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USMLE STEP 3 Questions > Derm > Flashcards

Derm Flashcards

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USMLE® Step 1 flashcards
1
Q

Nonpainful mass that evolves into abscesses, fistulas, yellow/thick discharge… The culprit?

A

Actinomycosis - gram pos, transmitted by humans only. Due to gingivitis, cavities, OMFS trauma

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2
Q

Pustule that ulcerates over time with nonpurulent discharge in a healthy person who is outdoors… What is the culprit?

A

Sporotrichosis - fungus into subq tissue

Tx with ittaconazole for 3 months

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3
Q

Chronic urticaria

A

Symp lasting >6 wks and disapear in a day

Due to histamine released from mast cells

Most idiopathic, other causes by stress, nsaids, cold/heat

No need for lab tests unless other systemic symp

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4
Q

Tx for chronic urticaria

A

H1 blocker, can add singulair and conside brief course steroids
Topical steroids not recommended

Should resolve in few yrs

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5
Q

Acne recommendations

A

Water based products (no oil)

Antibacterial face scrubs no evidence

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6
Q

Middle age adult with shiny, pruritis, polygonal shaped violaceous plaque and papule on flexure regions extremitieS, genitals

A

Dx clinically and with skin biopsy
Not infectious
Thought to be due to immune activation with t cells against basal keratinocytes of epidermis.

Assoc with hep c

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7
Q

Pruritic rash worse at night found on flexor regions of wrists, fingers. Excoriations with small crusting and linear burrows

A

Scabies

Dx with skin scrapings for mites, ova, feces

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8
Q

Tx of scabies

A

Permethrin cream and then wash 14 hrs later

Otherwise oral ivermectin

Bedding and clothes should be placed in plastic bag for at least3 days bc the mites cannot live away from human skin got more than 3 days.

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9
Q

Tx of photoaging and actinic keratosis (20% risk of SCC)

A

All trans retinoic acid which is fda approved to reduce fine wrinkles, hyperpigmentation, rough skin

Can also use for AK- 5FU, imiquimod

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10
Q

T cell lymphoma of skin due to mycosis fungiodes treatment

A

Interferon alpha

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11
Q

Tx of seborrheic dermatitis

A

Tar based cream and shampoo

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12
Q

Well demarcated circular areas of complete hair loss. Also see fingernail pitting.

Tx?

A

Alopecia areata

Often self limited but may relapse and be chronic and progressive

Incr risk autoimmune dz

Tx with intralesional steroids or TOPICSl steroids but be aware even wo tx may go away in a yr and its no cure.

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13
Q

What does hair loss from medications look like? Ie what kind of meds?

A

Thinning of hair

Bb, anticoag, anticonvulsanta, antithyroid

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14
Q

Hair loss from tinea capitus looks like:

Hair loss from trichitillomania looks like

A

Tinea capitus will have inflammation, black dot alopecia from breakage of hair near scalp

Trichotillomania - irregular shaped areas of hair loss with diff length hair

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15
Q

Scarring, nodular lesions, tenderness of axilla suspicious for? Treatment?

A

Hidradenitis - inflamm disorder of skin in axilla, groin etc

Icr w weight, fam hx, smoking

Tx
Mild- topical clinda
Moderate - scarring and sinus tract involvement- oral abx like doxy

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16
Q

Scarring, nodular lesions, tenderness of axilla suspicious for? Treatment?

A

Hidradenitis - inflamm disorder of skin in axilla, groin etc

Icr w weight, fam hx, smoking

Tx
Mild- topical clinda
Moderate - scarring and sinus tract involvement- oral abx like doxy

17
Q

Photosensitivity (sunburn) in someone on acne treatment due to what tx?
What is tx?

A

Benzoyl peroxide and oral tetracycline and doxycycline

Tx w NSAIDS to help w pain and redness, oral antihistamines. Not enough evidence for topical antihistamines

18
Q

What side effects to worry about in someone on oral isotretinoin?

A

HyperTG causing pancreatitis (so avoid alcohol), women to use two oral contraceptives, hyperglc. Men on it dont have to worry too much about contraception bc very little amount in semen

19
Q

Well circumscribed erythematous patch that becomes bullae and then ulcerates on abdomen?

What is tx?

A

Ecthyma gangrenosum - due to pseudo
Going into artery and vein and causing ischemic necrosis

Vs pyoderma gangrenosum usually on legs

Tx is only iv abx. Not surgical debridement. Need two drugs including tobra or amikacin.

20
Q

Erysipelas is due to which organism

A

Strep a!!!! Not staph

Red, painful demarcation, edem, elevated

21
Q

Wart on plantar foot tx?

How long for eradication?

A

Salicylic acid. First soak foot in warm water 20 min then salicylic acid and duct tape for 3 days and then sandpaper it down

2-3 weeks and then need to continue tx for 2 weeks more

22
Q

Treatment for tinea capita? Is it assoc with periauricular LAD?

A

With ORAL antifungal like oral griseofulvin. Yes assoc with LAD!

Note that lice does not cause alopecia like tinea capitus does

23
Q

Tx of keloid scar w
Excision
Cryosurg
IntraLESIONAL steroids

A

Intralesional steroids which are injections

24
Q

Tx of rosacea

Complication!?

A

If just erythema and telangiectasia- topical brimonidine

If papular postular - topical metronidazole or azelaic acid

Complication is ocular complaint like foreign body, blepharitis:keratitis:conjunctivits and chalazions

25
Q

Recent dx of diabetes and now w red crusting skin rash w central clearing, weight loss

A

Glucagonoma- check for high glucagon lvl

Tx is surg

26
Q

What is sunscreen rec for a kid who plays outdoors and fam hx of melanoma?

A

Put on sunscreen spf at least 30

Spf DOES protect against melanoma, basal and squamous!!

27
Q

Lichenified pruritis plaque along beltline is

A

Allergic contact dermatitis!! To nickel, rubber, leather etc

28
Q

Tx of seborrheic dermatitis?

A

Shampoo- selenium or zinc or tar

29
Q

Rash on hands, f, malaise and weight loss, difficulty climbing up stairs or raising from chair (proximal muscle weakness), w high ck has? What is test to dx?

A

Dermatomyositis

Dx w clinical and ANA, other tests like anti jo, la, sm, rnp

dont need skin biopsy unless equivocal results

30
Q

Dermatomyositis has incr risk of ?

A

Malignancy!!

Need routine screening done

31
Q

Hypopigmented spots w fam hx of deadness suggests what dz

A

nf-2!! Vs nf1 you get hyperpig

Deaf bc bl acoustic neuroma

Vs tuberous sclerosis have many organ hamartomas and cysts
Sturge weber us port wine stain and meningial angiomatosis

Osler rendu weber is telangiectasia and lesions of cns

32
Q

Mulitple red colored papules w central umbilication in hiv pt is

A

Cutaneous crypto

Dx w BIOPsY not india ink which is for csf

33
Q

Slow growing but hard tumor on abdomen w previous abd surgeries that took them out

A

Desmoid tumor are locally aggressive benign neoplasms w high rate recurrence

Vs dermatofibroma benign after truama or insect bite

USMLE STEP 3 Questions (20 decks)

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