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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
what is the most common drug reaction
skin reaction
26
what is the first line treatment for drug eruptions
remove the offending drug once its identified
27
What is Erythema Multiforme
acute, self-limited, and sometimes recurring skin condition that is considered to be a type IV hypersensitivity reaction affecting the skin and mucous membranes
28
what are the most common causes of erythma multiform
infection, herpes simplex, mycoplasma pneumonia and URI
29
what is the presentiation of erythema multiforme (EM)
Target (iris) lesions, dull "violet" red macules, vesciles, central bullae with pale red rim and peripheral red halo blanching and lack of itchiness
30
what are the divisions of erythema multiforme(EM)
Major: Causes widespread skin lesions afffects 2+ mucosal sites Minor: limited region of the skin and 1 type of mucosa (usually oral)
31
how is erythema multiforme diagnosed
clinical history and physical exam (-) Nikolskys sign
32
What is Fifths disease
erythema infectiousum "slapped cheek" rash on the face.
33
what causes erythema infectiousum
parvovirus B19
34
what is the duration of erythema infectiousum
2-3 weeks
35
how do you treat erythema infectiousum
supportive and anti-inflammatories
36
who is Hand-Foot-and-Mouth disease commonly seen in
children <10 yo
37
what causes Hand-foot-and-mouth disease
coxsackievirus type A virus.
38
what is the duration of Hand-foot and mouth disease
usually clears on its own within 10 days
39
how do you treat hand-foot and mouth disease
supportive and anti-inflammatories
40
what is another name for measles
rubeola
41
what are the 4 C's of measles/rubeola
Cough Coryza Conjunctivitis and Cephalocaudal spread
42
what is the presentation of measles/rubeola
morbiliform - maculopapular, brick red rash on face beginning at hairline then progressing to palms and soles last
43
how long does the measles rash last
7 days
44
what are Koplik spots
small red spots in buccal mucosa with blue-white pale center
45
what is the treatment for measles
supportive - anti-inflammatories isolate for 1 week after onset of the rash MMR vaccine (12-15mo, 4-6yo)
46
what is another name for Rubella
German measles
47
what is Rubella and how does it present?
"3-day rash" pink light red spotted maculopapular rash first appearing on face and spreading caudally to trunk and extremities
48
what are concerns with rubella during pregnancy
teratogenic in 1st trimester congenital syndrome- deafness, cataracts, TTP and mental retardation
49
what is the treatment for rubella
supportive care MMR vaccine (12-15mo, 4-6 years)
50
what causes Roseola
Herpesvirus 6 or 7
51
what is different about roseola
only childhood exanthem that starts on trunk and spreads to the face
52
what is the presentation of roseola
high fever 3-5 days then rose pink maculopapular blanchable rash on trunk/back and then face
53
what is a highly contageous skin infection that is commonly seen on the face and extremities often caused by S. aureus
impetigo
54
what are the syptoms of impetigo
red sores that form around nose and mouth. sores rupture and ooze for a few days then form a yellow-brown crust
55
how is impetigo diagnosed
gram stain and culture (-) Nikolsky sign
56
what is the treatment for impetigo
warm water soaks for 15-20 minutes then usually a topical mupriocin/bactroban x 5d
57
what is the treatment for wide spred impetigo infection
cephalexin or erythromycin x 1wk MRSA: Doxy MRSA and sick: Vanco
58
what is a complication of impetigo
poststreptococcal glomerulonephritis
59
what is the treatment for Lice
Permethrin topical is the DOC launder potential fomites such as sheets
60
what is the treatment of head lice
Permethrin shampoo x 10 minutes
61
what is the treatment of pubic lice
permethrin lotion x 8 hours
62
what is a chronic papulosquamous inflammatory dermatoses of unknown etiology that appears as purplish, itchy, flat-topped bumps on MM
Lichen Planus
63
what are the 5Ps of lichen planus
Purple Papule Polygonal Pruritus Planar
64
what are Wickham Striae
whitish lines visible in papules of lichen planus and other dermatoses
65
what is the treatment of lichen planus
topical steroids
66
What is the treatment of pityriasis rosea
self limiting topical or systemic steroids and antihistamines to relieve itching
67
how are scabies diagnosed
microscopic observation of mites, eggs or feces after skin scraping
68
what is the treatment of scabies
topical permethrin 5% - apply to entire body and wash after 8-14 hours - repeat in one week
69
when is oral ivermectin used with scabies who should avoid ivermectin
if extensive invovlement of immunocompromised patient - do not use in pregnant/breastfeeding women or children < 15kg
70
what is a rare and serious hypersensitivity complex that affects the skin and mucuous membranes of <10% of the body
SJS (stevens-johnson syndrome)
71
what are common medications known to cause SJS
anticonvulsants and sulfa drugs
72
what is the prodrome to SJS
flu-like sympotoms followed by painful red or purplish rash that spreads and blisters
73
how do you diagnose SJS
skin biopsy - shows necortic epithelium
74
what is the treatment of SJS
stop all offending medcations early admission to burn unit manage fluid/electrolytes/nutrition airway stability and eye care IVIG
75
what is Tinea
superficial fungal infection (not candidal) of skin, hair and nails. characterized by erythema, scaling, changes in color and pruritus.
76
what are risk factors for Tinea
increased skin moisture immunodeficiency (HIV, DM) peripheral vascular disease
77
how do you diagnose Tinea
KOH -dermatophytes: long, branching fungal hyphae with septations -candidiasis: budding yeast, peudohyphae -tinea versicolor: short hyphae and cluster of spores ("spaghetti and meatballs")
78
what are the major subtypes for Tinea infection (7)
Tinea Barbae Tinea Pedis Tinea Unguiu, (dermatophyte onchyomycosis) Tinea Cruris Tinea Capitis Tinea Corporis Tinea Versicolor
79
What is Tinea Barbae
papules, pustules around hair follicles
80
how do you treat tinea barbae
oral antifungal (Griseofulvin or Terbinafine) for 2-4 weeks can also use itraconzale or fluconazole
81
what is Tinea pedis
athletes foot: pruritic scaly eruptions between toes
82
what is the most common cause of athletes foot
trichophyton rubrum
83
what is the treatment of tinea pedis
topical antifungals (azoles) 1% clotrimazole or 2% ketoconazole m/c
84
what is another name for tinea uguium
dermatophyte onchyomycosis (infection of the nail)
85
what is the treatment of tinea unguium
terbinafine
86
what is tinea cruris and how do you treat it
jock itch topical antifungals (azoles)
87
what is tinea capitis
m/c fungal infection in pediatric pupulation (hair infection)
88
what is the treatment of tinea capitis
systemic therapy - oral Griseofulvin for 6-8 weeks in addition to topical therapy twice weekyl to suppress viable spores
89
what is the other name for ring worm
tinea corporis
90
what is the treatment of tinea corporis
topical antifungals (azoles)
91
what causes tinea versicolor
malassezia furfur - yeast found on human skin (hypo/hyperpigmentation of skin)
92
what is the treatment of tinea versicolor
selenium sulfide 2/5% applied to affected skin for 10 minutes - wash off thoroughly. apply daily for 7-10 days.
93
What is TEN
rare, life-threatening skin condition caused by reation to drugs that affects >30% of body
94
what is the treatment of TEN
admit to burn unit with supportive care consult opthalmology if eyes affected cyclosporine and possible plasma exchange for severe cases
95
what is Darier's sign
localized urticaria appearing where skin is rubbed (histamine release)
96
what is the treatment of urticaria
hives usually go away without treatment but antihistamine meds are helpful
97
what are the antihistamine options for urticaria treatment
second generation - block H1 (allegra, claritin, etc) first gen: for sleep disturbances: (hydroxyzine, benadryl) H2 blockers: (cimetidine, rinaitdine) steroids for exacerbations
98
what is the epinephrine dilution of IM administration for anaphylaxis
1: 1,000
99
what is the epinephrine dilution for IV administration for anaphylaxis
1: 10,000
100
what is the cause of warts
HPV
101
what is the treatment of veruccae
most resolve over 2 years without treatment cryotherapy with liquid nitrogen OTC salicylic acid

Pediatrics - clinical (13 decks)

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