Derm (Alice) (15%) Flashcards
1
Q
4 types of acne vulgaris
A
comedonal
papular
pustular
nodulocystic
2
Q
blackheads are _ comedomes
whiteheads are _ comedomes
A
blackheads: open
whiteheads: closed
3
Q
what type of acne is this
A
comedomal
4
Q
what type of acne is this
A
papular
moderate number of lesions, little scarring
5
Q
what type of acne is this
A
pustular
> 25 lesions
moderate scarring
6
Q
what type of acne is this
A
nodulocystic
severe scarring
7
Q
mc tx for acne
A
topical retinoids
8
Q
tx for cystic acne
A
- tetracyclines
- oral retinoids - isotretinoin
9
Q
s.e of isotretinoin
A
dry lips
liver damage
increased TG/cholesterol
pregnancy category X
10
Q
birth control protocol for pt on isotretinoin
A
2 pregnancy tests prior to starting
montly pregnancy test while on in
11
Q
gradual conversion of terminal hairs to indeterminate hairs to vellus hairs
aka male pattern baldness
A
androgenetic alopecia
12
Q
mc age for androgenetic hair loss, men vs women
A
men: 20-40 yo
women: after 50 yo
13
Q
bx findings of androgenetic hair loss
A
telogen and atrophic follicles
14
Q
3 hormones associated w. androgenetic hair loss
A
testosterone
DHEA
prolactin
15
Q
3 treatable causes of androgenetic hair loss
A
thyroid dysfunction
anemia
autoimmune
16
Q
tx for androgenetic hair loss
A
topical minoxidil/rogaine
finasteride
spironolactone
17
Q
pt ed for topical minoxidil/rogaine
A
hair loss before first regrowth
18
Q
moa for finasteride
A
blocks T and DHT
19
Q
moa for spironolactone
A
blocks DHT
20
Q
pruritic, eczematous lesions, xerosis, and lichenification
A
atopic dermatitis
21
Q
mc location of atopic dermatitis, infant vs adolescent
A
infant: face, scalp
adolescent: flexural surfaces
22
Q
atopic dermatitis is a type _ hypersensitivity
A
1
23
Q
management of atopic dermatitis (3)
A
clinical dx
patch testing to verify
allergy referral
24
Q
tx for atopic dermatitis
A
- review meds/possible allergens
- antihistamines
- topical vs oral steroids
- PUVA phototherapy
25
3 mcc of burns
scalding
direct thermal
flame
26
range of depth of burns
superficial partial thickness
deep partial thickess
full thickness
27
characteristics of acid burns
coagulation
necrosis
eschar
28
characteristics of alklaline burns
liquefaction necrosis
deep damage
29
degrees of burns
**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
30
what degree burn is this
2nd
31
what degree burn is this
third
32
what degree burn is this
4th
33
rule of 9's for pediatric burns
head: 18%
each arm: 9%
chest: 18%
back: 18%
each leg: 14%
34
palmar method for pediatric burns
patient's palm = 1%
*used for small burns*
35
tx for mild burns
ABCs
fluids
sulfadiazine
36
tx for mod/severe burns
cover with a dry dressing
admit
37
indications for fluids w. burns; children vs adults
children: > 10% BSA
adults: > 15% BSA
38
fluid protocol for burns: children vs adults
children: LR 3 ml/kg x %BSA
adults: LR 4 ml/kg x %BSA
*half over the first 8 hr, half over 16 hr*
39
bright pink, itchy rash with a linear pattern
+/- clear vesicles w.in
contact dermatitis
40
acute vs chronic contact dermatitis
**acute:** erythema, vesicles, bullae, burning, itching
**chronic:** scaling, lichenification, fissure - well demarcated border
41
allergic etiologies of contact dermatitis
nickel
poison ivy
42
allergic dermatitis is a type _ hypersensitivity
IV
43
irritant causes of contact dermatitis
cleaners
solvents
detergents
urine
feces
*direct toxic effect of offending agent*
44
pharm for contact dermatitis (5)
hydroxyzine vs benadryl
zinc oxide
triamcinolone vs oral steroids
burow's solution
PUVA phototherapy
45
zinc oxide is commonly used for
diaper rash
46
elevated, erythematous rash with satellite pustules
diaper rash
47
3 secondary infxns associated w. diaper rash
candidiasis
impetigo
HSV
48
satellite lesions w. diaper rash make you think of what pathogen
candidiasis
49
mcc pathogen associated w. impetigo
s. aureus
50
what type of dermatitis makes you concerned about child sexual abuse
HSV
51
you should always check for _ on a child w. diaper rash
thrush
52
what is spared in perioral dermatitis
vermillion border (lip margin)
53
tx for perioral dermatitis
1. topical metro vs erythromycin vs clindamycin
2. topical pimecrolimus
3. oral doxy
54
mc type of adverse drug rxn
skin
55
4 meds associated w. drug eruptions
PCNs
bactrim
NSAIDs
anticonvulsants
56
tx for anaphylaxis by pediatric weights
< 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
57
tx for DIHS (drug induced hypersensitivity syndrome)
systemic steroids: 1 mg/kg/day
slow taper over 6 weeks
58
tx for uticaria
2nd gen antihistamines (ex zyrtec)
59
non itchy, maculopapular rash
3 areas of concentricity which are red/white/purple
target lesions
erythema multiforme
60
erythema multiforme is a type _ hypersensitivity
IV
61
erythema multiforme mc occurs on the (3)
hands
feet
mucosa
62
mcc of erythema multiforme (3)
**pror infxn:**
**HSV**
mycoplasma pna
URI
63
3 drugs that can cause erythema multiforme
sulfonamides
b lactams
phenytoin
64
2 hallmark characteristics of erythema multiforme
blanching
lack of itchiness
65
classification of erythema multiforme
**minor:** limited region, one type of mucosa
**major:** widespread, 2+ mucosa
66
erythema mc affects what mucosa
oral
67
what are these
**target lesions -> erythema multiforme**
multiple rings w. dusky center
68
major differentiation btw erythema multiforme and SJS/TEN
no nikolsky sign w. erythema multiforme
69
management of erythema multiforme (4)
throat swoothie/magic swizzle
severe: systemic steroids
occular: emergent ophtho consult
recurrent: antiviral qd
70
exanthems to know (5)
erythema infectiosum (5th disease)
hand-food-mouth dz
measles (rubeola)
rubella (german measles)
roseola (sixth disease)
71
slapped cheek rash
lacy/reticular rash on extremities
erythema infectiosum (5th disease)
72
erythema infectiosum (parvovirus) mc affects the _
and spares the _
affects: extremeties
spares: palms, soles
73
management of parvovirus (3)
supportive
anti-inflammatories
resovles in 2-3 weeks
74
hand-foot-mouth dz is caused by what pathogen in kids < 10 yo
coxsackievirus type A
75
management of hand/food/mouth dz
supprotive
anti-inflammatories
resolves in 10 days
76
what are the 4 c's of measles (rubeola)
cough
coryza
conjunctivitis
cephalocaudal spread
77
what is this rash
**brick red rash -> measles**
78
what are these
koplik spots -> measles
*red spots in buccal mucosa w. blue-white pale center*
79
management of measles
supportive
antinflammatories
isolate for 1 weeks after onset of rash
MMR vaccine
80
3 day rash that first appears on the face, spreads caudally to the trunk and extremities, and becomes generalized w.in 24 hr
rubella (german measles)
81
differentiating factor btw rubeola and rubella
w. rubella:
rapid spread
rash does not darken or coalesce
82
serious complication of rubella
**teratogenic in 1st trimester:**
deafness
cataracts
TTP
mental retardation
83
management of rubella
supportive
MMR vaccine
84
only childhood exanthem that starts on the trunk and spreads to the face
HSV 6 or 7
85
-rose pink maculopapular blanchable rash on trunk/back and face
-preceded by high fever
roseola (sixth disease)
86
management of roseola
antipyretics
supportive
87
impetigo is mc caused by
1. s. aureus
2. GAS
88
impetigo mc occurs on the (2)
face
extremities
89
describe rash w. impetigo
red sores around nose/mouth that rupture, ooze, and form yellow-brown crust
90
mc type of impetigo
non bullous
91
bullae w. a varnish-like crust
fever, diarrhea
bullous impetigo
92
management of impetigo
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
complication of impetigo
post streptococcal glomerulonephritis
94
small white specs on the hair shaft
lice
95
management of lice
launder potential fomites
permethrin
96
-chronic, autoimmune, papulosquamous inflammatory dermatosis
-purplish, itchy flat-topped bumps on mucous membranes that form lacy white patches
lichen planus
97
5 p's of lichen planus
purple
papule
polygonal
pruritis
planar
98
what is this showing
lichen planus
99
what is this showing
whitish lines in the papules of lichen planus -> **wickham striae**
100
tx for lichen planus
topical steroids
101
what is this showing
pityriasis rosea
102
-oval patch w. central clearing followed by diffuse diffuse papulosquamous rash
-lesions along langer lines
-christmas tree pattern
pityriasis rosea
103
management of pityriasis rosea
self limiting
topical vs oral steroids
antihistamines
asymptomatic = no tx
104
what is this showing
interdigital rash -> scabies
105
describe rash associated w. scabies (4)
severely pruritic papules
s-shaped linear burrows
in web spaces of hands, wrist, waist
worse at night
106
dx for scabies
skin scrape microscopy
107
tx for scabies
-topical permethrin to entire body - repeat in 1 week
-sulfur ointment if < 2 yo
-severe: oral ivermectin
108
contraindication for oral ivermectin
pregnant/bf'ing
109
pt ed for scabies
pruritis may persist 2-4 weeks after tx
110
SJS affects _% of the body
TEN affects _% of the body
SJS: < 10%
TEN: > 30%
111
management of SJS/TEN (4)
early admit to burn unit
ABC
fluids/lytes/nutrition
IVIG
112
what med used to be used for SJS/TEN but is now thought to increase risk of sepsis
steroids
113
3 rf for superficial fungal infxns
increased skin moisture
immunodeficiency
PVD
114
what is this showing
branching fungal hyphae w. septations ->
**dermatophytes**
115
budding yeast
pseudohyphae
candidiasis
116
short hyphae and clusters of spores
tinea versicolor
117
what is this showing
spaghetti and meatballs -> tinea versicolor
118
dermatophyte (tinea) infxns to know (7)
barbae
pedis
unguium (onychomycosis)
cruris
capitis
corporis (ringworm)
versicolor
119
tx for tinea barbae
**oral antifungals:**
griseofulvin microsize
vs
terbinafine
120
what dermatophyte is mc associated w. tinea pedis
trichophyton rubrum
121
tx for tinea pedis
topical antifungals
122
what dermatophyte is associated w. tinea unguium
onychomycosis
123
tx for tinea unguium
terbinafine
124
tx for finea cruris
topical antifungals
125
what pharm is NOT effective for tinea infxns
nystatin
126
mc fungal infxn in peds
tinea capitis
127
first line tx for tinea capitis
oral griseofulvin
128
which tinea do you think of when you see wrestlers
corporis (ringworm)
think close physical contact
129
tx for tinea corporis
topical antifungals
130
what dermatophyte causes tinea veriscolor
malassezia furfur
131
describe the tinea versicolor rash
hypo or hyperpigmented macules that do not tan
132
tx for tinea versicolor
selenium sulfide 2.5% applied to the skin for 10 min
then wash off thorouthly
133
blanchable, edematous, pink, papules and wheels or plaques on the surface of the skin
uticaria (hives)
134
what is darier's sign
localized uticaria appearing where the skin is rubbed -> uticaria
135
darier's sign is caused by
histamine release
136
painless, deeper form of uticaria affecting the lips, tongue, eyelids, hands, and genitals
angioedema
137
what is this showing
angioedema
138
tx for angioedema
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
peds dosing for epinephrine
0.01 mg/kg SC/IV
140
flesh colored, sharply demarcated, rough, round, firm nodules
verruca - warts
141
all warts are caused by
HPV
142
5 types of warts
verruca vulgaris - common
verruca plana - flat
verrucae plantaris - plantar
condyloma acuminatum - venereal
epidermodysplasia verrucoformis: chronic, lifelong HPV
143
management of warts (3)
most self resolve w.in 2 years
cryotherapy
topical salycilic acid
