Derm

Question 1

• Top skin diseases? (3)
• Skin functions? (7)
• Largest organ?
• Vit D Synthesis: 7-dehydrocholesterol? Vit. D3? Vit D2? Converted to D3? Converted to D2? Turns them to 25-hydroxy vit D calcidiol? Converts it to 1,25 dihydroxy-Vit D calcitriol? This is?
• 6 Fitzpatrick scores with burning?
• 2 parts of dermis?
• Exam: Pt in? Don’t forget what? (4)
• Description includes? (4)
  1. ) Melanocytes (bottom): Type of cells? Contain? Called? Do what? 2 types? Colors? Protective? Distribution in light skin? Dark? Pigment depends on? Acquired depigmentation disease?

Answer 1

• Eczema, acne, bacterial skin infections
• decoration, barrier, vit D synthesis, water homeo, thermo reg, insulation, touch
• yes
• Skin + UVB; Diet, Diet; Skin + UVb and D3; D2; Liver; Kidney; Active form
• 1 = never tan; 2 = usually burns; 3 = sometimes burns; 4 = rare burn; 5 = very rare; 6 = never
• Reticular, papillary
• Gown; eyes, nails, scalp, mouth
• morph, distribution, arrangement, # lesions
• pigment; ganules, melanosomes; protect to UV; 1.) eumulation = black/brown 2.) pheomelanin = yellow/red (not protective); small melanosomes near nucleus or ker.; large melanosomes in cytoplasm of ker; type and distrribution; vitiligo (no melanocytes

Question 2

2. ) Keratinocytes: How long to mature? Primary responsibility?
   a. ) Basal cell layer: Aka? Division? Connects them to basal lamina of dermis? Related disease? Causes? Presentation? Mucus membranes?
   b. ) Stratum Spinosum: 2 roles? Provides adhesion b/n keratinocytes? Acquired Disease? What happens? Presentation Mucus membranes? Congenital disease? Defect?
   c. ) Stratum granulosum: Cells start to lose? Granules have what? Do what? Excrete?
   d. ) Stratum Lucidum: Purpose? Color?
   e. ) Stratum Corneum: Cells? Breakdown what to form natural moist factor? NMF with age? Leads to? Mutation to filagrinn diseases? (2)
3. ) APC immune cells?
4. ) Small nerve endings for fine touch?

Answer 2

• 28 days; form barrier
  a. ) Stem cells; yes rapidly; hemidesmosome; Bullous pemphigoid; AB to BP180/230; subepidermal blisters; not involved
  b. ) thick part and make up skin, nails, etc.; desmesomes; Pemphigus vulgaris = Abs to desmoglein 3/1 = intaepi blisters = mucus mem involved; Epidermolysis bullosa simplex = defects to keratin 5/14
  c. ) Nucleus; fillagrin (cross link keratin); lipids to keep skin moist
  d. ) Present in areas to reduce friction; clear
  e. ) Dead keratinocytes; filagrinn; decreases; eczema; Atopic dermatitis and icthyosis vulgaris (AD genetics)
• Langerhans cells
• Merkel cells

Question 3

Therapeutics:

• Penetration depends on? (3)
• Drug factors? (3)
• Absorption factors? (4)
• Ideal vehicle? (4)
• Powder and grease? Grease and liquid? (3) Liquid and powder? (2)
  1. ) OIntment? Irritation? Potency? Pts?
  2. ) Cream? Irritation? Pt preference?
  3. ) Gel? Drying? Irritation? Used where? (3)
  4. ) Lotion? Potency? Irritation? Pt? Used where? (2)
  5. ) Foam? Potency? Used where?
• What vehicles cause contact allergies?

Answer 3

• diffusion, channels/pores, appendeageal struc.
• conc., size., lipophilicity of vehicle
• barrier, anatomic, skin hydration, wrapped
• Easy to apply, non toxic, non irritating, stable
• Paste; ointments, cream, lotion; gels, drying pastes
  1. ) Water in oil; low; high; don’t like
  2. ) Oil in water; hogh; like
  3. ) Semisolid in alcohol; yes; high; oral, mucusal, scalp
  4. ) Powder in water; low; high; scalp, inter regions
  5. ) Bubbles in lquid; high; hair bearing areas
• Water based

Question 4

Therapeutics:

• FTU? Amount? Covers a man? FTU’s per face? Trunk? 1 Arm? 1 Hand? 1 Leg? 1 Foot?
• Glucocorticosteroids inhibit what? Classes? Strongest?
  1. ) Class 7 one? Used for? (2) Areas? (2) Forms? (2)
  2. ) Class 4 one? Forms? (2) Used for? Areas? (2) Limited use where? (2)
  3. ) Class 1 one? Form? Used for? Don’t use where? Monitoring?
• Adverse reactions: With long term use? (3)

Answer 4

• Finger tip unit; 0.5 grams; 20 g; 2.5; 7; 3;1;6;2
• NFKB and inflamm. cytokines; 1-7; 1
  1. ) Hydrocortisone 2.5%; mild excema/ inflamm. dermatoses; face/groin; cream/ointment
  2. ) Triaminalone 0.1%: Cream/ointment; moderate dermatoses; trunk/extremities; face/groin
  3. ) Clobetasol Propionate 0.05%: Drug rash/ acute reactions; face/groin; yes
• Skin atrophy, systemic side effects; adrenal supression

Question 5

• Dermis: Provides? Contains? (3) Lies between?
• What are appendageal structures? (5)
• Upper layer? Contains? Deeper layer? Contains?
  1.) Collagen provides? Structure? Pattern? Most of adult collagen? Most of fetal collagen? Procollagen synthesized where? Then? Cleaved into? Then?
  Related diseases: Acquired disease? Symptoms?
• Congent. disease? Due to? Leads to? May lack?
  2.) Elastic Fibers: Allows? Thin? Related acquired condition? Caused by? Congentital condtion related to mutated multi drug resistance gene? Leads to? Looks like?
  3.) Ground substance: Role? Acts as? 2 main GAGs glued by fibronectin? Related aquired disease? Congenital?

Answer 5

• tensile stength; bloods vessels, nerves, appendengeal; epi and subcutaneous fat
• Hair, sweat glands, sebaceous, vessels, nails
• papillary, thin collag;reticular thick col and elastic
  1. ) tensile strength; a helical; Gly-proline-hydroxyrpoline (x-y); type 1; type 3; fibroblasts; secreted; tropocollagen; x linked with vit c; Scurvy, corkscrew hair/hemmor; Ehlers Darlos; point mutation; flexible joints; lingual frinula
  2. ) Resiliance; yes; Solar elastosis sun damaged elastic fibers; Pseudoxanthoma Elasticum; brittle fibers; plucked chicken
  3. ) Facilitate diffusion; filling; hyaluronic acid and dermatan sulfate; cosmetic hyaluranic acid; no

Question 6

• Dermis Structures:
  1. ) Blood vessels: 2 related disorders?
  2. ) Nervous tissue: a.) Free endings: 2 types? mylelin? use? b.) Meisners corp: Shape? Location? Use? Pacinian corp: Shape? Location? Use?
  3. ) Hair: Terminal? Vellus? 3 cycles? Percent? Time? Disease?Due to?
  4. ) Sebaceous glands: Role? Build up? (2)
  5. ) Eccrine Glands: Merocrine sweat? Diseases: Heat shock: Anti persperants can cause? EDA mutation? Leads to?
  6. ) Apocrine Glands: Located where? (2) Salomucin sweat? Secrete how much sweat? Treat with?

Answer 6

1. ) Dilated caps = psioriasis/verruca; vasculitis
2. ) Type A = myelinated; touch, prop, pain; Type C = no myel; temp, itch; pine cone, DEJ, fine touch; onion, deeper, vibration/pressure
3. ) Thick; fine/thin; Anagen (grow) 85% 3 yrs; Telogen (rest) 10% 3 mos; Catagen (betw) 5% 3 wks; Androgenic Hair loss = Testosterone to DHT
4. ) Lubricate terminal hairs; acne, Rosacea
5. ) Odorless, watery; Miliria “prickly heat”; Antihydrotic Ectodermal Dysplasia; poor temp reg
6. ) Axillay, anogenital; sticky sweat that bacteria interacts with; 10x more; Botulinum