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3P > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what is Cholasma?

A

also known as melasma

“Mask of pregnancy”
sun spots of the face

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2
Q

what is straie gravidarum?

A

stretch marks

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3
Q

normal age related skin changes

A

loss of elastin, collagen & subcutaneous fat

**sweat glands & sebaceous glands decrease _> decrease thermoregulatory _> increases risk for heat stroke

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4
Q

what is NOT a normal age related skin change?

A

Dermatophytes - fungus infection on skin when in sun, skin turns darker pigment (expected) except for area with fungi infection which turns lighter

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5
Q

what is an example of a macule vs patch?

A

Macule is small (<1cm) = flat nevi (freckle)

Patch = bigger macule >1cm = mongolian spot, vitiligo, chloasma

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6
Q

location of tinea curis vs corporis vs capitis

A 
cruris = peri area 
corporis = body (ringworm) 
capitis = head (cradle cap in babies)
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7
Q

what is the tx for tinea capitis?

A

grisefulvin 500mg daily 4-6 weeks.

Take with high fat meals to improve absorption.
avoid sun exposure
may reduce efficacy of oral contraceptives
monitor for clay stool

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8
Q

when can children return to school after diagnosed with tinea capitis?

A

after treatment initiated

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9
Q

what could the diagnosis of a skin lesion that appears hypo or hyperpigmented with slightly scale macules on the trunk, neck, and upper arems?

A

Tinea Vesicolor (superficial fungal infection)

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10
Q

Treatment for Tinea fungal infection?

A

Topical : “-azole” creams (Clotrimazole 1%, miconazole 2%, ketoconazole 2%, econazole 1%)

Oral: Griseofulvin 125mg/250mg.
Derived from PCN, possible cross sensitivity
Take with high fat meal to improve absorption
Contraindicated in pts with hepatic dysfunction

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11
Q

after 3 weeks of antifungal therapy pt still has infection what should the provider do?

A

NOTHING. fungal infections take 4-8 weeks of antifungal therapy to resolve.

DO NOT change tx before this time frame

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12
Q

Most common causative agent of cellulitis?

A

Group A streptococcus

***If purulence is present think Staph/MRSA

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13
Q

Treatment for Group A streptococcus cellulitis?

A
  1. PCN
  2. if allergic to PCN –>
    1st gen cephalosporin (cephalexin) or macrolide (azithromycin)
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14
Q

Assessment of psoriasis

A

silvery scales on erythematous base
-often on extensor surfaces (outer surfaces) elbows, knees, scalp, gluteal cleft, fingernails, palms & soles of feet

-Nails may be pitted

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15
Q

what is an Auspitz sign?

what does it indicate?

A

Auspitz sign = pinpoint bleeding when plaque removed

Indicates PSORIASIS
differentiates psoriasis vs eczema

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16
Q

Treatment for Psoriasis

A

Keep skin hydrated with emollient
Topical steroids - low dose first
scalp: strong- potency steroid in alcohol base
Face: low potency

Tar solutions
Salicylic acid gel

*** no more then 50G/week for steroids

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17
Q

pt with psoriasis has salicylic acid sensitivity and should be instructed to avoid?

A

ALMONDS

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18
Q

what type of skin cancer arises from epithelial tumors from keratinocytes of the epidermis. Often are red, tan, brown and pearly gray

A

Squamous cell carcinoma (SCC)

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19
Q

What type of skin cancer develops in the basal cell layer of skin in middle aged men and appear pearly domed nodule?

A

Basil cell carcinoma (BCC)

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20
Q

Malignant melanoma

A

arising from melanocytes (pigment producing cells)

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21
Q

what is the most deadly form of skin cancer?

A

Malignant melanoma

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22
Q

ABCDE mnemonic

A 
Asymmetry 
Border irregular 
color variation 
diameter >6mm (size of pencil eraser) 
Evolving (elevation, hypo/hyper pigmentation, bleeding, scaling, texture)
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23
Q

HARMM risk tool evaluates what?

what does it stand for?

A

Melanoma risk model

Hx of previous 
Age >50
Regular derma visits missing 
Mole changing 
male gender
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24
Q

Pagets disease (breast cancer)

A

uncommon form of breast CA

Scaley, exzema like lesion that may weep, erode, crust

indicative of ductal breast cancer in situ

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25
Q

Peau d’orange

A

“orange peel breast”

breast dimpling or edema, thickened with enlarged pores

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26
Q

what is Herpes Zoster (HSV-3)

A

Shingles

reactivation of varicella-zoster virus (chickenpox) that lays dormant in nerve cells, typically along a single dermatome

27
Q

Can you transmit shingles to others?

A

Pts who have shingles are NOT able to transmit shingles to susceptible pts on transmit chickenpox virus to susceptible pts

-Older, immunocompromised, or pregnant pts should avoid contact with anyone with shingles

28
Q

Phases of herpes zoster virus

A

prodrome - occurs along 1/more dermatome from 1-10 days. fatigue, itching, burning, ect.

Acute phase - rash erupts over 3-4 days. maculopapular rash progresses to groupd vesicles. fever, malaise, headache, pain

Convalescent phase - w/in 2-3 weeks rash resolves. pain can last for more than 30 days

29
Q

what is post herpatic neuralgia and what is the tx?

A

pain for more than 30 days after HSV 3 rash resolved.

tx

  1. gabapentin
  2. lyrica
30
Q

Prevention of herpes zoster

A

VACCCINATION- shingrix, 2 doses 2-6 months apart

31
Q

can you give antiviral medications to pts with HSV 3?

A

yes, may shorten length and severity of illness if given within 48-72 hours of symptom presentation

32
Q

Symptom management for shingles

A

OTC analgesics
Capsaicin top cream - can lead to irritation of eyes and mucous membranes
antipuritic - calamine lotion, colloidal oatmeal bath
topical lidocaine (xylocaine) & nerve blocks
steroids

33
Q

What is eczema?

A

chronic pruritic skin eruption - common in pts with other atopic illness (asthma, allergic rhinitis)

34
Q

Assessment findings for eczema

A

pruritus, erythema, dry skin

patchy plaque on flexural surfaces (bends of the body - inside elbows, back of knees, ankles)

35
Q

Non pharm tx for atopic dermatitis/eczema

A

bathing, moisturizer applied 1-3 mins after patting skin dry

superfatted soaps best, low or neutral pH
prevent skin trauma /burns
soak in warm water for 20 mins prior to applying emollient
cool wet compress (burrows solution) if lesions are weeping or oozing
bleach baths 3x week (1/4c bleed in full bath, 2-3 mins)

36
Q

can you use ointments for oozing atopic dermatitis?

A

no. wait for lesions to dry

37
Q

pt has eczema would you give steroids?

A

Only low dose topical steroids

  • Alclometasone dipropionate/Aclovate 0.05%
  • Flucinolone acetonide 0.01%
  • Hydrocortisone buyrate 0.1%
38
Q

High dose topical steroids

A

Betamethasone dipropionate 0.05%/0.25%
Amcinoide 0.1%
Desoximetasone 0.05%, 0.25%

39
Q

Pharm management for eczema (general)

A

low dose topical steroids
antihistamine (oral/topical)
emollients (eucerin, lubriderm, cetaphil)
intralesional steroid injection
topical calcinerun inhibitors - pimecrolium cream 1% or tacrolimus ointment 0.03%

40
Q

Pt presents with inflammation and excoriated skin of the skin of the perineum, buttocks, lower abdomen and inner thighs.

what is the probable diagnosis and treatment?

A

Diaper dermatitis

Tx: Zinc oxide (skin barrier)

41
Q

what is a chronic superficial disorder affecting hairy area of the body where many sebaceous glands are present?

A

seborrheic dermatitis

42
Q

What is dermatyphytosis / dermatophytes

A

Fungal infection of the skin that causes pathologic changes

  • when in sun, skin turns darker pigment except for area with fungal infection which turns lighter
    tx: griseofulvin or other antifungal
43
Q

superficial dermatophytosis that attacks hair shafts on the scalp, eyebrows, and elelashes is known as…

A

tinea capitis

44
Q

can dermatophytes associated with tinea pedis survive for months in bathrooms, changing rooms and around swimming pools?

A

YESS = athletes foot

45
Q

what is the most common cause of onychomycosis ?

A

Trichophyton rubrum

46
Q

When sebaceous glands produce excessive sebum leading to comedones, pustules, papules, systic nodules, and scarring… what is this?

A

Acne Vulgaris

47
Q

what is the treatment of Acne Vulgaris?

A

Topical ABX + Benzoyl peroxide = combo prevents microbial resistance

erythromycin or clindamycin

Store in refigerator

48
Q

what is pediculus?

A

LICE

pruritis d/t allergic reaction

49
Q

Probable diagnosis for intensely pruitic skin infection with mite that burrows into the upper layer of the skin ?

A

Scabies. (Sarcoptes scabiei)

HIGHLY contagious

50
Q

Assessment findings for scaibes

A

Itching - more noticeable at night, small itching blisters in a thin line, scaling, erythema

Mites burrow between finger webbing, feet, wrists, axilla, scrotum, penis, waist, buttocks

Vesicles/papules may appear as a black dot or scab at end of a burrow

51
Q

Treatment for scabies

A

non pharm - wash all clothing, bedding, towels used w/in 4 days. vacuum/mop floors as usual.

Pharm- MUST tx all members of house at same time!
topical scabicides - inhibit nerve function in the mites producing paralysis and death.
3 days of treatment

-Permethrin 5% - ok in immunocompromised kids
wash off after 8-14 hours.
-Sulfur 6%
-Ivermectin (antiparasitic)

Retreat in 14 days if warranted

52
Q

what is paronychia?

A

inflammation of the perionchium = skin bordering the nails

tx: vinegar/water soaks –> fix green colored nail
mupirocin ointment
** if exposed to oral flora (nail biting/thumb sucking) then Amoxicillin/Clavulanate or Clindamycin

53
Q

antigen induced development of pruitic edematous circular plaques is known as….

A

Urticaria

54
Q

Fluorouracil (Carac) classification and use for treatment

A

Antineoplastic

Tx actinic keratosis

Contraindicated : Pregnancy

55
Q

what is Nystatin (Mycostatin) used for

A

topical antifungal agent

56
Q

what is pimecrolimus (Elidel) indicated for the treatment of…

A

Atopic dermatitis

57
Q

potential systemic reaction to imiquimod (Aldara) used to treat superficial BCC is….

A

flu like symptoms

58
Q

Minocycline (Dynacin) classification of abx and use for derm

A

Tetracycline

tx of acne / some skin infections

59
Q

Which of the following is NOT a topical pediculicide?

a. Benzyl alcohol
b. Ivermectin
c. Permethrin
d. Selenium sulfide

A

Selenium sulfide - used for dandruff not pediculidcide

60
Q

potential adverse reaction r/t use of sulfacetamide (klaron) topical, indicated for the tx of seborrheic dermatitis is….

A

SLE

Sulfa medications reactions : SLE, agranulocystosis, acute hemolytic anemia, aplastic anemia, purpura hemorrhagic, steven-johnson syndrome, toxic epidermal necrolysis ect

61
Q

Half life of Trimethoprim - sulfamethoxazole (bactrim)

A

10 hours.

62
Q

What is a Fingertip Unit (FTU)?

A

measured from the very tip of the finger to the first crease (DIP joint) in the finger.

-Each FTU is approx = to 0.5g (Men) and 0.4 grams (women) of ointment.

Estimate of number of FTUs required to cover various areas of the body as: Head/neck = 4.5, Trunk (front/back) = 7, arm = 3, hand = 1, leg = 6, foot = 2.

63
Q

Diclofenac (Solaraze), an antiflammatory, is used in the tx of…

A

Actinic keratosis

applied to lesion BID

64
Q

Tetracycline in children younger then 9 may cause…

A

bone growth retardation
tissue hyperpigmentation
enamel hypoplaisa
PERMANENT tooth discoloration

3P (16 decks)

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