derm Flashcards
erysipelas usually caused by..
group a streptococci
folliculitis treatment
- no abx
- heat
- if no resolution, topical mupirocin or chlorhexidine cleanser
skin abscess treatment
I&D
abx if febrile/immunocompromised/dieabetic
culture abscess?
yes, can help MRSA vs. MSSA
impetigo treatment
topical mupicirocin or bacitracin
ecthyma treatment
Cleanse with antibacterial wash followed by topical mupirocin + oral ceflex
if zoster recurs think
HIV
treatment of zoster
antiviral therapy within 2-3 hours of onset of rash may speed healing, decrease pain, and reduce incidence of postherpetic neuralgia.
what suggests stasis dermatitis vs. cellultis
- bilateral, absence of fever/leukocytosis, minimal pain
stasis dermatitis treatment
- topical glucocorticoids (if erythema and inflammation are present)
- leg elevation
- knee-level compression stockings
seborrheic dermatitis treatment
- low potency glucocorticoids (face)
- ketoconazole cream (face)
- medicated shampoos containing ketoconazole or selenium sulfide (scalp)
guttate psoriases
immune condition usually triggered by URI with streptococcus pyogenes
aphthous ulcer treatment
topical analgesics + topical glucocorticoids
Behcet’s presentation
aphthous ulcers + urogenital ulceration’s + iridocyclitis
when to screen for dyslipidemia
35 for men at average risk for CAD
secondary causes of dyslipidemia
hypothyroidism, obstructive liver disease, nephrotic syndrome, alcoholism uncontrolled diabetes, smoking, kidney failure
4 groups expected to benefit from statin therapy
1) clinical atherosclerotic cardiovascular disease
2) LDL-C greater than 190 mg/dL
3) Diabetes and age 40-75 years with an LDL-C of 70-189 and no ASCVD
4) No ASCVD or DM and estimated 10-year ASCVD risk greater than 7.5%
high intensity statin therapy recommendation
1) LDL of 190 or greater if less than 75
2) AASCVD if less than 75
3) diabetes if 40-75 with LDL-C of 70-189 and 10-year ASCVD risk greater than 7.5
moderate intensity statin therapy recommendation
1) ASCVD if greater than 75 years of age
2) diabetics if 40-75 years of age with an LDL of 70-189 and 10-year risk less than 7.5
moderate intensity statin therapy recommendation
1) ASCVD if greater than 75 years of age
2) diabetics if 40-75 years of age with an LDL of 70-189 and 10-year risk less than 7.5
lab to order before starting statin
aminotransferase (can elevate, greater than three times upper, don’t start)
labs to order when person is on statin
lipid testing q12 months to ensure adherence
other impt features of strep throat
- absent cough
- tender anterior cervical adenopathy
treatment of nodular (cystic) acne
Moderate: topical retinoid + benzoyl peroxide + topical antibiotics
severe: add oral antibiotics
unresponsive severe: oral isotretinoin
treatment of inflammatory acne
mild: topical retinoids + benzoyl peroxide
moderate: add topical antibiotics
severe: add oral antibiotics
treatment of comedonal acne
topical retinoids
pressure (decubitus) ulcers
- usually occur over bony prominences
SJS vs. TEN
SJS denotes involvement of less than 10% of body surface area, TEN denotes greater than 30%
epidermoid inclusion cysts vs. lipomas
- Lipomas are usually soft to rubbery and irregular and do not regress or recur.
- EICs are freely movable cysts or nodules with a small central punctum. Can gradually increase in size but usually resolve spontaneously.
other acanthosis nigricans associations
- PCOS (insulin resistance state)
- GI malignancy in older individuals
catch about d-dimer
good test for patients with low pre-test probability. problem is FALSE POSITIVES. It has very good negative predictive value though.
how to think about sensitivity
how often test picks up disease in population of patients with disease
how to think about specificity
how often test is negative in population of patients without disease
FOBT test
good sensitivity, good NPV
alpha1-antitrypsin deficiency patient
young person who develops COPD
stage III COPD management
1) long-acting bronchodilator (eg, tiotropium)
2) inhaled steroid (eg, fluticasone)
2) SABA on short-term basis
symptoms of right heart failure
Liver congestion, JVD, lower extremity edema.
mgmt of Rh negative woman
- Figure out if she has ab’s with indirect coombs test –> if negative no isoimmunization and RhoGam is given at 28-week gestation and again at delivery if baby is confirmed as Rh positive. If antibody screen is negative –> assessment of titer will tell you how at risk fetus is.
trisomy assessment for patient who doesn’t want invasive testing
US for nuchal translucency + serum hCG and PAPP-A can give risk for trisomy
when kid is supposed to sit forward-facing
- weighs more than 20 lbs
- older than 1
DTaP recommended at ages
2,4,6, and 12-15 months
oral polio vaccine for children?
not recommended. give inactivated, injectable
MMR vaccination
ages 12-15 months, 4-6 years
varicella vaccination?
12-15 months and 4-6 years
chronic allergy drug
montelukast
why second-generation antihistamines are better..
less sedating
bupropion and varenicline pregnancy categories
C. can be used during pregnancy.
most common cause of B12 dficiency
pernicious anemia (can be seen with vegetarians but the body’s b12 stores last several years before they are depleted)
