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Old DOOS > Derm 2 > Flashcards

Derm 2 Flashcards

1
Q

Greasy, “stuck-on” appearance
Average diameter is 1 cm
Flesh-colored, tan, brown, or black
Appear on the face, neck, scalp, back, upper chest and less frequently on the arms, legs and lower trunk

A

Seborrheic Keratosis (SK)

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2
Q

tx for seborrheic keratosis

A

Scissor biopsy, electrosurgery, liquid nitrogen, surgical excision
Often reoccur

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3
Q

Typically multiple pre-malignant lesions on sun-exposed areas.
Itching, burning or dry skin
looks rough and feels rough

A

actinic keratosis

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4
Q

first line tx for actinic keratosis

A

surgical- liquid nitrogen

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5
Q

other topical tx for actinic keratosis

A

fluorouracil (FU)
imiquimod
diclofenac

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6
Q

how do you dx actinic keartosis

A

touch it- will feel rough

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7
Q

does actinic keratosis occur on non-sun exposed skin?

A

No

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8
Q

how long can lice be asymptomatic for?

A

30 day (inducbation)

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9
Q

Tx for lice

A

Permethrin, malathion, lindane, benzyl alcohol
wash all bedding and clothing in hot water
remove nit s

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10
Q

should close contacts with lice be treated

A

Yes

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11
Q

inflammatory, erythematous pruritc papules. Most common in finger webs, flexor surfaces of wrists, elbows, axillae, buttocks. Burrows, worse at night.

A

Scabies

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12
Q

tx for scabies

A

Permethrin is most effective topical treatment

Treat all close contacts

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13
Q

if someone comes in with a “spider bite” but didn’t witness the bit bite what should you consider?

A

MRSA

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14
Q

Local- : pain that is sharp or burning, onset within minutes of the bite, typically resolving within minutes to hours. onset within 20 – 30 minutes, painful cramps or spasms, arm bite may lead to chest tightness or dyspnea. : tetanic contractions of the limbs, spasms, rigidity

A

Black widow spider bite

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15
Q

tx for black widow spider bite

A

Pre-hospital – immobilize the wound site
Supportive care, tetanus immunization prn
Venom extracting apparatus – must be used within 10 minutes of the bite

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16
Q

Local: often asymptomatic, pain that is stinging or burning, onset 1 – 24 hours after the bite
Systemic: fever, chills, malaise, nausea, vomiting

A

brown recluse spider

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17
Q

tx for brown recluse spider

A

Pre-hospital – immobilize the wound site, cool compresses
Supportive care, tetanus immunization prn
Venom extracting apparatus – must be used within 10 minutes of the bite

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18
Q

tests for brown recluse

A

venom can be detected in wound (not widely used)

UA for systemic hemolysis

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19
Q

what can happen with a brown recluse spider

A

tissue necrosis around bite

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20
Q

Pink papule/plaque, crusting, Rolled periphery, telangectasias, head/face/neck, atrophic center

A

basal cell carcinoma

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21
Q

tests for BCC

A

shave bx or punch bx to assess depth

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22
Q

most common skin cancer

A

BCC

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23
Q

tx for BCC

A

topical- 5-flurouracil, imiquimod
radiation, phototherapy
surgical excision is preferred

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24
Q

what is a melanoma that occurs on a nail?

A

ACRAL

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25
Q

does melanoma have to do with sun exposure?

A

No, there is some genetic predisposition

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26
Q

Tx for melanoma

A

surgical management

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27
Q

margins you need to get if melanoma is >1 mm thick

A

1 cm

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28
Q

margins needed if lesion is 1-2 mm thick

A

1-2 cm

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29
Q

Sun-exposed sites of elderly, fair-skinned individuals.
Majority of lesions arise from actinic keratoses but some arise de novo, also from old burn scar or from sites previously exposed to ionizing radiation, or preexisting human papilloma virus infection

A

Squamous cell carcinoma

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30
Q

where does SCC commonly metastasize to?

A

Lung

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31
Q

when is a SCC most apt to metastasize

A

when on the lip

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32
Q

tx for SCC

A

Total excision, electrocautery, or Mohs

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33
Q

loss of hair on the entire scalp

A

alopecia totalis

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34
Q

hair loss of all body hair

A

alopecia universalis

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35
Q

tests for alopecia

A 
TSH
CBC (anemia)
CMp (electrolytes)
testosterone
iron
ferritin
zinc
RPR (syphillis) 
prolactin (pituitary) 
ANA (autoimmune disorders)
KOH (tinea vs. alopecia)
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36
Q

test where you pull on the hair and depending on the number of hair that pall out can determine alopecia vs. androgen problem

A

light hair pull test

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37
Q

tx for alopecia areata

A 
intralesional steroids (painful) 
oral corticosteroids
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38
Q

Patchy, non-scarring hair loss

A

Alopecia Areata

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39
Q

Hair loss along with miniaturization of hair follicles
Men: frontal recession, then vertex affected; over time, only has lateral and occipital hair
Women: Thinning across the crown with frontal hair initially in place but later may be lost

A

Androgenetic alopecia

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40
Q

tx for androgenetic alopecia

A

Topical minoxidil or finasteride

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41
Q

Chronic fungal infection of the finger- or toenails. Subungual hyperkeratosis, subungual paronychia, onycholysis, nail dystrophy, discoloration (yellow-brown)

A

Onycomycosis

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42
Q

test for onycomycosis

A

KOH prep or culture

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43
Q

tx for Onycomycosis

A

Oral antifungals are first line, but some severe systemic side effects and drug reactions
Cicloporox 8% nail lacquer
Nail debridement

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44
Q

Swelling and erythema of the nail bed or surrounding tissues. Acute or chronic infection or eczematous inflammation of the skin folds surrounding the finger- or toenails

A

Paronychia

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45
Q

if there is a Green changes in nail it is typically what?

A

Pseudomonas

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46
Q

tx for paronychia

A

tetanus is indicated
abx, antifungals
I and D

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47
Q

Soft, skin-colored, fleshy warts that are caused by human papillomavirus (HPV)
Warts appear singly or in groups, on the vagina, cervix, around the external genitalia and rectum, and in the urethra and anus

A

Condyloma acuminatum

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48
Q

tests where Subclinical lesions can be visualized by wrapping the penis with gauze soaked with 5% acetic acid for 5 minutes. Using a 10× hand lens or colposcope, warts appear as tiny white papules.

A

acetowhitening test

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49
Q

tx for condyloma acuminatum

A

cryosurgery

imiquimod, podophyllin TCA acid

50
Q

usually painful vesicles that often occur in clusters on skin, cornea, or mucous membranes
May occur as encephalitis, pneumonia, or disseminated infection, and/or skin lesions including but not limited to oral and genital sites

A

herpes simplex

51
Q

tests for herpes simplex

A

STI screening
Tzanck smear
HSV culture

52
Q

tx for herpes simplex

A

antiviral (acyclovir)

53
Q

Dome-shaped papules with central umbilication
Common, benign, viral skin infection
Highly contagious with autoinoculation, skin-to-skin contact, sexual contact, shared clothing, towels, bathing water

A

Molluscum contagiosum

54
Q

Tx for molluscum contagiosum

A

Topical (harsh meds like cantharidin), podophyllin, cryosurgery

55
Q

how long can it take for molluscum contagiosum to go away

A

3 months

56
Q

who have hve molluscum contagiosum occur all over their body w/ hundres of lesions

A

those with HIV/ AIDS

57
Q

Raised, flesh-colored lesions, no central umbilication

A

verrucae

58
Q

what are common warts

A

verruca vulgaris

59
Q

what are plantar warts

A

verruca plantaris

60
Q

what are veneral warts

A

condyloma acuminatum

61
Q

Rough-surfaced, hyperkeratotic, papillomatous, raised, skin-colored to tan papules 5–10 mm in diameter; most frequently seen on hands, knees, and elbows; usually asymptomatic

A

verrucae

62
Q

tx for verrucae

A

Most warts regress spontaneously

OTC topicals, Rx topicals, cryotherapy

63
Q

what should you do before freezing warts off

A

take off the top layers of the wart off first

64
Q

Generally a unilateral, painful, vesicular eruption within a dermatome

A

varicella zoster

65
Q

tx for varicella zoster

A

Oral antivirals within 72 hours of onset of symptoms
Analgesics (NSAIDs, acetaminophen, opioids)
Gabapentin is commonly prescribed for pain (adverse reactions)

66
Q

pain associated along same area are varicella zoster

A

poster herpatic neurlagia

67
Q

Diffuse non-purulent infection of the skin and sub-Q tissues
Initially epidermis and dermis, but can spread to deeper fascia. Localized pain and tenderness, erythema
Fever, chills, malaise, regional lymphadenopathy
Itching, burning, irritability

A

cellulitis

68
Q

tests for cellulitis

A

Culture aspirates from point of maximum inflammation
Blood cultures
Plain radiographs show bubbles in soft tissues

69
Q

tx for cellulitis

A

Empiric therapy or mild cellulitis: oral dicloxacillin, cephalexin, clindamycin or IV cefazolin, oxacillin, or nafcillin
may want to culture area

70
Q

Presentation results from the destruction of blood vessel walls, with subsequent aneurysm, bleeding, thrombosis, or ischemia in the various vascular beds
Constitutional: malaise, fatigue, anorexia, sweats, and weight loss
Skin: palpable purpura, livedo reticularis, nodules, ulcers, gangrene, nail bed capillary changes

A

Vasculitis

71
Q

tests for vasculitis

A

Necessary to rule out multiple etiologies, so lots and lots of tests

72
Q

most common cause of vasculitis

A

adverse drug rxns

73
Q

tx for vasculitis

A

glucocorticoids then stronger immunosuppressive meds

remove offending agent if drug related

74
Q

Sharply demarcated, erythema, swelling, shiny

A

Erysipelas

75
Q

what bacteria causes erysipelas most commonly

A

S. pyogenes

76
Q

hx associated w/ erysipelas

A

Prodromal symptoms may occur in the first 48 hours that include chills, malaise, headache, fever, vomiting, and anorexia

77
Q

tx for mild erysipelas

A

penicillin V

78
Q

tx for moderate to severe erysipelas

A

cefazolin

79
Q

if MRSA is suspected how do you tx erysipelas

A

vanco

80
Q

Small, flaccid bullae, honey-colored crusts

A

impetigo

81
Q

most common cause of impetigo

A

staph aureus

82
Q

tx for impetigo

A

topical abx

83
Q

what should you not rx for impetigo due to huge resistance

A

penicillin and macrolide therapy

84
Q

Painful erythematous papules/nodules (1–5 cm) with central pustulation
Located in hirsute sites of body, especially areas prone to friction or minor trauma (e.g., underneath belt, anterior thighs, back of neck, buttocks)
Tender red perifollicular swelling, terminating in discharge of pus and necrotic plug; pus usually drains spontaneously

A

Furnucle/ carbuncle/ abscess

85
Q

tx for furnucle/ carbuncle/ abscess

A

drain
oral abx
use swab to get out inoculations
used those aimed at MRSA if suspected

86
Q

Dark, thick, velvety skin in body folds and creases

often hx of Obesity, endocrine disorders, namely diabetes

A

Acanthosis Nigricans

87
Q

Burn- Erythema of involved tissue, skin blanches with pressure, skin may be tender

A

first degree burn

88
Q

Burn- Skin is red and blistered, skin is very tender

A

second degree burn

89
Q

Burned skin is tough and leathery, skin is not tender

A

3rd degree burn

90
Q

how much is each upper extremity percentage

A

9% adult and child

91
Q

how much is each lower extremity rule of 9s

A

adult 18% child 14%

92
Q

anterior trunk percentage

A

18% adult and child

93
Q

posterior trunk percetnage

A

18% adult and child

94
Q

head and neck percentage

A

9% adult 18% child

95
Q

genitals percentage

A

1%

96
Q

stage of pressure ulcer with Nonblanching erythema, warmth, induration

A

Stage 1 pressure ulcer

97
Q

stage of pressure ulcer with that may include dermis; appears as abrasion, blister, or superficial ulcer

A

Stage II pressure ulcer

98
Q

stage of pressure ulcer that Extends through subcutaneous tissues but not fascia; may appear necrotic with changes in pigmentation

A

stage III pressure ulcer

99
Q

Ulcers extend beyond deep fascia into muscle or bone, decayed area may be larger than visibly apparent wound, osteomyelitis or sepsis may be present, and granulation tissue and epithelialization may be present at wound margins.

A

stage IV pressure ulcer

100
Q

will pressure ulcers heal without proper nutrition

A

No, need higher protein diet

101
Q

tx for pressure ulcers

A

antibiotics for cellulitis or osteomyelitis, silver dressings, triple antibiotic ointment can be tried for 2 weeks to treat bacterial overgrowth
Second Line – zinc and vitamin C if dietary deficiency

102
Q

Cyst-like abscesses in gland-bearing skin, boils. often happens in obese, smoking, females. Tender nodules (dome-shaped) 0.5–3 cm in size are present:
Large lesions often are fluctuant

A

Hidrandenitis suppurativa

103
Q

is there a staging system with hidradenitis suppurativa?

A

Yes- used to guide tx

104
Q

first line tx for hidradenitis suppurativa

A

I & D

oral antibiotics

105
Q

mobile mass
Most common soft tissue tumors
Mostly are subcutaneous and composed of normal adipose tissue
Slow growing, often asymptomatic, and usually diagnosed by palpation

A

Lipoma

106
Q

tx for lipoma

A

observatin

sx removal if questionable

107
Q

Common skin condition in which brown patches appear on the skin often affects the face
Typically young women who are pregnant or taking any form of hormone-based birth control

A

Melasma

108
Q

fast growing lipoma with a large diameter may indicate what?

A

liposarcoma

109
Q

Raised, red lesions with central clearing and swelling. blanching; associated with itching or burning. often will have generalized edema/ swelling of skin

A

Urticaria

110
Q

From sunlight exposure, usually UV; onset in minutes; subsides within 2 hours

A

solar urticaria

111
Q

Linear, itchy, red wheal and flare from scratching or rubbing the skin

A

Dermatographism

112
Q

hives from : From exposure to cold; usually idiopathic

A

cold urticaria

113
Q

hives from From strong vibrating mechanical forces, very rare

A

vibratory urticaria/ angioedema

114
Q

Owing to brief increase of core body temperature; small pin-sized (5- to 10-mm) wheals surrounded by an erythema but also can have larger wheals; from physical exercise, stress, and hot showers

A

Cholinergic urticaria

115
Q

Caused by stress; extremely rare; has pinpoint-sized red wheals with a white halo

A

Adrenergic urticaria:

116
Q

Wheals at sites where chemical substances contact the skin

A

contact urticaria

117
Q

Small wheals after contact with water at any temperature; rare

A

Aquagenic urticaria

118
Q

A leukocytoclastic vasculitis looking like urticaria and tending to last > 24 h; more painful than pruritic; may be palpable and purpuric; usually caused by a collagen-vascular disease

A

Urticarial vasculitis

119
Q

Acquired, slowly progressive, depigmenting condition of the skin due to the disappearance of previously active melanocytes

A

vitiligo

120
Q

what is repigmentation tx for vitiligo

A

corticosteroids, calcineurin inhibitors, phototherapy (narrow-band ultraviolet B (NB-UVB) or broadband ultraviolet B (BB-UVB), and surgery

121
Q

what is depigmentation tx

A

For vitiligo affecting more than 50% of the face or body and recalcitrant to therapy. Topical agents include monobenzyl ether of hydroquinone 20% and methoxy-phenol

Old DOOS (21 decks)

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