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PANRE > derm > Flashcards

derm Flashcards

1
Q

alopecia areata

A

ass with autoimmune
exclamation point hairs

complete scalp hair loss: totalis
complete hair loss on scalp and body–> universalis

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2
Q

androgenic alopecia

A

minoxidil and oral finasteride- androgen inhibitor

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3
Q

eczema

A

triad: eczema, allergic rhinitis and asthma
increase IGE production: ALLERGEE
flexor creases- blisters/papules/plaques- then looks similar to psoriasis when it crus over (antecubital or popliteal folds)

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4
Q

nummular eczema

A

coin shaped lesions (knees and elbows)- sharply defined- tx is topical corticosteroids- antihistamines, wet dressings. tracolimus, pimecrolimus (good alternatives to steroids- topical calcineurin inhibitors)

maintain skin hydration

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5
Q

dyshidrosis

A

tense vesicles on soles, palms and fingers (lateral digitis)

tx: topical steroids

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6
Q

lichen complex chronicus

A

skin thickening in patients WITH ECZEMA due to rubbing/scratching
EXAGGERATED SKIN LINES
- dont scratch lesions- topical steroids

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7
Q

lichen planus

A

INCREASED INCIDENCE WITH HEP C!!
idiopathic- cell mediated immune response!!
purple, polygonal, planar, pruritic papules WITH FINE SCALES!!
skin, mouth, scalp, genitals, nails- mucous
KOEBNER’s phenomenon-
WICKHAM Striae- oral mucosa fine white lines
TX: corticosteroids

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8
Q

pityriasis rosea

A

viral infection- HHV7
HERALD PATCH- salmon colored macule on trunk - then smaller oval salmon-colored papules with circular scaling along cleavage lines IN A CHRISTMAS tree pattern
NO TX: antihistamines for pruritis, oatmeal baths

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9
Q

Psoriasis- plaque, pustular, or guttate

A

hyperplasia- proliferation cells in the stratum basale and stratum spinosum due to T cell ACTIVATION and cytokine release
plque: silver/white scales- extensor surface- elbows/knees/scalp/neck nape- nail pitting- oil spot (discoloration under nail)
auspitz sign- bleed when removing plaque
koebner - new skin lesions at trauma

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10
Q

psoriatic arthritis

A

inflammatory arthritis associated with psoriasis- join stiffness more than 30 minutes- relieved with activity
sausage digits- pencil in cup deformity

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11
Q

TX FOR PSORIASIS

A 
topical steroids 1st LINE
vitamin D analogs 
topical tar
topical retinoids
vitamin A analogs

sever: phototherapy, UVB, PUVA, methotrexate

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12
Q

TINEA versicolor

A

malassezia furfur- YEAST!
hypo or hyperpigmented macules with FINE scaling- fails to tan
KOH PREP- hyphae and spores- SPHAggeti and meatballs
wood lamp- yellow-green flourescene-

TX: ANTIFUNGALS- selenium sulfide, zinc, azoles, itraconazole or fluconazole

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13
Q

seborrheic derm

A

hypersens to MALAssezia furfur possibly?
IN AREAS OF HIGH sebaceous gland oversecretion- scalp, face, eyebrows, body folds
worse in winter
CRADLE CAP FOR INFANTS!!- red plques with fine white scales
ADULTS- SCALP, eyelids, folds
TX: selenium sulfide, ketoconazole shampoo, zinc, steroids, antifungals (itra, fluco, keto, terbinafine),
FOR BABY with cradle cap: ketoconazole, baby shampoo

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14
Q

hypersenstivity reactison

A

triggers: food, bites, drugs, exercise induced, infectious
type I: ige mediated- urticaria and angioedema- immediate
type 2: antibodies mediated= causes cell lysis
type 3/: immune antibody-angine complex
type Iv: delayed- erythema multiforme - morbilliform-

Morbilliofrm/erythematous- most common

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15
Q

urticaria

A

blanchable, edematous pink papules, wheals or plaques- hives disappear within 24 hours and new crops come
can have dermatographism- local pressure causes wheals in that area
darierls sign: when skin is rubbed- urticaria formed
USE ANTIHISTAMINES AS TX

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16
Q

erythema mulltiform

A

TYPE IV hypersensitivyt reaction
HSV MC
SULFA, BETA LACTAMS, phenytoin, phenobarbital!!!
TARGET LESIons! : dusty-violet red, purpric macules/vesciles or bullae in the CENTER- surrounded by edematous rim and red halo

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17
Q

EM MINOR

A

no mucosal membrane lesions

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18
Q

EM major

A

involvement of more than 1 mucous membranes (oral, genital or ocular)- NO EPIDERMAL DETACHEMENT!
TX: symptomatic, STEROIDS

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19
Q

SJS

A

SULFA or anticonvulsant meds- NSAIDS< allopurinol, abx
10% of sloughing of body surface area
blisters everywhere, fever, URI symptoms- involves more than 1 mucous membrane WITH EPIDERmal detachment- NIKOLSKY sign
TREAT AS SEVERE BURNS!!

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20
Q

TEN

A

sloughing of more than 30 % of body

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21
Q

acne

A

due to increased sebum
clogged sebaceous glands
propionibacterium acne overgrown
inflammatory resposnse

blackhead-s - open
closed (white heads)

severe: nodular or cystic acne

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22
Q

management of acne

A

mild: retinoids, benzoyl peroxide, topical abx, ocps
retinoids- inflammatory acne
benzoyl peroxide: decreases propionibacterium
topical abx: clinda
MODERATE: oral abx and anti androgen agents like doxy or minocycle= tetracyclines and spironolactone

SEVERE: isotretinoin- highly teratogenic- must ahve 2 pregnacy tests before therapy- 2 forms of contraception

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23
Q

rosacea

A

triggers are ETOH, increase temp, hot drinks, hot /cold weather, hot baths, spicy foods

acne like rash and redness, facial flusing, telngiectasia, skin coaresening, papulopustules with burn and stinging.
NO BLACKHEADS!!!- this is what distinguishes from acne
TX: METRONIDAZOLE

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24
Q

TX FOR ROSACEA

A

METRONIDAZOLE! TOPICAL!!!!

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25
Q

actinic keratosis

A

MC premalignant skin condition to squamous cell carcinoma
DRY ROUGH SCALY sandpaper skin lesion- HYPERKERATOTIC plques!!

Tx: cryosurgery

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26
Q

seborrheic KERATOSIS

A

sebborheic- means its benign= MC benign skin tumor- velvet, warty lesion- GREASY /stuck on appearance
NO TREATMENT
but cryoterhapy if you want

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27
Q

common plantar warts

A

thrombosed capillaries- has red brown punctations

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28
Q

verruca plana- flat warts

A

flesh colored papules- seen on face, hands, shins

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29
Q

genital- condyloma acuminata

A

painless, soft fleshy califlower

30
Q

warts dx

A

whitening of lesion with acetic acid application- most will resolve within 2 years

31
Q

gardasil vaccination

A

11-26 women
gardasil 9 treats for 6,11,16, 18 and other types of HPV
gardasil alone for 6,11,16,18

32
Q

vitiligo

A

AUTOIMMUNE DESTRUCTION OF MELANOCYTEs- skin depigmentation

tx: corticosteroids, systemic phototherapy,

33
Q

basal cell carcinoma

A

SLOW GROWING! MC type of skin cancer in US
translucent, pearly, waxy papul with CENTRAL ulcerations and RAISED, rolled borderes- face, nose, trunk
BLEEDS EASILY!
- telangiectatic vessesll
punch or shave biopsy

0 electro desiccation, mohs

34
Q

malignant melanoma

A

UV RADIATION MOST COMMON REASON!
agressive- high mets potential!!!

ABCDE: assymetry, border,s irrgeular, color, diameter more than 6 mm, evolution
THICKNESS- used as prognastic for METS!!

full thickenss wide exciesional biposy plus lymph node biopsy

35
Q

SQUAmous cell carcinoma

A

red, elevated, thickened nodule with WHITE SCALY or crusted, bloody margins
do biopsy
wide local surgical excision

36
Q

kaposi

A

HHV- 8, HIV , HAART therapy

37
Q

erythema nodosum

A

anterior shins- painful, erythematous- due to ESTROGEN exposure, sarcoidosis, IBS, coccidiodomycosis!!!

38
Q

ipetigo

A 
highly contagious- HONEY COLORED RUST!!
staph AUREUS MC
also can be GABHS
tx: mupirocin- bactroban tid X 10
cephalexin- if systemic- 1st generation cephalosporin
39
Q

folliculitis

A

hair follicle=- staph aureus-

topical mupirocin, clinda, erythromycin

40
Q

furuncle (boil)

A

deeper infection of the hair follicle- Tender - fluctuant ABSCESS with CENTRAL plug- I AND D
heat compresses

41
Q

carbuncle

A

larger more painful than furuncles- but interlocking- abscesses with MULTIPLE openings or plus cellulitis

42
Q

cellulitis

A

mc caused by S. aureus!! and GROUP A beta hemolytic STREPtococcus - similar to impetigo cuases

erysipelas: strep A!!! mc - well demarcated margins of cellultis= intensely erytehmatous - involves FACE mostly!!!-

43
Q

TX for erysipelas

A

IV penicillin, vanycomycin if pen allergy or mrsa suspected

44
Q

cellulitis tx

A

cephalexin, dicloxacillin - 7-10 days

MRSa: iv vanco or linezolid

45
Q

cat bite

A

pasteurella multocida- AMOX/clauvulanate FIRST LINE

doxy- if pcn allergic

46
Q

dog bite

A

amox/clavulanate

47
Q

human bite

A

amox/clavulantte

48
Q

puncture wound through shoe

A

CIPRO- covers PSEUDOMANS

49
Q

paronychia

A

infection of nail margin- MC staph

warm soaaks, or cephalexin , I and D

50
Q

scabies

A

very itchy, linear burrows, intertriginous zones- web sapces between fingers/toes- more intense at night- papules or nodules on scrotum, glans or penile shaft, body folds- SCABIES!

51
Q

tx for scabies

A

permethrine topical- FIRST line

or LINDANE- don’t use after bath or shower- causes siezures- not to be used on young children or teratogenic

52
Q

molluscum

A

poxiridael family- highly contagious

DOME SHAPEd=- flehs colored pearly white, waxy papules with CENTRAL umbilication- no treatment

53
Q

dermatophytosis

A

fungal skin infections: trichophyton, microsporum,

IF MICROSPORUM- you will see green flourescence in wood’s lamp

54
Q

tinea capitus

A

alopecia- ring worm- po grisofulvin

55
Q

tinea pedis

A

athlet’es foot- topical antifungal or po griseofulvin

56
Q

onychomycosis

A

nail infection- itraconazole and terbinafine. systemic would be grisofulvin

57
Q

pemphigus vulgaris

A

AUTOIMMUNE!!!- desmosome disruption- no more barrier function- ANTI DESMOSOME/anti epithelia ab- TYPE II HSN

painful FLACCID skin bullae- ruptures easily - nikolsky sign
IGG throuthout the epidermis- skin biopsy dx
HIGH DOSE CORTICOSTEROIDS OR METHOTREXATE!

58
Q

bullous pemphigoid

A

ELDERLY!! type II just like- DRUG INDUCED!
TENSE BULLAE- dont rupture easily
NO NIKOLSKY!
systemic corticosteroids

59
Q

MELASMA

A

too much estrogen (OCPS, pregnancy), sun exposure

tX: hydroquinone

60
Q

BROWN RECLUSE SPIDER

A

local burning, then blanced area, erythematous margin around ischemic center, then heorrhagic BULLAE!!! NECROSIS!

local woundcare, pain control

61
Q

BLACK WIDOW SPIDER

A

usually contact with spider–outdoor activities, furniture outside use, gardening

SYSTEMIC SYMPTOMS- black widow tortures you systemically - muscle pain, spasms and rigidity- OPIOIDS FOR PAIN!! or muscle relaxants

62
Q

burn management

A 
rule of 9
head: 9
whole arm: 9
Trunk : 36
lower limbs: 18 each 
genital is 1
63
Q

burn!!!!

A

wash with mild soap and water- COOL COMPRESS!- do not apply ice directly!!!
debridement, remove the ruptured blisteres
aBX: silver sulfadiazine- DONT USE ON FACE!!! - no use if sulfa allergy or pregnancy or small children!!!

superficial burns- no dressing
cover partial and full thickness burns with sterile dressing to prevent infection
IV fluids

64
Q

superficial burn

A

epidermis- red, DRY, painful, +refill inteact

65
Q

superficial partial thickness- 2nd degree

A

epiderm and superficial portion of derm- pink, moist, weeping, +blistering
MOST PAINFUL OF ALL BURNS!!!- very tender
+refill intact

66
Q

deep partial thickness burn- 2nd degree

A

epiderm into deep portion of dermis, +blistering- not very finally - absent capillary refill- scarring

67
Q

full thickness - THIRD

A

WAXY, white, leathery, dry, painless no capillary refill

68
Q

4th DEGREE

A

black, charred, dry, painless, absent capillary refill

69
Q

carbon monoxide

A

odoroless, tasteless, colorless- 200 times more affinity to hemoglobin- seizures, brain hypoxia, coma, cardiac arrhtymias, diagnosed with ABG, give 100% oxygen

70
Q

high voltage electric injuries

A

ECG- rhabdo

PANRE (18 decks)

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