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MSK, Skin, and Connective Tissue First Aid USMLE Step 1 > Derm Path > Flashcards

Derm Path Flashcards

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USMLE® Step 1 flashcards
1
Q
  • Symptoms: *Warts. Soft, tan-colored cauliflower-like lesions. Epidermal hyperplasia, hyperkeratosis, koilocytosis. Verruca vulgaris on hands,; condyloma acuminatum on genitals (caused by HPV).
A

Verrucae

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2
Q
  • Symptoms: *Common mole that has hair growing from it (melanomas don’t have hair growing from it). Pathophysiology: *Benign neoplasm of basal melanocytes. Intradermal (adult) are papular while Junctional (children) are flat macules.
A

Nevocelluar nevus (Melanocytic Nevus)

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3
Q
  • Symptoms: Hives. Intensity pruritic wheals that form after mas cel degranulations. Lab Values: ** Pathophysiology: ** Treatment: *
A

Utricaria

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4
Q
  • Symptoms: *Freckle. Hyperpigmentation due to increased number of MELANOSOMES. Normal number of melaoncytes. Darkens with sunlight.
A

Ephelis

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5
Q
  • Symptoms: Commonly on face and flexor surfaces. Pruritic, erythematous, ooozing rash with vesicles and edema. Lab Values: ** Pathophysiology: *Often associated with other atopic diseases (asthma, allerigc rhinitis). Starts on the face in infancy and then moves to the antecubital fossae.
A

Atopic dermatitis (eczema)

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6
Q
  • Symptoms: Type IV hypersensitivity that follows epxosure to allergin; lesions occur at site of contact (nickle, poison ivy). Lab Values: ** Pathophysiology: ** Treatment: *
A

Allergic contact dermatitis

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7
Q
  • Symptoms: Papules and plaques with silvery scaling especially on knees and elbows. Acanthosis (thickening of dermis) with parakeratotic scaling (nuclei still in stratum corneum); increase stratum spinosum and decreased stratum granulosum. Lab Values: Auspitz sign (bleeding spots when scales are scraped off; due to elongated dermal papillae). Munro microabscesses in stratum corneum. Pathophysiology: Associated with nail pitting and psoriatic arthritis. Treatment: *Corticosteroids, UVA light with psoralen.
A

Psoriasis

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8
Q
  • Symptoms: *Flat, greasy, pigmented squamous epithelial proliferation with keratin-filled cysts (pseudo horn cysts). Looks “pasted on.” Lesions on head, trunk, extremeitis. Pathophysiology: Common benign neoplasm of older persons. Treatment: *
A

Seborrheic keratosis

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9
Q
  • Symptoms: *Sudden appearance of multipe seborrheic keratosis indicating an underlying malignancy (GI, lymphoid). Due to mutation in TGF alpha.
A

Sign of Leser-Trelat

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10
Q
  • Symptoms: May involve eye or bot skin and eye. Normal number of melanocytes. Lab Values: ** Pathophysiology: Due to defect in tyrosinase or migratinon of neural crests. Increased risk of skin cancer. Treatment: *
A

Albinism

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11
Q
  • Symptoms: Irregular areas of complete depigmentation. Lab Values: ** Pathophysiology: Due to local autoimmune destruction of melanocytes. Treatment: *
A

Vitiligo

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12
Q
  • Symptoms: Hyperpigmentation of cheeks associated with pregnancy (“mask of pregnancy”) or oral contraceptive use. Lab Values: ** Pathophysiology: ** Treatment: *
A

Melasma

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13
Q
  • Symptoms: Very superficial skin infection usually from S. aureus or S. pyogenes. Highly contagious. Honey color crusting. Lab Values: ** Pathophysiology: ** Treatment: *
A

Impetigo

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14
Q
  • Symptoms: Acute, painful spreading infection of dermis and subcutaneous tissue. Usually form S. pyogenes or S. aureus. Lab Values: ** Pathophysiology: ** Treatment: *
A

Cellulitis

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15
Q
  • Symptoms: Deeper tissue injury usually from anaerobic bacteria and S. pyogenes. Results in crepitus from methane and CO2 production. Lab Values: ** Pathophysiology: ** Treatment: *
A

Necrotizing fasciitis

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16
Q
  • Symptoms: Exotoxin destroys keratinocyte attachments to the stratum granulosum only. Fever, generalized erythematous rash with sloughing of upper layers of epidermis. Seen in young children. Lab Values: ** Pathophysiology: ** Treatment: *
A

Staphyloccal scalded skin syndrome

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17
Q
  • Symptoms: White, painless plaques on tonguet hat cannot be scraped off. EBV mediated. Occurs in HIV positive patients. Lab Values: ** Pathophysiology: ** Treatment: *
A

Hairy leukoplakia

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18
Q
  • Symptoms: Acantholysis of skin AND oral mucosa. Positive Nikolsky’s sign (separation of epidermis upon manual stroking of skin). Lab Values: Autoantibody (IgG) to desmoglein (desmosomes). Reticular or netlike pattern on IF. Pathophysiology: Autoimmune disorder (type II hypersensitivity). Treatment: *
A

Pemphigus vulgaris

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19
Q
  • Symptoms: Similar but less severe than pemphigus vulgaris - affects skin but SPARES ORAL MUCOSA. Negative Nikolsky’s sign. Blisters. Lab Values: Autoantibody (IgG) to hemidesmosomes. Linear pattern on IF. Eosinophiles with tense blisters. Pathophysiology: Autoimmune disorder (type II hypersensitivity). Treatment: *
A

Bullous pemphigoid

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20
Q
  • Symptoms: Pruritic papules and vesicles in a person with Celiac disease. Lab Values: Deposits of IgA at tips of dermal papillae. Pathophysiology: ** Treatment: *
A

Dermatitis herpetiformis

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21
Q
  • Symptoms: Presents with multiple types of lesions - macules, papules, vesicles, and target lesions. Lab Values: ** Pathophysiology: Associated with infections (mycoplasma, HSV), drugs (sulfas, penicillins, phenytoin), cancers, and autoimune disease (SLE). Treatment: *
A

Erythema multiforme

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22
Q
  • Symptoms: Prodrome of malaise and fever followed by rapid onset of erythematous/purpuric macules (oral, ocular, genital) . Skin lesions progress to epidermal necrosis and sloughing. Lab Values: ** Pathophysiology: ** Treatment: *
A

Stevens-Johnson syndrome

23
Q
  • Symptoms: *Pruritic, purple, polygonal papules. Occurs in wrists, elbows, and oral mucosa. * Lab Values: *Sawtooth infiltrate of lymphocytes at dermal-epidermal junction. * Pathophysiology: Associated with chronic hepatitis C infection. Treatment: *
A

Lichen planus

24
Q
  • Symptoms: *Premlaignant lesions caused by UVB exposure. Small, rough, erythematous or brownish papules. “Cutaneous horn.” * Lab Values: ** Pathophysiology: Risk of carcinoma is proprotional to epithelial dysplasia. Treatment: *
A

Acitinic keratosis

25
Q
  • Symptoms: Hyperplasia of stratum spinosum with darkening of the skin. Lab Values: ** Pathophysiology: * Associated with hyperinsulinemia (Cushing’s, disease, DM2) and VISCERAL MALIGNANCY.* Treatment: *
A

Acanthosis nigricans

26
Q
  • Symptoms: Inflammatory lesions of subcutaneous fat, usually on anterior shins. Associated with cocciodiomycosis, histoplasmosis, TB, leprosy, streptococal infections, sarcoidosis. Lab Values: Shows early septal widening and lymphohistiocyte infiltration without vasculitis.
A

Erythema nodosum

27
Q
  • Symptoms: Herald patch” followed days later by “Christmas tree” distribution. Multiple papular eruptions that remits spontaneously. Lab Values: ** Pathophysiology: Associated with HHV-7 Treatment: *
A

Pityriasis rosea

28
Q
  • Symptoms: Benign capillary hemangioma of infancy. Appears in first few weeks of life, grows rapidly and regresses at 5-8 years of age. Most common tumor of infants. Lab Values: ** Pathophysiology: ** Treatment: *
A

Strawberry hemangioma

29
Q
  • Symptoms: Benign capillary hemangioma of the elderly. Does not regress; increase frequency with age. Lab Values: ** Pathophysiology: ** Treatment: *
A

Cherry hemangioma

30
Q
  • Symptoms: Common on hands and face. Locally invasive but rarely metastasizes. Ulcerative red lesion. Associated with chronic draining sinuses. Lab Values: Keratin pearls. Pathophysiology: Associated with excessive exposure to UVNB sunlight or arsenic exposure. Acitinic keratosis is a precursor to squamous cell carcinoma. Treatment: *
A

Squamous cell carcinoma of skin

31
Q
  • Symptoms: Variant of squamous cell carcinoma that grows rapidly (4-6 weeks) and regresses spontaenously (4-8 weeks). Lab Values: Very well differentiated SCC. Cup-shaped tumor filled with keratin debris. Pathophysiology: ** Treatment: *
A

Keratoacanthoma

32
Q
  • Symptoms: Most common in sun-exposed areas of body, especially UPPER LIP. Locally invasive, but almost never metastasizes. Lab Values: Elevated nodule with central ulceration surroudned by telangiectasis. Pearly papules. Tumors have peripheral “palisading” nuclei. Pathophysiology: Due to exposure to UVB sunlight. Treatment: *Cryotherapy.
A

Basal cell carcinoma

33
Q
  • Symptoms: Common tumor with significant risk of metastasis. Dysplastic nevus (atypical mole) is a precusor to melanoma. Look for assymetry, border irregularity, color variation, diameter > 6 mm, and a history of change. Lab Values: S-100 tumor marker. Atypical pagetoid (upward spreading). BRAF activating mutation. P16 mutation. Pathophysiology: Fair skinned persons at increased risk. DEPTH of tumor correlates with risk of metastasis. Treatment: BRAF kinase inhibitor (vemurafenib) in pts with metastatic/unresectable melanoma with BRAF V600E mutation.
A

Melanoma

34
Q
  • Symptoms: *Flat discoloration < 1 cm (Tinea versicolor).
A

Macule

35
Q
  • Symptoms: *Macule > 1 cm
A

Patch

36
Q
  • Symptoms: *Elevated skin lesion < 1 cm (acne vulgaris)
A

Papule

37
Q
  • Symptoms: *Papule > 1 cm
A

Plaque

38
Q
  • Symptoms: *Small fluid containing blister (VZV)
A

Vesicle

39
Q
  • Symptoms: *Transient vesicle (hives)
A

Wheal

40
Q
  • Symptoms: *Large fluid-contianing blister (bullous pemphigoid)
A

Bulla

41
Q
  • Symptoms: *Irregular, raised lesion resulting from scar tissue hypertrophy (trauma to skin; Treponema pertenue)
A

Keloid

42
Q
  • Symptoms: *Blister containing pus
A

Pustule

43
Q
  • Symptoms: *Dried exudates from a vesicle, bulla, or pustule (impetigo)
A

Crust

44
Q
  • Symptoms: *Increased thickness of stratum corneum (psoriasis)
A

Hyperkeratosis

45
Q
  • Symptoms: *Hyperkeratosis with retention of nuclei in stratum corneum (psioriasis)
A

Parakeratosis

46
Q
  • Symptoms: *Separation of epidermal cells (pemphigus vulgaris)
A

Acantholysis

47
Q
  • Symptoms: *Epidermal hyperplasia (increased spinosum)
A

Acanthosis

48
Q
  • Symptoms: *Inflammation of the skin
A

Dermatitis

49
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: Hormone related increase in sebum and exces kertain block follicles (comedones) followed by inflammation of hair follicles and sebaceous glands by Proprionibacterium acnes infection. Treatment: *Benzoyl peroxide (antimicrobial), isoretinoin (lowers keratin production)
A

Acne vulgaris

50
Q
  • Symptoms: *Airses on palms or soles in dark skinned individuals. Pathophysiology: *Not related to UV light exposure.
A

Acral lentiginous melanoma

51
Q
  • Chronic excessive keratin accumulation (hyperkeratosis) resembling fish scales.
  • Primary deficit is increased cel-cell adhesions resulting in abnormal desquamation.
  • Compacted stratum corneum.
A

Ichthyosis

52
Q
  • Firm, pink umbilicated papules due to poxvirus.
  • Most often in children but also in sexually active adults and immunocompromised.
  • Hallmark is molluscum bodies in the affected keratinocytes.
  • Cheesy material from central umbilications contain molluscum bodies.
A

Molluscum Contagiosum

53
Q

Four Types:

  1. Superficial Spreading (radial growth), good prognosis
  2. Nodular: early vertical phase, poor prognosis
  3. Lentigo maligna: Remains along the dermal/epidermal junction - good prognosis
  4. Acrolentiginous: On palms/soles of dark-skinned individuals. Not related to UV Light Exposure
A

Melanoma

MSK, Skin, and Connective Tissue First Aid USMLE Step 1 (4 decks)

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