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USMLE Step Two > Dermatologic Disorders > Flashcards

Dermatologic Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

side effects of oral isoretinoin

A

teratogen, hepatotoxicity, hypertriglyceridemia, pancreatitis, suicidal ideation

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2
Q

adverse effect of combining oral isoretinoin with tetracycline

A

pseudotumor cerebri

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3
Q

treatment for necrotizing fascitis caused by streptococcus or clostridia

A

penicillin G +/- clindamycin

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4
Q

general empiric treatment of necrotizing fascitis

A

impinem +/- vancomycin

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5
Q

treatment for MRSA skin infections

A 
10-14 day course of:
bactrim + rifampin
clindamycin + rifampin
minocyclin + rifampin
linezolid \$\$$
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6
Q

classic presentation of rosacea

A

facial erythema with telangiectasias starting at the nose and cheeks
provoked by various stimuli including spicy foods
rhinophyma (sebaceous gland hyperplasia of the nose)

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7
Q

treatment for rosacea

A

topical:
sulfacetamide + sulfur
metro-gel, metronidazole
rhinophyma may require laser therapy

systemic treatment:
tetracycline, doxycycline, or accutane

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8
Q

when antibiotics should be used in the treatment of skin abscesses

A

if abscess is > 5cm or if patient has comorbidities: diabetes, immunocompromised

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9
Q

preferred medication in treatment of scabies

A

permethrin soap

second line: oral ivermectin

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10
Q

characteristic features of necrotizing fasciitis

A

necrosis, purple, woody texture, crepitus, pain extends beyond region of cellulitis

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11
Q

treatment for dry gangrene

A

auto-amputation

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12
Q

treatment for wet gangrene

A

debridement or amputation

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13
Q

medication options for treatment of acne vulgaris

A

first line: topical retinoin
second line: oral/topical antibiotic or benzoyl peroxide
other options: OCPs, spironolactone, or oral isoretinoin for cystic acne

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14
Q

time-frame in treatment of varicella

A

antivirals if within 72 hours

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15
Q

side-effects from oral isoretinoin

A

hepatotoxicitiy, suicidal ideation, teratogenic effects, elevated triglycerides and pancreatitis

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16
Q

appearance of molluscum contagiosum

A

painless shiny papules with central umbilication

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17
Q

treatment for molluscum contagiosum

A

self-limited, most resolve within 3 years
chemical, laser, or cryotherapy for removal
imiquimod will induce inflammatory reaction against lesion

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18
Q

treatment for tinea capitis

A

oral griseofulvin, terbinafine

topical will not work because the tinea is INSIDE the hair follicle

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19
Q

lichen planus features

A

pruritis, purple, polygonal, papules, and plaques
shiny and flat on flexor surfaces
associated with HIV and hepatitis C

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20
Q

treatment of lichen planus

A

topical or intralesional medium to high-potency steroids

acitretin (oral retinoid)

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21
Q

stages of decubitous ulcers

A

stage I: pressure related alteration in intact skin such as change in color, consistency, or temperature
stage II: superficial ulcer, abrasion, or shallow crater
stage III: full thickness skin loss
stage IV: extensive destruction or necrosis, damgage to muscle or bone

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22
Q

treatment of decubitous ulcers

A

address nutrition to help body heal
relieve pressure, soft mattress, elevate heels
debride if necessary with hydrocolloid dressing

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23
Q

stasis dermatitis

A

caused by vascular insufficiency
increased pigmentation, scaly and crusted erosions, ulcers
treat with compressive stockings, elevation of legs, topical steroids, consider horse chestnut seed extract, aspirin to accelerate healing of ulcers

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24
Q

medications that cause erythema multiforme

A

penicillins, sulfonamides, NSAIDs, OCPs, anti-convulsants

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25
Q

distinctions between erythema multiforme, stevens-johnson, and TEN

A

erythema multiforme: target lesions, no sloughing of skin

stevens-johnson: 30% body sloughing, decreased WBC, decreased H/H, elevated LFTs

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26
Q

classic presentation of pityriasis rosea

A

herald patch followed by christmas tree rash 1-2 weeks later

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27
Q

treatment for pityriasis rosea

A

self-limited, consider UV therapy

28
Q

clinical features of pityriasis versicolor

A

salmon/light brown hypopigmented macules that will scale when scraped off
wood-lamp shows blue-green scales

29
Q

treatment for pityriasis versicolor

A

ketaconozole, selenium sulfide

30
Q

classic presentation of erythema nodosum

A

associated with IBD, streptococcus, sarcoidosis

pretibial, tender, painful nodules

31
Q

classic presentation of lichen planus

A

pruritic, purple, polygonal, papule, plaque

32
Q

treatment for seborrheic dermatitis

A

selenium sulfide, tar, ketoconazole, topical steroids

33
Q

treatment options for psoriasis

A 
topical steroids (NOT ORAL)
tar, anthrolin, salicylic acid, UV therapy, anti-TNF agents in refractory cases
34
Q

diagnosis and management: melasma

A

hyperpigmentation of skin associated with pregnancy
minimize sunlight exposure
hydroquinone (inhibits tyrosine kinase to block melanin production)
mix with flucinolone, tretinoin

35
Q

diagnosis and management: vitiligo

A

sharply demarcated patches of complete depigmentation, loss of melanocytes, borders are hyperpigmented
associated with thyroid disease in 30% of patients
sunscreen, corticosteroids if <10% skin is affected
tacrolimus, pimecrolimus (can use around eyes unlike steroids), psoralens, UV light, surgical minigrafting, or depigmentation of normal skin using hydroquinone

36
Q

diagnosis and management: acanthosis nigricans

A

hyperpigmentation of skin in creases of body
treat diabetes, weight loss, discontinue steroids, survey for visceral malignancy
topical retinoin, steroids, fish oil

37
Q

purple-red hemangioma on face that does not regress with age

A

port-wine stain

associated with sturge-weber

38
Q

infant with bright-red lesion that regresses over months-years

A

strawberry hemangioma
most spontaneously resolve, use systemic steroids if periorbital, in airways, or associated with high-output heart failure

39
Q

benign small red papule that appears on skin with age

A

cherry hemangioma

40
Q

bright red papule with radiating blanching vessels

A

spider angioma

associated with cirrhosis

41
Q

blue compressible mass that does not regress

A

cavernous hemangioma

42
Q

red-pink nodule on a child that is often confused with melanoma

A

spits nevus

43
Q

diagnosis and management: alopecia areata

A

asymptomatic, non-inflamamtory, non-scarring areas of hair loss, often precipitated by stress
rule out other causes: CBC, BMP, ESR, TSH, ANA, SLE, syphillis, addison’s, trichotilliomania

treatment: fluocinolone oil/shampoo, intralesional steroid injections, topical minoxidil, anthralin cream, SADBE, topical steroids ineffective due to poor scalp penetration

44
Q

diagnosis and treatment: androgenic alopecia

A

male-pattern hair loss, check serum testosterone, DHEA, prolactin

men: finasteride +/- minoxidil
women: minoxidil +/- sprionolactone

45
Q

most important prognostic indicator of melanoma

A

depth of lesion

46
Q

skin condition associated with obesity, diabetes, or malignancy

A

acanthosis nigricans

47
Q

pigmented plaques that appear to be stuck onto the skin

A

seborrheic keratosis

48
Q

black velvety plaques on flexor surfaces and intertriginous areas

A

acanthosis nigricans

49
Q

rough lesions on sun exposed skin easier to feel than see

A

actinic keratosis

50
Q

circular rash with central clearing on the trunk or arms

A

tinea corporis

51
Q

classic appearance of basal cell cancer

A

pearly lesion with central ulceration and telangiectasias

52
Q

classic appearance of squamous cell cancer

A

erythematous papule with scaling or keratinized growths in sun-exposed area, may bleed or ulcerate

53
Q

classic appearance of porphyria cutanea tarda

A

blistering on sun-exposed skin, erosions and hyperpigmented skin

54
Q

how might pemphigus vulgaris be distinguishable from bullous pemphigoid

A

positive nikolsky test for pemphigus vulgaris

55
Q

treatment options for actinic keratosis

A

topical 5-FU or imiquimod, cryotherapy

56
Q

purple-red hemangioma on face that does not regress with age

A

port wine stain

57
Q

infant with bright-red lesion that regresses over months to years

A

strawberry hemangioma

58
Q

benign small red papule that appears on skin with age

A

cherry hemangioma

59
Q

bright red papule with radiating blanching vessels

A

spider hemangioma

60
Q

blue compressible mass that does not regress

A

cavernous hemangioma

61
Q

red-pink nodule on a child that is confused with melanoma

A

spitz nevus

62
Q

treatment available for androgenic alopecia

A

men: finasteride +/- minoxidil
women: minoxidil +/- spironolactone

63
Q

underlying causes of alopecia areata

A

trichotillomania, stress, autoimmune disorders, lupus, addison’s disease

64
Q

round, firm, rapidly growing papule with a central crater

A

keratoacanthoma

65
Q

rough surfaced, sharply demarcated, round, firm papule whose color may be gray, yellow, brown, or gray-black

A

wart

66
Q

friable, rapidly enlarging, erythematous, vascular-appearing papules with a collarette of scale

A

pyogenic ganuloma: most commonly develop at sites of previous minor injuries
(misnomer, more appropriately known as lobular capillary hemangioma)

treatment: surgical excision, curettage, or electrodesiccation

USMLE Step Two (17 decks)

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