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Derm Flashcards

1
Q

Syndromes associated with acanthosis nigrican?

A 
Hashimto's
Phenylketonuria
Dermatomyositis 
SLE
Scleroderma 
Wilson syndrome 
Hodgkin + nonhodgkin
Pheochromocytoma 
Ovarian / endometrial Ca
Genitourinary ca 
GI ca
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2
Q

What thyroid conditions associated with acanthosis nigrican?

A

Hashimto’s

Thyroid Ca

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3
Q

Rx of ganuloma annulare?

A

Self limiting (None)
Or
IL steroids
Topical / oral steroids

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4
Q

Is granuloma annulare contagious?

A

No.

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5
Q

Morphology of erysipelas?

A

Well demarcated warm tender erythema with raises borders.

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6
Q

Causative organism of erysipelas?

A

GAS (S. pyogenes)

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7
Q

Erysipelas in DM?

A

Associated with tinea pedis (portal of entry)

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8
Q

Why does s. aureus infection spreads to dermis & SQ?

A

Coagulase enzyme.

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9
Q

Characteristic features of actinomyces Israelii?

A

Infection of cervicofacial

Sinuses discharging sulphur granules

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10
Q

Hall mark of C. Perfringens?

A

Gas gangrene

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11
Q

Organism of molluscum?

A

Pox virus

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12
Q

Mode of infection of molluscum?

A

Direct contact

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13
Q

Classic molluscum?

A

Small nodule or papule with umbilicated center (1-5 mm)

Filled with caseous material.

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14
Q

Rx of erysipelas?

A

1st line: penicillin, dicloxacillin, cefazoline

2nd: cefaloxine, erythromycin

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15
Q

Most common cause of chronic urticaria?

A

Unknown

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16
Q

Infection associated with urticaria?

A

H. Pylori.

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17
Q

Classic BCC?

A

Slowly growing shiny papule with pearly borders and telangiectasia

With central dell or ulcer.

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18
Q

Rx of BCC?

A

Curettage
Excision
Radiation

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19
Q

Classic pyogenic granuloma?

A

Dumb-bell shapes bright red mass without white areas of surface ulcerations (<2.5 cm)

Found on mucosal surfaces after trauma or infection (oral)

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20
Q

Leukoplakia?

A

Persistent adherent white patch / plaque can’t be rubbed off.

Associated with smoking.

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21
Q

Rx of leukoplakia,

A

Stop smoking.

Disappears within year after smoking cessation.

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22
Q

Pityriasis Rosea Classic?

A

Red thin oval plaques / patches with central scaling

Starts as one herald patch the progresses.

Following Langer’s lines.

Christmas tree on back.

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23
Q

Varicella Rash?

A

2-3 successive corps of pruritic vesicles + papule over days

Evolve into pustules + crusts with various stages of development present.

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24
Q

Steroid induced acne?

A

Mono-morphic acne form eruption with explosive onset.

Upper trunk.

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25
Q

Skin tags association?

A

Obesity

DM

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26
Q

Skin tags + risk of cancer?

A

Not significant

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27
Q

Skin tags + risk of HIV?

A

Not associated.

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28
Q

Leishmaniasis classic?

A

Papule > ulcerates > shallow annular with raised margins

None healing after months.

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29
Q

Causes of scaring alopecia?

A 
1. Infection:
Syphilis
TB
AIDS
HZV
  1. Autoimmune:
    DLE
  2. Sarcoidosis
  3. Trauma
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30
Q

Scalp in trichotillomania?

A

Decrease hair density

Broken hair of varying length

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31
Q

Rx of rosacea?

A

Topical metro gel

Azelaic acid

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32
Q

Dupuytren’s contracture?

A

Shortened thickened fibrous fascia of palmar surface

With nodules on distal palms

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33
Q

Dupuytrens Contracture age?

A

> 40 YO

Men

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34
Q

Dupuytren’s contracture association?

A

DM
Smoking
Alcohol
Epilepsy

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35
Q

Rx of dupuytren’s contracture?

A

Observation
IL steroid injection
Surgery

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36
Q

Tinea pedis classic?

A

Painful, pruritic, vesicles/bullae with clear or purulent flui.
On anterior foot

Rupture => Scaling with erythema.

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37
Q

Complications of inflammatory tinea pedis?

A

Cellulitis, lymphangitis, adenopathy.

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38
Q

Tinea pedis association?

A

Dermatophytid reaction
On Palms and side of fingers symmetrically

Hyper sensitivity to infection on foot
(DDx dyshidrosis)

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39
Q

Rx of uncomplicated herpes zoster ophthalmicus?

A

Oral anti vitals
Acyclovir
Famcyclovir
Valicyclovir

Steroids for pain (no effect on post herpetic neuralgia)

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40
Q

Rx of post herpetic neurologia?

A

Capsaicin cream

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41
Q

Risk of paronychia?

A

Handling water

Exposure to irritant

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42
Q

Rx of paronychia?

A

Avoidance of water / chemicals

Potent topical steroids for 3-4 wk

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43
Q

Acute vs chronic paronychia?

A

Acute: swelling redness around nail + lateral pus

Chronic: swelling tenderness redness + thick discolored nail.

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44
Q

Pityriasis Rosea classic?

A

Herald patch:
3-5 cm erythematous patch with scaly border and central clearing

Followed by similar lesions on cleavage lines of skin.

Rash persist 2-3 mo

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45
Q

Rx of pityriasis Rosea?

A
  1. Reassurance
  2. Topical Steroids for itch
  3. Sever = phototherapy
    (?) erythromycin for 2 weeks.
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46
Q

Keratoacanthoma classic?

A

Skin colored - red Dome shaped nodule with central keratin plug smooth shiny surface heals within 6-12 mo

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47
Q

Most common cause of EM?

A

HSV

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48
Q

Rheumatological Dz with risk of Ca?

A

Dermatomyositis

49
Q

Cancer associated with dermatomyositis?

A 
Ovarian 
Lung
Pancreas 
Gastric 
CRC
Non-Hodgkin
50
Q

Sjogren syndrome associated with what Ca?

A

Non-Hodgkin lymphoma

51
Q

Dupuytren’s contracture affected finger?

52
Q

Trigger finger classic?

A

Locking of finger in flexed position when extended snaps back

Due to narrowing of space within sheath that surrounds tendon (inflammation)

53
Q

Sx of trigger finger?

A

Pain
Stiffness
Clicking with movement
Nodule on base of finger

54
Q

Most common affected finger in tigger finger?

55
Q

Camptodactylyl classic?

A

Painless flexion contracture of the proximal inter-phalangeal joint (progressive slowly)

56
Q

Most affected finger in camptodactylyl?

57
Q

Sx of camptodactylyl?

A 
No swelling (IMP)
Involves MP + distal IP
58
Q

What mediate an allergic reaction?

59
Q

Rx of cellulitis?

A

Oral:
Cephalexin
Dicloxacillin
Clindamycin

IV:
Cefazolin
Oxacillin
Nafcillin

60
Q

Rx of seborrheic dermatitis?

A
  1. Hygiene, shampoo, topical steroids

2. Resistant => oral ketoconazole or fluconazole

61
Q

Causative organism in seborrheic dermatitis?

A

Pityroaporum

62
Q

Rx of dental infection w/ cellulitis?

A

Penicillin

Clindamycin if allergic

63
Q

Risk of leukoplakia malignant transformation?

64
Q

Onychomycosis classic?

A

Nail plate separation from nail bed.

Thickened nail

Dystrophic nail

Discolored nail (white, yellow)

65
Q

Rx of onychomycosis?

A

1st line:
Terbinafine 250mg OD 6wk for fingernails + 12wk for toe nail.

2nd line:
Itraconazole 200mg for 6 + 12 wks.

66
Q

Monitor labs in terbinafine?

A

CBC, AST, ALT at 0, 4, 6

67
Q

Cause of acute paronychia?

A

Trauma to nail fold or cuticle

68
Q

Rx of acute paronychia?

A

Topical Abx +/- steroids.
Oral Abx
Warm compressors
I+D

69
Q

Rx of psoriasis?

A

Topical Steroid
Phototherapy
MTX
Etretinate stopped = risk of birth defects now used for T-Cell lymphomas.

70
Q

Erythema multiforme classic?

A

Target / iris like lesions

71
Q

Is nutritional supplement helpful in pressure ulcer healing?

72
Q

Head elevation is helpful in pressure ulcer to minimize sheer pressure?

73
Q

Degree of bed elevation in pressure ulcer to help minimize sheer pressure?

A

< 30 degrees

74
Q

When to use oral antibiotics in pressure ulcer?

A

Complicated by:
Cellulitis
Osteomyelitis
Bacteremia

75
Q

Period to use topical Abx in pressure ulcer?

76
Q

Cause of stasis dermatitis?

A

Chronic venous insufficiency

77
Q

Lichen simplex chronicus classic?

A

Habitual scratching > isolated hyper-pigmented edematous nodules/papules.

78
Q

Cause of chronic paronychia?

79
Q

Canadiasis classic?

A

Poorly marginated
Bright red plaques
With satellite papules / pustules

Pruritic

80
Q

Location of candidiasis in M+F?

A

Men: inguinal-scrotal fold > thighs , gluteal cleft , scrotum

Female: labia majora + minora +

81
Q

Dx of candidiasis?

A

KOH

Culture

82
Q

Rx of candidiasis?

A

Topical imidazoles BID (clotriazole, ketoconazole, miconazole)

Drying agents: anti-fungal powders (miconazole, nystatin, tolnaftate, 12% benzoic acid, undecylenic acid)
Or aluminum sulfate calcium acetate solution.

If sever itchiness > add steroids (hydrocortisone)

83
Q

Topical or oral anti-fungal for tinea capitulation? Why?

A

Oral

To penetrate hair shaft.

84
Q

Rx of contact dermatitis?

A

Anti-pruritic
Avoidance of irritants
Cool compressors (burow’s solution)
Topical steroid: (triamcinolone 0.1% or betamethasone valerate cream 0.1%)

Oral prednisolone 60mg OD for 7-14 days for sever blistering disease.

85
Q

Mechanism of action of minoxidil?

A

Prolongs anagen phase

Increase blood flow to follicle

86
Q

Minoxidil helps what areas of scalp the most?

A

Vertex alopecia

87
Q

Mechanism of action of finasteride?

A

5a reductase

Blocks conversion of testosterone to dihydrotesteron

88
Q

Dose of proscar?

A

1 mg PO OD

89
Q

Rx of andogentic alopecia?

A 
Minoxidil
Finastride
Hair transplant
OCP
Spirnolactone
90
Q

Natural course of actinic keratosis?

A

Most regress spontaneously

Some => SCC

91
Q

Felon classic?

A 
Sever pain 
Fluctuance 
Redness 
Tenderness 
On top of medial / dorsal finger.
92
Q

What’s felon / whitlow?

A

Infection of digital pulp of terminal phalanx

93
Q

Eponychia classic?

A

Painful

Pus around nail.

94
Q

When do symptoms of contact dermatitis appear and why?

A

12-48 hr after contact

Delayed hypersensitivity reaction

95
Q

Patch test results in contact dermatitis?

A 
\+1 = erythema + edema 
\+2 = papules 
\+3 = vesicles / bullae
96
Q

Leishmaniasis transmission?

A

Sandflies bite

97
Q

Rx of leishmaniasis?

A

Sodium stibogluconate

98
Q

What nutritional intervention help pressure ulcer?

A

Protein intake at 1.2-1.5 g/kg/day

+ increased calorie intake.

99
Q

Cause of erythrasm?

A

Corynebacterium infection

100
Q

Erythrasm under woods light?

101
Q

Rx of erythrasm?

A

Topical Abx:
Fusidic acid
Clindamycin (1st line)
Erythromycin

102
Q

Sx of sarcoidosis?

A
  • Eye = uveitis
  • Neuro = 7th CN
  • skin = lupus pernio + erythema nodosum
  • Cardio = restrictive cardiomyopathy
  • renal
  • hepatic
  • hyper calcemia
103
Q

What’s pernio lupus?

A

Indurated red-purple shiny nodules and papules on face

104
Q

Cause of hypercalcemia in sarcoidosis?

A

Secondary to Vit D production by granulomas

105
Q

Labs for HSV?

A

Culture
PCR
DIF
Serology

106
Q

Sx of sarcoidosis?

A
  • Eye = uveitis
  • Neuro = 7th CN
  • skin = lupus pernio + erythema nodosum
  • Cardio = restrictive cardiomyopathy
  • renal
  • hepatic
  • hyper calcemia
107
Q

What’s pernio lupus?

A

Indurated red-purple shiny nodules and papules on face

108
Q

Cause of hypercalcemia in sarcoidosis?

A

Secondary to Vit D production by granulomas

109
Q

Labs for HSV?

A

Culture
PCR
DIF
Serology

110
Q

Derm causes of pruritus?

A 
Scabies
Pediculosis 
Insect bite
Urticaria 
Atopic dermatitis 
Contact dermatitis 
Lichen planus
Dermatitis herpetiformis
111
Q

Anti-pruritic Rx?

A

Topical:
Camphor/menthol lotions

Systemic:
Hydroxyzine

112
Q

Rx of scabies?

A

Permethrin

Lindane

113
Q

Rx of dermatitis herpitiformis?

A

Dapson

Sulfonamides

114
Q

Prodorm of lichen planus?

A

Low grade fever for 2 days.

115
Q

Lichen planus classic?

A 
6 p
Purple 
Planar = flat topped 
papule
Plaques
Polygonal 
Pruritic 
Penis
116
Q

Maximal period of LP rash to spread!

117
Q

Rash of 2ry syphilis?

A

Proceeded by chancre
Maculopapular eruption
Widespread (+palms / soles)

118
Q

Tinea corporis classic?

A

Pink scaly patches with the raised borders and occasional Papules and pustule

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