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Derm and EENT > Derm > Flashcards

Derm Flashcards

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Dermatology Board Prep flashcards
1
Q

Different techniques/equipment for skin exam

A

Wood lamp: looking for bacterial
Patch testing: allergic rxn
Diascopy: no blanching = viral
Punch bx and simple excision

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2
Q

Dry skin tips:

A

do not shower for longer than 15 min
soak hands in lukewarm water for 10-15min before putting on topical steroid
do not bathe more than once a day
use mild soap (dove)

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3
Q

Pt presents with weepy lesions on trunk and extensor surfaces of body.

A

Nummular eczema

Tx: CS - triamcinolone and abx

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4
Q

Pt presents with a rash that itches on the flexor surfaces.
Parents have the same symptoms.
Upon examination:
Complication:

A

Atopic dermatitis eczema
Upon examination: there are ill defined borders, pruritus, dry skin, papules, and lichenification
Complication: secondary infection for (1) bacterial - imetigo (2) yeast - candidia (3) viral - molluscum contagiosum
Tx: Triamcinolone and abx

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5
Q

Pt presents with vesicles on the arm after hiking.

Chronic?

A

Allergic contact dermitits
chronic - scaling
Tx: CS, derm patch, hx taking is very crucial

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6
Q

Pt presents with scaling under the breasts.

A

Irritant contact dermitits

Tx: CS, history taking is very important

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7
Q

Pt presents with very dry skin and lines are prominent.

A

Lichen Simplex Chornicus
End stage dx
Tx: aggressively with glucosteroids

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8
Q

Pt is a young female with erythermous rash around mouth. She says it goes away, comes back, and goes away.
Upon examination: NO pastules/cysts.

A

Periorbital dermatits
Tx: metrondiazole gel
systemically use doxycyline and tetracylcine but that is only relieving antiinflammation not the bacteria

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9
Q

Pt presents with dandruff and scaling on scalp.

Upon examination, hair is very greasy and scaling comes off when pulled.

A

Seborreic dermatitis
Tx: antifungal - azole
adult: selenium sulfide and CS
babies: oil and baby shampoo

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10
Q

Pt has CHF and is concerned about the ant lateral lesions on her legs. She is also a cook and has given birth to her 4th child.

A

Statis dermatits
affects lower extremities and DVT pts (be worried about vein circulation)
early stages: ant lateral is fleshy
later stages: brown edemas and lichenification
Tx: treat the rash with emollients (CS), leg elevation, stockings, and avoid trauma

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11
Q

Pt has vesicles on her hands and scales on her feet. She lives in Az.
Upon examination:

A

Dyshidorsis (pompholyx)
atopy background and triggered by emotional stress and weather.
2 stages - 1) vesicles (palms and feet) 2) fissure (dry and itchy)
Upon examination: always inspect both hands and feet
Tx: CS
if secondary infxn occurs - use oral abx

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12
Q

Pt has been taking amoxcillin and started noticing red spots.

A

Morbilliform
NOT drug rxn - IgM mediated
looks like measles
Tx: stop drug and use topical CS and oral antihistamines

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13
Q

Pt takes a drug and rxn occurs as the same place all the time.

A

Fixed Drug Rxn
Tx: stop medication
erorded: abx
nonerosion: topical CS

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14
Q

Signs of when to stop medication:

A

blisters, ulcers, utricaria, facial edema, purapura, fever, lympadenopathy, mucosal invovlement

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15
Q

Spectrum of drug rxn (draw)

A

Inpatient: morbillform (IgM) - Fixed Drug rxn - Urticaria (IgE, I) - Erythema Multiforme Minor (cell, IV)
Outpatient: Erythema Multiforme Major (cell, IV) - Angioedema (IgE, I) - Anaphylaxis (IgE, I), SJS and TENS (cell, IV)

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16
Q

Pt presents with papulosquamous rash on her wrist.
Upon examination, there is wickham striae on her tongue.
affects:

A

Lichen planus
Affects: wrists, shins, lower back, and genitalia/gold and mercury
Tx: healing takes a long time but topical glucoCS +/- occulsion patching
systemic: oral glucoCS - derm referral

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17
Q

Pt comes in with Herold patches on the back.

Upon examination, the patches are clustered in christmas tree formation on the back.

A

Pityriasis Rosea
d/t viral - once you get it, you don’t get it again
Tx: supportive; CS and oral antihistamines for pruritics

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18
Q

Pt comes in with a white scaly lesion on elbow. She was playing football when she skinned her leg on the gravel ground. *
Upon examination, the scales do not come off and bleeds.* Plaques are well defined and on both elbows.

A

Plaque Psoriasis
d/t autoimmune - could affect joints and nails
DO NOT GIVE ORAL STEROIDS –> CAN FLARE PSORIASIS AND LEAD TO PUSTULES
d/t T cells playing a role - keratinzed skin life is shortened causing the plaques to look thick
*Koebner phenomenon: d/t trauma
*Ausptiz sign: picking up the scale and bleeding spots occur
Tx: topical steroids w/ occulsive dressing (oral steroids - derm referral)

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19
Q

Pt has red spots under armpits and breasts.

A

Inverse/Flexural psoriasis

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20
Q

Pt has strep and noticed rain drop lesions on arms

A

Guttate Psoriasis

d/t strep

21
Q

Pt presents with bright red spots on back w/ fever and chills

A

Erythroderma psoriasis

Hospitalized immediately

22
Q

Pt presents with nails rash, felt pain before noticing the rash.

A

Arthritis Psoriasis

23
Q

Pt is 85 yo and noticed blisters on armpit and thighs.

Upon examination, the blisters do not have a red base.

A

Bullous pemphigoid

Tx: oral steroids (prednisone)

24
Q

Pt is 20yo female with acne. She finds them on her face, neck, upper trunk, and upper arms. Her parents have them as well.
Upon examination there are white and blackheads.

A

Acne Vulgaris
Factors: incr androgens, P acnes (bacteria), plugging of hair follicle
May get papules (debris and bacteria)
White heads: closed comedones
Black heads: open comedones
Tx:
Mild comedonal: topical retinoid
Mild paulo-pustular: topical abx (erythomycin and clindamycin) and topical benzyol peroxide
Mod paulo-pustular: oral abx w/ retinoid and benzyol peroxide
Severe nodular and scarring keloids: derm referral

25
Q

Classification of acne

A

Mild - able to count comedones
Mod- not able to count
Severe - nodules

26
Q

Pt has red lesions on face and nose. Feels tight and irritated.
Upon examination, there are NO comedones present and telangiectases (spider veins).

A 
Rosecea 
Tx: NO steroids
topical metronidazole and abx (erythomycin)
Systemic: TCN, doxycline
Surgery for rhinophyma
27
Q

Pt noticed wart like lesions and when she tries to scratch them off they get flaky. She doesn’t feel pain but irritated when scratched.

A

Seborrheic Keratosis

28
Q

Pt is male and comes in with lesions that are yellow brown in color. He tried peeling them off but they started bleeding and adhered to skin.
Upon examination, they are better felt that seen. rough and often hyperkeratic

A 
Actinic Keratosis
d/t UV exposure
may lead to basal cell carcinoma
Tx: 5-fluro cream (new turn over of skin)
retinoid
29
Q

Pt presents with white patches. Pt lives in Hawaii and had radiation therapy.

A

Sclerosing BCC

Tx: Moh’s surgery

30
Q

Pt presents with pearly white bump and BV appreciated. Pt lives in Hawaii and had radiation therapy.

A

Nodule BCC

Tx: Moh’s surgery

31
Q

Pt presents with multiple bumps. Pt lives in Hawaii and had radiation therapy.

A

Superficial BCC

Tx: Moh’s surgery

32
Q

Pt presents with dark lesions. Pt lives in Hawaii and had radiation therapy.

A

Pigmented BCC

Tx: Moh’s surgery

33
Q

Pt has pink red macules, papules, and plaques. She has a lot of UV exposure because she is a PE teacher.

A

SCC
Bx
Tx: Topical chemo: 5-fluoruracil cream
Moh’s surgery

34
Q

Pt has purple brown lesions that is not itchy. She is HIV positive.

A

Kaposi Sarcoma
4types: epidemic AIDs related, immunocompromised, classic KS, endemic african
Tx: tx HIV: dec viral load and increase CD4 count
NOT HIV related: local therapy, cryotherapy

35
Q

Pt has itchy head.

A

Pediculosis (lice)
human-human, fomites
Tx: permtherin/pyrethrin

36
Q

Pt has rash that is very itchy at night.

Upon examination there are burrowing.

A

Scabies

Tx: Mineral Oil and permtherin 5%

37
Q

Pt lives in the woods and noticed purple bites.

A

Spider Bites

Tx: pain control

38
Q

Pt has cauliflower type biliform.

A

Condyloma Acuminatum
genital warts
Tx: Cryosurgery

39
Q

Pt child has central umbillication.

A

Molluscum contagiosum
prone to HIV and eczema
Tx: Cantharidin

40
Q

Pt presents with vesicles. Pt is in 1st grade.

Pt mom presents with vesicles along the dermatomes.

A

Varicella
Shingles
Tx: supportive
*once crusted - not contagious

41
Q

Pt presents with red-brown color that is isolated.

A

Verrucea (Wart)
Tx: irritate skin - immune system is activated and tissue is forced to replace itself
Apple cider vinegar

42
Q

Pt presents with a throbbing painful bump near a hair follicle.

A

Furuncle/Carbuncle
Tx: small - I&D
large - shrink it, then I&D

43
Q

Pt presents with infection with no abscess.

A 
Cellulitis/Erysipeals
d/t staph or strep
Tx: emprical abx 
Pen G and VK - extermities 
Vanco - face
TMP-SMX - diabetic and early; hosp if severe
44
Q

Pt presents with tender and pruirtic bumps after swimming in public pool.

A

Folliculitis
d/t staph
Tx: cipro

45
Q

Pt presents with honey crusted w/ exudates

A

Impetigo
common in teenagers
Tx: topical abx - Mupricocin

46
Q

Pt presents with beefy red w/satillite lesion in diaper and lacy white (in mouth)

A

Candidiasis

Tx: nystatin and azole creams

47
Q

Pt went tanning and noticed splotchy rash.
Used wood’s lamp and found bacteria
meatball and spaghetti

A

Tinea versicolor

Tx: azole, selenium sulfide

48
Q

Pt presents with wheal formation in superficial derm

A

Urticaria
Rash can disappear
Tx: oral antihistamine and topical steroid

49
Q

Pt has localized hair loss with exclamation point hairs.

A

Alopecia areta

Tx: topical steroids - GlucoCS

Derm and EENT (4 decks)

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