Dermatology Flashcards
1
Q
Atopic disease triad
A
- Eczema
- Allergic rhinitis
- Asthma
Starts in childhood
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)
3
Q
Hallmark of eczema
A
Pruritus
4
Q
Erythematous, ill-defined blisters/papules/plaques that later dries, crusts over and scales
A
Dermatitis (Eczema)
5
Q
Dermatitis (eczema) is most commonly seen on the
A
Flexor creases - antecubital and popliteal folds
6
Q
Localized development of hives when the skin is stroked
A
Dermatographism
7
Q
Management of dermatitis (eczema)
A
- Topical corticosteroids
2. Antihistamines for itching
8
Q
Burning, itching, and erythema to the affected area, dry skin, eczematous eruption
A
Contact dermatitis
9
Q
Tx for contact dermatitis
A
- Topical corticosteroids
2. Antihistamines for itching
10
Q
Most common drug eruption
A
Exanthematous/Morbilliform rash
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
12
Q
Most common causes of Exanthematous/Morbilliform rash
A
NSAIDs
Antibiotics
Allopurinol
Thiazide diuretics
13
Q
2nd most common type of drug eruption
A
Urticaria
14
Q
Most common causes of urticarial drug eruption
A
antibiotics
NSAIDs
Opiates
Radiocontrast media
15
Q
Third most common causes of drug eruption
A
Erythema multiforme
16
Q
Most common causes of erythema multiforme
A
Sulfonamides
Penicillins
Phenobarbital
17
Q
Management of exanthematous/morbilliform drug eruption
A
Oral antihistamines
18
Q
Management of drug induced urticaria
A
Systemic corticosteroids
Antihistamines
19
Q
Management of erythema multiforme
A
Symptomatic therapy
Topical steroids, oral antihistamines
20
Q
Management of anaphylaxis
A
IM epi
21
Q
Most common causes of SJS/TEN
A
Allopurinol Sulfonamides Lamotrigine NSAIDs Anticonvulsants
22
Q
Second most common causes of SJS/TEN
A
Mycoplasma pneumonia
Cytomegalovirus
23
Q
SJS affects _____ of total body surface area
A
< 10%
24
Q
TEN affects ____ of total body surface area
A
> 30%
25
Gentle pressure to the skin causes sloughing
Nikolsky sign
| SJS/TEN
26
Treatment for SJS/TEN
Admit to hospital, preferably to burn unit
| Supportive care is mainstay of tx
27
Pts with SJS/TEN are at very high risk for
respiratory failure
| Sepsis and shock secondary to infection
28
Chronic widespread autoimmune blistering skin disease primarily of the elderly
Bullous pemphigoid
29
Bullous pemphigoid will have a _____ Nikolsky sign
Absent
30
Management of bullous pemphigoid
Systemic corticosteroids
Antihistamines for itching
Immunosuppressants (Azathioprine)
Topical corticosteroids if mild
31
Management of lice
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)
32
Instructions for mom - kid with lice
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.
33
Intensely pruritic lesions, linear burrows that are commonly found in the intertriginous zones including web spaces between fingers/toes, scalp
Scabies
34
Diagnosis of scabies
Often clinical
| Skin scraping of the burrows with mineral oil to identify mites or eggs under microscopy
35
Management of scabies
1. Permethrin topical
Apply x1, then x 1 week later
2. Lindane (cheaper)
Do not use after showering
36
Instructions for pt with scabies
All clothing, bedding, etc. should be placed in a plastic bag at least 72 hrs then washed and dried using heat
37
Erythematous margin around ischemic center ("red halo")
Brown recluse spider bites
38
Management of brown recluse spider bites
1. Local wound care - cold packs, keep affected body part elevated
2. Pain control
3. Tetanus
4. Dermal necrosis - debridement
39
Classic appearance is a blanched circular patch with a surrounding red perimeter and central punctum (target lesion)
Black widow spider bite
40
Management of black widow spider bite
1. Mild: wound care - clean with soap and water, NSAIDs
| 2. Mod-Severe: opioids +/- muscle relaxants
41
Prodrome of high fever 3-5 days, leading to rose, pink, maculopapular, blanchable rash on the trunk/back, then to the face
Roseola Infantum (6th disease)
42
Only childhood exanthema that starts on trunk and spreads to face
Roseola infantum (6th disease)
43
Mild fever, URI sx, decreased appetite starting 3-5 days after exposure, leading to vesicular lesions with erythematous halos in the oral cavity
Hand Foot and Mouth Disease
44
Management for hand/foot/mouth dz
Supportive - antipyretics, topical lidocaine
45
Rashes that affect palms/soles
Coxsackie (HF&M)
RMSF
Syphilis (secondary)
Janeway lesions
46
Low grade fever, myalgias, headache, parotid gland pain and swelling
Mumps
47
Management of mumps
Supportive
| Anti inflammatories
48
Complications of mumps
Orchitis in males
| Most common cause of acute pancreatitis in children
49
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
Cough, coryza, conjunctivitis
| Rubeola (Measles)
50
Small red spots in buccal mucosa with pale blue/white center precedes rash by 24-48 hours, lasts 2-3 days
Koplik spots
| Rubeola (Measles)
51
Rubeola (measles) usually lasts __________
7 days - fades from top to bottom
52
____________ reduces mortality in all children with measles (Rubeola)
Vitamin A
53
Complications of rubeola (measles)
```
Diarrhea
Otitis media
Pneumonia
conjunctivitis
Encephalitis
```
54
3 day rash
Rubella (German measles)
55
Low grade fever, cough, anorexia, lymphadenopathy (posterior cervical, posterior auricular), followed by pink, light-red spotted maculopapular rash on face spreading to extremities
Rubella (German measles)
56
Small red macules or petechiae on soft palate
Forchheimer Spots
| Seen with Rubella (German measles)
57
Diagnosis of german measles
Rubella-specific IgM antibody via enzyme immunoassay
58
Rubella (german measles) is ____________, especially in the ______________
Teratogenic
First trimester
Sensorineural deafness, cataracts, TTP (blueberry muffin rash), mental retardation, heart defects
59
Coryza, fever, slapped cheek rash on face with circumoral pallor 2-4 days, lacy reticular rash on extremities
Erythema infectiosum (Fifth disease)
60
Virus that causes erythema infectiosum (fifth disease)
Parvovirus B19
61
The virus that causes erythema infectiosum (fifth disease) is known to cause ____________ in pts with __________ or ____________
Aplastic crisis
Sickle cell disease
G6PD deficiency
62
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
Varicella (chicken pox)
63
Shingles involving first division of the trigeminal nerve
Herpes Zoster Ophthalmicus
64
Lesions on the nose usually heralding ocular involvement with varicella
Hutchinson's Sign
65
_______ ________ usually seen on slit lamp with herpes zoster ophthalmicus
Dendritic lesions
66
Facial nerve palsy, otalgia, lesions on the ear, auditory canal and tympanic membrane, auditory sx (tinnitus, vertigo, deafness, ataxia)
Herpes Zoster Oticus (Ramsay-Hunt Syndrome)
67
Pain > 3 months after initial shingles development, hyperesthesias or decreased sensation
Post Herpetic Neuralgia
68
Treatment of herpes zoster (shingles)
Acyclovir, Valacyclovir, Famciclovir
Gabapentin
Prednisone
Hydrocodone
69
Treatment of herpes zoster ophthalmicus
PO antivirals
70
Treatment of ramsey hunt syndrome
Oral acyclovir plus corticosteroids
71
Treatment of post herpetic neuralgia
Gabapentin or tricyclic antidepressants, topical lidocaine gel
72
Raised with clear line of demarcation between infected and uninfected tissue
Erysipelas
73
Treatment of cellulitis with drainage
Treat for MRSA
| Clindamycin, TMP/SMX, doxycycline
74
Treatment for cellulitis without drainage
Clindamycin, Cephalexin, Dicloxacillin
75
Treatment for erysipelas
Penicillin, macrolide, cephalexin, clindamycin
76
Highly contagious superficial vesiculopustular skin infection
Impetigo
77
Impetigo occurs typically at sits of superficial _____________ primarily on exposed surfaces of the face and extremities
Skin trauma (insect bites)
78
Risk factors for impetigo
Warm, humid conditions
| Poor personal hygiene
79
Most common causes of impetigo
Staph aureus
| GABHS
80
Management of impetigo
Mupirocin (Bactroban) topical TID x 10 days
Bacitracin
Good skin hygiene
81
Management of impetigo with extensive disease of systemic symptoms (ex. fever)
Systemic antibiotics (Cephalexin, Dicloxacillin, clindamycin, erythromycin, azithromycin)
82
Tender abscess with drainage on or near the gluteal cleft near the midline of the coccyx or sacrum with small midline pits
Pilonidal disease
83
Management of pilonidal disease
Incision and drainage - excision of pilonidal sinus and tracts recommended if recurrent
84
Skin intact, superficial, nonblanchable redness that does not dissipate after pressure is relieved
Stage I pressure sore
85
Epidermal damage extending into the dermis. Shallow ulcer that resembles a blister or abrasion
Stage II pressure sore
86
Full thickness of the skin and may extend into the subcutaneous layer
Stage III pressure sore
87
Deepest, extends beyond the fascia, into the muscle, tendon or bone
Stage IV pressure sore
