Dermatology

Question 1

psoriasis usually presents on _____ surfaces

Answer 1

extensor

Question 2

what other body part should you be sure to observe in a patient with psoriasis?

Answer 2

nails

commonly have nail pitting, oil spots, onycholysis

Question 3

what is auspitz sign? what is it associated with?

Answer 3

bleeding when you peel the scales of psoriasis

Question 4

what is koebner phenomenon? what is it associated with?

Answer 4

patients prone to psoriasis will often develop a plaque at the site of trauma

Question 5

tiers of treatment for psoriasis, from mild to moderate?

Answer 5

1) mild = calcipotriene then topical steroids
2) moderate = UV light, methotrexate
3) severe = biologics like etanercept/enbrel, adalimumab/humiera, infliximab/remicade, ustekinumab/stelara

Question 6

most common bacteria associated with acne vulgaris?

Answer 6

propionibacterium acnes

Question 7

what psychiatric drug is associated with a lot of skin problems (like psoriasis, acne, etc.)?

Answer 7

lithium

Question 8

what endocrine drug is associated with a lot of skin problems (psoriasis, acne, etc.)?

Answer 8

steroids

Question 9

common topical antibiotics for acne?

Answer 9

clindamycin, erythromycin

Question 10

common oral antibiotics for acne?

Answer 10

doxycycline, minocycline

Question 11

oral medication for acne that carries black box warning for suicide and deformed babies?

Answer 11

isotretinoin

Question 12

flushing and telangiectatias of the face in response to stressors?

Answer 12

rosacea

stressors = heat, ETOH, spicy foods

Question 13

treatment of rosacea?

Answer 13

topical metronidazole OR oral tetracyclines

Question 14

treatment of perioral dermatitis?

Answer 14

topical metronidazole OR oral tetracyclines

Question 15

difference between contact dermatitis and atopic dermatitis?

Answer 15

contact = delayed type 4 hypersensitivity reaction

allergic = true type 1 hypersensitivity reaction

Question 16

poison ivy, sumac, nickel are common triggers for contact dermatitis or atopic dermatitis?

Answer 16

contact dermatitis

Question 17

treatment of both contact and atopic dermatitis?

Answer 17

topical steroids, antihistamines for itching

Question 18

atopic triad?

Answer 18

eczema, allergic rhinitis, asthma

Question 19

what condition often results from long-term atopic dermatitis?

Answer 19

lichen simplex chronicus w/ lichenification from scratching

Question 20

treatment of lichen simplex chronicus?

Answer 20

STOP itch-scratch cycle, topical steroids

Question 21

eruptions of small, fluid-filled vesicles on the hands that follow stress or hot, humid weather?

Answer 21

dyshidrotic eczema

Question 22

“tapioca pudding” in a derm question should make you think what?

Answer 22

dyshidrotic eczema

Question 23

treatment of dyshidrotic eczema?

Answer 23

burrow’s solution (domedoro astringent) or HIGH dose topical steroids

Question 24

greasy, yellow scaly macules, papules, plaques on scalp and ears

Answer 24

seborrheic dermatitis

Question 25

YEAST that causes seborrheic dermatitis?

Answer 25

pityrosporon ovale

Question 26

treatment of of seborrheic dermatitis?

Answer 26

ketoconazole shampoo or tar/zinc containing shampoos

Question 27

salmon herald patch followed by eruption in christmas tree distribution? what usually precedes?

Answer 27

pityriasis rosea usually preceded by viral infection

Question 28

treatment of pityriasis rosea?

Answer 28

self limited over 8-12 weeks; lotions, anti-pruritics

Question 29

what are the four p's of lichen planus?

Answer 29

purple, polygonal, pruritic, papule

Question 30

lichen planus is often associated with what?

Answer 30

hepatitis C

Question 31

treatment of lichen planus?

Answer 31

topical steroids lalala

Question 32

"stuck on" warty plaque; dx and treatment?

Answer 32

seborrheic keratosis cryotherapy or leave alone

Question 33

autoimmune disorder in elderly with large, tense bullae? treatment?

Answer 33

bullous pemphigoid TX with systemic prednisone +/- azithioprine (med given in organ transplant to prevent rejection)

Question 34

red annular patch with distinct borders, central clearing, and fine scale usually meansssss what

Answer 34

tinea corporis (superficial fungal infection)

Question 35

diagnosis and treatment of ringworm (tinea corporis)

Answer 35

DX with KOH -- branching hyphae TX is antifungals (topical clotrimazole)

Question 36

another word for tinea infections are _____ infections

Answer 36

dermatophyte infections

Question 37

hives are a type ___ hypersensitivity reaction involving which type of antibodies?

Answer 37

type 1 hypersensitivity involving IgE

Question 38

erythema multiforme is often preceded by what?

Answer 38

oral herpes infection (think in question of child with cold sore, then bullseye rash on legs) PCN or sulfa drugs

Question 39

treatment of erythema multiforme?

Answer 39

systemic steroids

Question 40

SJS is ____ or less percentage of body surfaces and involves ____ surfaces

Answer 40

SJS is less than 10 percent of BSA involves mucosal surfaces!

Question 41

TEN is over ____ percent of body surface areas what drugs are commonly associated with SJS and TEN?

Answer 41

over 30 percent PCN, sulfas, allopurinol, phentytoin

Question 42

the autoimmune destruction of melanocytes is called what?

Answer 42

vitiligo

Question 43

acanthosis nigricans should make you worry about what?

Answer 43

underlying diabetes, endocrine disorders

Question 44

pregnancy and oral contraceptive use put you at risk for what skin condition?

Answer 44

melasma

Question 45

treatment of melasma?

Answer 45

hydroquinone lightening cream, sunscreen

Question 46

pruritic burrows, vesicles, excoriations in web spaces of hands

Answer 46

scabies

Question 47

diagnosis and treatment of scabies?

Answer 47

DX = scraping, look under microscope TX = lindane or permethrin cream over entire body and pretty much BURN EVERYTHING

Question 48

thick, gold "honey crusted" lesions -- DX and etiology?

Answer 48

DX = impetigo etiology = staph more often than strep

Question 49

treatment of impetigo?

Answer 49

topical mupirocin

Question 50

two most common etiologies of folliculitis?

Answer 50

staph MC; pseudomonas if associated with hottub

Question 51

well-demarcated, shiny, abrupt onset, superficial spreading cellulitis? diagnosis and etiology?

Answer 51

erysipelas cause = group A strep

Question 52

treatment of both erysipelas AND cellulitis?

Answer 52

penicillin, cephalosporin, or macrolide

Question 53

acute fever, hypotension, diarrhea, generalized skin erythema with multiple organ failure is what?

Answer 53

toxic shock syndrome

Question 54

what causes toxic shock syndrome? how do we treat?

Answer 54

staph aureus making toxin TX = ICU admission, IV anti-staph ABX

Question 55

6 month old presents with acute fever, hypotension, discrete macules, papules, petechiae, and purpura. what should you be worried about?

Answer 55

meningococcemia (caused by neisseria meningitides)

Question 56

treatment of meningococcemia in an infant?

Answer 56

ICU, vancomycin and rocephin complication is meningitis

Question 57

hutchinson sign in regards to herpes simplex?

Answer 57

involvement of nasal tip suggests trigeminal involvement (also innervates cornea so we worry about blindness) EMERGENT optho referral

Question 58

herpetic whitlow most common in which populations?

Answer 58

boxers, nurses

Question 59

most common type of skin cancer?

Answer 59

basal cell carcinoma

Question 60

pearly, nodular papule with raised rolled borders and central depression and telangiectasias

Answer 60

basal cell carcinoma

Question 61

actinic keratoses are precursors to what?

Answer 61

squamous cell carcinoma

Question 62

erythematous scaling plaque with ulcerations and crust

Answer 62

squamous cell carcinoma

Question 63

margins when excising melanomas should be at least how big?

Answer 63

1 cm 10 mm