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MS3 Year > Dermatology > Flashcards

Dermatology Flashcards

1
Q

“Neutrophilic abscess” on biopsy of a skin lesion is?

A

Dermatitis herpetiformis (celiac skin manifestation)

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2
Q

Best way to treat dermatitis herpetiformis?

A

Remove gluten from diet

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3
Q

Pathology of bullous pemphigoid?

A

antibodies against hemidesmosomes (detached from basement membrane)

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4
Q

Pathology of pemphigus vulgaris?

A

antibodies against desmosomes (intra epithelial lesions)

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5
Q

Treatment for pemphigus vulgaris?

A

Steroids (if life threatening IVIG)

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6
Q

Blistering disease that involves the mucosa?

A

pemphigus vulgaris (oral mucosa)

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7
Q

Treatment for bullous pemphigus?

A

systemic steroids

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8
Q

Blisters that easily tear - what is the sign called and which one has it?

A

Nikolsky sign = pemphigus vulgaris

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9
Q

Best way to diagnose dermatitis herpetiformis?

A

diagnose celiac sprue (antibodies and egd) - NOT biopsy (but if you do and it says neutrophilic abscess = dermatitis herpeteformis)

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10
Q

Bullae on sun exposed regions, dx?

A

porphyria cutanea tarda (pt is also hairy!)

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11
Q

How do you diagnose porphyria cutanea tarda?

A

coral red urine under Wood’s lamp; 24-hr urine collection for uroporphyrins

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12
Q

What conditions are associated with porphyria cutanea tarda (4)?

A

1) hemochromatosis; 2) hep C; 3) EtOH; 4) OCPs

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13
Q

Nail pitting - dx?

A

Psoriasis

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14
Q

What is seborrheic dermatitis in an infant referred to as?

A

Cradle cap

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15
Q

Symmetric, well-demarcated silvery scales - dx?

A

Psoriasis

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16
Q

Workup for pityriasis rosea? Tx?

A

Clinical (may do RPR to rule out syphilis); none, self limiting

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17
Q

Treatment for lichen planus?

A

topical steroids

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18
Q

Treatment for psoriasis?

A

UV light is first line; topical steroids sparingly; oral steroids for severe disease (then can think about immune modulators like tacrolimus)

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19
Q

Flat salmon-colored macule?

A

herald patch = pityriasis rosea (then more will pop up and they will scale but the scaling does not reach the border - called a trailing scale)

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20
Q

Intensely pruritic raised purple lesion with thin white lines on the surface - dx?

A

lichen planus

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21
Q

Treatment for seborrheic dermatitis?

A

selenium shampoo (it’s a fungal infxn)

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22
Q

Red rash on the eyebrows and scalp - dx?

A

Seborrheic dermatitis

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23
Q

Treatment of eczema in a child?

A

Avoid triggers (removal of foods - likely allergen to food)

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24
Q

Dry, itchy, red rash on the extensor surfaces of a child?

A

Eczema

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25
Q

Volume overload with a hyperpigmented rash where fluid accumulates?

A

stasis dermatitis

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26
Q

Rash in the shape of a shoe sandal?

A

contact dermatitis

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27
Q

What type of hypersensitivity reaction is contact dermatitis?

A

Type IV

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28
Q

Rash in the shape of a watch?

A

Contact dermatitis

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29
Q

Treatment for stasis dermatitis?

A

Compression stockings, leg elevation

30
Q

Who gets hand dermatitis and what’s the tx?

A

people who wash too much (health care or food service worker); moisturizers and avoidance of harsh soaps

31
Q

Circular raised red lesion after a bee sting - dx?

32
Q

Treatment for SJS or TENS?

A

Remove ALL medications, do NOT give steroids, treat supportively as if burn pt

33
Q

Every time a sulfa drug is started the pt gets a dot on his thumb, dx and tx?

A

fixed drug eruption; don’t need to do anything, it’s okay to give pt drug (just may be annoying to them)

34
Q

Treatment for SSSS (staphylococcus scalded skin syndrome)?

A

Clindamycin

35
Q

What % BSA differentiates SJS from TENS

A

SJS is less than 10% BSA, and TENS is greater than 30%

36
Q

First thing to do if you see anaphylaxis?

A

SubQ Epi!!!

37
Q

When does a drug reaction occur? How do you tx?

A

7-14 days after drug exposure; diphenydramine

38
Q

What type hypersensitivity reaction is urticaria?

A

Type 1 (IgE induced mast cell degranulation leading to histamine release leading to leaky capillaries)

39
Q

Targetoid lesion on palms and soles = ?

A

syphilis or erythema multiforme

40
Q

What is Bowen’s disease?

A

Squamous cell carcinoma in situ (it is midway between actinic keratosis and full on SqCC)

41
Q

Erythematous with yellow or brown scale in a person who loved the sun, dx?

A

squamous cell carcinoma

42
Q

A black lesion on the lower lip of a pt who likes being in sun, dx?

A

squamous cell carcinoma

43
Q

What does ABCDE stand for?

A 
Asymmetry
Border irregularity
Color mixed
Diameter large (gt 5mm)
Evolving
44
Q

How do you diagnose melanoma?

A

wide excisional biopsy

45
Q

Treatment for actinic keratosis?

A

local = cryoablation; diffuse = 5-FU

46
Q

Brown, greasy lesion, on some old guy’s face = ?

A

Seborrheic keratosis

47
Q

Treatment for Kaposi’s sarcoma (first line)?

48
Q

Squamous cell carcinoma that suddently got better on its own, dx?

A

Keratocanthomas (can’t tell difference btwn it and SqCC until biopsied)

49
Q

What is the SqCC ulcers called that fail to heal?

A

Marjolin’s ulcer

50
Q

Diagnosis of vitiligo?

A

Biopsy shows no melanocytes annd wood’s lamp shows no pigment

51
Q

Hypopigmented macule that lights up on Wood’s lamp in a child = ?

A

Ash leaf spot, think tuberous sclerosis

52
Q

Patchy discoloration of varying color (both dark and light) = ?

A

Tinea versicolor (Malassezia furfur)

53
Q

Treatment for tinea versicolor?

A

Selenium sulfide (and/or ketoconazole)

54
Q

You find an ash leaf spot, what do you do?

A

Get a CT scan to find tubers in brain

55
Q

Spaghetti and meatballs on KOH prep - dx?

A

Tinea versicolor (hyphae and spores)

56
Q

Total lack of pigment - dx?

57
Q

Absent pigmentation on wood’s lamp = ?

58
Q

How do you diagnose tinea capitis?

A

KOH prep for fungal assessment (Wood’s lamp doesn’t work)

59
Q

Exclamation point sign (thinner hair by the scalp) and alopecia - dx?

A

Alopecia areata (autoimmune disease!)

60
Q

Treatment for tinea capitis?

A

Oral griseofulvin (oral because if you don’t tx it could permanently lose hair)

61
Q

Treatment for male pattern baldness in a woman (2 options)?

A

OCPs and/or spironolactone

62
Q

Treatment for alopecia areata?

63
Q

Patchy alopeica with hair in different lengths of regrowth - dx?

A

Trichotillomania

64
Q

Treatment for male pattern baldness?

A

Minoxidil topically, finasteride orally (choose minoxidil first)

65
Q

Circular, well defined bald spot, dx?

A

alopecia areata (give steroids) or tinea capitis (give anti-fungals) - make sure to r/o fungal infxn

66
Q

Tx for chemotherapy induced hair-loss?

A

None (wig)

67
Q

What organism cuases acne?

A

Propionibacterium acnes

68
Q

Erysipelas is __ infxn in __. Treatment for erysipelas?

A

Strep; lymphatics (shaped like tracks or lines); amoxicillin

69
Q

You’re going to start someone on isotretinoin; you must first?

A

Rule out pregnancy (it’s teratogenic)

70
Q

First line tx for impetigo? What if 1st line doesn’t work for impetigo?

A

Amoxicillin (or mupirocin if local); clindamycin (go after staph!)

71
Q

What is the 4 pronged ladder for treating acne?

A

Comedones = topical retinoids
Inflamed comedones = topical retinoids + benzoyl peroxide
Severe pustular = oral abx (doxy)
Resistant disease = isotretinoin

72
Q

Which two tinea infxns require oral tx and what is the tx?

A

Onychomycosis = terbinafine
Tinea capitis = griseofulvin
(the rest can have topical antifungals)

MS3 Year (18 decks)

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