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Emergency EOR > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Atopic disease triad

A
  1. Eczema
  2. Allergic rhinitis
  3. Asthma
    Starts in childhood
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2
Q

Altered immune reaction in genetically susceptible people when exposed to certain triggers. T cell mediated immune activation and increased IgE production

A

Dermatitis (Eczema)

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3
Q

Hallmark of eczema

A

Pruritus

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4
Q

Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales

A

Dermatitis (Eczema)

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5
Q

Dermatitis (eczema) is most commonly seen on the

A

Flexor creases - antecubital and popliteal folds

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6
Q

Localized development of hives when the skin is stroked

A

Dermatographism

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7
Q

Management of dermatitis (eczema)

A
  1. Topical corticosteroids

2. Antihistamines for itching

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8
Q

Burning, itching, and erythema to the affected area, dry skin, eczematous eruption

A

Contact dermatitis

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9
Q

Tx for contact dermatitis

A
  1. Topical corticosteroids

2. Antihistamines for itching

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10
Q

Most common drug eruption

A

Exanthematous/Morbilliform rash

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11
Q

Generalized distribution of “bright-red” macules and papules that coalesce to form plaques, typically begins 2-14 days after medication initiation

A

Exanthematous/Morbilliform rash

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12
Q

Most common causes of Exanthematous/Morbilliform rash

A

NSAIDs
Antibiotics
Allopurinol
Thiazide diuretics

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13
Q

2nd most common type of drug eruption

A

Urticaria

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14
Q

Most common causes of urticarial drug eruption

A

antibiotics
NSAIDs
Opiates
Radiocontrast media

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15
Q

Third most common causes of drug eruption

A

Erythema multiforme

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16
Q

Most common causes of erythema multiforme

A

Sulfonamides
Penicillins
Phenobarbital

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17
Q

Management of exanthematous/morbilliform drug eruption

A

Oral antihistamines

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18
Q

Management of drug induced urticaria

A

Systemic corticosteroids

Antihistamines

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19
Q

Management of erythema multiforme

A

Symptomatic therapy

Topical steroids, oral antihistamines

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20
Q

Management of anaphylaxis

A

IM epi

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21
Q

Most common causes of SJS/TEN

A 
Allopurinol
Sulfonamides
Lamotrigine
NSAIDs
Anticonvulsants
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22
Q

Second most common causes of SJS/TEN

A

Mycoplasma pneumonia

Cytomegalovirus

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23
Q

SJS affects _____ of total body surface area

A

< 10%

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24
Q

TEN affects ____ of total body surface area

A

> 30%

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25
Q

Gentle pressure to the skin causes sloughing

A

Nikolsky sign

SJS/TEN

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26
Q

Treatment for SJS/TEN

A

Admit to hospital, preferably to burn unit

Supportive care is mainstay of tx

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27
Q

Pts with SJS/TEN are at very high risk for

A

respiratory failure

Sepsis and shock secondary to infection

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28
Q

Chronic widespread autoimmune blistering skin disease primarily of the elderly

A

Bullous pemphigoid

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29
Q

Bullous pemphigoid will have a _____ Nikolsky sign

A

Absent

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30
Q

Management of bullous pemphigoid

A

Systemic corticosteroids
Antihistamines for itching
Immunosuppressants (Azathioprine)
Topical corticosteroids if mild

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31
Q

Management of lice

A
  1. Permethrin topical drug of choice
    Shampoo or lotion
    Safe in children > 2 y/o
  2. Lindane second line
    do not use after showering (neurotoxic)
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32
Q

Instructions for mom - kid with lice

A

Bedding/clothing should be laundered in hot water with detergents and dried in hot drier for 20 minutes. Toys that cannot be washed should be placed in airtight plastic bags x 14 days.

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33
Q

Intensely pruritic lesions, linear burrows that are commonly found in the intertriginous zones including web spaces between fingers/toes, scalp

A

Scabies

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34
Q

Diagnosis of scabies

A

Often clinical

Skin scraping of the burrows with mineral oil to identify mites or eggs under microscopy

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35
Q

Management of scabies

A
  1. Permethrin topical
    Apply x1, then x 1 week later
  2. Lindane (cheaper)
    Do not use after showering
36
Q

Instructions for pt with scabies

A

All clothing, bedding, etc. should be placed in a plastic bag at least 72 hrs then washed and dried using heat

37
Q

Erythematous margin around ischemic center (“red halo”)

A

Brown recluse spider bites

38
Q

Management of brown recluse spider bites

A
  1. Local wound care - cold packs, keep affected body part elevated
  2. Pain control
  3. Tetanus
  4. Dermal necrosis - debridement
39
Q

Classic appearance is a blanched circular patch with a surrounding red perimeter and central punctum (target lesion)

A

Black widow spider bite

40
Q

Management of black widow spider bite

A
  1. Mild: wound care - clean with soap and water, NSAIDs

2. Mod-Severe: opioids +/- muscle relaxants

41
Q

Prodrome of high fever 3-5 days, leading to rose, pink, maculopapular, blanchable rash on the trunk/back, then to the face

A

Roseola Infantum (6th disease)

42
Q

Only childhood exanthema that starts on trunk and spreads to face

A

Roseola infantum (6th disease)

43
Q

Mild fever, URI sx, decreased appetite starting 3-5 days after exposure, leading to vesicular lesions with erythematous halos in the oral cavity

A

Hand Foot and Mouth Disease

44
Q

Management for hand/foot/mouth dz

A

Supportive - antipyretics, topical lidocaine

45
Q

Rashes that affect palms/soles

A

Coxsackie (HF&M)
RMSF
Syphilis (secondary)
Janeway lesions

46
Q

Low grade fever, myalgias, headache, parotid gland pain and swelling

47
Q

Management of mumps

A

Supportive

Anti inflammatories

48
Q

Complications of mumps

A

Orchitis in males

Most common cause of acute pancreatitis in children

49
Q

URI prodrome of the 3 C’s and high fever, followed by koplik spots and morbilliform rash on face beginning and hairline going to extremities

A

Cough, coryza, conjunctivitis

Rubeola (Measles)

50
Q

Small red spots in buccal mucosa with pale blue/white center precedes rash by 24-48 hours, lasts 2-3 days

A

Koplik spots

Rubeola (Measles)

51
Q

Rubeola (measles) usually lasts __________

A

7 days - fades from top to bottom

52
Q

____________ reduces mortality in all children with measles (Rubeola)

53
Q

Complications of rubeola (measles)

A 
Diarrhea
Otitis media
Pneumonia
conjunctivitis
Encephalitis
54
Q

3 day rash

A

Rubella (German measles)

55
Q

Low grade fever, cough, anorexia, lymphadenopathy (posterior cervical, posterior auricular), followed by pink, light-red spotted maculopapular rash on face spreading to extremities

A

Rubella (German measles)

56
Q

Small red macules or petechiae on soft palate

A

Forchheimer Spots

Seen with Rubella (German measles)

57
Q

Diagnosis of german measles

A

Rubella-specific IgM antibody via enzyme immunoassay

58
Q

Rubella (german measles) is ____________, especially in the ______________

A

Teratogenic
First trimester
Sensorineural deafness, cataracts, TTP (blueberry muffin rash), mental retardation, heart defects

59
Q

Coryza, fever, slapped cheek rash on face with circumoral pallor 2-4 days, lacy reticular rash on extremities

A

Erythema infectiosum (Fifth disease)

60
Q

Virus that causes erythema infectiosum (fifth disease)

A

Parvovirus B19

61
Q

The virus that causes erythema infectiosum (fifth disease) is known to cause ____________ in pts with __________ or ____________

A

Aplastic crisis
Sickle cell disease
G6PD deficiency

62
Q

Clusters of vesicles on an erythematous base “dew drops on a rose petal” in different stages (macules, papules, vesicles, pustules and crusted lesions) beginning on face/trunk spreading to extremities

A

Varicella (chicken pox)

63
Q

Shingles involving first division of the trigeminal nerve

A

Herpes Zoster Ophthalmicus

64
Q

Lesions on the nose usually heralding ocular involvement with varicella

A

Hutchinson’s Sign

65
Q

_______ ________ usually seen on slit lamp with herpes zoster ophthalmicus

A

Dendritic lesions

66
Q

Facial nerve palsy, otalgia, lesions on the ear, auditory canal and tympanic membrane, auditory sx (tinnitus, vertigo, deafness, ataxia)

A

Herpes Zoster Oticus (Ramsay-Hunt Syndrome)

67
Q

Pain > 3 months after initial shingles development, hyperesthesias or decreased sensation

A

Post Herpetic Neuralgia

68
Q

Treatment of herpes zoster (shingles)

A

Acyclovir, Valacyclovir, Famciclovir
Gabapentin
Prednisone
Hydrocodone

69
Q

Treatment of herpes zoster ophthalmicus

A

PO antivirals

70
Q

Treatment of ramsey hunt syndrome

A

Oral acyclovir plus corticosteroids

71
Q

Treatment of post herpetic neuralgia

A

Gabapentin or tricyclic antidepressants, topical lidocaine gel

72
Q

Raised with clear line of demarcation between infected and uninfected tissue

A

Erysipelas

73
Q

Treatment of cellulitis with drainage

A

Treat for MRSA

Clindamycin, TMP/SMX, doxycycline

74
Q

Treatment for cellulitis without drainage

A

Clindamycin, Cephalexin, Dicloxacillin

75
Q

Treatment for erysipelas

A

Penicillin, macrolide, cephalexin, clindamycin

76
Q

Highly contagious superficial vesiculopustular skin infection

77
Q

Impetigo occurs typically at sits of superficial _____________ primarily on exposed surfaces of the face and extremities

A

Skin trauma (insect bites)

78
Q

Risk factors for impetigo

A

Warm, humid conditions

Poor personal hygiene

79
Q

Most common causes of impetigo

A

Staph aureus

GABHS

80
Q

Management of impetigo

A

Mupirocin (Bactroban) topical TID x 10 days
Bacitracin
Good skin hygiene

81
Q

Management of impetigo with extensive disease of systemic symptoms (ex. fever)

A

Systemic antibiotics (Cephalexin, Dicloxacillin, clindamycin, erythromycin, azithromycin)

82
Q

Tender abscess with drainage on or near the gluteal cleft near the midline of the coccyx or sacrum with small midline pits

A

Pilonidal disease

83
Q

Management of pilonidal disease

A

Incision and drainage - excision of pilonidal sinus and tracts recommended if recurrent

84
Q

Skin intact, superficial, nonblanchable redness that does not dissipate after pressure is relieved

A

Stage I pressure sore

85
Q

Epidermal damage extending into the dermis. Shallow ulcer that resembles a blister or abrasion

A

Stage II pressure sore

86
Q

Full thickness of the skin and may extend into the subcutaneous layer

A

Stage III pressure sore

87
Q

Deepest, extends beyond the fascia, into the muscle, tendon or bone

A

Stage IV pressure sore

Emergency EOR (12 decks)

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