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PANCE 2024 > DERM > Flashcards

DERM Flashcards

1
Q

Irritant vs Allergic Contact dermatitis

A

Irritant = diaper damage to kerotincytes and agent ; Vessicles FAST

Allergic = delayed hypersensitivity Type 4 [metals; nickel // fragrances ] ; slower

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2
Q

Mild severe CD management

A

Mild = topical high potency

PO predinisone = SEVERE

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3
Q

Eczema most common treatment for flares

A

High potency steroid

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4
Q

Eczema patho

A

Chronic skin barrier dysfunction

IgE mediated hypersensitive reaction

The ITCH that RASHES

Cyclic ; spares diaper ; extensor surface = kids ;; flexor surface kids

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5
Q

Pityriasis Rosea

A

Recent URI

Rash is sudden ; pruritic!@ “Christmas Tree Pattern”

1 Herald patch rash

HHV 6 // 7

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6
Q

PR treatment

A

Supportive self limited 6-8 weeks

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7
Q

Psoriasis nail findings

A

Nail pitting

Onycholysis

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8
Q

Psoriasis patho

A

T cell mediated ‘’keratin hyperproliferation”

+Koebner phenomenon

+Auspitz sign = scratch and bleed

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9
Q

What vitamin can be helpful in psoriasis

A

Vit D

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10
Q

Mild to moderate psoriases is how much of the body surface

A

10-30%

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11
Q

Organism of tinea vesicolor

A

M. Furfur

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12
Q

Woods lamp findings for tinea versicolor

A

Yellow green
Copper orange
Fluorescence

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13
Q

1st line tinea vesicolor

A

Azole anti fungals creams

Topical selenium sulfide
Topical zinc pyrithione

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14
Q

Superficial =

A

Epidermis only + blanching

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15
Q

Second degree burn

A

Deep partial thinkness in the dermis = not into the fat
[ sluggish blanching // pain is only to pressure]

Superficial partial thinkness
Partial thickness = + blanching
+ blisters

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16
Q

3rd degree burns =

A

= full thinking into the fat
Central white clearing

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17
Q

4th degree burn =

A

Full thickness into the muscle
“Painless”

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18
Q

Deep partial burn to 4th degree re fluid number

A

4 mL x TTBSA of burn (%) x body wt (kg)

First half over first 8 hours
Rest over 24 hours

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19
Q

Best topical antibiotics for burn conditions

A

Silver sulfadizine
Triple antibiotic ointment

TETANUS

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20
Q

Stage 1 vs stage 2 pressure ulcer

A

1 = in tact non blanching erythema ; intact skin
+/- pain

2= shallow open ulcer
Red pink wound bed

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21
Q

Stage 3 pressure ulcer

A

Into the fat slough + Eschar

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22
Q

Stage 4 pressure ulcer is concerning for what

A

Undermining tunneling // bugs —> osteomyelitis

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23
Q

Mc types of lesion in Steven Johnson sydnrome and what type of medication

A

Sulfa based

Mucosal lesions

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24
Q

MC cause of Erythema Multiforme

A

HSV

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25
Q

EM can effects what part of the body

A

Legs arms —> palms ,, soles

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26
Q

SJS and TEN

A

SJS = less than 10%

TEN = 30%

Epileptics and Bactrim

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27
Q

SJS TEN has lesions that are like what

A

Proximal > Distal ;; think in the faceeee and trunkkkkkk

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28
Q

Bx of SJS and TEN will show what

A

Epidermal necrosis

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29
Q

Bullous pemphigoid think what?

A

NEGATIVE NIKOLSKY no slough
IgG autoantiboides
Attack hemidesmosomes
PRURITIC

+FLEXURAL AREAS

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30
Q

Bullous pemigoig Dx

A

Dx

Histopathology ; linear deposition

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31
Q

Pemphigoius vulgaris patho

A

Connection between skin cells messed up!
Fucked up the desmosomes
Vesicular blistering
IgG deposition

ACANTHOLYSIS

+NIKOLSKY SIGN

[myathesenia gravis// thymoma] - assoc

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32
Q

1st line pemphigous vulgaris

A

IV CC

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33
Q

What part of the skin/hair is affected in acne vulgaris

A

P. Acne’s at the pilosebacuos follicle

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34
Q

Describe moderate acne

A

Comedomal with; inflammatory lesions

= no cysts no scars

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35
Q

Evolution of treatment in acne

A

Topical retinoid
BP
PO ABX
Isotretinoin

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36
Q

Rosacea colonization of what ?

A

Demodex mites

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37
Q

What 3 ocular sxs in rosacea

A

Eye pruritis
Dry eyes
Gritty watery eyes

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38
Q

Best topical vs. oral treatment for rosacea

A

Topical = metronidazole

Oral = Doxy

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39
Q

What is the melanoma prognostic

A

Breslows Thickness

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40
Q

Mc type of melanoma

A

Superficial spreading

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41
Q

Eye involvement with pupil changing size think what pathology

A

Melanoma

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42
Q

Precursor to squamous cell carcinoma

A

AK !

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43
Q

1 reason for squamous cell carcinoma in the skin

A

SUN

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44
Q

What does SCC look like

A

Pimple like on sun exposed area
+/ - bleeding
Non healing

Asxs

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45
Q

Describe AK

A

Solar keratosis

Atypical keratin cells
Thickness scaly crusted !
Hypopigmentation

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46
Q

SCCs management

A

5 ASA
Imiquimod

Standard excision
Radiation

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47
Q

BCC on the nose how do you treat it

A

MOhs Surgery !!

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48
Q

BCC looks like

A

MC type

Pearly nodule
Telenagiectasias

Mc type : NOdule ulcerated

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49
Q

Paronychia

A

Lateral proximal nail folds swelling infection on ONE finger
Wraps around the nail

Strep pyogenes
Staph A

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50
Q

Herpetic whitlow

A

Probably have HSV somewhere else , might be white

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51
Q

Felon is usually where on the nail

A

Palmar surface

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52
Q

Oral ABX for finger [ felon paraynchia ]

A

Dicloxacillin
Cephalexin

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53
Q

Cellulitis onset of sxs

A

Slow onset of chilled fever malaise
Tender erythematous gredaully increase in size

UNILATERAL

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54
Q

Upside down bottle leg

A

Lipedermatosclerosis

Fat limiting distal
Cellulitis complication

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55
Q

MRSA cellulitis

A

Vancomycin
Doxy
Clinda
Bactrim

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56
Q

Erysipeals mc infective agent

A

Strep pyogenes

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57
Q

Borders of erysipeals

A

WELL DEMARCATED epidermis

Super red

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58
Q

Oral ABX for erispeals

A

PCN
Amoxicillin
Cephalexin

IV = Ceftriaxone // Cefazolin

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59
Q

Derantophyte infection how do we diagnose

A

10% KOH

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60
Q

Tinea cap it’s has what characteristic sign

A

Black dot hyperkaratotic plaque

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61
Q

Tinea corporis
= TING WORM

A

Scaling annular lesion
Multiple stages of development

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62
Q

Tinea Pedis

A

Macerated wet moist interdigital show

KEEP IT DRY

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63
Q

Alopecia areata

A

Non scarring hair loss
Smooth

AUTOIMMUNE

64
Q

Mainstay tinea treatment

Corporis // curries

A

PO griseofulvin

Corporis .. Curtis = mild topical anitfungal

65
Q

Lice =

A

Pedicures is cavities
Hatch in 8 days NITS first then NYMPHS

Intense pruritis

66
Q

Head lice treatment

Body

Pubic

A

Topical permethrin

Body = PO ivermectin

Pubic = PO ivermectin

67
Q

Scabies transmitted

A

Skin to skin

68
Q

Scabies patho

A

Mites lays less and drops feces ;; mite continuous to burrow

69
Q

Treatment scabies

A

Topical // ORal

Permethrin

70
Q

Condyloma acuminatam

A

HHV 6 and 11 anal warts

71
Q

Treatment HHV 6 and 11

PA administered

A

Impiquimod
Podophyllotoxin
Sinecatchines

Physician administered : cryo // trichloroacetic acid // surgery

72
Q

Pilonidal disease affects where

Acute vs chronic

A

Gluteal cleft

Inflammation —> pore —> skin/hair inflammation
Sudden pain odor

Or recurrent = chronic

73
Q

What is the outer most layer of the dermis

A

Stratum Corneum

74
Q

3 primary lesions

A

Macule

Patch

Papule

75
Q

secondary lesions 3

A

Crusts

Erosions

Ulcers

76
Q

Small lightly pigmented

Rough

Sandpaper

Pre malignant

A

AK —> SCC

Field txm =
5ASA
Imiquimod
Diclofenac sodium

77
Q

HPV 12 18 31 plaque like psoriasis or AK and can progress to invasive SCC

A

Bowens

78
Q

MC least aggressive skin cancer

A

Basal cell carcinoma

79
Q

Most important prognostic factor for melanoma

A

Tumor thickness = breslow depth

80
Q

Diameter greater than what is concern in for melanoma

A

6cm

81
Q

If lesion is greater than what consider a sentinel lymph node test

A

1 cm

82
Q

Kaposi sarcoma [4]

A

HHV 8 // HIV AIDS

GI tract / lung / skin mucocutaneous plaques

Purplish brown [firm]

Antiviral therapy cryotherapy

83
Q

Expresses foul smelling cheese like material

From o plantations of epidermal elements

Erythematous

TXM?

A

Epidermal inclusion cyst

TXM = only if sxs = CC injection; ABX and Drainage = 2nd line

84
Q

Sign of lesser trellat

A

Sudden explosion of seb kerrotosis on the back of

85
Q

Proximal nail fold telangiectasias are found in what diseases

A

Scelroderma ; RA ; SLE

86
Q

The itch that rashes

Where MC?

A

Eczema = atopic dermatitis

Antecubital / flexural area

87
Q

Ointments

Creams

Gels

Lotions

Foams

A

O= most hydrating ; use in chronic

C = more drying ; better for acute subacute

G = best for acute ; weeping lesions

L = drying ; good for moist INTERTRIGINOUS areas or SCALP

F = quick absorption

88
Q

HOW LONG SHOULD ONE USE CORTISONE AND THEN STOP

A

LESS THAN 2 WEEKS

89
Q

Contact dermatitis does not what

A

Spread

90
Q

Poison ivy has what

A

Linear vesicles

91
Q

Pompholyx =

A

Dyshidrosis

TXM = CC

92
Q

Coin shaped plaques

Mild to Severe PRuritis

LE on Men

A

Nummular Eczema = winter months!

93
Q

MC location of lichen simplex chronicus

A

Itch scratch cycle

Neck and Extremities

Topical steriods w/ occlusion = TXM

94
Q

Pruritic / purple
Polygonal / popular
Planar

W/ what else ?

A

-Lichen Planus-

Wickhams striae

+koebners phenomenon

TXM = top cc,

95
Q

R/o what in pityriasis rosea

A

Syphillis

96
Q

Perioral dermatitis txm

A

Topical metronidazole

2nd = doxy

SPARES THE VERMILLION BOARDER!

97
Q

Seb dermatitis MC site

A

Scalp

TXM = selenium sulfide, ketoconazole foam
-worse in cold weather-

98
Q

Increased risk of what with stasis dermatitis

A

Contact dermatitis due to progressive loss of the derm boarder

99
Q

Photosensitivity reaction mgmt

A

UV protective clothing
Sync screen

100
Q

MC photodermatosis

A

Polymorphous light eruption

101
Q

2 MC drugs in drug eruptions

A

PCN and Sulfa drugs = MC

Tetracyclines, OCPs, NSAIDS

102
Q

Bilateral target lesion occur where
Dull red Mcauleys that enlarge

A

-Hands and genitals-

Erythema Multiforme

103
Q

MC drugs implicated in SJS and TEN

A

Allopurinol

Sulfonamides

Anticonvulsants

NSAIDs

104
Q

TEN is correlated with lower prognosis if what is present

A

Neutropenia

105
Q

Strep can set off what kind of psoriasis

A

Guttate psoriasis

106
Q

What does psoriasis do the nails

A

Pitting

107
Q

AUSPITZ sing in psoriasis

A

Pin point bleeding when you scrape the surface

108
Q

Can you use tazarotene in pregnancy

A

NO

109
Q

General mgmt psoriasis [4]

A

UVB light exposure

PUVA

Methotrexate

Oral retinoids

110
Q

Bullous pemphigus

A

Over 60 yrs old

Pruritis TENSE blisters

Bx and DIF [IgG and C3]

Negative nikolsky sign

111
Q

Pemphigus vulgaris begins where

A

The mouth ; mucous membranes

112
Q

Flaccid Bullae
Skin and mucous membranes
+nikolsky sign

Staph A septicemia = cause of death

A

Pemphigus vulgaris

113
Q

Tinea corporis

A

T. Rubrum

Round oval or semicircular border

Central clearing

TXM = azole ; PO if recalcitrant

114
Q

Tinea pedis

A

Dry scaly patches

Bottom of foot —> whole foot

Hyphae on JOH and dermatophyte on Cx

TXM buries wet dressings ; aluminum

115
Q

Tinea verisicolor [3]

A

Does not tan evenly

M. Furfur

Selenium lost ion shampoo; ketoconazole

116
Q

Beefy red satellite lesions

Itching burning

Body folds // umbilicus

A

Candidiasis

Keep trying

Nysastin // oral FLUCONAZOLE = TXM

117
Q

Cellulitis infection where

A

Dermis and subcutaneous tissues

Red hot tender fever + LAD

118
Q

Erysipelas is from what

A

B hemolytic strep

119
Q

Erysipelas TXM

A

IV PCN first 48 hours if severe

120
Q

Fifth disease
Slapped cheek

A

Parvovirus

Droplet spread

Lacey rash

Adults = joint pain

121
Q

Viruses of HFM : 2

A

Coxsackie and enterovirus

122
Q

Enterovirus 71 ; HFM think what

A

CNS involvement

123
Q

Measles [4]

A

Unvaccinated kids - respiratory

2-3 days after fever —> koplik spots —> rash at the hair line then spreads to trunk

Resolves 4 to 6 days

Multi-nucleated giants cells in secretions

124
Q

Treatment verrucae

A

OTC salicylic acid

Imiqomoud

Cryotherapy

Self limited in 3 years

125
Q

Genital warts

A

Condyloma acuminata

HPV 6 and 11

126
Q

Herpes has what on tzanck

A

Multinucleated giant cells

127
Q

Chicken pox vs. Shingles

A

Chickenpox = varicella

Shingles = herpes zoster

128
Q

How long does it take shingles to resolve on its on

A

2-3 weeks

129
Q

Post herpetic neuralgia can be treated with

A

Gabapentin

130
Q

Molluscus is what virus

A

POX virus

131
Q

Lice treatement

A

Malathion [flammable]

Topical ivermectin lotion

Clean and dispose of linen and clothing
Treat anyone in contact

132
Q

Scabies is due to what

A

Mites and ovaries

That burrow : hands ; genitals ; but ; axillae

133
Q

What is the stain for scabies

A

Lactophenol cotton blue

134
Q

Who do you treat for scabies

A

Patient and all members of family

135
Q

Why does acne improve in the summer

A

UV rays are anti-inflammatory

136
Q

Isotretinoin used with tetracycline can cause :

A

Pseudotumor ceribri

137
Q

Are there commodones in rosacea

A

No ;

Topical metronidazole = best treatment

PO = minocycline ; doxy ; oral tretinoin

138
Q

Hidradenitis affects where

A

Apocrine gland follicles

sinus tracts, double comedomes

139
Q

Folliculitis treatment

A

Bacterial;cephalosporin

Hot tub = self resolve

Gram negative on acne treatment = isotretinoi n

Esoinophillic = top cc + AH

140
Q

Vitiligo genetic component

A

More than 30% have family history

141
Q

Depigmented areas of vitiligo need what education

A

Sunscreen because highly prone to burning

142
Q

Acanthosis nigricans think what two things

A

Insulin resistance

Adenocarcinoma of the GI tract

143
Q

Electrical burn 2 high risk

A

Compartment syndrome

And

Necrosis

144
Q

Less than what on the hands does not need sutures

A

Less than 2 cm

145
Q

Highest rate of dehiscence

A

Adhesive tape

146
Q

Pressure over bony prominences think what

A

Pressure ulcer

147
Q

Wheals of varying sizes

Allergic or non allergic

Lesions can fade in 24 hours and then reappear ; differently

A

Urticaria

TXM = AH mainstay
CC

148
Q

Fleas present as

A

Popular urticaria

149
Q

Black widow bite

A

Red hour glas

Abdominal pain muscle cramping HTN

TXM = Antivenin of Lactrodectus

150
Q

Brown recluse

A

Violin marking
Later Local necrosis possible
Fever chills N//V

TXM = bite excision // PO CC / Dapsone /Colchicine

151
Q

Alopecia areata

A

Excalmmation point hairs
Non scarring hair loss

TXM = ILK

152
Q

Androgenic Alopecia

A

Men = receding hairline at temples and hair loss at the vertex

Women = loss of hair over central scalpe wide part

TXM = Male = minoxidil / Finasteride

153
Q

Onychomycosis

A

Fungal infection

T. Rubrum T. Ment.

R/O Diabetes

TXM = PO terbinafine /itraconazole = best

154
Q

Periodic what for oral antifungal therapy

A

CBC and LFTs

155
Q

Acute vs Chronic paronychia

A

Acute = S Aureus ; trauma hx
TXM = I & D if abscess ; PO ABX ; warm soaks

Chronic = Candida ; water workers
TXM = keep dry ; topical anti fungals

PANCE 2024 (15 decks)

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