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Surgery > Dermatology > Flashcards

Dermatology Flashcards

1
Q

_______ prophylaxis should initially be considered in all burns patients.

A

Tetanus

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2
Q

Dematographism is…

A

Local pressure to the skin may cause wheals in that area

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3
Q

Darier’s sign is…

A

Localized urticaria appearing where the skin is rubbed

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4
Q

Treatment of choice for post-op urticaria is ______.

A

Antihistamines!

Also eliminate precipitant factors, corticosteroids, H2 blockers

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5
Q

Type I HSN is…

A

IgE-mediated: urticaria & angioedema. Immediate!

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6
Q

Type II HSN is…

A

Ab-mediated, cytotoxic

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7
Q

Type III HSN is…

A

Immune antibody-antigen complex

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8
Q

Type IV HSN is…

A

Delayed (cell mediated)- Erythema Multiforme

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9
Q

______ is the MC skin eruption.

A

Exanthematous/Morbiliform rash

-Generalized distribution of “bright-red” macules & papules that coalesce to form plaques. Rash typically begins 2-14 days after meds initiation. Ex- ABX, NSAIDS, Allopurinol, Thiazide diuretics

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10
Q

____ rashes usually occur with minutes to hours after drug administration.

A

Urticarial

*MC triggers- ABX, NSAIDS, Opiates, Radiocontrast media

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11
Q

Erythema Multiforme most commonly caused by:

A

Sulfonamides, PCN, Phenobarbital, Dilantin

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12
Q

Most cutaneous drug rxns are self-limited if drug is discontinued.

A

Treatment- antihistamines and systemic corticosteroids

Epi for anaphylaxis

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13
Q

______ is the most common type of skin CA in the US

A

Basal cell carcinoma

*Slow growing, locally invasive but very low incidence of METS

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14
Q

Describe the appearance of BCC

A

Flat, firm area with small, raised, TRANSLUCENT/PEARLY/WAXY PAPULE AND CENTRAL ULCERATION & RAISED/ROLLED BORDERS

  • Often friable (bleeds easily)
  • *May have overlapping telangiectatic vessels
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15
Q

How is BCC worked up?

A

Punch or shave bx

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16
Q

How is BCC treated?

A
  1. Electrodesiccation/curettage in non facial tumors

2. Mohs surgery for facial involvement

17
Q

______ is the 2nd MC skin cancer and is often PRECEDED BY ACTINIC KERATOSIS, HPV Infection

A

Squamous cell carcinoma

*Usually on lips, hands, neck, and head

18
Q

Describe appearance of SCC…

A

Red, elevated, thickened nodule with adherent white scaly or crusted, bloody margins

19
Q

What is the treatment of choice for SCC?

A

Wide local surgical excision

Also electrodessication & curettage, Mohs, radiation therapy

20
Q

UV radiation is associated with 80% of cases of ______.

A

Melanoma

*Aggressive, High METS potential

21
Q

_____ is the MC skin cancer related death.

A

Melanoma

22
Q

What are the 5 major subtypes of melanoma?

A
  1. Superficial spreading: MC type
  2. Nodular
  3. Lentigo maligna
  4. Acral lentiginous
  5. Desmoplastic
23
Q

Describe the appearance of melanoma…

A

Irregular borders, dark blue/black color, usually ≥ 6mm in diameter

24
Q

______ is the most important prognostic factor for METS with Melanoma.

A

Thickness.

-10yr survival rate: <1mm= 95%; 1-2mm= 80%; 2-4mm= 55%; >4mm= 30%

25
Q

How is melanoma diagnosed?

A

Full thickness wide excisional bx + lymph node bx.

*Shave biopsy discouraged!

26
Q

How is melanoma treated?

A
  1. Complete wide surgical excision with lymph node biopsy or dissection
  2. +/- adjuvant therapy in some high-risk
27
Q

MC cause of cellulitis is _____ & _____.

A

S. aureus & GABHS

*Usually occurs after a break in the skin: underlying skin problems, trauma and surgical wounds

28
Q

Systemic infection with cellulitis is _____ (common/not common).

A

Not common–> if present may have fever, chills, +/- tender lymphadenopathy and lymphangitis, myalgias, bullae, hemorrhage and necrosis may develop

29
Q

_____ is the spread of a skin infection via lymphatic vessels. Seen as streaking from the infected area following the lymph vessels. Complications include bacteremia.

A

Lymphangitis

30
Q

Treatment of cellulitis includes…

A

Abx for 7-10 days

  • Cephalexin (Clinda or Erythro if PCN allergic)
  • Vanc and Linezolid PO for MRSA

Animal bites- Augmentin

Puncture wound through tennis shoe–> Cipro (covers Pseudomonas)

31
Q

Parkland formula for burns

A

4ml/kg/% TBSA IV for 1st 24 hours

-1/2 in first 8 hours and the other 1/2 over the remaining 16 hours

32
Q

Rule of Nines for estimating burn size…

A 
Adult- 
Head- 9%
Neck- 1%
Front trunk- 18%
Back trunk- 18%
UE 1- 9%
UE 2- 9%
LE 1- 18%
LE 2- 18%

(For child each leg is 14% and the head is 18%)

33
Q

Pressure ulcer staging…

A

Stage 1- Intact skin with non-blanchable redness

Stage 2- Partial thickness loss of dermis presenting as a shallow, open ulcer without slough

Stage 3- Full thickness tissue loss, sub-cutaneous fat may be visible. Slough may be present. May show tunneling

Stage 4- Full thickness tissue loss with exposed tendon or muscle. Slough or eschar may be present.

*If base of ulcer is hidden then the ulcer cannot be staged.

Surgery (11 decks)

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