Dermatology Flashcards
For a bullous lesion what is the ideal timing to get a biopsy?
early in presentation
For any pigmented lesion what skin biopsy technique should be used?
excisional biopsy
What does the ABCDE system consist of?
- Asymmetry
- Border irregular
- Color (2+)
- Diameter >6mm
- Evolution of lesion
What is the ABCDE system used for?
identifying high-risk lesions
For excisional biopsy, ____ length of the wound is the maximum width.
1/3
When performing an excisional biopsy you want to be _____ to the langer lines.
parallel
What are the 5 main etiologies of burns?
- thermal
- electrical discharge
- friction
- chemical
- radiation
What are the 4 burn classifications?
- first degree: superficial
- second degree: partial thickness
- third degree: full thickness
- fourth degree: deep tissue
Once you hit bone, muscle, or tendon what degree burn is that?
fourth degree burn
What is the most painful burn class?
superficial partial-thickness
How can you distinguish between a superficial vs. deep partial-thickness burn?
deep partial-thickness DOES NOT BLANCH
Over ____ % of body surface area is considered a significant burn
10%
What method of estimating total % of BSA that was burned is preferred in pediatrics?
Lund-Browder chart
Using the rule of nines for estimating burn extent what do the following represent?
- genitals
- head
- each arm
- each leg
- anterior trunk
- posterior trunk
- genitals = 1%
- head = 9%
- each arm = 9%
- each leg = 18%
- anterior trunk = 18%
- posterior trunk = 18%
A patient’s palm is considered what % of BSA?
1%
What are the 4 signs of pediatric physical abuse with burns?
- burns in distinct shape of an object
- small circular burns matching a cigarette
- burns on the perineal area matching a “dip-in” pattern
- scald burns that have sharply demarcated edges
What is the parkland formula for initial fluid resuscitation?
- LR 4 ml x TBSA burn (%) x Body weight (kg)
- give first half over the first 8 hours
- give second half over the next 16 hours
What measure do you want to monitor hourly when administering fluids? What is the goal?
- urine output (UOP)
- maintain UOP of 0.5 ml/kg/hr in adults
When approaching a soft tissue infection, if you see purulence what pathogen do you need to cover?
MRSA
What is the treatment for mild vs. moderate/severe purulent soft tissue infection?
- mild = I/D
- mod/severe = I/D + cover MRSA
What are the 4 oral agents that cover MRSA?
- clindamycin 450 mg PO TID
- Bactrim 2 DS tablets PO BID
- Doxycycline 100 mg PO BID
- Linezolid (Zyvox) 600 mg PO BID
What are the 2 IV agents that cover MRSA?
- vancomycin 15mg/kg IV every 8-12 hours
- Daptomycin (Cubicin) 4mg/kg IV daily
What is the treatment for a MILD nonpurulent soft tissue infection?
oral antibiotics
What is the treatment for a MODERATE nonpurulent soft tissue infection?
intravenous antibiotics
