Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med III > Derm Exam I > Flashcards

Derm Exam I Flashcards

1
Q

Initial approach to derm

A

Examine before taking history to avoid tunnel vision in diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Flat, non palpable lesion less than 10mm in diameter, discolored but not elevated

A

Macule - Patch if larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Palpable lesion less than 5mm in diameter - raised

A

Papule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elevated or depressed lesion, flat or rounded, greater than 10mm

A

Plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Firm lesion that extends into the dermis tissue

A

Nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clear fluid filled blisters under 10mm in diameter

A

Vescicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clear fluid filled blister over 10mm

A

Bulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vesicle that contains pus

A

Pustule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Wheals or hives characterized by elevated lesions caused by localized edema
Red

A

Urticaria - lasts for 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Heaped up accumulation of horny epithelium

A

Scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dried serum, blood or pus on the skin

A

Crust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Open areas of the skin from a partial loss of the epidermis

A

Erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Linear erosion caused by picking or scratching

A

Excoriation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Due to loss of epidermis and part of the dermis

A

Ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Non-blanchable, small purle lesions

A

Petechiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Larger, non-blanchable, possibly palpable purple

A

Purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ciggarette paper, dry skin

A

Atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Areas of fibrosis replacing damaged skin

A

Scar - Keloid extends beyond injury boundaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Foci of permanently dilated blood vessels that may occur with sun damage

A

Telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cavity containing liquid that looks superficial with a central punctate
May be deep
Yellow, blue, skin color

A

Cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ABCDE for melanoma

A

Asymmetry
Borders
Color
Diameter (larger than pencil eraser)
Elevation/Enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nummular

A

Coin like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Patters of skin lesions

A

Symmetric
Exposed area
Sites of pressure
Intriginous area
Follicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Location of skin lesions

A

Single
Localized
Generalized
Universal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

One thing that can help psoriasis

A

Sun exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fitzpatrick skin type I

A

Pale skin with light or read hair
Prone to freckles and burn easily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Fitzpatrick type II

A

May gradually tan but still sunburn
Beige
Still higher risk of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fitzpatrick type III

A

Light olive skin, burns with long exposure, usually tans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Fitzpatrick type IV

A

Tans easily, does not burn easily, medium brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fitzpatrick type V

A

Naturally brown skin, burns only with excessive exposure
Skin easily darkens further

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Fitzpatrick Type VI

A

Black skin with dark eyes and black hair
Skin easily darkens further
Can still get skin cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Diascopy

A

Press glass slide over lesion to determine capillary extravasation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Etiology of acne

A

Increased sebum production
Follicular hyperkertinization
Proliferation of cutibacterium acnes
Inflammation

Typically begins in puberty as a result of androgen stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Stages of acne

A

Open comedo - Black head
Close comedo - White head
Papule
Pustule
Nodule/Cyst - Rupture of follicular wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Medication causing acne

A

Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Things to consider in acne

A

Over-cleansing of face, Protective sports gear, Working in fast food - occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Diagnosis for acne

A

Clinical - skin biopsy in case of doubt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Moderate acne

A

20-100 Comedomes
15-20 Papules/Pustules/Nodules/Cysts with less than 5 of the last two
30-125 Total lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

IGA acne severity scale

A

0 - Clear skin
1 - Almost clear
2 - A few inflammatory lesions
3 - No more than one small nodule
4 - Many lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Pityrosporum folliculitis

A

Itchy acne on the upper back/shoulders/scalp
KOH testing and ketoconazole treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Management pearls in acne

A

Often resolves after teens
COnsistent care over months for results
Educate on medication us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Mild acne treatment

A

Topical retinoids
Benzoyl peroxide
Topical antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Retinoids

A

Tretinoin - Acutane
Apply peas sized amount to face
Tazarotene - Strong
Adapalene - Less intense
Trifarotene - Good for trunk/back

Build up tolerance to avoid allergic reactions (once every 3 days for starting out) - causes dryness, photosensitivity and CI in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

MOA of retinoids

A

Decreases cohesion and increases turnover of epidermal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Benzoyl peroxide

A

No bacterial resistance
Titrate dose up
Skin irritation, can bleach hair and clothes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Topical abx for acne

A

Clindamycin or Erythromycin
BPO first to reduce resistance -no monotherapy
SE: Skin irritation
Mild to moderate acne
BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Oral abx for acne

A

Tetracyclines - Doxy or mino
100mg BID
Inhibits bacteria

Macrolides for pregnancy
Second line Bactrim or Keflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Oral retinoids

A

Isotrentoin - Acutane
Dries sebaceous gland and decreases C. acnes
Monotherapy
4-6 month course w/ largest meal of the day - high fat
CI with tetracycline - pseudotumor cerebri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Birth control during acutane

A

Need to be on 2 forms of birth control during use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Tx for noninflammatory comedonal acne

A

Topical retinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Tx for mild papulopustular acne

A

BPO+ABX AND retinoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Tx for Moderate papulopustular acne

A

Topical retinoid+BPO+Oral ABX
Hormonal therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Tx for severe nodular ance

A

Topical retinoid+BPO+Oral ABX
Hormonal therapy
Oral isotretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Patient education with acne

A

6-8 weeks to improvement - might get worse before it gets better
Washing BID
Some association with dairy
Avoid touching face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Rosacea

A

Usually in fitzpatrick 1-2
Between 30 and 50
Linked to demodex mites
Telangiectasia and other lesions on eyes, nose, cheeks, etc. - Central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Types of rosacea

A

Erythematotelangiectatic rosacea
Papulopustular rosacea
Phymatous rosacea
Ocular rosacea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Difference between acne and rosacea

A

NO open comedomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Erythematotelangiectatic rosacea

A

central portion of face with stinging or burning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Papulopustular rosacea -

A

Acneiform papules/pustules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Phymatous rosacea

A

Inflammation and edema with sebaceous hyperplasia - bulbous cobblestoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Ocular rosacea -

A

Conjunctivitis, blepharitis and hyperemia, itchy eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Non-pharm tx for rosacea

A

Avoid triggers - spicy foods, hot steam, SUNLIGHT
Use good sunscreen
Cover-ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Pharm therapy for rosacea

A

Metronidazole prep BID gel for oily, cream for dry
Ivermectin
Sodium sulfacetamide - Lotion, cream cleanser
Azelaic gel
Brimonidine gel - Daily - can have revound erythema (oxymetazoline can help)
Permethrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Systemic tx for rosacea

A

Doxy daily
Flagyl
Z max

Isotretinoin for severe/refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Other tx for rosacea

A

Camoflauge
Surgery for rhinophyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Perdermal dermatitis presentation and tx

A

Discrete micropapules/microvescicles around the mouth
May be due to steroid and toothpaste use
D/C any triggering steroids and use topical/oral abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Pregnancy testing with accutane

A

Twice before starting and once monthly after starting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Impetigo

A

MC d/t staph
Can present with bullae
Can be from breaks in the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Bullous impetigo

A

S aureus in older children
Large bullae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Clinical presentation of non-bullous impetigo

A

Painful and tender
Erosions with crusts
1-3cm lesions
Regional lymphadenopathy
Scattered discrete lesions
Common around nares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Presentation of bullous impetigo

A

Vescicles progress quickly to bullae
No erythema
Collapse in 1-2 days leaving erosions and crusts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Dx of Impetigo

A

Gram stain and culture to determine agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Tx for impetigo

A

Warm water soak 15 -20 minutes BID followed by Mupirocin (Bactroban) 5 days

Widespread - 7 days Keflex or Erythromycin

MRSA - Doxy or Vanc or Linezolid

Severe/Bullous PO abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Pt education for impetigo

A

Hygeine
Clip nails
BPO wash for prevention
Avoid contact w/ others 24 hours post abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Impetigo tx for allergy to PCN

A

Macrolide or Clinda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Folliculitis presentation

A

Infection of hair follicle
Pustules in the ostium
Non-tender/Slightly tender
Pruritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Risk factors for folliculitis

A

Shaving hair areas
Occlusion of hair areas
Hot tub usage
Systemic abx
Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Causative agents of folliculitis

A

S aureus
Pseudomonas - hot tub!
Herpetic/Milluscum - Viral
Fungal - Candida, Malassezia
Syphillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Gram negative folliculitis presentation

A

Acne patient worsens with abx administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Dx of folliculitis

A

Clinical:
Gram stain, C&S, KOH for confirmation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Tx for mild folliculitis

A

Mild - Warm compress, wash with BPO, abx if no resolution in 2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Tx for moderate folliculitis

A

Topical abx - Clinda BID or Mupirocin TID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Tx for severe folliculitis MSSA or MRSA

A

MSSA - Keflex
MRSA - Doxy/Bactrim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Folliculitis prevention

A

BPO or chlorohexadine wash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Presentation of an abcess

A

Can be in skin, dermin, SQ fat, or muscle
Tender, red, hot, indurated nodule may have fever and constitutional symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Tx for abcess

A

I&D
IV for more serious - ie. rapid progress
Educate to avoid squeezing
Plastic surgery for more difficult areas - face, genitals….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Indications for abx post abcess

A

Over 2cm abcess
Multiple lesions
Surrounding cellulitis
Immune suppression
Systemic toxicity - Fever
Inadequate response to I&D
Indwelling medical device
High risk for transmission - Jails, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Furuncle

A

Acute, deep seated red hot tender nodule of abcess - boil
1-2cm
Cavitation after drainage
From staph folliculitis
In a hair bearing region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Tx for furuncle

A

Warm compress for 10 minutes daily
PO abx
Bactrim, Clinda, or Doxy for 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Carbuncle

A

Deeper infection of interconnecting abcesses
Fever with constitutional symptoms
MC on nape of neck, back, thighs
“All the furuncles get in the car”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Tx for uncomplicated and complicated carbuncle

A

Bactrim, Clinda, or Doxy PO

Admit if toxic appearing for IV vanc daily - complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Necrotizing fasciitis

A

Rapid progression of infection with extensive necrosis of soft tissues and overlying skin
Polymicrobial - Strep, P. aruginosa, Clostridium
Starts with deep site at non penetrating minor trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

DIagnosis of necrotizing fasciitis

A

Skin necrosis is not obvious with signs of sepsis
Severe pain, Indurated swelling, Bullae
Redness, edema, warmth, pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Red flags for necrotizing fasciitis

A

Severe, contant, out-of proportion pain, Dirty dishwater discharge
Crepitus in soft tissues
Edema beyond erythema
Progression despite abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Tx for necrotizing fasciitis

A

Surgical debreidment
CT/MRI
Broad spectrum abx - Carbepenem, Unasyn, Clinda, Vanc - depends of C&S/Gram stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Erysipelas

A

Acut superficial infection - MC beta hemlytic strep in children and older adults
Raised, indurated plaque with signs of sepsis, slapped cheeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Cellulitis etiology

A

MC staph aureus
Cat/Dof trauma - Pasturella
Water - Aeromonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Presentation of cellulitis

A

Fever, chills, anorexia, malaise
Red, edematous lesion with non distinct borders - non raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Dx for cellulitis

A

Clinical
Labs only needed if presenting with systemic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Abx tx for cellulitis

A

IV abx in spreading, systemic, or resistant conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Tx for dermatitis and erysipelas

A

Clinda first line PO for MRSA
Keflex for MSSA PO

IV Vanc for inpatient MRSA, daptomycin second
Cefazolin or Clinda inpatient MSSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Tx for special case dermatitis

A

Augmentin - Bite
Cipro - Water
Doxy - Salt water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Lymphaniitis tx

A

Distal wound with proximal infection
Can be herpetic
Clinical dx labs if systemic
Dicloxacillin with 1st gen cephalosporin
Clinda or Bactrim for MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Lymphangiitis follow up

A

24-48 hours
Abx for toxic patients or those with no improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Cutaneous candidiasis

A

Neonates, elderly, body folds
Candida albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Presentation of cutaneous candidiasis

A

Pruritic, tender, painful, macerated, erythematous patch with satellite lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Dx for cutaneous candidiasis

A

Clinical - KOH prep can be done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Tx for cutaneous candidiasis

A

Topical antifungals - Ketoconazole or other azole for 2-3 weeks
Oral fluconazole for severe 2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Cutaneous candidiasis prevention

A

Keep areas dry
Powders, Hair dryer, avoid occlusive clothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Balantitis

A

Inflammation of glans penis
Candida, Trichomonas, Gonorrhea, Strep
Improved hygeine and topical steroid to treat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Dermatophyte

A

Fungi that can infectnonviable cutaneous structures such as hair and nails - tinea etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Dx for dermatophytes

A

KOH prep for hyphae and spores
Green fluorescence under woods lamp
Fungal culture - takes a long time!
Skin biopsy when uncertain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Tx for dermatophytes - topical

A

Imidazoles - Clotrimazole, Ketoconazole
Allylamines - Naftfine, Terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Systemic treatment for dermatophytes

A

PO -azole or Terbinafine(MC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Presentation of tinea capitis

A

Gray scaly patch - ectothrix or black dot - endothrix
Can be inflammatory or noninflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Kerion

A

Inflammatory tinea capitis - boggy and purulent
Can lead to permanent hear loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Favus

A

Honeycomb tinea capitis
Yellow crust

118
Q

Tx for tinea capitis

A

Culture to r/o staph infection
PO terbinafine or griseofulvin
Ketoconazole shampoo

119
Q

Tinea cruris

A

Jock itch in inguinal folds
Typically with tinea pedis
Scaling with centrally cleared plaques - scale goes away when treated

120
Q

Tx for tinea cruris

A

Ketoconazole/Econazole
Drying powder
PO griseo fulvin for tx failure

121
Q

Prevention of tinea cruris

A

Wear shoes in locker room
Put on socks before pants
BPO wash

122
Q

Presentation and tx of tinea corporis

A

Asymptomatic - may be pruritic
Central clearing
Topical antifungals, PO for large area
Terbinafine for 4 weeks

123
Q

Presentation of tinea pedis

A

Erythema, scaling, maceration with or without bullae
Often in wet climates

124
Q

Interdigital tinea pedis

A

MC between 4th and fifth toe
Maceration, hyperhidrosis, fissuring, scaling

125
Q

Moccasin tinea pedis

A

Well demarcated, scaling w/ erythema
Soles and lateral feet bilaterally

126
Q

Inflammatory tinea pedis

A

Vescicles or bullae with clear fluid (pus=bacteria too)
Rupture erosions with ragged ringlike border
MC sole and web spaces

127
Q

Ulcerative tinea pedis

A

Extension of interdigital onto the plantar and lateral foot
May have secondary S. aureus

128
Q

Tx for tinea pedis

A

Topical antifungal - Keto or Eco
Oral terbinafine for hyperkaratotic

129
Q

Tinea versicolor

A

Not a dermatophyte, not contagious
Overgrowth of malassezia furfur
MC in adolescents and oily skin

130
Q

Presentation of tinea versicolor

A

Itching may be present
Macules, papules, and fine scales
Often an aesthetic concern

131
Q

Dx for tinea versicolor

A

KOH prep - spagghetti and meatballs=hyphae and budding yeasts

132
Q

Condyloma acuminata

A

Genital warts - HPC with 6 and 11 as MCC
STD - active lesions don’t need to be present
Any skin to skin lesions
2-3 month incubation

133
Q

Presentation of condyloma acuminatum

A

Look like skin tags in the genital or anal area
Cauliflower floret appearance
Keratotic warts
Flat topped papules/plaques - cervix
May persist in dormant state
Solitary or scattered

134
Q

Complication of condyloma

A

May result from immune compromise
Can get infected if they get too big
Can spread via shaving

135
Q

Dx for condyloma acuminatum

A

Pap smear and dermatopathology (biopsy)
May do viral subtype
Gardasil to prevent

136
Q

Penile pearly papules

A

Benign, normal little dots all around the glans of the penis

137
Q

Tx for condyloma

A

Imiquimod, Podofilox, trichloracetic acid

May also do cryosurgery or electrotherapy
Follow up monthly until lesions are gone

138
Q

Dosing of gardasil

A

2 doses in 9-14
3 doses in 15+ 0,2,6

139
Q

Imiquimod MOA

A

Immune modulator that induces the immune system to recognize and destroy lesions

140
Q

Application of imiquimod

A

Apply small amount at bedtime 3 times per week
Wash off upon awakening
Up to 16 weeks to work

141
Q

SE of imiquimod

A

Localized inflammation, may need an holiday
Avoid sexual contact

142
Q

MOA of podofilox

A

Prevents cell division and causes cell necrosis

143
Q

Application of podofilox

A

Cotton tipped application Q12 for 3 days on four days off over 5 max weeks total

144
Q

Area and volume restriction for podofilox use

A

Area 10cm squared or less
Volume 0.5 ml/day or less

145
Q

SE and education of podofilox

A

Skin irritation
Flammable
Avoid sex
CI in pregnancy

146
Q

MOA of trichloracetic acid

A

Burns, cauterizes and erodes skin lesions
Apply vaseline for a barrier when using
6-8 weeks

147
Q

Molluscum contagiosum

A

Viral infection - POX
Easily transmitted via water - swimmers
STD in adults

148
Q

Presentation of Molluscum contagiosum

A

Smoothed dome shaped papules with umbilicated center
In adults in groin or abdomen
Flesh colored
Curd like material filling

149
Q

Tx of molluscum contagiosum

A

0.5-2 years to regress
Cryotherapy maybe curettage
Podofilox or salicylic acid
DO NOT PICK

150
Q

Verrucae

A

Warts
HPV etiology from direct skin contact

151
Q

3 types of warts

A

Verruca vulgaris - Common
Verruca Plantaris - Plantar wart
Verruca Plana - Flat Warts

152
Q

Presentation of verrucae

A

1-10 mm papules
Isolated or multiple often located in areas of trauma, hands/ fingers, or knees
May see red or brown spots

153
Q

Presentation of verruca plantaris

A

Plaques with black thrombosed vessels
Painful - effect waliing

154
Q

Verruca plana

A

Areas that are shaved
Sharply defines 1-5mm
Round, oval polygonal, or linear

155
Q

Dx for verruca

A

Clinical biopsy if concern for cancer

156
Q

Pharm Tx for verrucae

A

May resolve in months to years
Salicylic acid
Imiquimod
Cantharidin

157
Q

Salicylic acid MOA

A

Keratolytic agent
Desquamates hyperkeratotic epithelium

158
Q

Salicylic acid use

A

Soak lesion, Sand down, then apply

159
Q

Canthrone AKA Catharidine

A

Derived from blister beetle
For warts or viral lesions
Painless - leave on for 4-6 hours

160
Q

Crytherapy with verruca

A

Made need to file down and freeze multiple times for the same wart

161
Q

Herpes Zoster

A

Dermatome-following infection
10-20% lifetime incidence
Passes from skin to sensory fibers

162
Q

Phases of herpes zoster

A

Prodrome
Active infection
Post herpetic neuralgia

163
Q

HZV prodrome

A

Mimics angina or acute abdomen - followed by rash
Paresthesias and flu-like symptoms

164
Q

Progression of herpetic lesions

A

Papules - 24 hours
Vescicles - 48 hours
Pustules - 96 hours
Crusts - 7-10 days

165
Q

Diagnosis for HZV

A

Often clinical
Tzank, DFA, Viral culture
MOST SENSITIVE - Viral PCR

166
Q

Tx for HZV

A

Educate on vaccination
Close follow up
Ophthalmology if eye involved

167
Q

Pharm for HZV

A

Valcyclovir, Famcyclovir, Acyclovir
7 days normal
10 days for immune compromised

168
Q

Supportive care for HZV

A

Bed rest
NSAID
Neurontin
Nerve block if severe

169
Q

For how long can new HZV lesions present

A

A week

170
Q

Pediculosis capitis

A

Head lice
Intense pruritic breakout

171
Q

Hair louse

A

1-3mm long
with lifespan of 14-18 days
Nits are 1mm and see-through

172
Q

Presentation of pediculosis capitis

A

MC in females - white school aged children and mothers
Alopecia - hair loss
Seeing lice
Maculae, cerulae and purpuric lesions
May see lymphadenopathy

173
Q

Scalp exam for pediculosis capitis

A

Start at the base of the hair and examine it in sections - lice will run away from you into the scalp

174
Q

Household management after lice

A

Wash all clothes, scrunchies, etc. Bag up andything that can’t be washed for 2 weeks

175
Q

Lice removal

A

Oil hair and work through in sections, discarding lice from comb after each pass

176
Q

Dx for Pediculosis Capitis

A

Demonstration of lice or nits visually or microscopically
Woods lamp to fluoresce nits

177
Q

Management of pediculosis capitis

A

Manual extraction with a topical as well
Standard and contact precautions

178
Q

Pharm for Pediculosis capitis

A

OTC before prescription
Only treat if you see active lice/eggs
Permethrin - apply to dry hair and rinse after 10 minutes
Pyretherin

179
Q

List of drugs that can be used to pediculosis capitis

A

Spinosad - children 4+
Malathion
Permethrin - Off label, 2 months+
Ivermectin 6 months+, no pregnant
Oral Ivermectin - 5+ years and can’t apply, all over

180
Q

Eyelid involvement for pediculosis capitis

A

Apply petrolatum twice daily for 8 days

181
Q

Pediculosis corporis

A

Usually in very hairy people
Hides in clothing seems
Macules and papules
Associated with poor hygeine

182
Q

Presentation of peduculosis corporis

A

Erythematous papule - bites
Maculae cerulea - blue gray macules - pathognomic for pediculosis corporis
May see excoriations from scratching

183
Q

Parasitic melanoderma

A

Vagabond skin
Thickening and darkening after chronic lice infection

184
Q

Management for pediculosis corporis

A

Standard and contact precautions
Check for secondary infection
OTC or prescription medication
Permethrin cream for heavy infestation

185
Q

Pediculosis pubic

A

STI - lice in the perineal area
NOT from house pets
May see scalp infestation

186
Q

Louse lifespan

A

Less than a month
Less than a day off human body
Take 7-10 days to hatch

187
Q

Presentation of peduculosis pubis

A

Lesions on dermoscopy
Macules, papules, wheals
Pinpoint bleeding on underwear
Inguinal node swelling

188
Q

Diagnosis of pediculosis pubis

A

Use dermoscopy
Woods lamp
Tape
Eval ALL hair baring areas
Finding a louse or nit is best

189
Q

Tx for pediculosis pubis

A

Treat any STI
Wash clothes at highest setting
2 week isolation for non washable
Avoid sharing clothes
Some OTC treatments, Shaving area

190
Q

Meds for pediculosis pubis

A

Permethrin cream 1%

191
Q

MOA of permethrin and use

A

For lice
Neurotoxin resulting in parasite resp paralysis
CI in under 2 months

192
Q

Pyrethrin/Piperonyl peroxide MOA

A

Neurotoxin with adjuvant
For lice and scabies

193
Q

Pyrethrin/Piperonyl peroxide SE and dosing

A

Pregnancy category C
Apply to wet, infested areas, leave for 10 minutes, wash
Transient burning, stinging, pruritis

194
Q

Malthion

A

For head lice
Neurotoxic via cholinesterase
CI in 6 or younger
Pregnancy category B

195
Q

Dosing for Malathion

A

Leave on for 7-10 hours
Flammable

196
Q

Lindane

A

Last resort for lice
Highly neurotoxic - causes louse seizures - BBW
Do not wash before use
Illegal in CA
Pregnancy C

197
Q

Scabies

A

Intensely pruritic eruption caused by a mite
Extremely contagious
Common in children

198
Q

Typical scabies infestation

A

10-20 mites
Mites burrow below stratum corneum
Worst itch of life
Burrows seen on skin - line with a pinhead dot

199
Q

Dx for scabies

A

Look for burrows
Aggressive scraping and dermoscopy to visualize mite
Negative prep does not rule out

200
Q

Crusted scabies

A

Severe and highly contagious
Have hundreds to thousands of mites all over
Permethrin AND Oral Ivermectin

201
Q

Scabies prep

A

Best test for scabies
Scrape and observe for mites with microscope

202
Q

Scabie management

A

Permethrin first line as topical
Oral Ivermectin - Second line
Separate treatments by 1-2 weeks

203
Q

Pt ed for scabies

A

Itching can last after treatment can give an antihistamine or even steroid

204
Q

Potential sources of error in scabies prep

A

Not enough specimen
Not enough time to dissolve in KOH
Abrasion resulting in blood contamination

205
Q

Black widow spider

A

Neurotoxic venom
Commonly live in wood piles
Red hourglass on back

206
Q

Presentation of black widow bite

A

Cholinergic excess!!
Hypertension, tachycardia, severe abdominal pain, salivation
Halo rash around bite

207
Q

Brown recluse bite presentation

A

Initially painless
Pain swelling, bullae minutes to hours later
Disseminated intravascular coagulopathy can occur

208
Q

Brown recluse spider

A

Brown and violin shaped spider

209
Q

Funnel-Web Spiders

A

PNW
Hobo spider

210
Q

Presentation of funnel web spider bite

A

Neurotoxic
Severe pain and systemic symptoms
Can be fatal if venom injected

211
Q

Tarantula irritation

A

Hairs cause urticaria, ocular problems, and rhinitis

212
Q

Things to look for in a spider bite

A

2 small puncta
Erythema and edema
Necrotic area with red dusky center

213
Q

Dx of spider bite

A

Done based on hx
Spider collection is ideal

214
Q

Monitoring for spider bites

A

Brown recluse bites can cause hemolysis
Serial hemoglobin and monitoring for rhabdomyolysis
Culture and purulent drainage

215
Q

Tx for spider bite

A

Compress, elevation of extremity
Antivenom
Tetanus prophylaxis
Dapsone for necrotic lesions within 36 hours

216
Q

Atopic dermatitis

A

IgE mediated
Asthma, Eczema, Hay fever

217
Q

Cycle of atopic dermatitis

A

Dry skin followed by itching followed by disruption and thickening of skin

218
Q

Transepidermal water loss

A

Mechanism in atopic dermatitis due to compromised barrier
Water out, irritant in

219
Q

Acute atopic dermatitis

A

Erythema, vescicles, weeping, crusts

220
Q

Subacute atopic dermatitis

A

Scaly plaques, papules, round erosions

221
Q

Chronic atopic dermatitis

A

Lichenifications, follucular eczema, and skin thickening

222
Q

Envionmental triggers for atopic dermatitis

A

Heating house
Detergent
Abrasive clothing
Alcohol in perfumes
Smoking
Stress - allergies to eggs milk, peanuts

223
Q

Presentation of atopic dermatitis

A

Itching causing scratching causing thickening
Water loss and cutaneous infections

224
Q

Secondary infections to atopic dermatitis

A

Staph
Coxsackie virus
HSV
Vaccina virus

225
Q

Common locations for atopic dermatitis

A

Neck, elbows, hands, cheeks, popliteal fossa

226
Q

Peds atopic derm signs

A

Dennine Morgan lines
Allergic shiner
Nasal crease
Open mouth with recessed lower jaw

227
Q

Tests for atopic dermatitis

A

Fam hx
Serum IgE
Culture or skin biopsy can help
Often a clinical dx

228
Q

Management for atopic dermatitis

A

Avoid triggers:
Hit water, stress, irritants
Clearance with Lowest strength steroid
Ointments without preservatives

229
Q

Skin care for atopic dermatitis

A

Gentle skin cleanser - CerVe, Cetaphil, Vanicream

230
Q

Medium potency steroids for atopic derm

A

Triamcinolone
Mometasone
Flucinolone

231
Q

Low potency steroid for atopic derm

A

Desonide

232
Q

Nonsteroidal tx for atopic derm

A

Not for children under 2
Tacrolimus
Pimecrolimus
Crisaborole

233
Q

Systemic tx for atopic derm

A

Dupilumab - (Dupixent) - Injected

234
Q

Treatment for pruritis of atopic derm

A

Diphenhydramine
Hydroxyzine
Cetirizine hydrochloride
Loratadine

235
Q

Contact dermatitis

A

Acute or chronic inflammatory reaction to a skin exposure to substance
Allergic or Irritant - Allergic is DELAYED

236
Q

Allergic contact dermatitis presentation

A

Break out 48 hours AFTER exposure

237
Q

Presentation of acute contact dermatitis

A

Erythema, Vesicles and bullae

238
Q

Presentation of chronic contact dermatitis

A

Scaling, lichenification, fissures and cracks
Geometric shapes

239
Q

Causes of contact derm

A

Soaps
Cement
Industrial chemicals
Fiberglass
Plants

240
Q

Tests for contact derm

A

Hx and PE are best
Patch testing for allergren verification - will need additional worup after

241
Q

Allergic contact derm causes

A

Diverse, T-cell mediated reaction
Erythema, papules, vesicles, erosions, then crusts

242
Q

Nickle allergy presentation

A

Nelow umbilicus from belt buckle or around jewelry

243
Q

Management for contact derm

A

Review meds
Time of showers - too long can be aproblem
Use a humidifier
Pets
Avoid offending agent, topical and potentially oral steroids
All creams

244
Q

Low potency steroids for contact derm

A

Hydrocortison
Desonide

245
Q

Medium potency steroids for contact derm

A

Triamcinolone
Mometasone
Flucinolone
All creams

246
Q

High potency contact derm steroids

A

Clobetasol
Halbetasol
Betamethasone
Flucinonode
Desoximetasone
All creams

247
Q

Phototherapy for contact derm

A

PUVSA treatment

248
Q

Diaper dermatitis presentation

A

Cutaneous candidiasis around the perineal reion
Miliaria - Blocked sweat ducts
Fussy w/ vescicles, papules, erosions

249
Q

Management for diaper dermatitis

A

Prompt changing of diapers
Not too tight
Dry bottom after bathing
Zinc oxide barrier cream
Nystatin, Clotrimazole, or Econazole for candidiasis

250
Q

Nummular eczema/dermatitis

A

Coin shaped plaques
Associated withfrequent bating, low humidity
skin trauma, hep C interferon therapy, irritating fabrics
Venous stasis on legs

251
Q

Presentation of nummular dermatitis

A

Similar to atopic dermatitis - itch that rashes
50-65 years old men MC
No personal of fam hx
Scaly paques, erosions, and crusts
Coalescence of lesions

252
Q

Best tests for nummular derm

A

Culture for bacteria
Scrape for fungi
Biopsy if needed

253
Q

Seborrheic dermatitis

A

Common inflammatory papulosquamous condition
Face scalp, neck, upper back, and chest
Caused by malassezia yeast

254
Q

Presentation of seborrheic derm

A

Dandruff fulminant rash
Dryness, prutitis, erythema, fine scaling
Change in pigmentation of dark skin

255
Q

Risk factors in seb derm

A

HIV and parkinsons
Look for erythematous plaques
May be associated with rosacea

256
Q

Tests for seborrheic derm

A

Clinical
Biopsy if refractory/resistant
Scraping if fungus suspected

257
Q

Management for seborrheic derm

A

No cure
Salicylic acid, Tar, or Ketoconazole shampoo
Clobetasol, Betmethsone, Flucinolone steroids

258
Q

First line for seb derm

A

Ketoconazole shampoo

259
Q

Presentation of stasis dermatitis

A

Due to venous dermatitis
Pruritis, heaviness, and edema in lower legs
Bilateral
Erythema and browning
Lichenification and loss of hair

260
Q

Management for stasis derm

A

Treat underlying conditions
Clean with water
Triamcinalone or Clobetasol
Compresion stockings

261
Q

Complications of stasis derm

A

Cellulitis
Wounds - non-healing
Consult vascular

262
Q

Lichen simplex chronicus

A

Repetitive lichenification of an area
From chronic skin conditions or habit forming scratching

263
Q

Findings of lichen simplex chronicus

A

Often found on scalp, ankles, lower legs, upper thighs, forearms, pubic region
Plaques, thick skin, excoriations, Hyperpigmentation

264
Q

Management for Lichen simplex chronicus

A

Stop scratch itch cycle
Cut fingernails
Benadryl
Apply dressing with mositurizer
Triamcinalone for hydration

265
Q

Peri-oral dermatits

A

Erythymatous papules and pustules of unknown origin
Fine scaling
May itch, burn, or not
Lip and chin distribution

266
Q

Management for peri-oral derm

A

May biopsy if uncertaib
Taper steroids to low potency
Will flare up after termination of topical steroid - use pimecrolimus to taper
Topical erythromycin, metro, clinda

267
Q

Dyshydrotic derm

A

Hands and feet
Tapioca vescicles on later aspect of digits
May do C&S or patch testing
Biopsy is diagnostic

268
Q

Tx for dyshidrotic eczema

A

Topical steroids for two weeks
PUVA (light) therapy

269
Q

Tx for secondary infection in dyshydrotic eczema

A

PO abx
Avoid irritants or over-exposure to water/excessive hand washing

270
Q

Emollients

A

Non cosmetic moisturizers
Increase skin moisture and flexibility - retinol preparations can make it worse
Apply w/o excessive rubbing
Use after flare is controlled
Cream, Lotion or Ointment

271
Q

Cream

A

Cream - best for most dermatoses, thick with blanced fat and water, moderate moisturizing effect

272
Q

Lotion

A

More water with less fat
Less effective for moisturizing, useful for hair covered areas

273
Q

Ointment

A

Greasy - bad for weeping skin or eczema
Preferable for dry/thickened skin

274
Q

Topical corticosteroids MOA - 4 aspects

A

Reduces the immune response via:
1.Stabilizes leukocyte/macrophage activity
2. Contstriction of capillaries
Decreases
3.Decreases activation of compliment cascade
4.Reduces fibroblast proliferation and collegen deposition which leads to reduced scar formation

275
Q

Indication for topical steroids

A

Atopic derm
Contact derm
Nummular derm
Chronin Lichenification
Psoriasis

276
Q

CI for steroids

A

Bacterial infection
Use on eye

Caution in chronic use - growth stunting in children
Pregnancy category C

277
Q

SE of steroids

A

Depends on potency and area
Atrophy, striae, rosacea, glaucoma in eyes

278
Q

Steroid ointment

A

Most potent vehicle
Semi occlusive
Increase active ingredient absorption

279
Q

Steroid creams

A

Less potent than ointment
Better feel

280
Q

Steroid lotion

A

Least potent
Less residue
Cooling effect and feel

281
Q

Steroid powders

A

Good in wet skin conditions

282
Q

Steroid gel

A

Oil and water in alcohol
Good for scalp with no residue

283
Q

Steroid foam

A

Easy to spread but more expensive

284
Q

Steroid solution

A

Low viscosity, alcohol causes a drying effect

285
Q

Classes of steroids

A

Determine strenght
I - strongest (clabetasol)
VI - Weakest (Hydrocortisone)

286
Q

Dosing for topical steroids

A

Daily or BID
Gradual taper
Use class I for under 3 weeks
Class ii-IV for 6-8 weeks
Class V or VI chronic or 1-2 week face, fold, genital limit

287
Q

Tachyphylaxis

A

Decrease in response to drug after prolonged exposure - need a holiday

288
Q

MOA of pimecrolimus and tacrolimus

A

Inhibition of T lymphocyte and release of cytokines
Used for atopic derm

289
Q

CI, SE and BBW for immune modulators

A

Skin malignancy - rare
CI under 2
Pregnancy category C
Burning sensation, URI, Fever
No skin atrophy like steroids

290
Q

Selenium sulfide

A

Reduces corneocyte production
seb derm and tinea versicolor

291
Q

Dosing and SE of selenium sulfide

A

Shampoo, lotion or foam
May have transient burining or stinging

292
Q

Pyrithione zinc

A

Reduces cell turnover in hair and skin
Seb derm
Shampoo for bar form

Clin Med III (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions