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Derm Flashcards

1
Q

Shave biopsy or full thickness biopsy for melanoma

A

Full thickness

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2
Q

Is shave biopsy okay for BCC

A

Yes

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3
Q

Type of surgery for BCC

A

MOHs micrographic surgery

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4
Q

Recurrence rate of BCC

A

Less than 5%

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5
Q

Describe MOHs microscopic surgery

A

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

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6
Q

Mohs surgery is best for what location

A

DELICATE areas— eyelid or ear

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7
Q

2 other places you find kaposis sarcoma

A

GI

LUNG

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8
Q

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

A

SEXUAL CONTACT

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9
Q

Treatment of kaposis sarcoma

A

HAART (no need to do surgery)

  • intra lesions vincristine or IFN
  • liposomal doxorubicin= last resort
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10
Q

Age of atopic dermatitis

A

Before 30yo

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11
Q

Lichenified

A

Thickened skin from scratching

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12
Q

Scaly rough areas of thickened skin

A

Eczema

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13
Q

What is common with eczema

A

Secondary infection with S aureus

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14
Q

Do food allergies exacerbate atopic dermatitis

A

NOOOO

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15
Q

Tx of eczema skin care

A
  1. Stay moisturized – lotion and humidifier
  2. Avoid bathing, soaps and washcloths
  3. Cotton> wool
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16
Q

Medical tx eczema

A
  1. Topical steroids
  2. Tacrolimus or pimecrolimus– helps them GET OFF steroids
  3. Antihistamines
  4. Antibiotics
  5. UVB – severe recalcitrant disease
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17
Q

Use of tacrolimus or pimecrolimus in eczema

A

Helping them GET OFF steroids

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18
Q

Severe eczema which anti-histamine

A

DOXEPINE

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19
Q

Mild eczema antihistamines

A

NON- sedating

Cetirizine, fexofenadine, loratadine

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20
Q

Which antibiotics when impetigo in eczema

A

Cephalexin
Mupirocin
Retapamulin

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21
Q

Risk of tacrolimus and pimecrolimus giving lymphoma

A

LOW RISK

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22
Q

Tx of psoriasis local disease

A
  • topical steroids
  • vit A and D
  • coal tar
  • tacrolimus and pimecrolimus
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23
Q

Tacrolimus and pimecrolimus use in psoriasis

A

FACE and PENIS since less potentially deforming

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24
Q

How do steroids cause skin atrophy

A

Inhibit collagen formation and growth

Try and convert all amino acids into glucose for gluconeogenesis

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25
Q

Worst prognostic factor skin cancer

A

Growing lesions

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26
Q

Tx of extensive psoriasis

A
  1. UV light
  2. Anti-TND
  3. MTX
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27
Q

Seborrheic dermatitis= dandruff

A

Hypersensitivity to dermal infection

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28
Q

Seborrheic = same as….

A

benign

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29
Q

Dandruff more common in patients with

A

AIDS

Parkinson’s disease

30
Q

What drug associated with pemphigus vulgaris

A

ACE inhibitors

31
Q

Most accurate diagnosis of pemphigus vulgaris

A

BIOPSY– Abs on immunofluorescent

32
Q

No tx of pemphigus vulgaris

33
Q

Weaning pemphigus vulgaris patients off steroids with….

A

Azathioprine or mycophenolate

34
Q

Initial tx of bullous pemphigoid

A

Prednisone

35
Q

Tx of mild bullous pemphigoid

A

Erythromycin
DAPSONE
Nicotinamide (not niacin)

36
Q

Porphyria cutanea tarda associated with

A

HepC
Iron overload
Estrogen use

37
Q

Most accurate diagnostic test in PCT

A

Increased uroporphyrins in a 24hr urine collection

38
Q

Where does PCT present?

A

Backs of the hands and face

39
Q

What is Porphyria Cutanea Tarda

A

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

40
Q

Number 1 tx of mild impetigo

41
Q

Community acquired MRSA impetigo tx

A

Doxy
CLINDAMYCIN
TMP-SMX

42
Q

Cause of eryysipelas

A

Strep> staph

43
Q

Mild skin infections = ORAL

A

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

44
Q

Severe skin infections–IV

A

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

45
Q

Antistaph penicillins

A

Ox, clox, diclox, naf

46
Q

Only cephalosporin that covers MRSA

A

Ceftaroline

47
Q

Penicillin allergy= rash and skin infection use…

A

Cephalosporins

48
Q

Penicillin allergy= mild anaphylaxis with skin infection use…

A

Macrolides
Clindamycin
Doxycycline
TMPSMX

49
Q

Penicillin allergy= severe anaphylaxis with skin infection use…

A

Vancomycin

Linezolid

50
Q

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

A

Second gen cephalosporins
Beta lactam/ beta lactamase combos
Carbapenems

51
Q

Most accurate test for tinea

A

Fungal culture

52
Q

Best initial tx of tinea

A

Topical fungal if no hair or nail involvement

53
Q

Best initial tx for hair or nail tinea

A

TERBINAFINE

54
Q

Best initial test for tinea

55
Q

Diagnosis of most cases of tinea Cruris

A

NO specific diagnostic test– aided by KOH

56
Q

Which specific type of ketoconazole causes Gynaecomastia

A

ORAL ketoconazole

57
Q

Efficacy of griseofulvin

A

LESSSSSSSSS than TERBINAFINE or intraconazlle

58
Q

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

A 
Penicillins
Sulfa drugs
Allopurinol 
Phenytoin
Lamotrigine
NSAIDs
59
Q

Spectrum of skin drug reactions

A

TEN> SJS> erythema multiforme> morbilliform rash

60
Q

Tx morbilliform rash

A

No specific tx

61
Q

Tx erythema multiforme

A

Prednisone

62
Q

Tx of SJS

A

Steroids are NOT NOT beneficial

Use IV IMMUNOGLOBULINS

63
Q

Do steroids help in TEN

A

NOOOOOOOO,

Tx= IV IMMUNOGLOBULINS

64
Q

Do antibiotics reverse SSS and TSS

A

Nooooooo, the just kill the staph producing the toxin

65
Q

Tx mild acne

A

Benzoyl peroxide

66
Q

Mild acne– if benzoyl peroxide is ineffective

A

Clindamycin or erythromycin

67
Q

Tx moderate acne

A

Topical vit A

68
Q

Topical vitamin A

A

Tretinoin
Adapalene
Tazarotene

69
Q

Moderate acne– if the topical vitamin A is ineffective,

A

Oral antibiotics

  • minocycline
  • doxycycline
70
Q

Severe acne tx

A

Oral vitamin A– isoretinoin

71
Q

Isoretinoin

A

Teratogenic

Hyperlipidaemia

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