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Step I > Dermatolgy > Flashcards

Dermatolgy Flashcards

1
Q

epidermal layers

A 
Californians Like Girls in String Bikinis 
stratum Corneum
stratum Lucindum
stratum Granulosum
Stratum Spinosum
Stratum Basalis
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2
Q

tight jnxs

A

zonula occludens

composed of claudins and occludins

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3
Q

adherens jnx

A 
zonula adherens
below tight jnx
connects actin cytoskeltons of adjacent cells  with CADherins
Ca dependent, ADhesion proteins  
loss of E-cad -> mets
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4
Q

desmosomes

A

macula adherens
structural support via keratin interactions
autoAb -> phemphigus vulgaris

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5
Q

hemidesmosomes

A

connects keratin in basal cells to BM
autoAb -> bullous pemphigoid
hemidesmosomes are down bullow

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6
Q

macule

A

flat lesion

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7
Q

patch

A

macule >1cm

birthmark/congenital nevus

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8
Q

papule

A

elevated solid lesion > 1cm

mole/nevus, acne

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9
Q

plaque

A

papule >1 cm

psoriasis

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10
Q

vesicle

A

small fluid containing blister

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11
Q

bulla

A

large fluid containing blister >1cm

bullous pemphigoid

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12
Q

pustule

A

vesicle w/pus

pustual psorisis

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13
Q

scale

A

flaking off of stratum corneum
eczema
psoriasis
SCC

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14
Q

crust

A

dry exudate

impetigo

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15
Q

hyperkeratosis

A

increased thickening of stratum corneum
psoriasis
calluses

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16
Q

parakeratosis

A

hyperkeratosis w/retention of nuclei in stratum corneum

psoriasis

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17
Q

spongiosis

A

epidermal accumulation of edematous fluid in intercellular spaces
eczematous dermatitis

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18
Q

acanthrolysis

A

seperation of epidermal cells

pemphigus vulgaris

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19
Q

acanthosis

A 
epidermal hyperplasia (increased spinosum)
acanthrosis nigricans
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20
Q

albinism

A

normal melanocyte number w/decreased melanin production
d/t decreased tyrosinase activity or defective transport
can also be d/t failure of neural crest cell migration
increased risk for skin CA
partial albinism seen in chediak higashi syndrome

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21
Q

melasma

A

hyperpigmentation associated w/prego (mask of prego)

or OCP use

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22
Q

vitiligo

A

irregular areas of complete depigmentation d/t autoimmune destruction of melanocytes

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23
Q

acne

A

obstructive and inflammatory disease of pilosebaceous unit

24
Q

atopic dermatitis

A 
aka eczema
pruitic eruption 
commonly on skin flexures
associated w/other ectopic diseases (asthma, allergic rhinitis)
starts on face in infancy 
antecubital fossa in adullts
25
Q

melanocytic nevus

A

common mole benign
melanoma can arise
intradermal nevi are papular
jnx nevi are flat

26
Q

psoriasis

A

papules and plaques w/silvery scaling
knees, elbows
acanthosis w/parakeratotic scaling
increased stratum spinosum
decreased stratum granulosum
Auspitz sign- pinpoint bleeding spts (exposed dermal papillae)
associated w/nail pitting and psoriatic arthritis

27
Q

rosacea

A

inflammatory facial skin disorder characterized by erythematous papules and pustules, no comedones
facial flushing
chronic inflammatory changes -> rhinophyma

28
Q

seborrheic keratosis

A

flat greasy pigmented squamous epi proliferation w/keratin filled cysts (horn cyst)
common in elderly
benign

29
Q

leser-trelat sign

A

sudden appearance of multiple seborrheic keratoses indicates underlying malignancy (GI, lymphoid)

30
Q

verrucae

A

warts caused by HPV
soft, tan colored, cauliflower like papules
epidermal hyperplasia, hyperkeratosis, koilocytosis
condyloma acumminatum on genitals

31
Q

urticaria

A

hives

pruitic wheals that form after mast cell degraulation

32
Q

impetigo

A

S. aureus or S. pyogens

33
Q

bullous impetigo

A

usually S. aureus

34
Q

cellulitis

A

acute, painful spreading infection of deeper dermis and subq

S. pyogens or S. aureus

35
Q

erysipelas

A

upper dermis and superficial lymp
S. pyogens
well demarcated

36
Q

abscess

A

S. aureus

37
Q

necrotizing fasciitis

A

anerobes
S. pyogens
crepitus
bullae and purple color

38
Q

staphylococcal scalded skin syndrome

A

exotoxin destroys keratinocyte attachements to stratum granulosum destryoing epidermal-dermal jnx
fever and generalized erythematous rash w/sloughing of upper layers of epi that heals completely

39
Q

molluscum contagiosum

A

poxvirus

40
Q

hairy leukoplakia

A

irregular white painless plaques on tongue that cannot be scraped off
EBV mediated
HIV and organ transplant recipients

41
Q

pemphigus vulgaris

A

potentially fatal autoimmune disorder
IgG against desmoglein
flaccid intraepidermal bullae d/t acantholysis
oral mucosa involved
immunofluroescenes -> reticular(net-like) pattern
nikolsky sign +

42
Q

bullous pephigoid

A

less severe then pemphigus vulgaris
IgG against hemidesmosomes (abs are bullow)
tense blisters containing eos affect skin, but spare oral mucosa
linear pattern at epi-dermal jnx
nikolsky sign -

43
Q

dermatitis herpetiformis

A

pruitic papules, vesicles, and bullae
elbows
IgA at dips of dermal papillae
celiacs

44
Q

erythema multiforme associaions

A 
M. pneumoniae
HSV
sulfa drugs
beta lactams
phenytoin
CA
autoimmune
45
Q

erythema multiforme

A

multiple types of lesions

macules, papules, vesicles, target lesions

46
Q

SJS

A

> 30% of skin involved called toxic epidermal necrolysis

SJS-TEN

47
Q

acanthosis nigricans

A 
hyperinsulinemia (DM, obesity, cushings)
visceral malignancy (gastric adenocarcinoma)
48
Q

actinic keratosis

A

premalignant lesions d/t sun
small, round, erythematous or brownish papules or plaques
SCC risk

49
Q

erythema nodosum

A 
painful inflammatory lesion of subq fat
ant shin
sarcoidosis
coccidiomycosis
histo
TB
strep
leprosy
chrons
50
Q

6 P’s of lichen Planus

A 
Pruitic
Purple
Polygonal
Plnar
Papules
Plaques
51
Q

lichen planus

A

wickham striae
sawtooth infiltrate of lymphocytes at dermal-epi jxn
associated w/hepC

52
Q

pityriasis rosea

A

Herald patch followed by scaly erthematous plawues often in ‘x-mas tree’
resolves in 6-8wks

53
Q

BCC

A 
MC skin CA
sun-exposed areas
locally invasive rarely mets
pink pearly nodules 
telangiectasias
rolled borders
central crusting/ulceration
basal cells have pallisading nuclei
54
Q

SCC

A 
2nd MC skin CA
excessive sun exposure 
immnosupressed
arsenic
face, lower lip, ears, hands, 
locally invasive 
may spread to lymph nodes 
r w/scale 
keratin perals arely mets
ulcerative red lesions
55
Q

keratoacanthoma

A

variant that grows rapidly (4-6wks)

may regress spontaneously

56
Q

melanoma

A 
significant risk of mets
S-100
HMB-45
activating BRAF kinase mutation 
Tx w/vemurafenib (BRAF kinase inhibitor)
57
Q

types of melanoma

A

superficial spreading
nodular
lentigo maligna
acral lentiginous

Step I (22 decks)

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