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Pediatrics - clinical > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what are open comodones

A

black heads
incomplete blockage

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2
Q

what are closed comedones

A

white heads
complete blockage

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3
Q

how is acne vulgaris characterized

A

areas of open comedones, closed comedones, papules, pustules, nodules or cysts. May result in scarring.

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4
Q

how is acne vulgaris graded

A

Grade 1: Mild acne (comedones)
Grade 2: Moderate acne
Grade 3: severe acne
Grade 4: cystic acne (severe scarring)

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5
Q

how is rosacea differentiated from acne vulgaris

A

rosacea does not have comedones

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6
Q

what is the treatment of acne vulgaris

A

most acne - topical retinoids
cystic acne - tetracyclines, then oral retinoids - isotretinoin

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7
Q

what are SE of Isotretinoin

A

dry lips
liver damage
increased triglycerides/cholesterol
pregnancy category X

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8
Q

what needs to be obtained prior to starting isotretinoin

A

2 pregnancy tests prior to starting and monthly while on it.

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9
Q

what is androgenetic alopecia

A

Permanent hair loss from the scalp, causing baldness.

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10
Q

what is the common patient population affected by androgenetic alopecia

A

-genetic predisposition
-M 20-40yo, W after 50
- men>women (m/c in white men)

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11
Q

how is androgenic alopecia diagnosed

A

usually clinically
- microscopic exam of cut or plucked hair fibers and scalp biopsies may provide additional information (bx - telogen and atrophic follicles)
- can assess hormones: testosterone, DHEA, Prolactin
- Can look for treatable causes: thyroid (TSH), anemia (CBC), autoimmune (ANA)

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12
Q

what is the treatment of androgenetic alopecia

A

topical: minoxidil/Rogaine 2%, 5%
Finasteroid 1mg - inhibits T and DHT
Spironolactone - blocks DHT

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13
Q

What is atopic dermatitis and how does is present

A

pruritic eczematous lesions, xerosis (dry skin) and lichenification. m/c in flexor creases
- IgE, type 1 hypersensitivity
- Infant - face/scalp
- Adolescent - flexure surfaces

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14
Q

what is xerosis

A

dry skin

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15
Q

what is thickening of skin and increase in skin markings

A

lichenification

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16
Q

how is atopic dermatitis diagnosed

A

history and physical
conduct patch testing to verify
allergy referral

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17
Q

what medications are recommended for atopic dermatitis

A

Antihistamine (hydroxyzine or benadryl)
topical or oral steroids
PUVA phototherapy

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18
Q

what level burn is it when the skin is red and blistered and tender

A

partial thickeness
2nd degree

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19
Q

what level burn is it when the skin is tough and leathery and non-tender

A

full thickness
3rd degree

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20
Q

what is the rule of 9s

A

head: 18%
Each arm: 9%
chest: 18%
back: 18%
Each leg: 14%

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21
Q

what is the Palmar Method for assessing burns

A

pts palm equates to 1%; used for small burns

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22
Q

how are burns treated

A

monitor ABCs, fluid replacement and sulfadiazine
- mild: clean with soap and water, drain and debride bullae; cover with 1% silver sulfadizaine
- Mod/Severe: cover with a dry dressing, admit to hospital

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23
Q

what labs should be obtained with burn patients

A

ABG
CBC
CK
CMP
UA
Carboxyhemoglobin

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24
Q

what are the recomendations for fluid replacement in burn victums
(child and adult)

A

children with >10% total BSA and adults with >15% TBSA need formal fluid resuscitation
IV Fluids: LR via 2 large bore IVs
adult: LR 4ml x wt (kg) x %BSA
child: LR 3ml x wt (kg) x %BSA
(half given over first 8 hours, then 16h)

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25
Q

what is the most common drug reaction

A

skin reaction

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26
Q

what is the first line treatment for drug eruptions

A

remove the offending drug once its identified

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27
Q

What is Erythema Multiforme

A

acute, self-limited, and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction affecting the skin and mucous membranes

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28
Q

what are the most common causes of erythma multiform

A

infection, herpes simplex, mycoplasma pneumonia and URI

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29
Q

what is the presentiation of erythema multiforme (EM)

A

Target (iris) lesions, dull “violet” red
macules, vesciles, central bullae with pale red rim and peripheral red halo
blanching and lack of itchiness

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30
Q

what are the divisions of erythema multiforme(EM)

A

Major: Causes widespread skin lesions afffects 2+ mucosal sites
Minor: limited region of the skin and 1 type of mucosa (usually oral)

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31
Q

how is erythema multiforme diagnosed

A

clinical history and physical exam
(-) Nikolskys sign

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32
Q

What is Fifths disease

A

erythema infectiousum
“slapped cheek” rash on the face.

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33
Q

what causes erythema infectiousum

A

parvovirus B19

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34
Q

what is the duration of erythema infectiousum

A

2-3 weeks

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35
Q

how do you treat erythema infectiousum

A

supportive and anti-inflammatories

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36
Q

who is Hand-Foot-and-Mouth disease commonly seen in

A

children <10 yo

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37
Q

what causes Hand-foot-and-mouth disease

A

coxsackievirus type A virus.

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38
Q

what is the duration of Hand-foot and mouth disease

A

usually clears on its own within 10 days

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39
Q

how do you treat hand-foot and mouth disease

A

supportive and anti-inflammatories

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40
Q

what is another name for measles

A

rubeola

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41
Q

what are the 4 C’s of measles/rubeola

A

Cough
Coryza
Conjunctivitis
and Cephalocaudal spread

42
Q

what is the presentation of measles/rubeola

A

morbiliform - maculopapular, brick red rash on face beginning at hairline then progressing to palms and soles last

43
Q

how long does the measles rash last

A

7 days

44
Q

what are Koplik spots

A

small red spots in buccal mucosa with blue-white pale center

45
Q

what is the treatment for measles

A

supportive - anti-inflammatories
isolate for 1 week after onset of the rash
MMR vaccine (12-15mo, 4-6yo)

46
Q

what is another name for Rubella

A

German measles

47
Q

what is Rubella and how does it present?

A

“3-day rash” pink light red spotted maculopapular rash first appearing on face and spreading caudally to trunk and extremities

48
Q

what are concerns with rubella during pregnancy

A

teratogenic in 1st trimester
congenital syndrome- deafness, cataracts, TTP and mental retardation

49
Q

what is the treatment for rubella

A

supportive care
MMR vaccine (12-15mo, 4-6 years)

50
Q

what causes Roseola

A

Herpesvirus 6 or 7

51
Q

what is different about roseola

A

only childhood exanthem that starts on trunk and spreads to the face

52
Q

what is the presentation of roseola

A

high fever 3-5 days then rose pink maculopapular blanchable rash on trunk/back and then face

53
Q

what is a highly contageous skin infection that is commonly seen on the face and extremities often caused by S. aureus

A

impetigo

54
Q

what are the syptoms of impetigo

A

red sores that form around nose and mouth. sores rupture and ooze for a few days then form a yellow-brown crust

55
Q

how is impetigo diagnosed

A

gram stain and culture
(-) Nikolsky sign

56
Q

what is the treatment for impetigo

A

warm water soaks for 15-20 minutes then usually a topical mupriocin/bactroban x 5d

57
Q

what is the treatment for wide spred impetigo infection

A

cephalexin or erythromycin x 1wk
MRSA: Doxy
MRSA and sick: Vanco

58
Q

what is a complication of impetigo

A

poststreptococcal glomerulonephritis

59
Q

what is the treatment for Lice

A

Permethrin topical is the DOC
launder potential fomites such as sheets

60
Q

what is the treatment of head lice

A

Permethrin shampoo x 10 minutes

61
Q

what is the treatment of pubic lice

A

permethrin lotion x 8 hours

62
Q

what is a chronic papulosquamous inflammatory dermatoses of unknown etiology that appears as purplish, itchy, flat-topped bumps on MM

A

Lichen Planus

63
Q

what are the 5Ps of lichen planus

A

Purple
Papule
Polygonal
Pruritus
Planar

64
Q

what are Wickham Striae

A

whitish lines visible in papules of lichen planus and other dermatoses

65
Q

what is the treatment of lichen planus

A

topical steroids

66
Q

What is the treatment of pityriasis rosea

A

self limiting
topical or systemic steroids and antihistamines to relieve itching

67
Q

how are scabies diagnosed

A

microscopic observation of mites, eggs or feces after skin scraping

68
Q

what is the treatment of scabies

A

topical permethrin 5% - apply to entire body and wash after 8-14 hours - repeat in one week

69
Q

when is oral ivermectin used with scabies
who should avoid ivermectin

A

if extensive invovlement of immunocompromised patient
- do not use in pregnant/breastfeeding women or children < 15kg

70
Q

what is a rare and serious hypersensitivity complex that affects the skin and mucuous membranes of <10% of the body

A

SJS (stevens-johnson syndrome)

71
Q

what are common medications known to cause SJS

A

anticonvulsants and sulfa drugs

72
Q

what is the prodrome to SJS

A

flu-like sympotoms followed by painful red or purplish rash that spreads and blisters

73
Q

how do you diagnose SJS

A

skin biopsy - shows necortic epithelium

74
Q

what is the treatment of SJS

A

stop all offending medcations
early admission to burn unit
manage fluid/electrolytes/nutrition
airway stability and eye care

IVIG

75
Q

what is Tinea

A

superficial fungal infection (not candidal) of skin, hair and nails. characterized by erythema, scaling, changes in color and pruritus.

76
Q

what are risk factors for Tinea

A

increased skin moisture
immunodeficiency (HIV, DM)
peripheral vascular disease

77
Q

how do you diagnose Tinea

A

KOH
-dermatophytes: long, branching fungal hyphae with septations
-candidiasis: budding yeast, peudohyphae
-tinea versicolor: short hyphae and cluster of spores (“spaghetti and meatballs”)

78
Q

what are the major subtypes for Tinea infection
(7)

A

Tinea Barbae
Tinea Pedis
Tinea Unguiu, (dermatophyte onchyomycosis)
Tinea Cruris
Tinea Capitis
Tinea Corporis
Tinea Versicolor

79
Q

What is Tinea Barbae

A

papules, pustules around hair follicles

80
Q

how do you treat tinea barbae

A

oral antifungal (Griseofulvin or Terbinafine) for 2-4 weeks

can also use itraconzale or fluconazole

81
Q

what is Tinea pedis

A

athletes foot:
pruritic scaly eruptions between toes

82
Q

what is the most common cause of athletes foot

A

trichophyton rubrum

83
Q

what is the treatment of tinea pedis

A

topical antifungals (azoles)
1% clotrimazole or 2% ketoconazole m/c

84
Q

what is another name for tinea uguium

A

dermatophyte onchyomycosis
(infection of the nail)

85
Q

what is the treatment of tinea unguium

A

terbinafine

86
Q

what is tinea cruris and how do you treat it

A

jock itch
topical antifungals (azoles)

87
Q

what is tinea capitis

A

m/c fungal infection in pediatric pupulation (hair infection)

88
Q

what is the treatment of tinea capitis

A

systemic therapy - oral Griseofulvin for 6-8 weeks
in addition to topical therapy twice weekyl to suppress viable spores

89
Q

what is the other name for ring worm

A

tinea corporis

90
Q

what is the treatment of tinea corporis

A

topical antifungals (azoles)

91
Q

what causes tinea versicolor

A

malassezia furfur - yeast found on human skin (hypo/hyperpigmentation of skin)

92
Q

what is the treatment of tinea versicolor

A

selenium sulfide 2/5% applied to affected skin for 10 minutes
- wash off thoroughly. apply daily for 7-10 days.

93
Q

What is TEN

A

rare, life-threatening skin condition caused by reation to drugs that affects >30% of body

94
Q

what is the treatment of TEN

A

admit to burn unit with supportive care
consult opthalmology if eyes affected
cyclosporine and possible plasma exchange for severe cases

95
Q

what is Darier’s sign

A

localized urticaria appearing where skin is rubbed (histamine release)

96
Q

what is the treatment of urticaria

A

hives usually go away without treatment but antihistamine meds are helpful

97
Q

what are the antihistamine options for urticaria treatment

A

second generation - block H1 (allegra, claritin, etc)
first gen: for sleep disturbances: (hydroxyzine, benadryl)
H2 blockers: (cimetidine, rinaitdine)
steroids for exacerbations

98
Q

what is the epinephrine dilution of IM administration for anaphylaxis

A

1: 1,000

99
Q

what is the epinephrine dilution for IV administration for anaphylaxis

A

1: 10,000

100
Q

what is the cause of warts

A

HPV

101
Q

what is the treatment of veruccae

A

most resolve over 2 years without treatment
cryotherapy with liquid nitrogen
OTC salicylic acid

Pediatrics - clinical (13 decks)

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