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Panre > Derm > Flashcards

Derm Flashcards

0
Q

Red, scaly, patchy rash with licenification. Very itchy seen on scalp, face, extensor and flexor surfaces. Sharply defined coin shaped plaques.

A

Eczema.

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1
Q

Two things in history to suspect atopic eczema?

A

Hx of allergies or asthma.

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2
Q

Treatment for eczema?

A

Motsturize with emmoliants, topical corticosteroids, antipruretics. Antihistamines.

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3
Q

This causes tense pruritic vesicles on palms and soles. Difficult to manage. Looks like tapioca. Dx? Tx?

A

Dyshidrotic eczema. Super potent corticosteroids, tar soaks, erythromycin, refer to derm.

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4
Q

Irregularly grouped, red papulopustules on a red base, peri oral but spare the vermillion border. Dx? Tx?

A

Peri oral dermatitis. Abx, flagyl, erythromycin

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5
Q

Eczema like eruption on lower legs with varicose ties, swelling and edema. Dx? Cause? Tx?

A

Stasis dermatitis. Secondary to PVD. Support stockings, elevation, exercise, weight loss, topical steroids.

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6
Q

Dry to inflammatory scaly and greasy plaques. Dx? Tx?

A

Seborrheic dermatitis. Tx with shampoos, ketoconazole cream, may resemble malignant melanoma.

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7
Q

Solitary patch of itchy skin with licenification. Greater than 1 cm. dx? Tx?

A

Lichen simplex chronicus. Avoid itching and steroids.

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8
Q

5 P’s: purple, planar, polygonal, pruritic, papules….. Dx? Tx?

A

Lichen planus. Dx with punch bx. Treat with corticosteroids.

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9
Q

Round or oval salmon colored lesions follow a Christmas tree pattern after a herald patch on the trunk. Variable latching lasts weeks to months. Dx? Tx?

A

Pityriasis rosea. Can mimic secondary syphilis so do RPR. Tx with corticosteroids and UVB light.

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10
Q

This is a T cell mediated disease of unknown etiology. Rut hematomas silver scaly plaques. Mostly on extensor surfaces. Dx? Tx?

A

Psoriasis. Tx is topical steroids, retinoids, tars, shampoos. Uv light. Avoid systemic steroids and refer!

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11
Q

This causes plaques, blisters in a target like shape on the extensor surfaces. Caused by an immunologic reaction in skin to an antigen. Dusky red target lesions. Dx? Tx?

A

Erythema multiforme.

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12
Q

Meds that can cause erythema multiforme?

A

NSAIDs, sulfa, quinolone, allopurinol, colchicine.

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13
Q

Erythema multiforme can progress to what and then what?

A

Stevens Johnson syndrome then to toxic epidermal necrolysis.

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14
Q

This often starts with a targetoid lesion then becomes painful and tender oral and skin lesions.

A

Stevens Johnson syndrome.

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15
Q

Percent of epidermal detachment in Stevens Johnson syndrome?

A

Less than 10%

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16
Q

Treatment for SJS?

A

Systemic steroids, supportive care, stop the drug causing it!!!

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17
Q

This is a severe form of SJS. Usually has high fever.

A

TENS.

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18
Q

What is the percent of epidermal detachment in TENS?

A

Greater than 30%.

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19
Q

This is an autoimmune disease causing very painful mouth erosions and bullae. The slightest pressure can cause the skin to pull off in sheets. Dx? Tx?

A

Pemphigus vulgaris. Dx by bx. Treatment is systemic steroids.

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20
Q

This is an autoimmune attack on the basement membrane causing sub epidermal blistering. Common in the elderly. Dx? Tx?

A

Bullous pemphigoid. Dx with punch bx. Treat with corticosteroids or methotrexate.

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21
Q

Treatment for acne comedones?

A

Benzoyl peroxide, retinoids

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22
Q

Treatment for acne papules and pustules?

A

Benzoyl p, retinoids, abx.

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23
Q

Treatment for acne nodules or cysts?

A

Accutane. It is teratogenic. And elevates lipids.

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24
Q

Describe rosacea?

A

Adult acne with no comedones, pos blushing and telangectasias. Treat with trigger avoidance, m
Flagyl, clindamycin.

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25
Q

Treatment for warts?

A

Podofilox, liquid nitrogen, imiquimod

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26
Q

Pearly umbilicated papules 1-5mm, on face, neck, trunk, thighs. Dx. Tx?

A

Molluscum contagiosum. Spread by skin to skin contact. May resolve on own or cryosurgery and curettage.

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27
Q

This is a superficial bacterial infection of the epidermis. Honey colored crusting lesions . Dx? Tx?

A

Impetigo. Treat with mupirocin.,

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28
Q

Bacteria that causes impetigo?

A

S. Aureus.

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29
Q

This is a deep dermis and subcutaneous tissue infection. Can cause fever, chills, malaise, pain with erythema and edema.

A

Cellulitis.

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30
Q

Risk factors for cellulitis?

A

DM, cirrhosis, malnutrition, cancer.

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31
Q

Common bacteria causing cellulitis?

A

Staph or group a strep.

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32
Q

Treatment for cellulitis?

A

Augmentin, keflex

33
Q

This is an infection of the epidermis and dermis, sometimes bright red. Patient has fever, malaise, calls, nausea and adenopathy. Elevated sharply demarcated borders of rash. Dx? Tx?

A

Erysipelas. Common strep pyogenes. Tx with pen, azithromycin, Keflex.

34
Q

Tx for hot tub folliculitis and bug common?

A

Pseudomonas and tx with cipro.

35
Q

Tx for Tinea capitis?

A

Oral griseofulvin.

36
Q

Fungus that causes Tinea versicolor?

A

Malassezia furfur.

37
Q

Chronic paronychia organism?

A

Candida

38
Q

Beefy red rash with satellite pustules? Dx? Tx?

A

Candida. Area clean and dry, nystatin or azoles.

39
Q

Noted on chronic sun exposed skin. Rough Sandpapery patch, crusted. Dx? Tx?

A

Actinic keratosis. Shave bx to rule out SSC. Treat with liquid nitrogen, 5FU, sun protection and regular follow up.

40
Q

Benign epidermal neoplasm with a stuck on appearance. Dx? Tx?

A

Seborrheic keratosis. Can resemble MM so bx if needed. Treat with liquid nitro, curettage, shave.

41
Q

Most common skin cancer?

A

Basal cell carcinoma.

42
Q

This is a pearly white lesion with a translucent rolled border. Can ulcerated and bleed. Dx?

A

Basal cell carcinoma.

43
Q

Treatment for basil cell carcinoma?

A

Punch biopsy. Surgery, 5FU.,follow up with frequent skin exams and avoid sun.

44
Q

Eczema that doesn’t itch?

A

Squamous cell carcinoma.

45
Q

Second most common skin cancer?

A

Squamous cell carcinoma.

46
Q

Where are SCC found on skin?

A

Lips, hands, neck head. Red scaly papule or plaque.

47
Q

Cutaneous horns associated with?

A

SCC.

48
Q

Warts on hands that don’t improve on own or with treatment what next?

A

Bx to rule out SCC.

49
Q

Treatment for SCC?

A

Wide local excision. Radiation. Follow up often, avoid sun.

50
Q

Most common cancer in women ages 25-30?

A

Melanoma

51
Q

What must you get when biopsying a lesion suspected to be melanoma?

A

Subcutaneous tissue to heck for breslows depth. For staging.

52
Q

Clinical presentation of melanoma.?

A

Itching tenderness, bleeding ulceration or change in ABC’s.

53
Q

Treatment for melanoma?

A

Excision. Interferon reduces recurrence.

54
Q

A tumor caused by human herpes virus 8.

A

Kaposi sarcoma. Aids defining illness.

55
Q

Biopsy of kaposi sarcoma shows?

A

Spindle cells

56
Q

Tx of kaposi sarcoma?

A

Lesions shrink. With antiretroviral therapy. No cure.

57
Q

Scabes treatment for pregnant or babies?

A

6-10% sulfur in petroleum.

58
Q

Spider bite that causes immediate sharp pain and can lead to abdominal, leg and back pain. Dizziness, headache, sweating, nausea, vomiting. Dx? Tx?

A

Black widow bite. Tx with antivenin, calcium gluconate and analgesic.

59
Q

Spider bite during moving logs or wood. Mild at first then severe pain with necrotic fatty areas. May have blue grey vesicles. Dx? Tx?

A

Brown recluse. Ice, elevate, avoid strenuous activity, abx, ASA.

60
Q

Loss of hair without scarring in a well circumcised area, exclamation point hairs. Likely autoimmune. Dx? Tx?

A

Alopecia areata. Tx with corticosteroids and minoxidil.

61
Q

Hair loss due to stress?

A

Telogen effluvium.

62
Q

Nail plat is yellow or white. Dx? Tx?

A

Onychomycosis. Test with KOH. Tx with lamisil 6 wks. Fingers and 12 wks toes.

63
Q

This is a rapid onset of bright red, pus, painful swelling of the lateral nail bed. Dx? Tx? Common pathogen?

A

Acute paronychia. I&D, s. Aureus. Keflex

64
Q

Describe first degree burn.

A

Minor epithelial damage, sunburn. No blisters!

65
Q

Describe second degree burn.

A

Superficial partial thickness: epidermis and superficial dermis, pink soft moist skin with thin walled blisters.
Deep partial thickness: epidermis into lower dermis, red, white skin with thick walled blisters.

66
Q

Describe throw degree burns.

A

Full thickness burns. Skin is white and leathery and numb. From immersion burns, flames, high voltage electricity.

67
Q

Describe 4th degree burns.

A

Full thickness of skin and other tissues.

68
Q

Rule of nines for adults?

A

9% head, each upper extremity.
18% anterior trunk, posterior trunk and each leg.
1% genitals.

69
Q

Rule of 9’s for kids?

A 
18% head and neck.
9% each arm. 
18% anterior trunk, posterior trunk. 
13% each leg
1% genitals.
70
Q

How do you treat suspected inhalation injury pre hospital?

A

Humidified O2 no rebreather 10-12 LPM

71
Q

What is the Parkland formula for burns?

A

4mL/kg/%burned in first 24 hrs. (Half given in first 8hrd, rest over next 16 hrs). Use lactated ringers!

72
Q

Pain med of choice for burns?

A

Morphine.

73
Q

This is an inflammatory disorder of the apocrine glands causing double open comedones. Dx? Tx?

A

Hydradenitis suppurative. Treat with weight loss, decrease friction, cleansers, abx and surgery.

74
Q

If you see acanthosis nigricans screen patient for what?

A

Internal malignancy or DM.

75
Q

Thick velvety plaques in neck, axilla, thighs. Dx? Tx?

A

Acanthosis nigricans. Treat with 12% lactic acid lotion. Screen for lymphoma or adenocarcinoma!

76
Q

Autoimmune attack on melanocytes. Woods lamp accentuates. Dx? Tx?

A

Vitiligo. Treat with topical corticosteroids or phototherapy.

77
Q

What is urticaria caused from?

A

Hypersensitivity reaction mediated by IgE and mast cells.

78
Q

If individual urticaria lesions last greater than 24 hrs…..

A

Biopsy. Rule out vasculitis, connective tissue dz, drug eruption.

79
Q

Treatment of urticaria?

A

H1 blockers, H2 blockers, tricyclic antidepressant like doxepin

80
Q

Palpable purpura?

A

Vasculitis. Must biopsy.

Panre (18 decks)

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