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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
hymenoptera
bee, wasp, ants | can cause anaphylaxis -IgE type 1 mediated rxn
26
tx of lyme disease
doxy | if breast feeding or child amoxicillin
27
tx of rocky mountain spotted fever
doxy (for both kids and adults)
28
UVB
what burns you, cataracts (b for burn, blindness)
29
UVA
tans you, ages you (A for age, a for tan)
30
basal cell carcinoma
``` 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
squamous cell carcinoma
``` actinic (solar) keratosis scaling, crusting, telangestias raised nodule, shallow ulcer head, neck, oral dx- punch bipsy ```
32
melanoma
``` 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
kaposi sarcoma
HIV or immunosuppressed herpes virus 8 most common in men on men painless purple red blue papules
34
formula for IV fluids for burns
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
what burns are worse
alkali
36
signs of inhalation burns
singed nose hairs facial burns carbonaceous sputum
37
rosacea
chronic skin disorder with intermittent facial flushing, telangectasias, and often large bulbous red nose
38
molloscum contagiosum
discrete, flesh colored, waxy dome shaped umbilicated papules pox virus
39
warts
verrucae caused by HPV topical therapies imiquod, surgery (cryosurgery-freeze)
40
dermatophyte lesions
``` 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
griseofulvin
antifungal | need to be careful in pts w/ alcohol (antabuse)
42
tinea versicolor
yeast infection of skin | tx- selenium sulfide shampoo (selson blue)
43
seborrheic dermatitis
itchy, flaking (usually found on scalp, behind ears, eyebrows, or nasolabial folds) erythematous, greasy, yellow scaling papules and patches with indistinct border
44
migrans vs marginatum vs multiform
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
what to do next if pap smear shows atypical squamous cells of undetermined significance
do HPV viral testing | If HPV comes back positive then do colposcopy
46
most common type of thyroid cancer
papillary
47
most common cause of encephalitis
HSV
48
most common cause of SVC syndrome
lung cancer (especially adenocarcinoma)
49
most common cause of acute bronchitis
rhinovirus
50
1st line tx in pcos
ocp
51
chornic silicosis
diffuse rhonchi and low pitched rales
52
wilson disease
ceruplasmin decreased copper accumulation liver biopsy is gold standard

PANCE (14 decks)

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