalp overnight and covered with ashower cap to smother the lice
Hair clean 1-2-3 hairspray is an oil that kills lice in 15 minutes

176
Q

A patient presents with malaise, mild fever and a sore throat. Upon examination you note that there is a herald patch on the trunk and there is a Christmas tree pattern on the back. The patient explains there is some mild itching but for the most part it is only the sore throat and fever they notice. What is the likely diagnosis

A

Pityriasis rosea

177
Q

What is the treatment for rosea

A

No treatment or symptomatic treatment is all that is required
- antihistamines for the itching
-topical corticosteroids commonly used but logistically drains the Amal

178
Q

What type of HSV is transmitted via mucous membranes and open or abraded skin by kissing or sharing utensils

A

HSV 1

179
Q

What type of HSV is from oral-genital contact

A

Hsv 2

180
Q

A patient reports with peri oral tingling, itching, numbness and pain. They state this has happened before and they notice it gets worse when in the sun, they’re stressed out, illness, fatigue, dental work, or menstruation occurs. What might be the diagnosis

A

Herpes labialis / herpes simplex

181
Q

What is the treatment for HSV 1

A

Patient education- avoid kissing during episodes
Analgesics and hydration
Antivirals not required due to self limiting nature

182
Q

When would antivirals be prescribed for HSV 1

A

Frequent outbreaks
Moderate to severe cases
- antivirals reduce duration but do not cure the infection (lifelong latency)
—acyclovir

183
Q

What is diffuse pox-like eruptions complicating atopic dermatitis, sudden appearance of lesions in typical atopic areas such as the upper trunk, neck and head, high fever, localized edema and adenopathy

A

Eczema herpeticum

  • not small pox because small pox has been eradicated
184
Q

What is localized infection of affected finger with intense itching and pain followed by vessicles that may coalesce with swelling and erythema. It mimics progenitor Paronychia

A

Herpetic whitlow

185
Q

65 y/male presents with a rash that has a deep burning, throbbing, or stabbing sensation. You notice the rash is unilateral and in your history the patient reports a history of chicken pox as a child

A

Herpes zoster (shingles)

186
Q

What is the treatment for herpes zoster

A

Goal is to limit extent/duration/severity of pain and rash and prevent disease elsewhere

<72 hour = antiviral therapy - Valcyclovir/ acyclovir
> 72 hours = antivirals if new lesions are appearing. Give NSAIDs and acetaminophen, possibly in conjunction with opioid analgesics

187
Q

What is occurrence of pain for months or years in the same dermatomal distribution that was affected by the herpes zoster

A

Postherpetic neuralgia (PHN)

188
Q

What type of herpes zoster affects the trigeminal nerve and presents with malaise, fever, headache and perioribtal itching or burning

A

Herpes zoster opthalmicus

189
Q

What is hutchinsons sign

A

Vesicles on the tip/side of the nose

190
Q

What virus causes warts

A

Human papilloma virus

191
Q

What type of warts is found on the hands, periungual skin, elbows, knees, plantar surfaces

A

Verrucae vulgaris (common wart)

192
Q

What type of wart is slight elevated or flat top and occurs on the forehead, back of hands, chin, neck and legs

A

Flat(plane) warts

193
Q

What type of warts occur on the points of maximal pressure such as over the heads of the metatarsal bones

A

Plantar warts
- a cluster is called mosaic wart

194
Q

What is the treatment for warts

A

Patient education
Salicylic acid (compound W)
Cryotherapy
Duct tape

195
Q

What type of contact dermatitis is caused by chemical agents, alcohol, powders, moisture, friction and extreme temperatures

A

Irritant dermatitis

196
Q

A patient presents with erythema, dryness,painful cracking and tenderness/burning of the dorsal side of the hands. He states he was at work when the tenderness and burning started. What might be causing his pain

A

Irritant dermatitis

197
Q

What is the treatment for irritant dermatitis

A

Early diagnosis and treatment
Topical steroid ointment
Antihistamine
FREQUENT APPLICATION OF BLAND EMOLLIENT TO EFFECTED SKIN IS ESSENTIAL

198
Q

If a patient comes in contact with poison oak and their hands are itchy and swelling. What is this called

A

Allergic contact dermatitis

199
Q

What is the treatment for allergic contact dermatitis

A

Remove the agent
Apply wet dressing with burrows solution
Educate on potential source of exposure

200
Q

What is red, greasy, scaling rash that consists of patches and plaques with in distinct margins on the scalp, eyebrows or eyelid margins

A

Seborrheic dermatitis (dandruff)

201
Q

What is the treatment for seborrheic dermatitis

A

Shampoos containing:
Zinc pyrithione
Selenium sulfide
Ketoconazole
Salicylic acid
Coal tar

202
Q

What is a chronic inflammatory disorder that is characterized by cutaneous eruthematous plaques with silvery scale and is found on the extensor surfaces of extremities, especially the knees, umbilicus, lower back, inter gluteal cleft and nails.

A

Psoriasis

203
Q

What sign is associated with psoriasis which is pinpoint bleeding with the removal of the scale

A

Auspitz sign

204
Q

What is the treatment for psoriasis

A

Topical retinoids- medium potency corticosteroid daily
Systemic therapy
Phototherapy

205
Q

What are some factors that influence acne

A

Oily cosmetics
Rubbing skin surface
Numerous drugs
Endocrine disorders such as PCOS
Stress
High dairy diet
Smoking makes worse

206
Q

What is the treatment for acne

A

Topical retinoid / topical antimicrobial or topical antimicrobial / topical antibiotic

MODERATE:
Topical retinoid / ORAL antibiotic / topical benzoperoxide

SEVERE:
Oral isotretinoin mono therapy - derm only

207
Q

What is the causative agent of acne

A

C. Acnes

208
Q

Patient presents with a tender, swollen,fluctuant nodule along the superior gluteal fold. Patient states that sitting or stretching the skin in that region makes the pain worse what is the diagnosis

A

Pilonidal abscess

209
Q

What is the treatment for pilonidal abscess

A

Asymptomatic - nothing

Acute abscess - prompt i&d and pack the wound with gauze
Antibiotics are reserved for those with cellulitis in absence of an abscess or if significant cellulitis following drainage

210
Q

What is the most common form of hair loss in males that occurs in a high reproducible pattern affecting the temples, vertex and mid frontal scalp

A

Androgenetic alopecia

211
Q

What is perfectly smooth, round patches of hair loss believed to be immunologic

A

Alopecia areata

212
Q

What type of alopecia occurs following any type of trauma or inflammation of the hair follicules

A

Cicatricial alopecia -scarring alopecia

213
Q

What is the treatment for alopecia

A

Most areas the hair regrows and no treatment needed
- consider sending to counseling for emotion stress
- consider derm for intense cases

214
Q

What are the complications of a sunburn

A

Melanoma
AK

215
Q

What is the most important treatment of a sunburn

A

Prevention - sun avoidance

216
Q

Chronic urticaria is how long

A

Greater than 6 weeks

217
Q

When working up a patient with urticaria what must be ruled in or out

A

Ingestants
Inhalants
Injectants
Infections
Internal disease

218
Q

What is the treatment for urticaria

A

Discontinue trigger
Antihistamine
Prednisone for those who are difficult to treat with antihistamine
Epinephrine for severe cases

219
Q

What commonly effects the greater toe and is caused by improper or excessive trimming of the lateral nail plate or from trauma. Symptoms include pain, redness and swelling around the nail tissue

A

Ingrown nail

220
Q

What is the treatment for an ingrown nail

A

Remove the nail

221
Q

What form must be signed before removal of an ingrown nail

A

Sf522

222
Q

What is the most common injury to the upper extremities resulting from a direct blow to a fingernail

A

Subungual hematoma

223
Q

What is the treatment for a subungual hematoma

A

Evacuation of the hematoma via TREPHINATION of the nail
Drain by:
Heated paper clip
Cautery pen
Drill method
Needle method

224
Q

What is a benign skin lesion that is circumscribed tan brown patches or thin plaques that have. Greasy scale and a stuck on appearance

A

Seborrheic keratosis (SK)

225
Q

What is the treatment for SK

A

Treatment generally not required
-cryotherapy
- shave/excise
- electrodessication

226
Q

What is a precancerous lesion found on the face, head, neck and dorsal aspect of the hands described as having a rough sandpaper like feeling and as the lesion becomes more defined and develops a thin/adherent yellow - transparent scale. It gets thicker and more yellow in color over time

A

Actinic keratosis (AK)

227
Q

What is a complication of AK

A

Squamous cell carcinoma

228
Q

What is a malignant tumor that arises from melanocytic cells and can be any where on the body. Symptoms include pruitis early on and tenderness,bleeding, ulceration as later symptoms. History may include many blistering sunburns as a child

A

Melanoma

229
Q

What is the treatment for melanoma

A

Refer
IDC cannot treat

230
Q

What are the goals of wound repair

A

Achieve HEMOstasis
Prevent infection
Preserve function
Restore appearance
Minimize discomfort

231
Q

What is phase one of wound healing

A

Lag phase
0-5 days

232
Q

What is phase two of wound healing

A

Fibroplasia phase
5-14 days
- rapid increase in wound strength

233
Q

What is phase three of wound healing

A

Final maturation
Day 14 until healing is complete
- further connective tissue remodel

234
Q

What are contraindications of wound repair

A

Wounds more than 12 hours old (24+ for face)
Animal bites or human bites
Puncture wounds

235
Q

What are four principles that should be incorporated into the process before closing a wound

A

Stop the bleeding
Eliminate dead space
Accurately approximate tissue layers
Approximate wound with minimal tension

Derm (2 decks)

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