Derm

Question 1

Hypersensitivity is a___ mediated reaction that produces _____ on the skin.

Answer 1

IgE mediated
Hives/urticaria

Question 2

Describing hives:

Answer 2

Erythematous, raised, evanescence wheals

Question 3

Sometimes hives are not itchy

Question 4

For kids over _____ kg, you give the adult Epi pen.

Answer 4

30 (65lbs)

Question 5

Hives cocktail

Answer 5

Epinephrine
Systemic steroids (2-3 days)
Antihistamines (Benadryl 1st line, cetirizine, Claritin preferred over hydroxyzine)
H2 blockers (famotidine)

Question 6

Drug eruptions usually most closely mimic _____ however tend to be more dense with mono-posterior lymphadenopathy. Starts on the trunk and spreads to extremities. It can also mimic _____ which is usually on extremities and flexor surfaces.

Answer 6

Measles
Strep rash

Question 7

Chief offenders for drug eruption rash?

Answer 7

Amoxicillin, NSAIDS, PCN, cephalosporins, sulfonamides (bactrim), anticonvulsants, antifungals.

Question 8

Diaper area is usually ____ in atopic dermatitis due to moisture held in the area.

Answer 8

Spared.

Question 9

Antihistamines don’t work for the itching involved with atopic dermatitis because _____

Answer 9

It’s not IgE mediated

Question 10

_____ are better than creams because they’re more potent and stay on longer. Creams are better than _____

Answer 10

Ointments
Lotions.

Question 11

Least potent OTC steroid?

Answer 11

Hydrocortisone 1% ointment

Question 12

If you don’t taper higher doses of steroids in the tx of AD, what can happen?

Answer 12

Rebound itching.

Question 13

Non-steroidal medications for atopic dermatitis

Answer 13

TCI (topical calcineurin inhibitors) - Pimecrolimus, Tacrolimus (elidel) >2yrs
PDE4 (phosphodiesterase T4 inhibitors) - Eucresia >2yrs expensive.

Question 14

What are the main offending agents for super imposed infections on AD?
Tx?

Answer 14

Staph aureus and GAS. - mupirocin.
HSV
Diluted bleach baths.

Question 15

When would you recommend a diluted bleach bath in AD?

Answer 15

With a superimposed bacterial infection. 10mins soak 2-3x/week.
1/8-1/2 cup bleach per standard bath tub.

Question 16

Contact diaper dermatitis spares the _____ whereas fungal infections usually _____ the folds.

Answer 16

Folds.
Involves.

Question 17

Seborrheic dermatitis results from ____ pathogen. Tx?

Answer 17

Yeast
Antifungals -ketoconazole, cicloprox. Soft bristle brush.

Question 18

Seborrheic dermatitis involving multiple folds ? Suspect _____

Answer 18

Food allergy/intolerance
Milk, eggs,
BAKE the eggs.

Question 19

Acne involves 3 things:

Answer 19

Accumulation of excess sebum
keratinous debris as skin is turning over
Bacteria

Question 20

Antibiotics effective in treating acne.
Orals use for _____ max or taper as improvement is noted.

Answer 20

Topical:Clindamycin, erythromycin, sulfacetamide, dapsone.
Oral: MINOCYCLINE (1st line) Tetracycline, erythromycin, doxycycline.
6mo

Question 21

Tx options for impetigo.

Answer 21

Mupirocin
Systemic - Cephalexin or dicloxacin
MRSA - Clindamycin or bactrim.

Question 22

Children with impetigo - when can they go back to school/daycare?

Answer 22

24hours after start of tx.

Question 23

Tx of localized cellulitis?
Tx of cellulitis with s/s of systemic infection?

Answer 23

Cephalexin x5-10 days.
Clindamycin or Cephalexin AND bactrim.

Question 24

Tx for Preseptal cellulitls

Answer 24

Augmentin

Question 25

When can those who have MRSA return to sports?

Answer 25

After 72hrs of treatment and no drainage.

Question 26

2 thoughts for babies with oral thrush?

Answer 26

Treat mom’s breasts if breastfeeding
Change out or sterilize pacifiers.

Question 27

Treatment for candida diaper dermatitis

Answer 27

Nystatin, miconazole or clotrimazole cream
Open to air as much as possible
Frequent diaper changes.

Question 28

Topical treatments for tinea:

Answer 28

ketoconazole, miconazole, clotrimazole, terbinadine, tolnaftate.

nystatin only works on candida species - diflucan.

Question 29

If you are prescribing oral terbinafine or fluconazole for an antifungals, what else do you need to do?

Answer 29

Get baseline labs (LFTs) and again 1month into treatment.
Fluconazole, LFTs, CBC and electrolytes.

Question 30

Tx for tinea versicolor or Pityriasis versicolor?

Answer 30

Ketoconazole shampoo or topical selenium sulfide.

Question 31

Treatement for Pityriasis rosea?

Answer 31

It is left over from a viral infection. Manage pruritis and wait for resolution. Self-limiting

Question 32

Moluscum is self limiting and should resolve in _____

Answer 32

9-15mo

Question 33

Cutaneous warts are caused by ____

Answer 33

HPV

Question 34

What is a herpetic whitlow?

Answer 34

Kids who suck their fingers (usuallly thumb) who transmit HSV to the finger. PainFULL.
May require oral acyclovir for 5-10 days.

Question 35

Tx for scabies?

Answer 35

Permethrin cream - head to toe, sleep in it and then wash off in am.

Question 36

What should we tell the parents of a baby with hemangioma?

Answer 36

As long as it’s not on lips or genetalia and not in a place where it’s getting rubbed and bumped a lot -
It will resolve on its own.
If meds are needed - propanolol.

Question 37

Look up Erythema Infectiosum, Roseola, Verrucae, Transient Neonatal Pustular Melanesia, sebaceous nexus, aphasia cutis congenita, and scarlet fever in Peds DERM book.