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Clin Med I Disease Key Notes > Derm (Exam 1) > Flashcards

Derm (Exam 1) Flashcards

1
Q

What disease is Kerions associated with?

A

Tinea Capitis

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2
Q

What disease is Favus associated with?

A

Tinea Capitis

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3
Q

What disease is common in children and African Americans?

A

Tinea Capitis

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4
Q

What disease has scaly patches with alopecia or patches with black dots?

A

Tinea Capitis

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5
Q

What disease has erythematous plaques with central clearing and a raised border

A

Tinea Corporis

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6
Q

What disease starts in the inguinal fold and spreads outward? What body part is spared?

A

Tinea Cruris

- Scrotum spared

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7
Q

What disease is associated with “moccasin ringworm”?

A

Tinea Pedis

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8
Q

What disease is associated with tine manuum, and what does this mean?

A

Tinea Pedis

- Tinea manuum: two feet, one hand

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9
Q

What is another name for Tinea Versicolor and how does this present?

A

Pityriasis Versicolor

- Hypopigmentation, hyperpigmentation or erythema; common on trunk/UE

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10
Q

What are the three types of Onychomycosis?

A
  • Distal Subungual Onychomycosis
  • Proximal Subungual Onychomycosis
  • White Superficial Onychomycosis
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11
Q

How does Distal Subungual Onychomycosis spread?

A

Yellow/white/brown discoloration that starts distally and spreads towards cuticle

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12
Q

How does Proximal Subungual Onychomycosis spread?

A

Yellow/white/brown discoloration that starts at cuticle and spreads distally

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13
Q

How does White Superficial Onychomycosis spread?

A

White spots on nail surface that spread centrifugally until the entire nail is involved

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14
Q

What disease typically occurs at skin folds?

A

Candidal Intertrigo

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15
Q

What disease begins with an initial lesion then subsequent burrowing?

A

Scabies

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16
Q

What is Norwegian Scabies? What population does this occur in?

A

Crusted scabies; considered severe

- Occurs in immunocompromised

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17
Q

What disease involves itching in the groin or axilla area

A

Pubic Lice

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18
Q

What disease is treated with Griseofulvin? Is this medication topical or systemic?

A

Griseofulvin (systemic)

- Tinea Capitis

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19
Q

What two diseases are treated with Terbinafine? Is this medication topical or systemic?

A

Terbinafine (systemic)

  • Tinea Capitis
  • Onychomycosis
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20
Q

What five diseases are treated with Itraconazole? Is this medication topical or systemic?

A

Itraconazole (systemic)

  • Onychomycosis
  • Tinea Corporis
  • Tinea Cruris
  • Tinea Pedis
  • Tinea Versicolor
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21
Q

What four diseases are treated with Clotrimazole? Is this medication topical or systemic?

A

Clotrimazole (topical)

  • Tinea Corporis
  • Tinea Cruris
  • Tinea Pedis
  • Tinea Versicolor
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22
Q

What other two medications are used to treat Tinea Versicolor? Are these topical or systemic?

A
  • Selenium Sulfice (topical)

- Zinc Pyrithione (topical)

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23
Q

What disease is treated with Nystatin? Is this medication topical or systemic?

A

Nystatin (topical)

- Candidal Intertrigo

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24
Q

What disease is treated with Fluconazole? Is this medication topical or systemic?

A

Fluconazole (systemic)

- Candidal Intertrigo

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25
Q

What disease is treated with Permethrin 5%? Is this medication topical or systemic?

A

Permethrin 5% (topical)

- Scabies

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26
Q

What disease is treated with Permethrin 1%? Is this medication topical or systemic?

A

Permethrin 1% (topical)

- Pubic Lice

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27
Q

What disease is treated with Ivermectin? Is this medication topical or systemic?

A

Ivermectin (systemic)

- Scabies

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28
Q

What is the clinical progression of Acne Vulgaris?

A

Comedo (blackhead, whitehead) → Inflammatory papule → Pustule → Nodule/Cyst

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29
Q

What is the treatment for comedonal Acne Vulgaris?

A

Topical retinoids (Tretinoin)

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30
Q

What is the treatment for mild inflammatory Acne Vulgaris?

A

Benzoyl peroxide + topical retinoid (Tretinoin) +/- topical antimicrobials (Erythromycin, Clindamycin)

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31
Q

What is the treatment for moderate inflammatory Acne Vulgaris?

A

Benzoyl peroxide + topical retinoid (Tretinoin) + oral antibiotics (Tetracycline)

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32
Q

What are the two possible treatments for severe inflammatory Acne Vulgaris?

A

Benzoyl peroxide + topical retinoid (Tretinoin) + oral antibiotics (Tetracycline)
OR
Accutane

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33
Q

What is the treatment for Acne Vulgaris in a PREGNANT woman? What two medications cannot be used and why?

A

Oral Erythromycin, topical Clindamycin or topical Azelaic Acid

  • CANNOT use retinoids because they’re teratogenic, no benzoyl peroxide
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34
Q

What type of Acne Rosacea has chronic redness of central face, flushing (wet or dry), telangiectasias?

A

Erythematotelangiectatic Acne Rosacea

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35
Q

What type of Acne Rosacea has papules and pustules on central face with no comedones?

A

Papulopustular Acne Rosacea

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36
Q

What type of Acne Rosacea has tissue hypertrophy causing irregular contours? What population is this typically seen in?

A

Phymatous Acne Rosacea

- Common in males

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37
Q

What disease involves dry eyes, pain, itching, blurred vision, photosensitivity, blepharitis (eyelid swelling), keratitis, conjunctivitis, stye?

A

Ocular Acne Rosacea

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38
Q

What disease has skin pigmentation via autoimmune process directed against melanocytes?

A

Vitiligo

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39
Q

How is Vitiligo treated?

A

Topical/systemic corticosteroids, Calcineurin inhibitors

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40
Q

What is another name for Acne Inversa?

A

Hidradenitis Supprurativa

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41
Q

What is another name for Hidradenitis Supprurativa?

A

Acne Inversa

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42
Q

What disease starts as a single, deep-seated inflammatory nodule that can form abscess then progression may include sinus tracts, comedones and scarring?

A

Hidradenitis Supprurativa

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43
Q

How is Hidradenitis Supprurativa treated?

A

Topical Clindamycin or systemic antibiotics (Doxycycline)

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44
Q

Describe the four grades of scorpion stings.

A
  • Grade 1: local pain and paresthesias at site of sting (mild)
  • Grade 2: local symptoms with remote pain and paresthesias
  • Grade 3: cranial nerve OR somatic skeletal neuromuscular dysfunction
  • Grade 4: cranial nerve AND somatic skeletal neuromuscular dysfunction (severe)
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45
Q

What are five examples of CN dysfunction?

A
  • Hypersalivation
  • Abnormal eye movements
  • Blurred vision
  • Slurred speech
  • Tongue fasciculations
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46
Q

What are five examples of somatic skeletal neuromuscular dysfunction?

A
  • Fasciculations
  • Shaking/jerking extremities
  • Opisthotonos (back arching)
  • Emprosthotonos (forward flexion of body)
  • Fever of 104+ F
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47
Q

What group of medications should not be given in conjunction with scorpion antivenom and why?

A

Benzos

- Respiratory decline may occur with benzos and antivenom

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48
Q

What disease has the “itch that rashes”

A

Atopic Eczema (Atopic Dermatitis)

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49
Q

What is the Atopic Triad?

A
  • Atopic Eczema
  • Allergic rhinitis
  • Asthma
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50
Q

What is a severe complication of Atopic Eczema?

A

Eczema Herpeticum

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51
Q

What MUST the clinical presentation of Atopic Eczema include (4)?

A
  • Pruritis
  • Eczema
  • Typical morphology/age patterns
  • Chronic/relapsing history
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52
Q

What is the gold standard for moisturization?

A

Vaseline

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53
Q

What disease is caused by itching, rubbing or scratching?

A

Lichen Simplex Chronicus

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54
Q

What is another name for Lichen Simplex Chronicus?

A

Neurodermatitis

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55
Q

What disease has a “tapioca-like” appearance?

A

Dyshidrotic Eczema

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56
Q

What disease is a disorder of horny plugs in hair follicles?

A

Keratosis Pilaris

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57
Q

What disease is an itch of a localized area occurring 1-2 days after exposure?

A

Allergic Contact Dermatitis

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58
Q

What disease has burning/stinging pain that occurs immediately?

A

Irritant Contact Dermatitis

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59
Q

Is lip lickers dermatitis considered allergic or irritant?

A

Irritant Contact Dermatitis

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60
Q

What type of drug reaction is drug hypersensitivity considered? How does this present?

A

Type IV

- Exanthem

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61
Q

What type of drug reaction is drug allergy considered? How does this present?

A

Type I

- Urticaria and angioedema

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62
Q

What “Type” is allergy mediated? Which “Type” is cell-mediated?

A
  • Type I: allergy mediated

- Type IV: cell mediated

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63
Q

What disease involves fever, facial edema, rash, lymphadenopathy, blood abnormalities and visceral involvement?

A

Drug-Induced Hypersensitivity Syndrome (DIHS)

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64
Q

What disease has epidermal necrosis and sloughing of mucous membranes and skin?

A

Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN)

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65
Q

How do you differentiate between SJS and TEN (hint: think TBSA)?

A
  • SJS if <10% TBSA

- TEN if >30% TBSA

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66
Q

What is Nikolsky sign? What disease is it associated with?

A

Elicitation of blistering as a result of gentle mechanical pressure
- Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN)

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67
Q

What is a major complication of SJS/TEN?

A

Septicemia (S. aureus and P. aeruginosa)

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68
Q

What are the three cases for which Mohs surgery is used?

A
  • Recurrent tumors
  • Tumors that are >0.6 cm on face or >2 cm on body/extremities
  • Tumors in high-risk anatomical locations
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69
Q

What disease involves “age spots” or “senile freckles”?

A

Solar Lentigo

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70
Q

What disease involves proliferation of melanocytes?

A

Solar Lentigo

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71
Q

What disease involves a rapidly growing round, flesh-colored nodule with central keratin plug?

A

Kertaocanthoma

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72
Q

What disease presents as warty, waxy and appears “stuck on”?

A

Seborrheic Keratosis (SK)

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73
Q

What disease involves scaly/gritty macules or papules?

A

Actinic Keratosis (AK)

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74
Q

What can Actinic Keratosis (AK) progress to?

A

SCC

- AK → SCC in situ → SCC

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75
Q

What disease presents as pearly papule with telangiectasias and rolled borders?

A

BCC

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76
Q

What skin layer does BCC arise from?

A

Basal layer of epidermis

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77
Q

What disease presents as scaly, hyperkeratotic, indurated and/or friable?

A

SCC

78
Q

What skin cell does SCC arise from?

A

Keratinocytes

79
Q

What type of malignant melanoma is most common and confined to the epidermis?

A

Superficial Spreading Melanoma

80
Q

What type of malignant melanoma is very aggressive and involves rapid vertical growth?

A

Nodular Melanoma

81
Q

What is the general idea of Breslow depth?

A

As depth increases, prognosis worsens

82
Q

What are the excisions measurements for surgical removal of malignant melanoma?

A

At least 2 cm clear margins

83
Q

What virus is associated with Measles (Rubeola)?

A

Paramyxovirus

84
Q

What virus is associated with Erythema Infectiosum (Fifth Disease)?

A

Parvovirus B-19

85
Q

What virus is associated with Rubella?

A

Rubella virus

86
Q

What virus is associated with Roseola Infantum?

A

Herpes virus (HHV-6)

87
Q

What virus is associated with Hand, Foot & Mouth Disease?

A

Coxsackie A16 virus

88
Q

What virus is associated with Molluscum Contagiosum?

A

Poxvirus

89
Q

What virus is associated with Human Papillomavirus?

A

Human Papillomavirus

90
Q

What virus is associated with Varicella (Chicken Pox)?

A

Varicella-Zoster virus (VZV), a herpes virus

91
Q

What virus is associated with Herpes Zoster (Shingles)?

A

Varicella-Zoster virus (VZV), a herpes virus

92
Q

What two virus subtypes are associated with Herpes Simplex Virus (HSV)? What body regions does each involve?

A
  • HSV I (oral)

- HSV II (genital)

93
Q

What disease has the 3 C’s? What are they?

A

Measles

  • Cough
  • Coryza (runny nose)
  • Conjunctivitis
94
Q

What disease has Koplik spots? What are these?

A

Measles

- Koplik spots: cluster of tiny bluish-white papules on buccal mucosa

95
Q

What two diseases involve a rash that starts on face and spreads from head to toe?

A
  • Measles

- Rubella

96
Q

What disease involves a rash that starts on the neck/trunk then spreads to face/extremities?

A

Roseola Infantum

97
Q

What disease has “slapped cheek” appearance

A

Erythema Infectiosum (Fifth Disease)

98
Q

What disease has a lacy pink body rash?

A

Erythema Infectiosum (Fifth Disease)

99
Q

What is a major complication of Measles?

A

Subacute Sclerosing Panencephalitis (SSPE)

- Can occur 2-10 years after exposure

100
Q

What are two major complications of Erythema Infectiosum (Fifth Disease)?

A
  • Transient aplastic crisis (sickle cell anemia-like)

- Hydrops Fetalis in pregnant women

101
Q

What is a major complication of Rubella?

A

Congenital Rubella Syndrome with “blueberry muffin”

102
Q

What disease can be treated with Vitamin A?

A

Measles

103
Q

What disease involves a very high fever?

A

Roseola Infantum

104
Q

What disease has pearly papules with umbilication?

A

Molluscum Contagiosum

105
Q

What is the name of the HPV subtype involving the mucous membranes?

A

Condyloma Acuminata

106
Q

What disease has cauliflower-like lesions? What population is this disease common in?

A

Condyloma Acuminata

- Most common anorectal infection in homosexual males

107
Q

How can Condyloma Acuminata be treated?

A

Podophyllin cream

108
Q

What is the name of the HPV subtype involving the skin (cutaneous)?

A

Verruca Vulgaris

109
Q

How can Verruca Vulgaris be treated?

A

15-blade to visualize thrombosed capillary underneath

110
Q

What disease involves a generalized vesicular rash with 3 stages? What are the 3 stages?

A

Varicella (Chicken Pox)

  1. Papule
  2. Blister
  3. Ulcer (crusts over)
111
Q

What two diseases can be diagnosed using a Tzanck smear?

A
  • Varicella (Chicken Pox)

- HSV-II

112
Q

What disease has a unilateral rash following a dermatomal distribution?

A

Herpes Zoster (Shingles)

113
Q

What are the two major complications of Herpes Zoster (Shingles)?

A
  • Post-herpetic neuralgia (PHN)

- Herpes Zoster Ophthalmicus (HZO)

114
Q

What is with Hutchinson’s sign and what disease complication is it associated with?

A

Hutchinson’s sign: vesicles on the tip of the nose or on the side of the nose precede the development of Herpes Zoster Ophthalmicus (HZO)

115
Q

What two diseases are Famciclovir or Valacyclovir used for?

A
  • Herpes Zoster (Shingles)

- Herpes Simplex Virus (HSV)

116
Q

What disease involves grouped vesicles on an erythematous base?

A

HSV II

117
Q

What are two complications of HSV II?

A
  • Erythema multiforme

- Eczema herpeticum

118
Q

What are the three types of soft tissue tumors?

A
  • Epithelial Inclusion Cyst (Epidermoid Cyst)
  • Lipoma
  • Sarcoma
119
Q

Which type of soft tissue tumor involves rapid growth?

A

Sarcoma

120
Q

What soft tissue tumor is composed of fluid?

A

Epithelial Inclusion Cyst (Epidermoid Cyst)

121
Q

What soft tissue tumor is composed of adipose tissue?

A

Lipoma

122
Q

What disease is associated with Malassezia furfur?

A

Seborrheic Dermatitis

123
Q

What disease has a biphasic incidence, and what does this mean?

A

Seborrheic Dermatitis

- Occurs as an infant then again as an teen/adult

124
Q

What disease involves yellow, greasy scales?

A

Seborrheic Dermatitis

125
Q

What disease involves “cradle cap”?

A

Seborrheic Dermatitis

126
Q

What two diseases involves Blaschko lines?

A
  • Pityriasis Rosea

- Seborrheic Keratosis (SK)

127
Q

What disease involves the Herald patch?

A

Pityriasis Rosea

128
Q

What disease involves testing to rule out secondary syphilis, and what is this test called?

A

Pityriasis Rosea

- RPR test

129
Q

What disease involves the 4 P’s and what are they?

A

Lichen Planus

  • Pruritic
  • Purple
  • Polygonal
  • Papules
130
Q

What disease involves Wickham’s striae, and what does this look like?

A

Lichen Planus

- Wickham’s striae: tiny white lines running through papules

131
Q

What disease involves Koebner phenomenon, and what is this?

A

Lichen Planus

- Koebner phenomenon: development of lesions at sites of trauma

132
Q

What disease involves erythematous plaques with a silvery-white scales?

A

Psoriasis

133
Q

What disease involves “oil spots” on the nails?

A

Nails Psoriasis

134
Q

What disease is associated with Auspitz sign, and what does this look like?

A 
Psoriasis Vulgaris (Chronic Plaque Psoriasis)
- Auspitz sign: removal of plaque reveals a smooth, glossy membrane with tiny punctate bleeding
135
Q

What two subtypes of Psoriasis are considered emergencies?

A
  • Pustular Psoriasis

- Erythrodermic Psoriasis

136
Q

What percentage of TBSA affected in Psoriasis is considered mild/moderate? What are the two ways by which this can be treated?

A

Mild/moderate: <5% TBSA affected

  • Intermittent therapy: topical steroids, Vitamin D
  • Continuous therapy: Calcineurin inhibitors
137
Q

What percentage of TBSA affected in Psoriasis is considered severe?

A

Severe: >5% TBSA affected

138
Q

If less than 20% of TBSA is affected in Psoriasis, how is this treated?

A
  • Referral to derm
  • Vitamin D
  • Phototherapy
139
Q

If more than 20% of TBSA is affected in Psoriasis, how is this treated?

A
  • Referral to derm
  • Systemic therapy
  • Phototherapy
140
Q

What body parts are most affected by Psoriatic Arthritis (PsA)? What test is often elevated with PsA?

A

PsA involves the spine and DIP joints (“sausage fingers”)

- Sed rate will be elevated

141
Q

What is Folliculitis and how does it progress (3 steps)?

A

Hair follicle inflammation

Folliculitis to Furuncle to Carbuncle

142
Q

What is the bacteria often associated with Folliculitis?

A

S. aureus

143
Q

What is the bacteria that causes “hot tub folliculitis”?

A

Pseudomonas

144
Q

How is moderate/severe Folliculitis treated?

A
  • Topical antibiotics (Mupirocin)

- Oral antibiotics (Keflex)

145
Q

If MRSA is suspected to be the etiology behind a disease, what three oral antibiotics are recommended for treatment? What is the recommended IV antibiotics?

A

Oral

  • Sulfa drugs (Trimethoprim-Sulfamethoxazole)
  • Clindamycin
  • Doxycycline

IV: Vancomycin

146
Q

For “hot tub folliculitis”, what is the recommended treatment?

A

Oral antibiotics (Cipro)

147
Q

What disease involves “honey-colored crusting”?

A

Impetigo

148
Q

What is the clinical progression seen with Nonbullous Impetigo?

A

Papule to Vesicles to Pustules to “Honey-colored crusting”

149
Q

What two diseases are associated with a flaccid bulla?

A
  • Bullous Impetigo

- Pemphigus Vulgaris

150
Q

What disease involves a “punched out” appearance, almost like cigarette burns?

A

Ecthyma Impetigo

151
Q

What is the recommended treatment for Nonbullous or Bullous Impetigo?

A
  • Mild: topical antibiotics (Mupirocin)

- Moderate/severe: oral antibiotics (Keflex, Dicloxacillin)

152
Q

What is the recommended treatment for Ecythema Impetigo?

A

ALWAYS oral antibiotics (Keflex, Dicloxacillin)

153
Q

What are the two types of Nonpurulent Cellulitis and what bacteria are they often associated with?

A

Cellulitis or Erysipelas

- B-hemolytic Strep

154
Q

What are the two types of Purulent Cellulitis? What two bacteria are they often associated with?

A

Abscess or Purulent Cellulitis

- S. aureus, MRSA

155
Q

What is the recommended treatment for Nonpurulent Cellulitis?

A
  • Oral antibiotics (Keflex)

- IV antibiotics (Cefazolin, Rocephin)

156
Q

For Abscess/Purulent Cellulitis, what is the first recommended treatment? What further treatment may also be indicated, and under what circumstances?

A

ALWAYS I&D if there is fluctuance
- IV antibiotics (Cefazolin, Rocephin) also indicated if abscess is >2 cm, there are multiple, or if there is any toxicity, extensive cellulitis, an in dwelling medical device, immunosuppression or at high risk for transmission (athlete, military)

157
Q

What are the two types of Systemic Lupus Erythematosus (SLE)?

A
  • Discoid

- Malar

158
Q

What three diseases can be diagnosed via DIF?

A
  • Dermatitis Herpetiformis
  • Pemphigus
  • Pemphigoid
159
Q

What disease involves a “butterfly rash”? What area of the face is spared?

A

Malar Lupus

- Nasolabial folds are spared

160
Q

What disease involves erythematous, scaly plaques on sun-exposed areas?

A

Discoid Lupus

161
Q

What disease is associated with a gluten sensitivity?

A

Dermatitis Herpetiformis

162
Q

What is the recommended treatment for Dermatitis Herpetiformis?

A

Dapsone

- Also eliminate gluten from diet

163
Q

What disease involves “target-like” lesions?

A

Erythema Multiforme

164
Q

What is the most common virus that causes Erythema Multiforme?

A

HSV

165
Q

What disease affects the epidermis and involves flaccid bullae?

A

Pemphigus Vulgaris

166
Q

What is a hallmark finding of Pemphigus Vulgaris, and how does this present clinically (hint: sign)?

A

Acantholysis (Nikolsky’s sign)

167
Q

What is the recommended treatment for Pemphigus Vulgaris?

A

Systemic corticosteroids and immunosuppressive agents

- URGENT derm referral

168
Q

What disease involves tense bullae?

A

Bullous Pemphigoid

169
Q

What is the recommended treatment for Bullous Pemphigoid?

A

Topical/systemic corticosteroids

170
Q

What disease involves the “mask of pregnancy”?

A

Melasma/Chloasma

171
Q

What disease involves hyperpigmented, velvety plaques?

A

Acanthosis Nigricans

172
Q

What two chronic conditions is Acanthosis Nigricans often associated with?

A

Insulin-resistance (DM, obesity)

173
Q

What disease involves male pattern hair growth in women?

A

Hirsutism

174
Q

What disease involves adrenal excess and how does this present?

A

Cushing Syndrome

- Affects the pilosebaceous units of the skin

175
Q

What disease involves adrenal insufficiency and how does this present on the skin?

A

Addison’s disease

- Hyperpigmentation

176
Q

What disease involves an “orange peel appearance”?

A

Hyperthyroidism

177
Q

What disease involves dry, cool skin?

A

Hypothyroidism

178
Q

What disease involves a deficiency of UROD?

A

Porphyria Cutanea Tarda (PCT)

179
Q

Porphyria Cutanea Tarda is a deficiency of what? How is this treated?

A

UROD

- Treatment: skin protection, phlebotomy (deplete iron to prevent formation of UROD inhibitor)

180
Q

What are the four stages of pressure ulcers (hint: think skin layers involved)?

A
  • Stage 1: intact skin with localized erythema
  • Stage 2: partial thickness skin loss with exposed dermis
  • Stage 3: full thickness skin loss with exposed adipose tissue
  • Stage 4: full thickness skin loss with exposed fascia, tendon, muscle, and/or bone
181
Q

What disease involves a “Bull’s eye” appearance?

A

Erythema Migrans

182
Q

What is the pathogen of Erythema Migrans?

A

Borrelia Burgdorferi

183
Q

What is the recommended treatment for Erythema Migrans?

A

Oral antibiotics (Doxycycline, Amoxicillin)

184
Q

What disease initially presents as nonspecific symptoms followed by a rash that is macular to petechial?

A

Rocky Mountain Spotted Fever (RMSF)

185
Q

What is the pathogen for RMSF?

A

Rickettsia rickettsia

186
Q

How is RMSF treated?

A

Doxycycline

187
Q

What can be prescribed prophylactically for tick borne illnesses? When should it be prescribed?

A

Single dose Doxycycline 200 mg within 72 hours of tick removal

188
Q

What disease involves infection of hair follicles?

A

Folliculitis

189
Q

What disease can become infectious via S. aureus or Pseudomonas?

A

Folliculitis

190
Q

What is another name for Folliculitis caused by Pseudomonas?

A

Hot tub folliculitis

191
Q

What is the potential progression of Folliculitis?

A

Folliculitis → Furuncle → Carbuncle

Clin Med I Disease Key Notes (4 decks)

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