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Derm Flashcards

1
Q

Who are the typical people to come in for acne vulgaris? Where on the body is it? What bug is this?

A

males b/c increase of androgen

found: face, neck, back, upper arms
p. acnes

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2
Q

What are the types of acne vulgaris?

A

open: black heads
closed: white heads

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3
Q

How to tx acne vulgaris?

A

first line: benzoyl peroxide

2) topic retinoid
3) erythromycin
4) refer for systmic abx

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4
Q

Pt has telangiectases- how to tx?

A

rosacea
spider veins on face
tx: metronidazole; NO STEROIDS

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5
Q

Pt has skin that does not tan with other skin-what to expect on KOH prep?

A

tinea veriscolor

koh: “spaghetti and meatballs”

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6
Q

What is tinea veriscolor and how to tx?

A

fungal infxn - needs antifungal topical/systemic

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7
Q

How does the rosacea present unlike acne vulgaris?

A

rosacea: mid age, starts on the nose, NO COMEDOMES

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8
Q

Pt is under stress at work, greasy skin, and has pururitus w/patches- how to tx?

A

seborrheic DERMATITIS aka dandruff

tx: OTC selenium sulfide

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9
Q

Pt has OCD and washes hands every 5min- what are they at risk for? Tx?

A

IRRITANT contact dermatitis

Tx: topical corticosteroids

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10
Q

How to differentiate irritant vs allergic dermatitis? Examples?

A

irritant: RIGHT AFTER EXPOSURE
- spit, sweat
allergic: DELAYED after exposure
- ivy, nickel allergy

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11
Q

Baby has bib on and when you remove, you see a pink rash?

A

irritant contact dermatitis

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12
Q

What are the stages of contact dermatitis?

A

acute: may look like eczema
chronic: scaling, may look like psoarsis
hx is very important

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13
Q

Pt wife noticed a “ring worm” appearance on husband’s back and now it has spread everywhere; concerned that she “caught it”- what is the “ring worm”, what is the “spread”, can she “catch it”, tx?

A 
pityriasis rosea
ring worm- herald patch
spreading-christmas tree fashion
caught it-nope, not contagious
tx-antihistamines for pruritis
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14
Q

Pt has a painful nodule on leg after infxn-tx?

A

erythema nodosum

tx: self-limiting

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15
Q

What can cx erythema nodosum?

A

strep infxn
syphilis
TB
sarcoidosis

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16
Q

Pt has “bulls eye lesions” that are pruritic and painful - cx?

A

erythema multiforme

cx: drugs or HSV infxn

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17
Q

How to tx erythema multiforme?

A

antihistamines

-if related to HSV: acylovir can prevent erythema multiforme

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18
Q

Erythema multiforme minor vs major?

A

minor: NO mucosal involvement
major: mucosal involvment

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19
Q

What is the most severe case of SJS? Cx? How to manage?

A

TEN is most severe

cx: drugs
manage: ICU/burn unit

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20
Q

What are the 4Ps of lichen planus? What to see on PE tongue? Tx?

A 
Purple
Pruritic
Polygonal
Papules
"wickham straie"
glucocorticoids
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21
Q

Which is the common wart that is found anywhere on skin and which is isolated to genitals?

A

anywhere-verruca vulgaris

genitals - condyloma acuminatum

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22
Q

How to tx warts?

A

freeze, excise

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23
Q

Central umbilication - what to check if child has it?

A

molluscum contagiosum

child abuse

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24
Q

Is molluscum contagiousum contagious?

A

YES

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25
Q

“Dewdrops on an erythematous base” -how does it present and how to tx?

A

herpes zoster
dermatone pattern
tx: acylcovir; vaccinate if possible

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26
Q

Pt has wart on foot - what are the two types?

A

verruca plantaris - pain w/ rough hyperkertotic surface

verruca plana - smooth papaules

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27
Q

Pt is back from a business trip and has a rash except head and neck; mostly on hands, wrist, ankles - when does it itch the most and how to tx?

A

scabies
itch is worst at night
tx: permethrin 5% overnight and clean out EVERYTHING

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28
Q

If permethrin doesn’t work for scabies?

A

lindane

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29
Q

Pt has been a PE teacher for 20yrs and didnt put on sunscreen and now there is a yellow brown nodule on face and sandpaper texture? Tx and caution? What can this lead to?

A

actinic keratosis/solar keratosis
tx: remove, even without sun more papules can occur
can lead to squamous cell carcinoma

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30
Q

What are the 3 Ps for basal cell carcinoma and how to tx?

A

Pearly
Pink
Papule

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31
Q

What are the types of basal cell carcinoma?

A 
nodular-Pearly
ulcerating- crusty
sclerosing- whitish patch w/ill defined borders
superficial- scaly plaques
pigmented-hard dark lesions
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32
Q

Pt has been a lifeguard for 10yrs + well demarcated macules - hyperkeratotoic? Tx?

A

squamous cell carcinoma

tx: refer

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33
Q

Pt lived in HI until 25yo and complains about not tanning and always getting burned-highest risk for? What is the criteria?

A 
malignant melanoma
A-symmetery 
B-order
C-olor
D-iameter
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34
Q

Pt has dementia and is brought in by wheelchair b/c of recent hip replacement- what to check for? Complications? Preventions?

A

decibitus ulcers-dementia, recent surgery to become bed ridden
complication-necrosis of skin and bone
prevention- move pt q2hrs

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35
Q

Pt is 60-80yo has NO erythematous base under blister - What is it? Tx?

A

bullous pemphigoid
autoimmune disorder
tx: systemic prednisone

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36
Q

Baby has “cradle cap”-how to tx?

A

seborrheic dermatitis

tx: olive oil +baby shampoo

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37
Q

Pt has “dry” skin worse in the winter on the elbows, knees- what to see on PE? Pt tried peeling scale off and started to bleed-name? Tx?

A

psoriasis
PE: “well demarcated plaques overlying silvery scale”
Auspitz sign
tx: topical steroids - cannot cure, only manage

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38
Q

Pt has depigmented patches- associated with? Tx?

A

virtiligo

association: DM, hypothyroidism, pernicious anemia, addison dz
tx: sunscreen

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39
Q

Seborrheic keratosis - PE? Tx?

A

scratch –> FLAKEY

tx: numb and shave off

40
Q

Pt says hives were there last night but now it’s gone! Pt should describe it as? Tx?

A

urticaria
“wheals”
tx: oral antihistamine

41
Q

Pt was recently dx with acute renal failure and now has fat lips? Where else could this occur? What should pt use instead?

A

angioedema-d/t ACE-I
eyelids, lips, tongue, genitalia, hands, ft
use instead: ARB

42
Q

How to tx urticaria and angioedema?

A

epinepherine

43
Q

Fungal infxn on body/trunk, looks oval in shape? Tx?

A

tinea corporis-ring worm

Tx: antifungal

44
Q

Pt has itchy skin on inside of elbows? Where it would be on babies?

A

atopic dermatitis -eczema

babies: cheek, EXTENSOR surfaces

45
Q

How to tx atopci dermatitis/eczema?

A

topical CS

46
Q

Pt has coin shaped/nummular lesions? Tx?

A

nummular dermatitis

topical CS

47
Q

Pt has “elephant skin”? Tx?

A

lichen simplex chronicus

tx: CS, PO antihistamine to STOP ITCHING

48
Q

Pt has rash around MOUTH? Tx?

A

perioral dermatitis

FUNGAL INFXN-USE METRONIDAZOLE NO TOPICAL CS

49
Q

Pt has “tapioca vesicles” on FEET and PALMS? Tx?

A

dyshidrosis-pompholyx

Tx: CS +/- abx if bacterial infxn

50
Q

Pt has RANDOM patches of hair - what to see on PE? Tx?

A

alopecia areata
PE: exclamation point hair!
tx: CS

51
Q

Pt has NO hair on scalp/eyebrows?

A

alopecia totalis

52
Q

50yo male complaining of hair loss? Tx?

A

androgenic alopecia

tx: PO finasteride

53
Q

Pt has nail that is THICK and YELLOW? Next step? Tx?

A

onychomycosis

tx: culture 1st THEN azole

54
Q

Pt finger is PAINFUL near the nail bed? Tx?

A

paronychia

I&D culture

55
Q

Pt has itchy head after camping? PE? Tx?

A

pediculosis
PE: dead nits- not active infxn
tx: permitherin 1%

56
Q

Pt has cutaneous lesions that are palpable and NOT itchy, symmetric? Pt most likely has?

A

kaposi sarcoma

AIDS

57
Q

Pt has DM?

A

acanthosis nigricans

58
Q

Pt has comedones in axilla?

A

hidradenitis suppurativa

59
Q

Pt has a soft moveable tumor?

60
Q

“Pregnancy mask”? Tx?

A

melasma

sunscreen and topical tretinoin

61
Q

What is pilonidal dz? Tx?

A

painful mass on the sacrococcygeal region

tx surgery

62
Q

Pt has pustules EVERYWHERE after discontinuing CS?

A

pustular psoriasis

63
Q

Pt has rash DOES blanch but NOT ithcy?

A

viral exanthems

64
Q

Pt has erythema + warmth + pain + swelling +/- fever after getting IV fluids? Bug?

A

cellulitis

s aureus

65
Q

How to tx cellulitis?

A

GET TISSUE CULTURE

IV abx

66
Q

Pt has a pain out of proportion on face with fever? Bug? What could this lead to? Tx?

A

necrotizing fasciitis
sepsis
toxic shock syndrome
medical emergency - SURGERY

67
Q

Pt is a handyman with a cut on his arm from his saw last week; now has lock jaw? Tx?

A

tetanus

tx: ICU w/ respiratory support, update tdAP

68
Q

What are the two types of osteomyelitis?

A

hematogenous - secondary from sepsis

open fractures - trauma

69
Q

What labs should be used to monitor osteomyleitis?

A

ESR and CRP

70
Q

How to dx osteomyleitis?

A

needle aspiration

MRI

71
Q

Pt has osteomyleitis in the vertebral d/t TB?

A

pott’s dz

72
Q

How to tx osteomylitis?

A

IV abx and surgery

73
Q

Pt has PAIN with ROM? What to expect on PE?

A

septic arthritis

PE: effusion

74
Q

What bug for septic arthritis?

A

s aureus

gonococcal in young sexually active adults

75
Q

What joint does septic arthritis affect first?

A

KNEE –> hip –> wrist –> shoulder

76
Q

What dz can spread via hematogenously or trauma?

A

osteomylitis

septic arthritis

77
Q

How to dx septic arthritis? What to expect?

A

joint aspiration and synovial fluid analysis

  • HIGH WBC
  • check for gout and gonocccal: crystals and PCR
78
Q

How to tx septic arhtritis?

A

abx

aspriation

79
Q

Pt went hiking and now has a large, painless but well demarcated target lesion? Bug? What stage is this in?

A

lyme dz
bug: borrelia burgdorferi
stage 1

80
Q

What are the stages of lyme dz?

A

stage 1- painless target lesion
stage 2 - infxn spreads to lymphatics days to wks - has flu like sx
stage 3 - arthritis at the knees; chronic CNS dz (subacute, mild encephalitis

81
Q

What complications can occur in stage 2 of lyme dz?

A

meningits
encephalitis
peripheral radiculoneuropathy

82
Q

How to dx lyme dz?

A

ELISA - serum IgM and IgG ab –> western blot to confirm

83
Q

How to tx lyme dz?

A

early (phase 1) - abx x10days
phase 2 - abx x2–30days
phase 3 (early) - doxycyline 21days OR amox (for pregnant and children

84
Q

Pt went hiking 1wk ago and now has flu like sx? Bug? What to PE to expect?

A

Rocky mountain spotted fever
bug: rickettsia rickettsii
rash first at extremities THEN centerally

85
Q

How to dx rocky mountain spotted fever? Tx?

A

dx: skin bx
tx: doxycycline x7days

86
Q

Pt was bitten by dog and is at the ER, will they have sx? When will they have sx? What kind of sx?

A

rabies
no
sx occur 30-90days after bite
sx: pain at bite, encephalitis, hydrophboia (unable to drink water), ascending paralysis
prodromal: flu like sx - sore throat, fatigue, HA, N/V

87
Q

How to dx rabies?

A

negri bodies - histology

PCR

88
Q

How to tx rabies?

A

passive immunization: into the wound and IM, and active immunization: 3 IM doses over 28days

89
Q

What are RF for candida?

90
Q

“Satellite lesions”?

A

cutaenous yeast finxn

91
Q

“Cottage cheese”?

A

vagina yeast infxn

92
Q

How to dx candida?

93
Q

What are the diff areas candida can occur?

A

vagina - cottage cheese
mouth - thrush
cutaneous - satellite lesios

94
Q

How to tx candida?

A

oral - nysattin
vagina - miconazole
cutaneous - oral nystatin powder

95
Q

Pt has HIV and lives near a bird farm?

A

cryptococcosis

WHOLE PT (19 decks)

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