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usmle step 2 > Dermatologie > Flashcards

Dermatologie Flashcards

1
Q

quid of herpes zoster

A

rash along dermatomal distribution

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2
Q

other name of herpes zoster

A

shingles

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3
Q

rx of shingles(3)

A 
acyclovir
or
valacyclovir
or
famcyclovir
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4
Q

patient with sore throat ,after receiving amox develops rash dx?

A

hypersensitivity type 1

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5
Q

rx of hypersentivity syndrome in a patient taking amox

A

antihistaminic

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6
Q

when anti histaminic is good in allergy

A

when you have no systemic symptom

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7
Q

drugs most commonly implicated in hypersensitivity type 1 reaction(5)

A 
B lactam
neuro mxar blocking agents
quinolones
chemo drugs containing platinum
foreign protein chimeric antibodies
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8
Q

disease associated with acnthosis nigricans(2)

A

condition associated with insulin resistance

GI malignancy

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9
Q

condition associated with insulin resistance(2)

A

Diabete type 2

OMPK

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10
Q

disease or state associated with multiple skin tags(3)

A

insulin resistance
pregnancy
chron disease(peri anal fissure)

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11
Q

skin condition associated with Hep C

A

porphyrie cutanea tarda

cutaneous leucocytoclastic vasculitis secondary to mixed cryoglobulinemia

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12
Q

condition associated with cutaneous leucocytoclastic vasculitis

A

palpable purpura

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13
Q

disease associated with dermatitis herpetiforme

A

celiac disease

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14
Q

skin manif associated with HIV(2)

A

severe seborrheic dermatitis

sudden onset of severe psoriasis

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15
Q

disease associated with explosive itchy seborrheic keratosis

A

GI malignancy

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16
Q

disease associated with pyoderma gangrenosum

A

IBD

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17
Q

quid of skin tag

A

pedonculated outgrowth of normal skin

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18
Q

flushing of the skin caused by hot drinks,heat and emotion

A

rosacea

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19
Q

rx of rosacea

A

topical metronidazole

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20
Q

quid of rosacea

A

telangiectasia over cheeks chin and nose

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21
Q

actinic keratosis(3)

A

sunexposed areas
sandpaper like texture
squamous cell carcinoma

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22
Q

second most common cause of ca in the US

A

SCC

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23
Q

risk factor for SCC

A

sunlight exposure

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24
Q

biopsy of SCC of skin

A

polygonal cell withb atypical nuclei at all levels of the epidermis with zone of keratinization

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25
Q

the more agressive ca of the skin

A

SCC

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26
Q

rx of cellulitis with systemic symptom(2)

A

IV nafcilin
or
cefazolin

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27
Q

cellulitis with systemic Symptom and MRSA rx?

A

IV vancomycin

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28
Q

physio patho of bullous pemphigoid

A

IGG and C3 deposits at the dermal epidermal junction

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29
Q

medication which can trigger bullous pemphigoid(4)

A

furosemide
NSAIDS
captopril
penicillamine

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30
Q

localisation of bullae in BP

A

subepidermal

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31
Q

workup for bullous pemphigoid

A

direct immunofluorescence

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32
Q

necrotizing fascitis

A

pain and fever in the zone of a trauma

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33
Q

clue for NF

A

purplish discoloration of the skin with gangrenous changes

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34
Q

best rx of NF(2)

A

debridement

antibio

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35
Q

bugs causing necrotizing facitis(3)

A

staph aureus
group A strepcocci
anaerobes

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36
Q

what test to perform in necrotizing fasciitis

A

check for diabetes

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37
Q

antibio used in Necrotizing fasciitis(2)

A

ampi sulbactam
plus
clyndamycin

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38
Q

cause of idiopathic necotizing fasciitis(2)

A

srotal
or
Penile NF

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39
Q

Rx of scabies

A

5% permethrin cream

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40
Q

patient of chronic lip ulceration(3)

A

malignant
chronic infection
autoimmune

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41
Q

cause of malignant lip ulceration

A

SCC

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42
Q

biopsy for SCC

A

invasion cords of squamous celle with keratin pearls

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43
Q

sun exposure occupation plus isolated vermillon ulcer(zone of lower lip)

A

SCC

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44
Q

biopsy for BCC

A

spindle cells surrounded by palissade basal cells

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45
Q

type of acne(3)

A

comedones
inflammatory acne
nodular cystic acne

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46
Q

rx of comedal acne

A

topical retinoids

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47
Q

quid of inflammatory acne

A

inflamed papules and pustules

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48
Q

RX of inflammatory acne (mild)(2)

A

topical retinoid
plus
benzoyl peroxid

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49
Q

moderate inflammatory acne rx(3)

A

topical retinoid
plus
benzoyl peroxid
plus topical antibio

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50
Q

topical antibio used in moderate inflammatory acne(2)

A

clyndamycin

erythromycin

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51
Q

severe inflammatory acne rx(3)

A 
topical retinoid
plus
benzoyl peroxid
topical antibio
plus oral antibiotherapy
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52
Q

quid of nodular cystic acne

A

large nodule > 5mm ,can appear cystic

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53
Q

rx of moderate nodular cystic acne(3)

A

topical retinoids
topical antibio
benzoyl peroxyde

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54
Q

rx of severe nodular cystic acne(4)

A

topical retinoids
topical antibio
benzoyl peroxyde
plus oral antibiotherapy

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55
Q

rx of nodular cystic acne rebelle au rx for severe cystic acne next step

A

add oral isotretinoin

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56
Q

quid of herpetic withlow

A

viral infection of the hand

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57
Q

profession at risk for herpetic withlow(2)

A

dentist

health worker with direct contact with orotracheal lesion

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58
Q

Dx of herpetic withlow

A

cytodiagnostic de TZANCK

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59
Q

cause of herpetic withlow

A

herpes virus type 1 et 2

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60
Q

skin lesion in PBC(2)

A

xanthoma

xanthelasma

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61
Q

quid of xanthelasma

A

benign lesion of medial eyelid characterised by lipid filled macrophages in the dermis

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62
Q

why can you have osteoporosis in PBC

A

inability to absorb fat soluble vit specially vit D

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63
Q

cause of angioedema

A

C1 inhibitor deficiency

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64
Q

Symptom of angioedema(3)

A

face swelling
laryngeal edema
edema of bowel

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65
Q

cause number 1 of acquired angioedema

A

ACE inhibitor

66
Q

physiopatho of edema in hereditary angioedema(3)

A

no C1 inhibitor
lots of C2b and bradikiine are produced—>
edema

67
Q

causes triggering hereditary angioedema(3)

A

dental procedure
infection
trauma

68
Q

disease causing C1Q depressed

69
Q

patient taking drugs for acne develops redness and swelling of the skin when exposure to sun dx?

A

drug induced phototocixity

70
Q

drug causing phototocic drug eruptions

A

all cyclines

71
Q

cherry hemangioma appearrance

A

ti point rouje anba po w

72
Q

strawberry hemangioma

A

bigger than cherry hemangioma

73
Q

patient presenting difficulty respiratoire and facial edema 2 weeks after beginning ACE inhibitor

A

ACE inhibitor angioedema

74
Q

why in the same vignette patient has rash problem you dont pick aspirin as the right answer

A

rash in aspirin appears immediately after taking the drug

75
Q

how ace inhibitor causes angioedema

A

by inhibiting ACE you have high level of bradikinin

76
Q

when angioedema with ace inhibitor can occur

A

at any time

77
Q

clue for tinea versicolor

A

hypopigmented macules that don’t tan and don’t appear scaly but scale on scraping

78
Q

bug causing tinea versicolor

A

malasezia furfur

79
Q

Dx of tinea versicolor(2)

A

KOH preparation

spaghetti or meat balls appearrance

80
Q

rx of Tinea versicolor

A

selenium sulfide lotion

81
Q

patient with redness and blisters on breast and thighs ,patient taking warfarin

A

warfarin induced necrosis

82
Q

condition associated with warfarin induced necrosis

A

protein C deficiency

83
Q

lieu of warfarin induced necrosis(4)

A

breast
thigh
buttocks
abdomen

84
Q

rx of frostbite

A

rapid rewarm with warm water (40-44 C)

85
Q

rx of dermatite herpetiforme(2)

A

dapsone

gluten free diet

86
Q

causativ agent of molluscum contagiosum

87
Q

risk factor for molluscum contagiosum

A

AIDS with CD4 less than 100

88
Q

rx of molluscum C(2)

A

curretage
or
application of liquid nitrogen

89
Q

lesion in Molluscum C

A

papules with central umbilification

90
Q

patient with mole becoming larger what skin examination clue would be more consistent with malignancy

A

zones of different skin colors

91
Q

features of melanoma(5)

A 
Asymetric lesions
Border irregularities
Color variegation
Diameter > 6 mm
Enlargement or evolution of skin lesion
92
Q

quid of tinea corporis

A

circular lesion with scaly borders and central clearing

93
Q

bug in tinea corporis

A

trichophyton rubrum

94
Q

rx of tinea corporis(2)

A

topical terbinafine 2%
plus
oral griseofulvine

95
Q

clue for seborrheic keratosis(4)

A

warty appearance
waxy
well circumscribed
stuck on appearance

96
Q

localisaion of herpes simplex(2)

A

mouth

genital area

97
Q

bug causing chicken pox

A

varicella zoster (varicelle)

98
Q

quid of shingles

A

reactivation of varicella zoster

99
Q

pruritic circumferantial rash over wrist

A

allergic contact dermatidis

100
Q

most commonly involved substance in contact dermatidis(2)

A

poison ivy

nickel jewelry

101
Q

type of hypersensitivity in allergic contact dermatidis

102
Q

cells inplicated type 4 hypersensitivity

A

lymphocyte T

103
Q

rx allergic contact dermatidis(3)

A

calamine
antihistamines
topical steroids

104
Q

use of oral steroid in contact dermatidis

A

in sever case

105
Q

quid of stevens jhonson syndrome

A

erythema multiform major

106
Q

clue for stevens jhonson syndrome(2)

A

Mucocutaneous lesion
plus
target shaped lesions

107
Q

quid mucocutaneous lesion in steven jhonson syndrome(3)

A

conjonctivitis
pa ka pipi
paka vale

108
Q

quid of erythema multiform minor(4)

A

rash occuring after herpes infection
target lesions are present
mucosal invlovement
no systemic symptom

109
Q

patient after working in woods develops vesicules on forearms vesicule full with coagulase negative organism dx

A

contact dermatidis

110
Q

substance found in wood causing contact dermatidis(2)

A

sumac

woody shrug

111
Q

why you foun coagulase negative bacteria in vesicle fluid in contact dermatidis

A

secondary infection by S epidermidis

112
Q

definition of ichtyosis(2)

A

dry skin and scaly worst during winter season

dry skin with horny plates on the extensor surfaces of limbs

113
Q

clue for senile purpura

A

ecchymosis in older patient with nothing else

114
Q

cause of senile purpura(2)

A

perivascular connective tissue atrophy

loss of elastic fiber

115
Q

other name of senile purpura

A

solar or actinic purpura

116
Q

rx of senile purpura

A

no rx needed

117
Q

clinic of senile purpura(2)

A

brown discoloration

dark purple of skin

118
Q

disease associated with vitiligo(6)

A 
pernicious anemia
thyroid disease
diabete type 1
primary adrenal insufficiency
hypopituitarism
alopecie areata
119
Q

thyroid disease associated with vitiligo(2)

A

graves

autoimmune thyroiditis

120
Q

quid of chalazion

A

obstruction of mebomian gland

121
Q

CAT in case of reccurent chalazion

A

meibomian gland carcinoma

also called sebaceous carcinoma

122
Q

best test in case of reccurent chalazion

A

histopatho

123
Q

Dx differential of chalazion

A

BCC of the eyelid

124
Q

the most common tumor of the eyelid

125
Q

most common tumor in mankind

126
Q

pathology of vitiligo

A

autoimmune destruction of melanocytes

127
Q

if you see changing mole what to think

A

eliminer melanoma

128
Q

most commonly drug involved in SJ syndrome(3)

A

sulfonamide
NSAIDS
Phenytoin

129
Q

drug causing toxic epidermal necrolysis(2) TEN

A

same as SJ syndrome

barbiturate

130
Q

Between TEN and SJS difference

A

up to 10 % of the body involved=SJS

more than 30%=TEN

131
Q

nickolsky sign

A

patches of skin slide off with slightest pressure

132
Q

after marrow transplantation patient develops diarrhea and pruritic maculopapular rash Dx

A

graft versus host disease

133
Q

physiopatho of graft versus host disease

A

recognition of host major and minor HLA antigens by donor T cells and activation of T cells and cell mediated immune response

134
Q

target of graft versus host disease(3)

A

foie
intestin
peau

135
Q

waxy loose scaleswith erythema of scalp ,central face umbilicus interscapular area body fold presternal region
dandruft in hair

A

dermatidis seborrheic

136
Q

disease associated with seborrheic dermatidis(2)

A

HIV

Parkinsonism

137
Q

immunologic condition associated with M contagiosum

A

cellular immuno deficiency
chemo
corticosteroid use

138
Q

patient with slightly elevated lesion ,brown colored measuring > 7mm,with irregular border Dx

139
Q

study of Melanoma

A

excisionnal biopsy with narrow margin

140
Q

study for melanoma with less than 1 mm depth

A

excision on 1 cm tumor free margin

141
Q

study for melanoma with more than 1 mm depth

A

look for a lymph node sentinel study

142
Q

vulgaris pemphigus(2)

A

flaccid bullae

slightly rubbing of the involved skin causes easy separation of the epidermis=nickolsky sign

143
Q

immunofluorecence finding in pemphigus vulgaris

A

IGG deposits intercellular in the epidermidis

144
Q

target of antibody in Pemphigus vulgaris

A

desmoglein

145
Q

Rx of Pemphigus vulgaris

A

steroids

or azathioprine plus prednisone plus metotrexate

146
Q

flaccid blister

A

P vulgaris

147
Q

tense blister

148
Q

bug causing acne

A

propionibacterium acne

149
Q

clue for porphyria cutanea tarda(2)

A

painless blister of hand

hyperpigmentation hypertrichosis

150
Q

rcause of PCT

A

deficiency in uroporphyrinogen decarboxylase

151
Q

role of uroporphyrinogen decarboxylase

A

heme synthesis

152
Q

trigger of PCT

A

alcohol

estrogen

153
Q

rx of PCT(3)

A

hydroxychloroquine
or
phlebotomy
interferon @ to rx Hep C

154
Q

Clue fro Necrotizing fasciitis

A

patient after trauma in leg develops pain and fever

155
Q

rx of scabies

A

5% permertrin cream

156
Q

general measure for scabies

A

bedding and clothing should be cleaned or set aside for 2 weeks

157
Q

quif edema producing factor in angioedema(2)

A

c2B

bradikynin

158
Q

rx of tinea versicolor

A

selnuim sulfide

ketoconazole shampoo

159
Q

physiopatho of SJS

A

immune complex mediated

160
Q

quid of stye or Hordeolum(orgelet)

A

acute infection of eyelids glands

161
Q

zone bastion du psoriasis(5)

A 
scalp
oreille
coude
genou
organes genitaux

usmle step 2 (22 decks)

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