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Derm Flashcards

1
Q

What is the atopic triad

A

Asthma
Eczema
Allergic rhinitis

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2
Q

Contact dermatitis is what kind of reaction

A

Type iv hypersensitivity

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3
Q

“Linear” or “angular” rash often refers to

A

Contact dermatitis

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4
Q

Define papules

A

Elevated solid skin lesion <1cm

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5
Q

Plaque is a

A

Papule >1cm

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6
Q

Describe type I hypersensitivity reaction

A

First and fast (anaphylaxis, urticaria)

Antigen cross-links Ige on last cells and triggers release of histamines

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7
Q

What is serum sickness

A

Antibodies to the foreign proteins are produced in -5 days, immune complexes are deposited on membranes

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8
Q

Serum sickness is usually caused by

A

Drug reaction

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9
Q

Tb skin tests, transplant rejection and contact dermatitis are examples of ___ hypersensitivity

A

Delayed, type IV

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10
Q

Seborrheic dermatitis can be caused by a hypersensitivity reaction to

A

Malassezia furfur, a yeast

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11
Q

Cradle cap is due to

A

Seborrheic dermatitis

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12
Q

What am I? Severe red diaper rash with yellow scale, erosions and blisters

A

Seborrheic dermatitis

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13
Q

Tx of seborrheic dermatitis in adults

A

Selenium sulfide or zinc pyrithione shampoos

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14
Q

Baby with hx of eczema with new onset rash and fever and grouped vesicles in eczematous areas. What is it?

A

Eczema herpeticum, Medical emergency due to systemic spread of hsv infection

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15
Q

Tx of eczema herpeticum

A

Iv acyclovir

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16
Q

A rash involving extensor surfaces

A

Psoriasis

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17
Q

Rash involving flexor surfaces

A

Atopic dermatitis

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18
Q

What is auspitz sign

A

Classical presentation of psoriasis-pinpoint bleeding when scale is scraped

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19
Q

Drug reaction rashes usually occur how long after exposure

A

7-14 days

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20
Q

What kind of lesions do you see in erythema multiforme

A

Target lesions

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21
Q

Palms, soles and mucus membranes are often affected in

A

Erythema multiforme

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22
Q

Nikolsky sign in erythema multiforme is

A

Negative

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23
Q

If nikolsky sign is present, what two scary things should be on your differential

A

Sjs and ten

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24
Q

Biopsy of sjs shows

A

Degeneration of basal layer of epidermis

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25
Q

Biopsy in ten shows

A

Full thickness eosinophilic epidermal necrosis

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26
Q

Scalded skin syndrome is usually seen in____ and has an ___ etiology

A

Kids under six

Infectious

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27
Q

Sjs/ten is usually seen in ___ and is generally caused by ___

A

Adults

Drug reaction

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28
Q

Location of blisters in bullous pemphigoid

A

Basement membrane zone

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29
Q

Location of blisters in pemphigus vulgaris

A

Intraepidermal

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30
Q

Autoantibodies in bullous pemphigoid are directed against

A

Hemidesmosomal proteins

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31
Q

Autoantibodies in pemphigus vulgaris are directed against

A

Desmoglein responsible for keratinocyte adhesion

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32
Q

Nikolsky sign is ___ in bullous pemphigoid and ___ in pemphigus vulgaris

A

Negative

Positive

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33
Q

Pt age in bullous pemphigoid

A

> 60

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34
Q

Pt age in pemphigus vulgaris

A

40-60

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35
Q

Erosions are more common in bullous pemphigoid or pemphigus vulgaris

A

Pv

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36
Q

Tx of bullous pemphigoid

A

Steroids

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37
Q

Tx of pemphigus vulgaris

A

High dose steroids + immunomodulatory therapy

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38
Q

Dermatitis herpetiformis is associated with which dz

A

Celiac

39
Q

Dx of herpes simplex lesion

A

Viral culture of lesion

40
Q

If you have herpes what do you see on tzanck smear

A

Multinucleated giant cells

41
Q

Molluscum contagiosum is what kind of virus

A

Pox virus

42
Q

Tiny flesh colored dome shaped waxy papules with central umbilication. What am I

A

Molluscum contagiosum

43
Q

Impetigo tx

A

Mild localized dz: topical abx like mupirocin

Severe non-Mrsa: cephalexin, dicloxacillin

Severe Mrsa: bactrim

44
Q

Community acquired ___ is an increasingly common cause of cellulitis

A

Mrsa

45
Q

Dysphasia, drooling, fever and red warm mouth. What am I?

A

Ludwig angina, a bilateral cellulitis

46
Q

What is Fournier gangrene

A

A form of necrotizing fasciitis that is localized to genital and perineal area

47
Q

A small red patch on a Child’s cheek or extremities that turns into a painful shiny plaque. What am I

A

Erysipelas, common causes by gas

48
Q

Tx of erysipelas

A

Penicillin

49
Q

Tinea versicolor is caused by

A

Malassezia furfur

50
Q

Tx of tinea versicolor

A

Ketoconazole or selenium sulfide

51
Q

Treatment of lice

A

Permethrin

52
Q

Intense pruritus esp at night and after hot showers is characteristic of

A

Scabies

53
Q

Scabies generally appears in ___ tracks

A

Linear, representing burrows of the mite

54
Q

Which can be seen with the naked eye, lice or scabies?

A

Lice

55
Q

Three subtypes of gangrene

A

Dry
Wet
Gas

56
Q

Dry gangrene is due to

A

Insufficient blood flow to tissue usually from atherosclerosis

57
Q

Wet gangrene is due to

A

Bacterial infection, usually with skin flora

58
Q

Gas gangrene is due to

A

C perfringens infection

59
Q

Demographic of pts with rosacea

A

Middle aged with fair skin more common in women

60
Q

Tx of rosacea

A

Metronidazole

61
Q

Which spares palms and soles, pityriasis rosea or secondary Syphillis

A

Pityriasis rosea

62
Q

Initial treatment of dermatitis herpetiformis

A

Dapsone

63
Q

Immediately after severe burns, infections tend to be caused by

A

Gram positives eg staph aureus

64
Q

After 5 days post a severe burn, most infections are due to

A

Gram negatives (pseudomonas) or fungi

65
Q

Right sided heart failure following an implantable pacemaker, think

A

Tricuspid regurg

66
Q

Treatment of congenital long qt

A

Refraining from vigorous exercise, avoiding meds that can cause long qt, maintaining normal levels of calcium, potassium and magnesium

Beta blockers and pacemaker

67
Q

What am I? Painful vesicles with an erythematous base that evolves to a punched out erosions with hemorrhagic crusting

A

Eczema herpeticum

68
Q

Eczema herpeticum is due to what virus

A

Hsv1

69
Q

What non-skin findings are associated with eczema herpeticum

A

Fever, irritability, lymphadenopathy

70
Q

Tinea versicolor is caused by what bug

A

Malassezia globosa

71
Q

Arterial ulcers occur where

A

Farthest distal places like tips of toes

72
Q

What is a marjolin ulcer

A

Scc arising in a burn wound

73
Q

Bright sharply demarcated erythema over perianal/perineal area in school aged children is likely

A

Perianal strep

74
Q

Tinea capitis is most common in kids of what race

A

African American

75
Q

Scaly, erythematous plaque on scalp that can progress to patchy alopecia plus lymphadenopathy

A

Tinea capitis

76
Q

3 ds of pellagra

A

Dermatitis
Diarrhea
Dementia

77
Q

In acute intermittent porphyria can you have diarrhea?

A

Yes

78
Q

In acute intermittent porphyria are symptoms episodic or chronic

A

Episodic

79
Q

Can pellagra by triggered by isoniazid

A

Yes

80
Q

Can acute intermittent porphyria by triggered by isoniazid

A

Yes

81
Q

What is a dermatofibroma

A

Common benign fibrous nodule on lower legs often hyperpigmented

See dimpling in the center when the area is pinched

82
Q

What is congenital melanocytic Nevus

A

Benign proliferation of melanocytes usually forming solitary, hyperpigmented lesions with increased density of overlying dark coarse hairs

83
Q

A furuncle is a

A

Hair follicle abscess

84
Q

Tx of furuncle/folliculitis

A

Topical abx (mupirocin) for mild disease

More severe disease-treated like impetigo-oral cephalexin or cloxacillin

85
Q

Is eczema itchy and scaly

A

Yes

86
Q

Rash in someone on infliximab/generally immunocompromised? Think

A

Shingles

87
Q

Tx of staph scalded skin syndrome

A

Nafcillin

88
Q

Anaphylactic reaction mechanism

A

Antigen cross links igE on mast cells, releasing histamine

89
Q

What is anaphylaxis

A

Hypotension in response to allergic reaction

90
Q

What happens to hives when you push on them

A

They blanch

91
Q

Immune response to sle and rheumatoid arthritis

A

Type iii, antigen-antibody immune complexes activate complement

92
Q

Erythema multiforme is ___mediated, forming a ___ lesion and most commonly associated with

A

Immune complex
Targetoid lesion
Hsv

93
Q

Tx of sunburn

A

Cool compresses, calamine lotion, NSAIDs

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