Derm

Question 1

Shave biopsy or full thickness biopsy for melanoma

Answer 1

Full thickness

Question 2

Is shave biopsy okay for BCC

Answer 2

Yes

Question 3

Type of surgery for BCC

Answer 3

MOHs micrographic surgery

Question 4

Recurrence rate of BCC

Answer 4

Less than 5%

Question 5

Describe MOHs microscopic surgery

Answer 5

Removing skin cancer under a dissecting microscope with immediate frozen section; loss of only smallest amount of normal tissue;
No need to remove a wide margin

Question 6

Mohs surgery is best for what location

Answer 6

DELICATE areas— eyelid or ear

Question 7

2 other places you find kaposis sarcoma

Answer 7

GI

LUNG

Question 8

AIDS from injecting drugs or sexual contact more likely to give kaposis sarcoma

Answer 8

SEXUAL CONTACT

Question 9

Treatment of kaposis sarcoma

Answer 9

HAART (no need to do surgery)

• intra lesions vincristine or IFN
• liposomal doxorubicin= last resort

Question 10

Age of atopic dermatitis

Answer 10

Before 30yo

Question 11

Lichenified

Answer 11

Thickened skin from scratching

Question 12

Scaly rough areas of thickened skin

Answer 12

Eczema

Question 13

What is common with eczema

Answer 13

Secondary infection with S aureus

Question 14

Do food allergies exacerbate atopic dermatitis

Answer 14

NOOOO

Question 15

Tx of eczema skin care

Answer 15

1. Stay moisturized – lotion and humidifier
2. Avoid bathing, soaps and washcloths
3. Cotton> wool

Question 16

Medical tx eczema

Answer 16

1. Topical steroids
2. Tacrolimus or pimecrolimus– helps them GET OFF steroids
3. Antihistamines
4. Antibiotics
5. UVB – severe recalcitrant disease

Question 17

Use of tacrolimus or pimecrolimus in eczema

Answer 17

Helping them GET OFF steroids

Question 18

Severe eczema which anti-histamine

Answer 18

DOXEPINE

Question 19

Mild eczema antihistamines

Answer 19

NON- sedating

Cetirizine, fexofenadine, loratadine

Question 20

Which antibiotics when impetigo in eczema

Answer 20

Cephalexin
Mupirocin
Retapamulin

Question 21

Risk of tacrolimus and pimecrolimus giving lymphoma

Answer 21

LOW RISK

Question 22

Tx of psoriasis local disease

Answer 22

• topical steroids
• vit A and D
• coal tar
• tacrolimus and pimecrolimus

Question 23

Tacrolimus and pimecrolimus use in psoriasis

Answer 23

FACE and PENIS since less potentially deforming

Question 24

How do steroids cause skin atrophy

Answer 24

Inhibit collagen formation and growth

Try and convert all amino acids into glucose for gluconeogenesis

Question 25

Worst prognostic factor skin cancer

Answer 25

Growing lesions

Question 26

Tx of extensive psoriasis

Answer 26

1. UV light 2. Anti-TND 3. MTX

Question 27

Seborrheic dermatitis= dandruff

Answer 27

Hypersensitivity to dermal infection

Question 28

Seborrheic = same as....

Answer 28

benign

Question 29

Dandruff more common in patients with

Answer 29

AIDS | Parkinson's disease

Question 30

What drug associated with pemphigus vulgaris

Answer 30

ACE inhibitors

Question 31

Most accurate diagnosis of pemphigus vulgaris

Answer 31

BIOPSY-- Abs on immunofluorescent

Question 32

No tx of pemphigus vulgaris

Answer 32

DEATH

Question 33

Weaning pemphigus vulgaris patients off steroids with....

Answer 33

Azathioprine or mycophenolate

Question 34

Initial tx of bullous pemphigoid

Answer 34

Prednisone

Question 35

Tx of mild bullous pemphigoid

Answer 35

Erythromycin DAPSONE Nicotinamide (not niacin)

Question 36

Porphyria cutanea tarda associated with

Answer 36

HepC Iron overload Estrogen use

Question 37

Most accurate diagnostic test in PCT

Answer 37

Increased uroporphyrins in a 24hr urine collection

Question 38

Where does PCT present?

Answer 38

Backs of the hands and face

Question 39

What is Porphyria Cutanea Tarda

Answer 39

Hypersensitivity of skin to abnormal porphyrins when they are exposed to light

Question 40

Number 1 tx of mild impetigo

Answer 40

MUPIROCIN

Question 41

Community acquired MRSA impetigo tx

Answer 41

Doxy CLINDAMYCIN TMP-SMX

Question 42

Cause of eryysipelas

Answer 42

Strep> staph

Question 43

Mild skin infections = ORAL

Answer 43

Dicloxacillin, cephalexin, cefadroxyl Penicillin allergy: erythromycin, clarithromycin MRSA: doxycycline, clindamycin, TMPSMX

Question 44

Severe skin infections--IV

Answer 44

Oxacillin, nafcillin, cefazolin Penicillin allergic: clindamycin, vancomycin MRSA: vancomycin, linezolid, daptomycin, tigecycline, ceftaroline

Question 45

Antistaph penicillins

Answer 45

Ox, clox, diclox, naf

Question 46

Only cephalosporin that covers MRSA

Answer 46

Ceftaroline

Question 47

Penicillin allergy= rash and skin infection use...

Answer 47

Cephalosporins

Question 48

Penicillin allergy= mild anaphylaxis with skin infection use...

Answer 48

Macrolides Clindamycin Doxycycline TMPSMX

Question 49

Penicillin allergy= severe anaphylaxis with skin infection use...

Answer 49

Vancomycin | Linezolid

Question 50

Broad spectrum agents that cover staph but are not specific for skin infections-- NO need to add anything for skin infection if already on them

Answer 50

Second gen cephalosporins Beta lactam/ beta lactamase combos Carbapenems

Question 51

Most accurate test for tinea

Answer 51

Fungal culture

Question 52

Best initial tx of tinea

Answer 52

Topical fungal if no hair or nail involvement

Question 53

Best initial tx for hair or nail tinea

Answer 53

TERBINAFINE

Question 54

Best initial test for tinea

Answer 54

KOH

Question 55

Diagnosis of most cases of tinea Cruris

Answer 55

NO specific diagnostic test-- aided by KOH

Question 56

Which specific type of ketoconazole causes Gynaecomastia

Answer 56

ORAL ketoconazole

Question 57

Efficacy of griseofulvin

Answer 57

LESSSSSSSSS than TERBINAFINE or intraconazlle

Question 58

Drugs that causes hypersensitivity reactions are the same that cause hemolysis, interstitial nephritis and often drug induced thrombocytopenia (except heparin)

Answer 58

``` Penicillins Sulfa drugs Allopurinol Phenytoin Lamotrigine NSAIDs ```

Question 59

Spectrum of skin drug reactions

Answer 59

TEN> SJS> erythema multiforme> morbilliform rash

Question 60

Tx morbilliform rash

Answer 60

No specific tx

Question 61

Tx erythema multiforme

Answer 61

Prednisone

Question 62

Tx of SJS

Answer 62

Steroids are NOT NOT beneficial Use IV IMMUNOGLOBULINS

Question 63

Do steroids help in TEN

Answer 63

NOOOOOOOO, | Tx= IV IMMUNOGLOBULINS

Question 64

Do antibiotics reverse SSS and TSS

Answer 64

Nooooooo, the just kill the staph producing the toxin

Question 65

Tx mild acne

Answer 65

Benzoyl peroxide

Question 66

Mild acne-- if benzoyl peroxide is ineffective

Answer 66

Clindamycin or erythromycin

Question 67

Tx moderate acne

Answer 67

Topical vit A

Question 68

Topical vitamin A

Answer 68

Tretinoin Adapalene Tazarotene

Question 69

Moderate acne-- if the topical vitamin A is ineffective,

Answer 69

Oral antibiotics - minocycline - doxycycline

Question 70

Severe acne tx

Answer 70

Oral vitamin A-- isoretinoin

Question 71

Isoretinoin

Answer 71

Teratogenic | Hyperlipidaemia