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Derm > derm > Flashcards

derm Flashcards

1
Q

dx with wright stain showing multinucleated giant cell and eosinophilic intranuclear inclusions

A

neonatal herpes

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2
Q

incontinentia pegmenti

A

vesicles in a linear pattern without an erythematous base

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3
Q

rash present at birth with multiple pustules, brown macule, vesicles, pustules on a non erythematous base

A

transient neonatal pustular melanosis
“leaving a collarette”
more common in African Americans

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4
Q

gram stain in transient neonatal pustular melanosis

A

PMNs without organisms

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5
Q

neonatal rash with yellow pustules on an erythematous base

A

E tox

not present at birth
spares palms and soles
not in premies
fades in ~1wk

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6
Q

neonatal rash with generalized erythematous macules with solitary papules or vesicles in the center

A

E tox

not present at birth
spares palms and soles
not in premies
fades in ~1wk

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7
Q

gram stain in E tox

A

eosinophils

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8
Q

neonatal rash with diffuse scaling and erythematous papules and pustules

A

cutaneous candidiasis

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9
Q

eczema herpeticum

A

invasion of eczematous skin with herpes virus
-inflamed eczema which is not responding to steroids or abx
-vesicle and punched out or crusted lesions
-usually see on the face
tx w/ acyclovir

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10
Q

eczema with evidence of immunodeficiency

A

Wiskott Aldrich syndrome & hyperimmunoglobulin E syndrome

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11
Q

young child with seb derm also w/ profuse ear discharge and profuse urine output

A

histiocytosis x

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12
Q

how is the poison ivy rash contagious?

A

it isn’t!

fluid from the vesicles does not spread the rash

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13
Q

rash to the soles of the feet that is scaly, thick and has hyperlinearity of the distal soles with nl normal interdigital skin

A

juvenile plantar dermatosis

type of contact dermatitis
tx with steroids cream-triamcinoloone

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14
Q

erythematous plaques surrounded by thick adherent scales. with pinpoint hemorrhages under the plaques

A

psoriasis

pinpoint bleeding is called Auspitz sign

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15
Q

round, oozing, crusting, erosions and dry macules with scaly pattern

A

nummular eczema

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16
Q

small, oval, thick scaling plaques with the long axis lesions parallel to the likes of skin stress

A

pityriasis rosea

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17
Q

treatment for pityriasis rosea

A

nothing

but exposure to sun or light improves sx and may hasten resolution

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18
Q

thin scales with pasted on appearance

A

ichthyosis vulgaris

looks like fish skin

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19
Q

treatment for ichthyosis vulgaris

A

keratolytic agents- ammonium lactate cream
alpha hydroxy acid
urea containing emollients

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20
Q

non scaling annular lesion without epidermal involvement

A

granuloma annulare

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21
Q

what is the cause of staph scalded skin syndrome

A

exotoxin produced by staph aureus

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22
Q

what is the cause of toxic shock syndrome

A

caused by toxin production either by S aureus or strep- mortality of strep TSS is much higher than staph TSS

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23
Q

what is the cause of scarlet fever

A

toxin caused by erythrogenic exotoxin produced by GAS- commonly a/w strep pharyngitis

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24
Q

what is the difference of staph scalded skin and TEN

A

SSSS does not involve the dermis and TEN does

  • distinguish by biopsy
  • also SSSS often in younger kids and TEN in older kids
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25
Q

what is TEN from

A

a hypersensitivity rxn

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26
Q

rash with boggy and blue ulcers on a necrotic base

A

pyoderma gangrenosum

usual a/w systemic dz

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27
Q

erythema infectiousum

A

fifth disease
slapped cheek
a/w parvo

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28
Q

erythema marginatum

A 
a/w rheumatic fevers
Jones criteria
Joint involvement w/migratory arthritis
O myOcarditis
Nodes subq
Erythema marginatum
Sydenham chorea
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29
Q

treatment for scabies

A

permethrin 5%

tx all family members bc highly contagious

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30
Q

how long can lice live away from scalp

A

36 hrs without a blood meal

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31
Q

maculae caeruleae

A

blue-grey macules on the abdomen or inner thigh

c/w pubic lice

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32
Q

treatment for molluscum

A

nothing! will clear in mos to yrs

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33
Q

wright stain for molluscum

A

viral inclusion bodies

34
Q

pink, excoriated, pruritic lesions with central punctum in clusters on the extensor surfaces of the arms and legs

A

papular urticarial

occurs typically at night
can last up to 7 days

35
Q

what is the cause of papular urticaria

A

delayed hypersensitivity rxn to an insect bite

36
Q

what causes the black color of blackheads

A

melanin

37
Q

adenoma sebaceum

A

angiofibromas that can appear red/pink/brown

38
Q

meds that lead to acne

A

systemic steroids, anticonvulsants

39
Q

side effects of isoretinoin

A
  • dry lips
  • dry eyes
  • dry skin
  • nose bleeds
  • HA
40
Q

gold standard for dx of tinea capitis

A

fungal cx

41
Q

tx of choice for tinea capitis

A

griseofulvin 6-12 wks

or fluconazole or terbinafine

42
Q

what is telogen effluvium

A

loss of large amounts of hair after washing or brushing- triggered by stressful event/illness

43
Q

pigmented lesions that turn into hives and develop blisters- particularly with rubbing

A
  • also called darier sign
  • uticaria pigmentosa
  • occurs typically in first 6 mos of life
  • worsened by narcotics, NSAIDs, and contrast
44
Q

how to dx tinea versicolor

A

KOH prep

45
Q

how to tx tinea versicolor

A

astringents and topic antifungals

limit sun exposure as this worsens rash

46
Q

incontinenentia pigmenti

A

xlinked dominant- lethal in males

1- erythematous papules and vesicles in crops along the lines of Blaschko that last 1-2 wks
2- swirls of warty growths
3- streaks of hyperpigmentation in marble cake pattenr
4- hypopigmentation

47
Q

pityriasis alba

A

post inflammatory hypopigmentation in atopic skin

48
Q

MRI finding in sturge weber

A

venous leptomeningeal angiomatosis- a/w port wine stain

49
Q

tx of port wine stain

A

tunable dye laser (pulsed dye laser)

50
Q

where is the port wine stain in sturge weber?

A

trigeminal distribution

need ophtho referral

51
Q

what is the inheritance of ichthyosis vulgaris

A

AD

52
Q

what is the dx:

child presents in the first year of life with prominent scales over the extensor surfaces with flexor sparing. The rash improves with warm/humid weather. On exam there is noted hyperlinearity of the palms and soles

A 
ichthyosis vulgaris (AD)
d/t loss of fxn of filaggrin
tx with emollients and keratolytics (lactic acids) avoid salicylates
53
Q

what are the adverse effects of topical steroids (6)

A
  • folliculitis
  • perioral dermatitis
  • steroidal acne
  • skin atrophy
  • telangiectasias
  • adrenal suppression
54
Q

what is the difference between eczema herpeticum and eczema coxsackium

A

eczema coxsackium is more superficial

55
Q

what bony deformities are seen with NF1

A 
macrocephaly
short stature
sphenoid dysplasia
cervicothoracic kyphoscoliosis
pseudoarthrosis of tibia
pectus excavatum
genu valgum/varum
scoliosis
56
Q

chromosome __ is involved in NF1

A

17q11.2

neurofibromin (guanosine diphosphate-activating protein GAP) = tumor suppressor

57
Q

chromosome __ is involved in NF2

A

22

58
Q

what is mccune albright syndrome (5)

A 
large segmental cafe au lait
also a/w...
- accelerated linear growth
- precocious puberty
- skeletal defects- polyostotic fibrous dysplasia with bowing of arms
- endocrine abnormalities
59
Q

what is PHACES

A 
Posterior fossa malformation
Hemangioma (segmented, cervicofacial)
Arterial anomalies (intracerebral)
Cardiac anomalies/coarc
Eye abnormalities
Sternal defects
60
Q

what do you need to investigate in children with lumbosacral hemangiomas

A

spinal cord or GU abnormalities

61
Q

what do you need to investigate in children with beard-like hemangiomas

A

airway compromise

62
Q

what do you need to investigate in children with multiple (>5) hemangiomas

A

internal/visceral hemangiomas (live, lung, GI, eyes, CNS)

63
Q

what is the dose of griseofulvin for tinea capitits

A

20 mg/kg/d with fatty foods to increase absorption

tx 6-8 wks

64
Q

what is the dx

2 week old infant with bullous rash
noted to have staph colonization of the umbilical stump

A

bullous impetigo

65
Q

how long does pustular melanosis last

A

present at birth-several mos

66
Q

gram stain findings with:

miliaria rubia (heat rash)

A

many PMN

no bacteria

67
Q

gram stain findings with:

e tox

A

many eos
maybe some PMN
no bacteria

68
Q

gram stain findings with:

transient neonatal pustular melanosis

A

many PMNs

no bacteria

69
Q

gram stain findings with:

bullous impetigo

A

any PMN

gram pos cocci in clusters

70
Q

name the dx

child with many 0.2-1 cm scaly papules and plaques distributed symmetrically over the trunk and proximal extremities following GAS

A

guttate psoriasis

71
Q

what is the concern in an infant with a large congenital melanocytic nevi

A

neurocutaneous melanosis, melanoma, spinal dysraphism, dandy walker

72
Q

what is the diagnostic criteria of juvenile dermatomyositis (5)

A

skin signs plus 3

  • cutaneous featurs (heliotrope, gottons sign)
  • progressive symmetrical weakness of proximal mm
  • elevated muscle enzymes
  • myopathy on EMG or MRI
  • biopsy evidence of myositis and necrosis
73
Q

what further work up must be done in a child with a midline facial dermoid cyst

A

need MRI to look for CNS comminication

74
Q

what bug is usually a/w necrotizing fasciitis

A

GABHS

75
Q

how do you transmit molluscum

A

skin to skin and autoinnoculation

76
Q

what do you need to worry about in the future for children d/w lichen sclerosis

A

increase risk of lesional squamous cell carcinoma in affected adults

77
Q

what is the inheritance of hidrotic ectodermal dysplasia

A

AD

78
Q

what is the inheritance of hypohidrotic ectodermal dysplasia

A

x linked R

79
Q

name the dx

child with nail dystrophy, hyperkeratosis of the alms and soles, and hair defects
of note there are NO abnl facies

A

hidrotic ectodermal dysplasia

80
Q

name the dx

young boy with absent/reduced sweating, hypotrichosis, defective dentition

A

hypohidrotic ectodermal dysplasia

Derm (1 decks)

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