Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My CCFP > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How long do you leave sutures in?

A

Face 5d
Joints 14d
Rest of the body 7-10d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Suture Types and which to use

A

Nonabsorb : Ethiopian, Prolene

Absorb : plain or chromic gut, vicryl

Face use 5-6 nonabsorb
Skin use 4-5 nonabsorb
(3-4 vicryl for deep tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the animal and human bite pathogens

A

Animal : Pasturella multocida, S Aureus, S Viridans

Human : Eikenella corrodens, Staph, alpha-hem strep, bacteroides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the animal and human bite pathogens

A

Animal : Pasturella multocida, S Aureus, S Viridans

Human : Eikenella corrodens, Staph, alpha-hem strep, bacteroides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain the treatment for bite lacerations

A

No suture! Heals by secondary closure

Ensure tetanus prophylaxis

Antibiotics : Clavulin 875 BID or Amox 40mg/kg/d TID
2nd line : Doxy 100BIDx1 (2-4) then 100OD (1-2) or Ceftri 1-2gOD IV/IM (50-10)

Consider rabies for animal bites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain rabies treatment in animal bites

A

IgG 20u/kg around wound or IM
AND
Vaccine 1.0mL deltoid day 3,7,14,28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lidocaine max dose

A

1% 5mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which lacerations are more complicated and may require special skills for repair

A

Second versus third-degree perineal tear , lip or eyelid lacerations involving margins, arterial lacerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What kind of lacerations require more than simple sutures
Name some complications

A

Flexor tendon lacerations
open fractures
bites to hands or face
neurovascular injury
foreign bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List wounds at high risk for infection.
Do you close these?

A

Puncture wounds
Some bites
Some contaminated wounds

Do not suture them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the systematic approach to repairing second-degree perineal lacerations

A
  1. identify the apex of the lac, hymenal ring, perineal muscles, intact anal sphincter
  2. secure the apex and align the hymen and perineal body, then suture vaginal mucosa from apex to hymen
  3. Suture perineal muscles
  4. Suture skin or plan to let heal by 2nd intention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the systematic approach to repairing second-degree perineal lacerations

A
  1. identify the apex of the lac, hymenal ring, perineal muscles, intact anal sphincter
  2. secure the apex and align the hymen and perineal body, then suture vaginal mucosa from apex to hymen
  3. Suture perineal muscles
  4. Suture skin or plan to let heal by 2nd intention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the systematic approach to repairing second-degree perineal lacerations

A
  1. identify the apex of the lac, hymenal ring, perineal muscles, intact anal sphincter
  2. secure the apex and align the hymen and perineal body, then suture vaginal mucosa from apex to hymen
  3. Suture perineal muscles
  4. Suture skin or plan to let heal by 2nd intention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of Acne

A
  1. Benzoyl Peroxide 2.5-5%
  2. Topical retinoids (Adapalene 0.1%)
  3. Combined BP/Adap (TactuPump) or BP/Clinda (Clindoxyl)
  4. Clinda 1%/tretinoin 0.025%
  5. OCP / Spirinolactone 50-200mgOD
  6. Oral abx : Minocycline 100mg then 50mg > Doxy 100mg > Tetra 500mg then 250-500mg > Erythro same dose
  7. Isoretinoin / Accutane

ALWAYS USE TOPICALS WITH ORAL ABX, DO NOT USE ORALS FOR >3MO WITHOUT FU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Isoretinoin Dosage and Precautions

A

Accutane 0.5mg/kg/d ÷ OD-BID x 4w then 1mg/kg/d x 3-7mo

Prgnancy tests, double contraception, avoid pregnancy 3mo post tx, monitor CBC, LFTs, lipids at 0, 1, +q3mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DDx : Acne (4)
how to differentiate

A
  • Rosacea : mostly central face, pustules, flush reaction, telangiectasia
  • Perioral dermatitis : only pustules, mostly around the mouth
  • Folliculitis : pustules around beard area
  • Acneiform erruption : drug reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of acne (5), which to refer*?

A
  • Comedones : open or obstructed, little inflammation
  • Common/vulgaris : pustules + comedones
  • *Cystic : form scars
  • *Conglobata : multilobular inflammatory scar-forming cysts
  • *Fulminans : systemic sx (fever, arthralgia, skeletal foci of inflammation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Associated features of eczema/atopic dermatitis

A

Atypical vascular responses (facial pallor, white dermographism, delayed blanch response)
Keratosis pilaris, pityriasis alba, hyperlinear palms, ichthyosis
Ocular/periorbital changes
Perifollicular accentuation, lichenification, prurigo lesions
Asthma, hay fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ddx : eczema/atopic dermatitis

A

Scabies
Seborrheic dermatitis
Cutaneous T-cell lymphoma
Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pharmacological tx of eczema

A
  1. Intermittent topical steroids
  2. Intermittent tacrolimus 0.03-0.1%(lymphoma risk)
  3. Pimecrolimus 1% (lymphoma risk)
  4. Crisaborole 2% BID
  5. Ruxolitinib cream (black box warning)
  6. Systemic (phototherapy, methotrexate, cyclosporine, azathioprine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is tacrolimus ?

A

Tacrolimus, brand name Prograf among others, is an immunosuppressive drug in a class of medications called topical calcineurin inhibitors. It works by stopping the immune system from producing substances that may cause eczema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Provide examples of topical corticotherapies (low to high strength)

A

Low : HC 0.5-2.5% (hyderm, Emo-cort)

Med : Betamethasone (Betaderm) 1%

High : Betamethasone (Diprolene < Diprosone) 0.05% and Clobetasol (Dermovate) 0.05%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How many grams of cream/lotion/ointment do you provide for given body areas?

A

Hand : 1g x BID = 15g per week
Face : 2g x BID = 30g
Arm : 3g x BID = 45g
Leg : 4g x BID = 60g
Whole body : 30-60g x BID = 500-1000g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types of dermatitis and their tx

A
  • Atopic (eczema) –> steroids, tacrolimus
  • Contact –> steroids, tacrolimus
  • Dyshidrotic –> high potency HC
  • Nummular –> high potency HC
  • Seborrheic –> ketoconazole (nizoral), selenium, Zn pyrithione (Head and Shoulders), HC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diagnose and Investigate : Pemphigus

A

Pemphigus presents with fragile, flaccid blisters on the skin and mucous membranes. It’s serious due to risk of widespread skin involvement, infection, and complications from blisters in mucous membranes.

Direct immunofluorescence microscopy of a skin biopsy showing intercellular IgG deposits between keratinocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Name the six main types of psoriasis.

A

Plaque (vulgaris)*, guttate (strep), inverse, pustular (life threatening), erythroderma (>90% of body, life threatening), annular.

*most common 80%

“Psoriasis Is Always Gonna Evolve Poorly”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

List some risk factors associated with psoriasis.

A

Genetic predisposition, stress, obesity, smoking, alcohol use, certain medications (BB, NSAIDs, Li, tetracycline), infections (strep –> guttate), trauma (Koebner phenomenon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does plaque psoriasis typically present?

A

Symmetric, well-defined, raised, red plaques with silvery-white scales, often on extensor surfaces such as elbows, knees, and scalp. Usually not itchy, but can be. Can be painful.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What percentage of psoriasis patients develop psoriatic arthritis? What kind of arthropathy is it?

A

Approximately 20-30% of psoriasis patients develop PsA.
Seronegative arthropathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Types of psoriatic arthritis

A

Distal / DIP
- asymmetric oligo
- symmetric poly
- arthritis mutilans
- spondyloarthropathy

often develops dactylitis (sausage digit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

DDx : psoriasis

A

Atopic dermatitis
Contact dermatitis
Lichen PLanus
Secondary syphilis
Mycosis fungoides
Tinea corporis
Pityriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the nail changes seen in psoriasis?

A

Pitting, onycholysis (detachment of the nail), oil-drop sign, and subungual hyperkeratosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are first-line topical treatments for mild to moderate psoriasis?

A
  1. Lubricants
  2. Corticosteroids (mod to strong)
  3. Vitamin D analogs (calcipotriene, calcitriol) : Dovobet (D + betamet) or Dovonez
  4. Topical retinoids (tazarotene) Tazorac gel)
  5. Coal tar
  6. Salicylic acid
  7. Anthralin
  8. Phototherapy, cyclosporine, MTX, oral retinoid (acitretin)
  9. Biologics (Adalimumab, Etanercept, Infliximab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Chicken Pox presentation

A

Rash from face to trunk to extremities
Papules to vesicles to pustules to crust
Dewdrop on a rose petal

35
Q

Kawasaki Presentation

A

CRASH
- Bilateral conjunctivitis
- Rash : polymorphous
- ADNP
- Strawberry tongue
- Hands and Feet desquamation

36
Q

Kawasaki Complications

A

Coronary artery aneurysm, myocarditis, pericarditis, pericardial effusion, valvular dysfunction, LV dysfunction, arrythmia

37
Q

Kawasaki Management

A

IVIG + high dose ASA (80-100mg/kg/d/QID)

Decr to ASA 3-5mg/kg/d x 6-8weeks after fever (48-72h)

38
Q

Lyme Disease Pathogen and Presentation

A

Borrelia Burgodorferi

Erythema migrans : red patch / target / bulls eye

39
Q

Measles Presentation

A

Macular rash from face to shoulders downwards on d4 of fever

The C’s : coryza, cough (bark-like), Koplik’s spots

Fades in 4-6d, incubation 10-14d, infective 4d pre-rash

40
Q

Parvovirus Names and Presentations and Complication

A

5ths Disease / Slapped Cheek

Cheeks to lacy reticular rash post fever
Wax + wane x 6wks

Severe aplastic anemia in pts w/ chronic haemolytic anemia

41
Q

Rocky Mountain Spotted Fever Presentation

A

Abrupt T, HA, myalgias –> rash 4d later : Pink macules to red papules to petechiae on wrists and ankles towards center (palms + soles late in disease)

Possible bradycardie, leukopenia

42
Q

Roseola virus and presentation

A

HHV-6

Fever x 3-4d –> Rash within 2-3d –> Lasts 2-3d

Diffuse, face-sparing, macular rash

43
Q

Rubella Presentation

A

Pink macules and papules from forhead downwards within 1d, fades in reverse order

Forchheimer spots**

Infective 7dpre to 5d post rash

Prodrome uncommon in children
Mild URTI, anorexia, malase, HA in adults

44
Q

Scarlet Fever Presentation

A

Punctuated rash on trunk to extremities, flushed face, perioral pallor, fades in 4-5d, followed desquamation

Clues : 2-3d after strep, Pastia’s sign (folds), white to red strawberry tongue

45
Q

Rosacea Presentation

A

central face with transient or persistent erytehma, telangiectasia, inflammatory papules/pustules, hyperplasia of connective tissues

feeling of warmth

46
Q

DDX : Rosacea

A
  • Acne vulgaris
  • Seborrheic dermatitis
  • SLE
  • Carcinoid syndrome
47
Q

Rosacea subtypes

A

Erythematotelangiectatic
Papulopustular
Phymatous
Occular

48
Q

Rosacea 1st line treatment

A

Metronidazole 1% gel or cream
Azelaic acid gel
Brimonidine

49
Q

Rosacea 2nd line treatment

A

ABx : Doxycycline or Tetracycline
Laser / Light Therapy
Propranolol

50
Q

Rosacea flushing treatments

A

Propranolol 20-40mg (for flushing)
Carvedilol (BB)
Clonidine (ablocker)

51
Q

Ocular rosacea treatments

A

Eyelid hygiene / massages / warm compresses / artificial tears

Oral doxycycline or tetracycline

Referral to an ophthalmologist may be necessary in severe cases.

52
Q

Clinical Features of T Cell Lymphoma

A

**Persistent, patchy, red, scaly skin lesions that do not improve with standard treatments, and can progress to plaques or tumors over time.

Mycosis Fungoides (limited superficial)
- patches –> poikiloderma (thinning and telangiectasia) –> plaques –> tumour stage

Sezary Syndrome
- widespread systemic type, “red man” syndrome, fatigue, fever, often fatal

53
Q

What is the treatment for T Cell Lymphoma types?

A

Mycosis Fungoides : Topical steroids, PUVA or UVB application

Sezary Syndrome : Oral retinoids and interfereon, extra-corporeal photophoresis, possible radiotherapy

54
Q

Diagnose and Investigate : Cutaneous T-cell lymphoma

A

Skin biopsy with immunohistochemistry, flow cytometry, or T-cell receptor gene rearrangement studies.

55
Q

Diagnose and Investigate : Melanoma

A

“ABCDE” criteria (Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution)
+EFG : Elevated, firm, growing (Nodular Melanoma)

56
Q

How do you treat melanoma? What’s the prognosis?

A

Biopsy, typically an excisional or punch biopsy, depending on lesion size and location, to provide histopathological analysis. Avoid shave biopsy. Remove full depth of dermis.

Staging/prognosis = Breslow thickness

57
Q

Differentiate between the non-melanoma skin cancers (NMSC)

A

BCC : pearly, telangiectasia, on face, slow, local, can treat by excision, radiation or Aldara

SCC : scale/crust, on sun exposed areas, fast, 5-10% metastasize, can treat by excision or radiation

58
Q

What are the characteristic cutaneous findings in systemic lupus erythematosus (SLE)?

What investigations are useful for confirming (SLE)?

A

Malar (butterfly) rash on the cheeks and nose, photosensitivity, discoid lesions, and oral ulcers.

ANA (antinuclear antibody), anti-dsDNA, anti-Smith antibodies, and complement levels (C3 and C4).

59
Q

How does Wegener’s granulomatosis (now known as Granulomatosis with Polyangiitis) typically present on the skin?

Which lab test is commonly used to help diagnose (GPA)?

A

Purpura, ulcers, and nodules, often with necrotic centers, due to vasculitis.

c-ANCA (cytoplasmic anti-neutrophil cytoplasmic antibodies), along with biopsy of affected tissues showing granulomatous inflammation.

60
Q

What are common cutaneous signs of a drug reaction?

A

Rash, urticaria, fixed drug eruptions, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and drug-induced hypersensitivity syndrome (DRESS).

61
Q

What are cutaneous signs of dermatomyositis, and what systemic disease should be considered?

Which investigations confirm a diagnosis of dermatomyositis?

A

Heliotrope rash on the eyelids, Gottron’s papules on knuckles, and shawl sign. Consider underlying malignancy or interstitial lung disease.

Muscle enzymes (CK, aldolase), EMG, skin/muscle biopsy, and antibody testing (anti-Jo-1, anti-Mi-2).

62
Q

What are the cutaneous manifestations of systemic sclerosis (scleroderma)?

What key investigations help confirm systemic sclerosis?

A

CREST : Calvinist’s, Raynaud, esophageal dysfunction, sclerodactyle and skin thickening, telangiectasias.

ANA, anti-Scl-70 (anti-topoisomerase I), and anti-centromere antibodies, along with organ-specific tests (e.g., PFTs for lung involvement).

63
Q

What are the skin manifestations of sarcoidosis?

How is sarcoidosis confirmed after observing cutaneous signs?

A

Erythema nodosum (red, painful nodules on shins) and lupus pernio (violaceous plaques on the nose, cheeks, and ears).

Chest X-ray or CT for pulmonary involvement, serum ACE levels, and biopsy of affected skin or lymph nodes showing non-caseating granulomas.

64
Q

What is DRESS syndrome, and how does it present?

Which investigations are key in diagnosing DRESS syndrome?

What is the management ?

A

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) presents with fever, widespread rash, facial edema, and lymphadenopathy, often with eosinophilia and liver involvement.

CBC (eosinophilia), liver function tests, and history of recent drug exposure.

Stopping the offending drug is critical +/- corticosteroids

65
Q

What cutaneous signs might indicate vasculitis as a systemic condition?

A

Palpable purpura, livedo reticularis, ulcers, and nodules, often seen in small-vessel vasculitis.

66
Q

What is Stevens-Johnson Syndrome (SJS), and how does it typically present?

A

SJS is a severe mucocutaneous reaction characterized by widespread skin detachment, painful erythematous or purpuric macules, and mucosal involvement, often triggered by medications.

67
Q

How is SJS distinguished from Toxic Epidermal Necrolysis (TEN)?

A

SJS involves <10% body surface area (BSA) detachment, while TEN involves >30% BSA detachment. Between 10–30% BSA is classified as SJS/TEN overlap.

68
Q

What is the initial management of Stevens-Johnson Syndrome (SJS)?

A

Stop the offending drug, initiate supportive care (fluids, pain management), transfer to a burn unit if extensive, and consider systemic steroids or IV immunoglobulin in severe cases.

69
Q

What is the primary bacterial cause of invasive cellulitis?

A

Group A Streptococcus and Staphylococcus aureus, including MRSA, are common causes of invasive cellulitis.

70
Q

What are key signs of invasive cellulitis?

A

Rapidly spreading erythema, warmth, tenderness, swelling, fever, and systemic symptoms. Can progress to necrotizing fasciitis if untreated.

71
Q

What is the initial treatment for invasive cellulitis?

A

Empirical IV antibiotics targeting Streptococcus and Staphylococcus (e.g., cefazolin or clindamycin), followed by wound assessment and debridement if needed.

72
Q

How does necrotizing fasciitis differ from cellulitis, and what is its hallmark sign?

A

Necrotizing fasciitis is a rapidly progressive infection of the fascia with severe pain, often disproportionate to physical findings, and can include crepitus and skin necrosis.

73
Q

What is the urgent treatment for necrotizing fasciitis?

A

Immediate surgical debridement, broad-spectrum IV antibiotics (e.g., piperacillin-tazobactam with vancomycin), and supportive care in an ICU setting.

74
Q

What are common causes of chemical burns?

A

Acids (e.g., hydrochloric acid), alkalis (e.g., lye), and other irritants, with alkalis causing deeper and more severe tissue damage.

75
Q

What is the first step in treating a chemical burn?

A

Immediately irrigate with copious amounts of water (at least 20–30 minutes), remove contaminated clothing, and avoid neutralizing agents, which can worsen the burn.

76
Q

What are signs of severe thermal burns that require emergency intervention?

A

Burns involving >10% BSA in adults, >5% in children, or any burn involving the face, hands, feet, genitals, or respiratory tract.

77
Q

What are the symptoms of toxic shock syndrome (TSS), what pathogens are responsible? What abx do you give?

A

Sudden high fever, diffuse rash resembling sunburn, hypotension, and multiorgan involvement, often linked to Staphylococcus aureus or Streptococcus infections.

Start with Clindamycin plus Vanco

**In prophylaxis, you can give clavulin

78
Q

What is erythema multiforme? What is the treatment?

A

Erythema multiforme major typically presents with target lesions and minimal mucosal involvement, often linked to infections.
Treat underlying infection (e.g., HSV with antivirals), supportive care for skin lesions, and hospitalization if severe.

79
Q

What is the pharmacotherapy of candidiasis for thrush, skin, vs vulvovaginal?

A

Thrush : nystatin
Skin : nystatin

Vulvovaginal : Clotrimazole 200mg PV x 3d or 2% x 3d, Miconazole 400mg or 4% x 3d, or Fluconazole 150mg PO x1

**if >4 episodes per year : fluconazole 150mg PO q3dx3 doses or topical azole x 10-14d THEN Fluconzaole 150mg PO q1wk x 3-6 MONTHS

80
Q

What is the pharmacotherapy of tinea corporus? Tinea pedis?

A

Ketoconazole cream or oral for 10d

Pedis : terbinafine 1% 1-4w or azoles (clotrimazole 1% 4-6w), tea tree oils, foot hygiene **oral ony in severe / tx failure / immunocompromised cases

81
Q

How do you treat onychomycosis?

A

Efinaconazole +/- Terbinafine
Oral terbinafine if >60% involvement

**lab test before treatment

82
Q

What is the etiology of Impetigo? The clinical features? What is the pharmacotherapy?

A

Group A Strep or S. Aureus

Vesciles –> golden, honey crusted lesions

Topical 5-7d > oral abx 7-10d
Mupirocin 2% TID, Fusidic acid 2% TID-QID or Ozenoxacin 1% BID
Cephalexin 50-100mg/kg/d QID (max 250-500mg QID) or Cloxacillin 50mg/kg/d QID (max 250-500) or Clinda or Doxy

**If MRSA risk : swab and tx w/ Septra or Doxy

83
Q

What is a risk of lice? What is the pharmacotherapy?

A

Secondary bacterial infection

Pyrethrins <2mo day 1 and repeat day 10
Permethrin >2mo and repeat day 7

84
Q

What kind of infection is scabies? What is the pharmacotherapy?

A

Parasitic, transmitted skin to skin, itching begins 1mo after incubation and can last 2-3wks post tx

Permethrin 5% day 1 x 12h and repeat day 7

My CCFP (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions