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eor - pediatrics (alice copy + seth's) > Derm (Alice) (15%) > Flashcards

Derm (Alice) (15%) Flashcards

1
Q

4 types of acne vulgaris

A

comedonal
papular
pustular
nodulocystic

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2
Q

blackheads are _ comedomes
whiteheads are _ comedomes

A

blackheads: open
whiteheads: closed

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3
Q

what type of acne is this

A

comedomal

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4
Q

what type of acne is this

A

papular

moderate number of lesions, little scarring

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5
Q

what type of acne is this

A

pustular

> 25 lesions
moderate scarring

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6
Q

what type of acne is this

A

nodulocystic

severe scarring

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7
Q

mc tx for acne

A

topical retinoids

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8
Q

tx for cystic acne

A
  1. tetracyclines
  2. oral retinoids - isotretinoin
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9
Q

s.e of isotretinoin

A

dry lips
liver damage
increased TG/cholesterol
pregnancy category X

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10
Q

birth control protocol for pt on isotretinoin

A

2 pregnancy tests prior to starting
montly pregnancy test while on in

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11
Q

gradual conversion of terminal hairs to indeterminate hairs to vellus hairs

aka male pattern baldness

A

androgenetic alopecia

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12
Q

mc age for androgenetic hair loss, men vs women

A

men: 20-40 yo
women: after 50 yo

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13
Q

bx findings of androgenetic hair loss

A

telogen and atrophic follicles

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14
Q

3 hormones associated w. androgenetic hair loss

A

testosterone
DHEA
prolactin

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15
Q

3 treatable causes of androgenetic hair loss

A

thyroid dysfunction
anemia
autoimmune

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16
Q

tx for androgenetic hair loss

A

topical minoxidil/rogaine
finasteride
spironolactone

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17
Q

pt ed for topical minoxidil/rogaine

A

hair loss before first regrowth

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18
Q

moa for finasteride

A

blocks T and DHT

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19
Q

moa for spironolactone

A

blocks DHT

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20
Q

pruritic, eczematous lesions, xerosis, and lichenification

A

atopic dermatitis

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21
Q

mc location of atopic dermatitis, infant vs adolescent

A

infant: face, scalp
adolescent: flexural surfaces

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22
Q

atopic dermatitis is a type _ hypersensitivity

A

1

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23
Q

management of atopic dermatitis (3)

A

clinical dx
patch testing to verify
allergy referral

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24
Q

tx for atopic dermatitis

A
  1. review meds/possible allergens
  2. antihistamines
  3. topical vs oral steroids
  4. PUVA phototherapy
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25
Q

3 mcc of burns

A

scalding
direct thermal
flame

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26
Q

range of depth of burns

A

superficial partial thickness
deep partial thickess
full thickness

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27
Q

characteristics of acid burns

A

coagulation
necrosis
eschar

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28
Q

characteristics of alklaline burns

A

liquefaction necrosis
deep damage

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29
Q

degrees of burns

A

1st (sunburn): skin blanches with pressure;
tender
2nd degree (partial thickness): skin red and blistered; tender
3rd degree (full thickness): skin tough/leathery; nontender
4th degree: into bone/muscle

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30
Q

what degree burn is this

A

2nd

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31
Q

what degree burn is this

A

third

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32
Q

what degree burn is this

A

4th

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33
Q

rule of 9’s for pediatric burns

A

head: 18%
each arm: 9%
chest: 18%
back: 18%
each leg: 14%

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34
Q

palmar method for pediatric burns

A

patient’s palm = 1%

used for small burns

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35
Q

tx for mild burns

A

ABCs
fluids
sulfadiazine

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36
Q

tx for mod/severe burns

A

cover with a dry dressing
admit

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37
Q

indications for fluids w. burns; children vs adults

A

children: > 10% BSA
adults: > 15% BSA

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38
Q

fluid protocol for burns: children vs adults

A

children: LR 3 ml/kg x %BSA
adults: LR 4 ml/kg x %BSA

half over the first 8 hr, half over 16 hr

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39
Q

bright pink, itchy rash with a linear pattern
+/- clear vesicles w.in

A

contact dermatitis

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40
Q

acute vs chronic contact dermatitis

A

acute: erythema, vesicles, bullae, burning, itching
chronic: scaling, lichenification, fissure - well demarcated border

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41
Q

allergic etiologies of contact dermatitis

A

nickel
poison ivy

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42
Q

allergic dermatitis is a type _ hypersensitivity

A

IV

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43
Q

irritant causes of contact dermatitis

A

cleaners
solvents
detergents
urine
feces

direct toxic effect of offending agent

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44
Q

pharm for contact dermatitis (5)

A

hydroxyzine vs benadryl
zinc oxide
triamcinolone vs oral steroids
burow’s solution
PUVA phototherapy

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45
Q

zinc oxide is commonly used for

A

diaper rash

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46
Q

elevated, erythematous rash with satellite pustules

A

diaper rash

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47
Q

3 secondary infxns associated w. diaper rash

A

candidiasis
impetigo
HSV

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48
Q

satellite lesions w. diaper rash make you think of what pathogen

A

candidiasis

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49
Q

mcc pathogen associated w. impetigo

A

s. aureus

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50
Q

what type of dermatitis makes you concerned about child sexual abuse

A

HSV

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51
Q

you should always check for _ on a child w. diaper rash

A

thrush

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52
Q

what is spared in perioral dermatitis

A

vermillion border (lip margin)

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53
Q

tx for perioral dermatitis

A
  1. topical metro vs erythromycin vs clindamycin
  2. topical pimecrolimus
  3. oral doxy
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54
Q

mc type of adverse drug rxn

A

skin

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55
Q

4 meds associated w. drug eruptions

A

PCNs
bactrim
NSAIDs
anticonvulsants

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56
Q

tx for anaphylaxis by pediatric weights

A

< 7.5 kg (16 lb): weight based; 0.15 mg of 1 mg/mL solution if no weight available

7.5 kg - 25 kg (16-55 lb): 0.15 mg autoinjector of 1 mg/mL solution

> 50 kg (110 lb): 0.5 mg of 1 mg/mL solution

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57
Q

tx for DIHS (drug induced hypersensitivity syndrome)

A

systemic steroids: 1 mg/kg/day
slow taper over 6 weeks

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58
Q

tx for uticaria

A

2nd gen antihistamines (ex zyrtec)

59
Q

non itchy, maculopapular rash
3 areas of concentricity which are red/white/purple
target lesions

A

erythema multiforme

60
Q

erythema multiforme is a type _ hypersensitivity

A

IV

61
Q

erythema multiforme mc occurs on the (3)

A

hands
feet
mucosa

62
Q

mcc of erythema multiforme (3)

A

pror infxn:

HSV
mycoplasma pna
URI

63
Q

3 drugs that can cause erythema multiforme

A

sulfonamides
b lactams
phenytoin

64
Q

2 hallmark characteristics of erythema multiforme

A

blanching
lack of itchiness

65
Q

classification of erythema multiforme

A

minor: limited region, one type of mucosa
major: widespread, 2+ mucosa

66
Q

erythema mc affects what mucosa

A

oral

67
Q

what are these

A

target lesions -> erythema multiforme

multiple rings w. dusky center

68
Q

major differentiation btw erythema multiforme and SJS/TEN

A

no nikolsky sign w. erythema multiforme

69
Q

management of erythema multiforme (4)

A

throat swoothie/magic swizzle
severe: systemic steroids
occular: emergent ophtho consult
recurrent: antiviral qd

70
Q

exanthems to know (5)

A

erythema infectiosum (5th disease)
hand-food-mouth dz
measles (rubeola)
rubella (german measles)
roseola (sixth disease)

71
Q

slapped cheek rash
lacy/reticular rash on extremities

A

erythema infectiosum (5th disease)

72
Q

erythema infectiosum (parvovirus) mc affects the _

and spares the _

A

affects: extremeties
spares: palms, soles

73
Q

management of parvovirus (3)

A

supportive
anti-inflammatories
resovles in 2-3 weeks

74
Q

hand-foot-mouth dz is caused by what pathogen in kids < 10 yo

A

coxsackievirus type A

75
Q

management of hand/food/mouth dz

A

supprotive
anti-inflammatories
resolves in 10 days

76
Q

what are the 4 c’s of measles (rubeola)

A

cough
coryza
conjunctivitis
cephalocaudal spread

77
Q

what is this rash

A

brick red rash -> measles

78
Q

what are these

A

koplik spots -> measles

red spots in buccal mucosa w. blue-white pale center

79
Q

management of measles

A

supportive
antinflammatories
isolate for 1 weeks after onset of rash
MMR vaccine

80
Q

3 day rash that first appears on the face, spreads caudally to the trunk and extremities, and becomes generalized w.in 24 hr

A

rubella (german measles)

81
Q

differentiating factor btw rubeola and rubella

A

w. rubella:
rapid spread
rash does not darken or coalesce

82
Q

serious complication of rubella

A

teratogenic in 1st trimester:
deafness
cataracts
TTP
mental retardation

83
Q

management of rubella

A

supportive
MMR vaccine

84
Q

only childhood exanthem that starts on the trunk and spreads to the face

A

HSV 6 or 7

85
Q

-rose pink maculopapular blanchable rash on trunk/back and face
-preceded by high fever

A

roseola (sixth disease)

86
Q

management of roseola

A

antipyretics
supportive

87
Q

impetigo is mc caused by

A
  1. s. aureus
  2. GAS
88
Q

impetigo mc occurs on the (2)

A

face
extremities

89
Q

describe rash w. impetigo

A

red sores around nose/mouth that rupture, ooze, and form yellow-brown crust

90
Q

mc type of impetigo

A

non bullous

91
Q

bullae w. a varnish-like crust
fever, diarrhea

A

bullous impetigo

92
Q

management of impetigo

A
  1. warm water soaks q 15-20 min
  2. topical mupirocin x 5 days
  3. widespread or bullous: oral keflex vs erythromycin
  4. MRSA: doxy
  5. sick + MRSA: vanco
93
Q

complication of impetigo

A

post streptococcal glomerulonephritis

94
Q

small white specs on the hair shaft

A

lice

95
Q

management of lice

A

launder potential fomites
permethrin

96
Q

-chronic, autoimmune, papulosquamous inflammatory dermatosis
-purplish, itchy flat-topped bumps on mucous membranes that form lacy white patches

A

lichen planus

97
Q

5 p’s of lichen planus

A

purple
papule
polygonal
pruritis
planar

98
Q

what is this showing

A

lichen planus

99
Q

what is this showing

A

whitish lines in the papules of lichen planus -> wickham striae

100
Q

tx for lichen planus

A

topical steroids

101
Q

what is this showing

A

pityriasis rosea

102
Q

-oval patch w. central clearing followed by diffuse diffuse papulosquamous rash
-lesions along langer lines
-christmas tree pattern

A

pityriasis rosea

103
Q

management of pityriasis rosea

A

self limiting
topical vs oral steroids
antihistamines
asymptomatic = no tx

104
Q

what is this showing

A

interdigital rash -> scabies

105
Q

describe rash associated w. scabies (4)

A

severely pruritic papules
s-shaped linear burrows
in web spaces of hands, wrist, waist
worse at night

106
Q

dx for scabies

A

skin scrape microscopy

107
Q

tx for scabies

A

-topical permethrin to entire body - repeat in 1 week
-sulfur ointment if < 2 yo
-severe: oral ivermectin

108
Q

contraindication for oral ivermectin

A

pregnant/bf’ing

109
Q

pt ed for scabies

A

pruritis may persist 2-4 weeks after tx

110
Q

SJS affects _% of the body
TEN affects _% of the body

A

SJS: < 10%
TEN: > 30%

111
Q

management of SJS/TEN (4)

A

early admit to burn unit
ABC
fluids/lytes/nutrition
IVIG

112
Q

what med used to be used for SJS/TEN but is now thought to increase risk of sepsis

A

steroids

113
Q

3 rf for superficial fungal infxns

A

increased skin moisture
immunodeficiency
PVD

114
Q

what is this showing

A

branching fungal hyphae w. septations ->
dermatophytes

115
Q

budding yeast
pseudohyphae

A

candidiasis

116
Q

short hyphae and clusters of spores

A

tinea versicolor

117
Q

what is this showing

A

spaghetti and meatballs -> tinea versicolor

118
Q

dermatophyte (tinea) infxns to know (7)

A

barbae
pedis
unguium (onychomycosis)
cruris
capitis
corporis (ringworm)
versicolor

119
Q

tx for tinea barbae

A

oral antifungals:
griseofulvin microsize
vs
terbinafine

120
Q

what dermatophyte is mc associated w. tinea pedis

A

trichophyton rubrum

121
Q

tx for tinea pedis

A

topical antifungals

122
Q

what dermatophyte is associated w. tinea unguium

A

onychomycosis

123
Q

tx for tinea unguium

A

terbinafine

124
Q

tx for finea cruris

A

topical antifungals

125
Q

what pharm is NOT effective for tinea infxns

A

nystatin

126
Q

mc fungal infxn in peds

A

tinea capitis

127
Q

first line tx for tinea capitis

A

oral griseofulvin

128
Q

which tinea do you think of when you see wrestlers

A

corporis (ringworm)

think close physical contact

129
Q

tx for tinea corporis

A

topical antifungals

130
Q

what dermatophyte causes tinea veriscolor

A

malassezia furfur

131
Q

describe the tinea versicolor rash

A

hypo or hyperpigmented macules that do not tan

132
Q

tx for tinea versicolor

A

selenium sulfide 2.5% applied to the skin for 10 min
then wash off thorouthly

133
Q

blanchable, edematous, pink, papules and wheels or plaques on the surface of the skin

A

uticaria (hives)

134
Q

what is darier’s sign

A

localized uticaria appearing where the skin is rubbed -> uticaria

135
Q

darier’s sign is caused by

A

histamine release

136
Q

painless, deeper form of uticaria affecting the lips, tongue, eyelids, hands, and genitals

A

angioedema

137
Q

what is this showing

A

angioedema

138
Q

tx for angioedema

A
  1. second gen antihistamines (H1 blockers -> zyrtec, allegra, claritin etc)
  2. first gen antihistamines if sleep disturbance (hydroxyzine, diphenhydramine)
  3. H2 blockers - cimetidine, ranitidine
  4. steroids
139
Q

peds dosing for epinephrine

A

0.01 mg/kg SC/IV

140
Q

flesh colored, sharply demarcated, rough, round, firm nodules

A

verruca - warts

141
Q

all warts are caused by

A

HPV

142
Q

5 types of warts

A

verruca vulgaris - common
verruca plana - flat
verrucae plantaris - plantar
condyloma acuminatum - venereal
epidermodysplasia verrucoformis: chronic, lifelong HPV

143
Q

management of warts (3)

A

most self resolve w.in 2 years
cryotherapy
topical salycilic acid

eor - pediatrics (alice copy + seth's) (22 decks)

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