Derm (Alice) (15%) Flashcards
4 types of acne vulgaris
comedonal
papular
pustular
nodulocystic
blackheads are _ comedomes
whiteheads are _ comedomes
blackheads: open
whiteheads: closed
what type of acne is this
comedomal
what type of acne is this
papular
moderate number of lesions, little scarring
what type of acne is this
pustular
> 25 lesions
moderate scarring
what type of acne is this
nodulocystic
severe scarring
mc tx for acne
topical retinoids
tx for cystic acne
- tetracyclines
- oral retinoids - isotretinoin
s.e of isotretinoin
dry lips
liver damage
increased TG/cholesterol
pregnancy category X
birth control protocol for pt on isotretinoin
2 pregnancy tests prior to starting
montly pregnancy test while on in
gradual conversion of terminal hairs to indeterminate hairs to vellus hairs
aka male pattern baldness
androgenetic alopecia
mc age for androgenetic hair loss, men vs women
men: 20-40 yo
women: after 50 yo
bx findings of androgenetic hair loss
telogen and atrophic follicles
3 hormones associated w. androgenetic hair loss
testosterone
DHEA
prolactin
3 treatable causes of androgenetic hair loss
thyroid dysfunction
anemia
autoimmune
tx for androgenetic hair loss
topical minoxidil/rogaine
finasteride
spironolactone
pt ed for topical minoxidil/rogaine
hair loss before first regrowth
moa for finasteride
blocks T and DHT
moa for spironolactone
blocks DHT
pruritic, eczematous lesions, xerosis, and lichenification
atopic dermatitis
mc location of atopic dermatitis, infant vs adolescent
infant: face, scalp
adolescent: flexural surfaces
atopic dermatitis is a type _ hypersensitivity
1
management of atopic dermatitis (3)
clinical dx
patch testing to verify
allergy referral
tx for atopic dermatitis
- review meds/possible allergens
- antihistamines
- topical vs oral steroids
- PUVA phototherapy
3 mcc of burns
scalding
direct thermal
flame
range of depth of burns
superficial partial thickness
deep partial thickess
full thickness
characteristics of acid burns
coagulation
necrosis
eschar
characteristics of alklaline burns
liquefaction necrosis
deep damage
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
what degree burn is this
2nd
what degree burn is this
third
what degree burn is this
4th
rule of 9’s for pediatric burns
head: 18%
each arm: 9%
chest: 18%
back: 18%
each leg: 14%
palmar method for pediatric burns
patient’s palm = 1%
used for small burns
tx for mild burns
ABCs
fluids
sulfadiazine
tx for mod/severe burns
cover with a dry dressing
admit
indications for fluids w. burns; children vs adults
children: > 10% BSA
adults: > 15% BSA
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
bright pink, itchy rash with a linear pattern
+/- clear vesicles w.in
contact dermatitis
acute vs chronic contact dermatitis
acute: erythema, vesicles, bullae, burning, itching
chronic: scaling, lichenification, fissure - well demarcated border
allergic etiologies of contact dermatitis
nickel
poison ivy
allergic dermatitis is a type _ hypersensitivity
IV
irritant causes of contact dermatitis
cleaners
solvents
detergents
urine
feces
direct toxic effect of offending agent
pharm for contact dermatitis (5)
hydroxyzine vs benadryl
zinc oxide
triamcinolone vs oral steroids
burow’s solution
PUVA phototherapy
zinc oxide is commonly used for
diaper rash
elevated, erythematous rash with satellite pustules
diaper rash
3 secondary infxns associated w. diaper rash
candidiasis
impetigo
HSV
satellite lesions w. diaper rash make you think of what pathogen
candidiasis
mcc pathogen associated w. impetigo
s. aureus
what type of dermatitis makes you concerned about child sexual abuse
HSV
you should always check for _ on a child w. diaper rash
thrush
what is spared in perioral dermatitis
vermillion border (lip margin)
tx for perioral dermatitis
- topical metro vs erythromycin vs clindamycin
- topical pimecrolimus
- oral doxy
mc type of adverse drug rxn
skin
4 meds associated w. drug eruptions
PCNs
bactrim
NSAIDs
anticonvulsants
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
tx for DIHS (drug induced hypersensitivity syndrome)
systemic steroids: 1 mg/kg/day
slow taper over 6 weeks