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PANCE > derm > Flashcards

derm Flashcards

1
Q

most common cause of abscess

A

staph aureus

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2
Q

erysepelas

A

most common strep progenes
induration differentiates from cellulitis (more superficial)
usually on lower legs (most common) or face

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3
Q

impetigo

A

usually staph
honey colored crusts
warm cloth to remove crusts and then mupricon (bactroban)
avoid scratch

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4
Q

bullous pemphigoid vs pemphigoid vulgaris

A

bullous pemph- low mortality, elderly, NEGATIVE nikolsky, tense bullae, no oral lesions, usually due to drug rxn

pemph vulgaris- NIKOLSKY (acantholysis), high mortality, younger, flacid bullae (due to acantholysis), ORAL LESIONS, systemic immune problem, IV steroids

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5
Q

what has positive nikolsky sign

A

Staph scalded skin syndrome
Toxic epidermal necrolysis (TEN)
pemph vulgaris

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6
Q

desquamation

A 
erythema multiform (EM minor)- target lesions, palms and soles, herpes (90%), mycoplasma pneumonia
steven johnson syndrome- MUCOUS MEMBRANE involvement, pcn, sulfa, 30%BSA, burns icu
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7
Q

atopic dermatitis

A

associated with IgE

usually have asthma and allergies as well (atopy triad)

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8
Q

contact dermatitis

A

plants- toxicodendron (family of poison ivy)
id rxn- rxn to something that touches one part of your body and now another part of your body gets a rxn
tx- systemic steroid taper (if small topical steroid)

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9
Q

dishydrosis

A

pomphylx
itchy vessicles
due to excessive sweating
topical steroids

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10
Q

lichen simplex chronicus

A

due to itchy areas

tx- topical steroids

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11
Q

psoriasis

A 
extensor surfaces
plaques with silvery scales
can get pitting of nails
auspitz sign
koeber phenomina 
tx- topical steroids (strong like betamethasone and clobetasol), uv light, retinoids (isoretnoin)
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12
Q

most common psoriasis

A

plaque psoriasis

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13
Q

psoriatic arthritis

A 
hla b27 positive
iritis
sacroilitis
IBD
sausage fingers 
pencil cup deformity
tx- systemic steroids
immune modulators (methotrexate)
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14
Q

pityriasis rosea

A 
herpes 7
herald patch
viral prodrome
christmas tree distribution
tx- self limited
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15
Q

lichen Planus

A

wrist, ankle, mouth
5 p’s
pruritic, planar, purple, polygonal, papules
tx- topical steroids

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16
Q

actinic keratosis

A

due to sun damage

pre cancerous for SQUAMOUS CELL

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17
Q

seborrheic keratosis

A

beige to brown or black with a velvety warty surface
benign
waxy plaque
appears “stuck on”

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18
Q

paronychia

A

infection of nail fold

I&D

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19
Q

Lice

A 
pediculosis
usually pruritic
excoriations
tx- permethrin (elimite/nix), malthion
retreat in 7 days
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20
Q

scabies

A 
burrows (tunnels)
intense pruritic
blue dot
intertriginous areas (wrist, web spaces, flexor, axilla)
tx permethrin cream, antipruritic meds
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21
Q

crusted/norwegian scabies

A 
hyperkeratotic
immunosuppressed
HIV pts
dermatologist
ivermectin tx
22
Q

bed bugs

A

can be pruritus (not usually)
blood stained bedding
groups of 3’s for bites
tx supportive (unless secondary infection)

23
Q

black widdow

A

woodpiles, outhouses
painful bite (skin prick)
bulls eye (central blanching w/ erythema
sxs- muscle cramps, diaphoresis, abdominal pain, spasm
can present like acute abdomen w/ negative ct
tx- pain control, benzos, antivenom

24
Q

brown recluse

A 
fiddle back spider (violin on head)
3 pairs of eyes (not 4)
necrotic arachnidism (cell ulcer that progresses to necrosis)
painless bite
rare comp- shock, dic, hemolysis
tx- supportive
25
Q

hymenoptera

A

bee, wasp, ants

can cause anaphylaxis -IgE type 1 mediated rxn

26
Q

tx of lyme disease

A

doxy

if breast feeding or child amoxicillin

27
Q

tx of rocky mountain spotted fever

A

doxy (for both kids and adults)

28
Q

UVB

A

what burns you, cataracts (b for burn, blindness)

29
Q

UVA

A

tans you, ages you (A for age, a for tan)

30
Q

basal cell carcinoma

A 
most common
in sun exposed areas
pearly waxy papule
easy bleeding
central crater w/ rolled border
non healing
dx- biopsy, punch
tx- surgical (mohs), cryotherapy, topical (imiquimod)
31
Q

squamous cell carcinoma

A 
actinic (solar) keratosis
scaling, crusting, telangestias
raised nodule, shallow ulcer
head, neck, oral
dx- punch bipsy
32
Q

melanoma

A 
bad one
causes most skin cancer deaths
can cause subungal
ABCDE (asymetry, irregular border, variation in color, diameter >6mm, evolution of lesions)
dx- wide margin excision biopsy
33
Q

kaposi sarcoma

A

HIV or immunosuppressed
herpes virus 8
most common in men on men
painless purple red blue papules

34
Q

formula for IV fluids for burns

A

4cc/kg x %BSA in the first 24 hours
Give 1/2 of fluid in 8 hours
based on time of injury
parkland formula

35
Q

what burns are worse

A

alkali

36
Q

signs of inhalation burns

A

singed nose hairs
facial burns
carbonaceous sputum

37
Q

rosacea

A

chronic skin disorder with intermittent facial flushing, telangectasias, and often large bulbous red nose

38
Q

molloscum contagiosum

A

discrete, flesh colored, waxy dome shaped umbilicated papules
pox virus

39
Q

warts

A

verrucae
caused by HPV
topical therapies imiquod, surgery (cryosurgery-freeze)

40
Q

dermatophyte lesions

A 
fungal infections (ring worm)
erythematous, annular patch w/ distinct red raised border with central clearing
tinea...
foot (pedis)
groin (cruris)
trunk/arm/leg (corporis)
41
Q

griseofulvin

A

antifungal

need to be careful in pts w/ alcohol (antabuse)

42
Q

tinea versicolor

A

yeast infection of skin

tx- selenium sulfide shampoo (selson blue)

43
Q

seborrheic dermatitis

A

itchy, flaking (usually found on scalp, behind ears, eyebrows, or nasolabial folds)
erythematous, greasy, yellow scaling papules and patches with indistinct border

44
Q

migrans vs marginatum vs multiform

A

Erythema migrans is called so because the rash appears to migrate outward with a central clearing. Hence if you observed the rash for some days you would be able to differentiate migrans from multiforme and marginatum. It would also be a single lesion at the site of the tick bite (although in disseminated infections they can be multiple). Erythema multiforme has multiple lesions, which are raised (and pruritic). Erythema marginatum is found mostly on extensor surfaces, ring like but not raised (and not pruritic). So yes, clinical context is always useful (and often necessary).

45
Q

what to do next if pap smear shows atypical squamous cells of undetermined significance

A

do HPV viral testing

If HPV comes back positive then do colposcopy

46
Q

most common type of thyroid cancer

A

papillary

47
Q

most common cause of encephalitis

A

HSV

48
Q

most common cause of SVC syndrome

A

lung cancer (especially adenocarcinoma)

49
Q

most common cause of acute bronchitis

A

rhinovirus

50
Q

1st line tx in pcos

A

ocp

51
Q

chornic silicosis

A

diffuse rhonchi and low pitched rales

52
Q

wilson disease

A

ceruplasmin decreased
copper accumulation
liver biopsy is gold standard

PANCE (14 decks)

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