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Step 2 Rotation Cards > Derm > Flashcards

Derm Flashcards

1
Q

phemigus vulgaris basics

A

antibodies to desmosomes (desmoglein)
(+) nikolsklys sign
(+) oral mucosa involvement

30-50 y/o

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2
Q

dx and tx of phemphigus vulgaris

A

dx - biopsy - thin walled blister, cells all over the place
—> IF - throughout slide

tx - steroids then mycophenolate or rituximab

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3
Q

bullous phemigoid

A

abs against hemidesmosomes
60-80 y/o
(-) nikolskys sign, (-) oral mucosa

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4
Q

dx and tx of bullous phemphigoid

A

dx - intact epithelium, IF - BM lights up

tx - steroids (systemic), topical (if local)

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5
Q

dermatitis herpetiformis

- path -

A
  • celiac sprue
  • IgA deposition in the dermis

every pt with this dz has celiacs disease

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6
Q

dermatitis herpetiformis presentation

A

vesicular lesions
extensor surfaces
especially the buttock

pt will have celiac symptoms

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7
Q

dx and tx of dermaitis herpetiformis

A

1st - antibodies to antitransglutaminase, anti endomyseal

2nd - EGD -> biopsy
neutrophilic abscess

tx - avoid gluten

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8
Q

Porphyria cutanea tarda

A

path - uroporphyrinogen

pt - blisters on sun exposed areas, hairy, easy blistering on the dorsum of the hand

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9
Q

dx and tx of porphyria cutanea tarda

A

dx - woodlamp - turns coral red

tx - avoid sun exposure

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10
Q

insults that can cause cutanea tarda

A

hep c
hemachromatosis
recent OCPs

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11
Q

seborrheic dermatitis

A

autoimmune dz, malazzi

rash, flakes, face - where there is hair = rash
areas without hair will not have rash

tx - selenium shampoo

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12
Q

psoriasis

pathophys

A

autoimmune T helper cells

abundance of keratinocytes

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13
Q

psoriasis

presentation

A

erythematous patch with silver scale that bleeds when picked

extensor surfaces, gluteal fold
nail pitting
onchymycosis

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14
Q

dx and tx of psoriasis

A

dx - clinical

tx - UV light first –> topical steroids

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15
Q

sketchy lymphoma kinda hx and new psoriasis always

A

biopsy to rule out lymphoma

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16
Q

pityriasis rosea

A

self limiting
herald patch - oval well demarcated
- white ppl - salmon colored
- dark ppl - hyperpigmented

spares - palms and soles

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17
Q

lichen planus

A

purple palpable raised
lacy white line network

tx - topical steroids

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18
Q

medications that cause lichen planus

A

ace- i
thiazides
diuretics

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19
Q

atopic dermatitis

A

allergies, asthma, atopy,

pt - symmetric licheniefication, AC fossa, popliteal fossa and extensors

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20
Q

tx of atopic dermatitis

A

avoid trigger –> emollients –> topical steroids

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21
Q

contact dermatitis

A

type IV HSR
poison ivy, nickel, latex

tx - avoid trigger, topical diphehydramine

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22
Q

stasis dermatitis

A

path - peripheral edema, skin stretched overtime

edema, erythema, darkens (treebarkish) - bilaterally

tx - diuretics, compression stockings, elevate legs

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23
Q

stasis dermaitis is associated with

A

malleolar ulcers (stasis ulcers)

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24
Q

hand dermatitis

A

too much hand washing - health care workers, food industry

tx - stop it dont use harsh soaps

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25
Q

urticaria

pathophys

A

type I HSR
mast cell degranulation

IgE cross links mat cells –> histamine release –> capillary dilates –> leaky fluid

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26
Q

pt presentation of urticaria

A

annular red papule that does blanche

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27
Q

dx of urticaria

A

anaphylaxis –> hypotension –> IM epi

no ^^^ –> steroids + H1 + H2 antihistamines

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28
Q

drug rxn rash

A

pink morebiliform rash that is symmetric and widespread

(7-14) days after medication

tx - stop offending drug - antihistamines (mild) steroids (mod-severe)

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29
Q

erythema multiforme

path and presentation

A

path - immune complex mediated

pt - targetoid lesion, acral sights - knees, palms, faces sights

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30
Q

MCC of erythema multiforme

A

HSV, Drug Rxn, Syphillis

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31
Q

tx of erythema multiforme

A

topical steroids

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32
Q

steven johnson syndrome

A

degeneration of basal layer
dusky
<10%

tx - stop all meds –> burn unit –> pray

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33
Q

TEN

A

same as SJS except >30%

F/U - oral and ophtho involvement

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34
Q

drugs that can cause SJS/TEN

A

sulfa drugs
PCN

cephalosporins
antiretrovirals
anticonvulsants

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35
Q

staph scalded skin syndrome

A

staph infection that attacks desmosomes

infant –> febrile illness –> sloughing of skin –> starts in the skin folds

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36
Q

tx of staph scalded skin syndrome

A

Naficillin

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37
Q

Mole

A

benign
from melanocytes

R/o - ABCDE

38
Q

seborrheic keratosis

A

benign - kertinocytes
large greasy stuck on appearances

dx - if chronic - clinical vs if new - biopsy

39
Q

keratocanthoma

A

SCC that spontaneously resolves after 6wks

40
Q

Kaposi sarcoma

A

HHV 8
AIDs pt
Purple lesion

tx- treat aids its gets better

41
Q

actinic keratosis

A

premalignant lesion of keratinocytes

erythematous lesion with sand paper like scale
yellow to brown color

hx of sun exposure

42
Q

tx of actinic keratosis

A

biopsy –> cryoablation –> 5 FU

43
Q

Squamous cell carcinoma

A

path - malignant lesion of keratinocytes

MC location - lower lip 90%
flesh colored lesion with ulceration

sun exposure hx

44
Q

dx and tx of SCC

A

dx - biopsy

tx - resection - dont be shy as it can metastasize

45
Q

tinea versicolor

A

fungus, malezzia

scaly macules of varying color
areas that dont tan

46
Q

dx and tx of tinea versicolor

A

KOH prep (sphaghetti + meatballs)

tx - selenium shampoo or ketoconazole

47
Q

vitelligo

A

path - AI distinction of melanocytes

pt - sharply demarcated patches that are completely white

48
Q

dx and tx of vitilligo

A

dx - woodslamp - bx absence of melanocyte

tx - local high potency topical steroids
—> extensive –> UV light

49
Q

albinism

A

path - AR, decrease tyrosinase activity, cant make melanin

pt - white fair hair eyes skin

tx - keep out of sun

50
Q

prealbinism

A

melanocytic migration
or
white furlock

51
Q

ash leaf spots

A

tuberous sclerosis
congenital defect

check for shagreen patches (blood vessels) or adenoma sebacaie

52
Q

dx and tx of ash leaf spots

A

dx - woodslamp –> CT scan

tx - nothing they have MR szs and die young

53
Q

kid thats albino and has funny smell and orange crystals in diaper

A

PKU

54
Q

androgen alopecia

A

path - 5 Dihydrotestosterone

pt - circular patch that starts at back of head and circles and go forward

55
Q

tx of androgen alopecia

A

minoxidil

finasteride

56
Q

alopecia areata

A

path - AI destruction of hair follicle

pt - patch well circumscribed can be anywhere 
exclamation point (hair thins out as it goes down to follicle)
57
Q

tx of alopecia areata

A

steroids

58
Q

tinea capitis

A

path - fungal infection (trichophyton tonsurans)

pt - well circumscribed patch of hair loss with equal length

59
Q

dx and tx tinea capitis

A

dx - KOH prep

tx - oral griseolfulvin

60
Q

traction alopecia

A

path - pull hair too tight
pt - woman, braid, ponytail

dx - clinical
tx - none

61
Q

trichotillomania

A

path - OCD, PTSD
pt - pulls hair out, compulsion, hair in different length s

dx - clinical
tx - OCD

62
Q

stages of hair

A

1) anogen - growth
2) catogen - progression
3) telogen - resting
4) Exogen - shedding
5) back to anogen

63
Q

Anogen effluvium

A

takes growing hair to shedding phase

64
Q

Telogen effluvium

A

takes growing hair –> telogen phase

65
Q

Impetigo

A

path - strep or staph
kid, honey, crusted lesion on face

dx - clinical
tx - amoxicillin (allergy –> clinda)

complication –> glomerulonephritis, No RF

66
Q

Erisypelas

A

path - strep
pt - adults, infection of lymphatics, dark red well defined, indurated, climbing up the limb

dx - clinical
tx - Amoxicillin

67
Q

Acne path

A

propronium bacteria
hyperkeratinoziation
sebaceous glands

68
Q

acne ladder tx

A

1) topical retinoids - comedones
2) + benzyl peroxide - inflammed, pustules
3) + abx (doxy) - refractory, severe
4) Isotenion (teratogenic AF)

69
Q

tinea pedis and tinea cruris tx

A

topical antifungals

70
Q

tinea corporis

A

body
well described, circumscribed
moderate scaling with central clearing

tx - antifungall topical

71
Q

onchymycosis (nails)

A

oral terbenafine

dx - via KOH first

72
Q

acne vulgaris

pathogenesis

A

obstruction of sebaceous follicles by sebum –> leads to the proflieration of proprionbacterium

73
Q

risk factors for acne vulgaris

A

young pubertal male
cushing syndrome
oily complexion
androgens

74
Q

rosacea

A

reddening of face (forehead, nose, cheeks)
30-50 y/o
cacausian women

75
Q

tx of rosacea

A

topical metro (gel form)

76
Q

irritant contact dermatitis

A

ACUTE
rapid onset
more common

detergents, handwashing (chemical or physical)

77
Q

allergic contact dermaitis

A

delayed type IV HSR
poison ivy, nickle, latex

rash appears 1-2 wks after med - 1st exposure
hours to days - subsequent exposures

78
Q

acute stages of contact dermatitis appearance

A

erythematous papules and vesicles that are oozing

also maybe edema

79
Q

chronic stages of contact dermaitis appearance

A

crusting
thickening
scaling

80
Q

pityriasis rosea

A

xmas tree pattern
oval lesions
herald patches - papulosquamous eruption

spontaneously remits 6-8wks

81
Q

causes of erythema mutiforme

A

meds (sulfa MCC) PCN

HSV - acyclovir - recurs

82
Q

lichen planus

A

pruritic, poygonal, purple, flat toped papules

wrists shins oral mucosa, genitalia,

tx - glucorticoids

83
Q

most common STD

A 
codyloma acuminata (HPV) 
6,11 strains
84
Q

molloscum contagiosum

A

self limited viral infection - caused by poxvirus
small papules (2mm to 5mm) with central umbilication
highly contagious

85
Q

tx of scabies

A

permethrin

86
Q

scabies

A

interdigits of the fingers
extremely pruritic - worse at night
extremely contagious

87
Q

basal cell carcinoma

A

most common skin cancer
sun exposure, fair skinned ppl

NOSE = most common site
pearly smooth, pink papule

tx - resection

88
Q

marjoin ulcer

A

SCC arising from a chronic wound such as previous burn scar tends to be very aggressive

89
Q

most important prognostic indicator for melanoma

A

depth of invasion

90
Q

melanoma

A

ABCDE
changing mole MC presentation
MC site is BACK

advanced lesions present with itching and bleeding

91
Q

vitiligo is associated with

A

DM
hypothyroidism
Addisons disease
pernicious anmeia

Step 2 Rotation Cards (14 decks)

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