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Derm Flashcards

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1
Q

What diseases should be in the ddx if there are recurrent aphthous ulcers?

A

IBD
Celiacs
Becets

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2
Q

What is the treatment for herpes gingivostomatitis?

A

IBU/tylenol
hydration
acyclovir

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3
Q

Who gets herpes gingivostomatitis? Why?

A

Children, since this only occurs with the first episode

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4
Q

If gingivostomatitis presents in adults, how does this differ form presentation in kids?

A

More posterior in the posterior oropharynx

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5
Q

What is the treatment for herpetic whitlow?

A

Supportive care

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6
Q

How do you differentiate between aphthous ulcers vs herpes labialis?

A

Herpes will be along the vermillion border, whereas aphthous ulcers will be in the oropharynx

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7
Q

What are the red/brown dots that are characteristic of warts (verruca vulgaris)?

A

Thrombosed capillary loops

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8
Q

How do you differentiate between a callus vs a wart?

A

Dermatoglyphic will be intact with a callus, whereas they will be distorted with a wart

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9
Q

Genital warts in children = ?

A

Sexual abuse

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10
Q

How do you differentiate between condyloma accuminata vs condyloma lata?

A

Lata = wet, soft , velvety = syphilis

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11
Q

What are the three C’s of measles?

A

Cough, coryza, conjunctivitis (Koplik spots)

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12
Q

How does the rash of Measles spread and resolve?

A

Head to feet, coalesces, then disappears in the order is came

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13
Q

What is the treatment for measles?

A

Supportive care or IgM if immunocompromised. Should get better in 1-2 weeks

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14
Q

What is the diagnostic test for measles?

A

Serum IgM + RNA PCR of saliva, serum, urine

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15
Q

What are the skin findings of scarlet fever? (4)

A
  • Pastia lines
  • Sandpaper rash the desquamates
  • Strawberry tongue
  • Circumoral pallor
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16
Q

How does the rash in rubella differ from rubeola?

A

Rash does not darken like measles

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17
Q

How long does rubella vs rubeola last?

A 
Rubella = 3 days
Rubeola = weeks
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18
Q

What are forchheimer spots?

A

Palatal petechiae seen in rubella (also seen with strep pharyngitis)

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19
Q

What is erythema infectiosum? Presentation? Treatment?

A

Slapped cheek syndrome caused by parvovirus

  • Slapped cheeks, lacy rash with circumoral pallor
  • GSC
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20
Q

Who should kids with erythema infectiosum avoid?

A

SCC or pregnant pts

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21
Q

What is erythema subitum (sixth disease)? Presentation? Treatment?

A
  • High fever for several days, then morbilliform rash forms with defervescence
  • gsc
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22
Q

Pruritic dew drops on a rose petal in different stages = ?

A

VZV

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23
Q

What is the treatment for chickenpox?

A

gsc or acyclovir if immunosuppressed or older than 12 yo

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24
Q

How does herpangina present compared to coxsackievirus?

A

High fever with papulovesicles in the posterior oropharynx

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25
How do you differentiate herpangina vs HSV that involves the posterior oropharynx?
Many more lesions with HSV than with herpangina
26
What medication can be given to older pts in anaphylaxis who do not respond to epi?
Glucagon
27
What is the appearance of erythema multiforme?
Target lesions that involves palms and soles
28
What is the major viral cause of erythema multiforme?
HSV
29
True or false: erythema multiforme does not involve the mucosa
True, for the most part
30
True or false: SJS and TEN do not involve the mucosa
False
31
IS SJS/TEN nikolsky sign positive or negative?
Positive
32
What TBSA distinguishes TEN from SJS?
Less than 10% for SJS vs greater than 30% for TEN
33
What IV therapy may benefit SJS/TEN (not IVFs)?
IVIG
34
What is the classic abx that causes SJS?
Bactrim
35
Describe the following for staph scalded skin syndrome: - Nikolsky - Painful? - mucous membrane involvement - Tense or flaccid bullae
- Positive nikolsky - Very painful - No mucus membrane involvement - Flaccid bullae
36
What is and is NOT the treatment for staph scalded skin syndrome?
- Anti-staph abx | - NO steroids
37
What are the three phases of staph scalded skin syndrome?
- Tender erythroderma - Exfoliation - Desquamation
38
What are the characteristics of the rash with meningococcemia?
Palpable purpura with dusky, necrotic centers
39
What is the classic presentation of necrotizing fasciitis?
``` POOP BUllae with crepitance Rapid progression Systemic toxicity DIrty dishwater discharge ```
40
How does the rash of Rocky mountain spotty fever progress?
Wrists and ankles, spreads inward
41
What is the treatment for RMSF?
Doxycycline
42
What is the natural history of RMSF?
MSOF in many
43
What are the components of the mnemonic "Sifting Rocks scabbed Emma's Palms", to help remember the rashes that involve the palms?
``` Syphilis RMSF Scabies Erythema multiforme PALMS ```
44
Which has a positive Nikolsky sign: pemphigus vulgaris or bullous pemphigoid?
Pemphigus vulgaris
45
Which has tense bullae, and which has flaccid bullae: pemphigus vulgaris vs bullous pemphigoid?
``` Flaccid = PV Tense = BP ```
46
What is the treatment for pemphigus vulgaris?
Parkland formula, admit, **steroids**
47
Which involves mucus membranes: PV or BP?
PV
48
What is the treatment for BP?
Steroids
49
What is the difference in natural history of PV vs BP?
PV dies | BP typically do not
50
What is the presentation of toxic shock syndrome?
- Fever - Shock with MSOF - Erythroderma
51
What is purpura fulminans?
Loss of protein C leads to diffuse coagulopathy, causing clots to forms everywhere
52
What is the presentation associated with purpura fulminans?
- Fever - Shock - Hemorrhagic skin necrosis with widespread ecchymosis
53
What is the treatment for purpura fulminans?
- Tx underlying cause - Transfuse - Admit
54
What is the presentation of disseminated gonococcus? (rash, s/sx)
- 10-20 Petechiae/necrotic pustules that are gunmetal gray - Suppurative arthritis - Flu like symptoms
55
What are the highest yielding cultures for disseminated gonococcus?
- Cervix/penis | - throat
56
What is the treatment for impetigo?
Mupirocin
57
What is the presentation of bullous impetigo? Treatment?
- Impetigo that is bullous | - Mupirocin
58
What is the treatment for erysipelas?
Strep abx
59
What is a kerion? Treatment?
- Deep boggy abscess of fungal infx of the scalp | - Oral antifungals (DO NOT I+D)
60
Molluscum contagiosum in adults = what other infection?
HIV
61
What is the presentation of scabies? Treatment?
- Pruritic papules in the intertriginous or interdigital web spaces - Permethrin or ivermectin
62
What is the presentation of pediculosis (lice)? Treatment?
- Intensely pruritic macules/wheals | - Permethrin
63
What anatomically does atopic dermatitis typically present?
Flexural surfaces
64
What other infection must be considered with seborrheic dermatitis?
HIV
65
How does basal cell carcinoma present?
Painless pink pearly papules with telangiectasias
66
What does squamous cell cancer look like?
Ulcerated center with firm-raised borders
67
Diameter over what is concerning for melanoma?
Over 6 mm
68
What does Kaposi's sarcoma look like? Painful or painless? Pruritic?
Red/purple plaques/papules that are painless, nonpruritic
69
What is the treatment for Kaposi's sarcoma?
Treat underlying HIV
70
How does erythema nodosum present? Painful? Where on the body does it typically occur?
Discreet painful red/violet nodues over the tibia (classically)
71
What is the etiology of erythema nodosum? Treatment?
- Idiopathic/drugs/inf/sarcoid | - Supportive care
72
What is the classic presentation of pityriasis? Pruritic? Treatment?
- Flu like illness followed by herald patches, then christmas tree pattern papules on the back - Can be itchy - r/o and treat syphilis. o/w supportive
73
What is the way to differentiate sebaceous cysts vs lipomas on exam?
Slippage sign positive with lipomas

Hippos (23 decks)

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