Derm

Question 1

sx bullous pemphigoid

Answer 1

pruritus + urticaria + large bull that don’t rupture easily

negative nikolsky sign

Question 2

biopsy bullous pemphigoid

Answer 2

C3 and IgG
blisters
eosinophilia

Question 3

tx bullous pemphigoid

Answer 3

topical steroids —> doxy –> systemic steroids

Question 4

MCC cellulitis and erysipelas

Answer 4

GAS

Question 5

sx cellulitis

Answer 5

localized erythema without sharp margins

Question 6

tx cellulitis

Answer 6

mild - Cef, amoxicillin, dicloxacillin

purulent or MRSA - doxycycline, trimethoprim-sulfamethoxazole, clindamycin, and linezolid (outpatient); vancomycin, clindamycin, telavancin, daptomycin, and linezolid (inpatient)

Question 7

sx erisypelas

Answer 7

raised, sharp margins

Question 8

tx erisypelas

Answer 8

PCN, cef
can do IV cef

Question 9

in what 3 rashes are palms and soles spares

Answer 9

drug eruption
SJS
TEN

Question 10

dx herpes zoster

Answer 10

PCR or direct immunofluorescence
Tzanck smear - multinucleated giant cells

Question 11

Hutchinson’s sign

Answer 11

herpes zoster on the nose

Question 12

zoster ophthalmicus

Answer 12

CN 5 - trigeminal nerve
dendritic lesions in the eye on slit lamp exam

Question 13

zoster oticus

Answer 13

CN 7 - facial nerve
Ramsay Hunt syndrome
affecting the ear

Question 14

tx herpes zoster

Answer 14

acyclovir

Question 15

brown recluse spider bite

Answer 15

red halo –> hemorrhage bulla –> eschar

not tons of sx

tx - wound care and pain control; debride if necrotic

Question 16

black widow spider bite

Answer 16

hourglass on belly of spider!!

muscle pain, spasms, rigidity

blanched circular patch w red perimeter (target(

tx - wound care, pain control, benzo, muscle relaxer

Question 17

how much of the body is affected in TEN

Answer 17

> 30%

Question 18

what sign do we see in urticaria

Answer 18

darters sign - urticaria appearing where skin is rubbed due to histamine release

Question 19

what causes HFM

Answer 19

coxsackie

Question 20

measles is also called

Answer 20

rubeola

Question 21

German measles is also called

Answer 21

rubella

Question 22

roseola is caused by

Answer 22

HHV6

Question 23

high fever in roseola?

Answer 23

YES

Question 24

high fever in rubella?

Answer 24

NO

Question 25

high fever in measles?

Answer 25

YES

Question 26

tx scabies

Answer 26

Permethrin 5% cream on day 1, then reapply in 1-2 weeks

Question 27

when should we avoid ivermectin

Answer 27

pregnancy or children < 15 kg, kids < 5 years old

Question 28

What type of hypersensitivity reaction is contact dermatitis?

Answer 28

type 4 (delayed reaction)

Question 29

what type of hypersensitivity reaction is urticaria

Answer 29

IgE mediated -- type 1

Question 30

tx pilonidal abscess

Answer 30

incision and drainage with outpatient surgery follow-up -- don't pack the incision Antibiotics are only required if there are signs of surrounding cellulitis

Question 31

meds that causes SJS

Answer 31

* Sulfonamides * Phenobarbital, carbamazepine, lamotrigine * Allopurinol * NSAIDS

Question 32

infections that cause SJS

Answer 32

mycoplasma pneumonia

Question 33

parkland formula

Answer 33

4 × patient’s weight in kg × % TBSA of burns, not including superficial burns Half should be given in the first 8 hours and the other half over the next 16 hours

Question 34

What is the goal urine output in patients with significant thermal burns?

Answer 34

0.5–1 mL/kg/hr.

Question 35

What skin lesion commonly precedes squamous cell carcinoma?

Answer 35

Actinic keratosis

Question 36

antivenin in spider bites

Answer 36

black widow - can use it in very very severe cases brown recluse - don't use