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Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How would you diagnose melanoma?

A

a. asymmetry
b. border irregularities
c. color irregularities
d. diameter greater than 6 millimeters
e. evolution (changing in appearance over time)

Biopsy any suspicious lesion

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2
Q

What kind of biopsy will you do for malignant melanoma?

A

Full thickness biopsy

DO NOT do a shave biopsy

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3
Q

Besides sunlight, this type of cancer is greatly increased by organ transplant secondary to the long-term use of immunosuppressive drugs.

A

Squamous Cell Cancer

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4
Q

This is the most common form of skin cancer. It is described as a waxy lesion that is shiny like a pearl.

A

Basal Cell Carcinoma

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5
Q

This is the best procedure in removing skin cancer for delicate areas like the eyelid or ear.

A

Mohs Micrographic Surgery

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6
Q

This skin cancer is from human herpes virus 8 and the most common cause is AIDS. The lesion is more reddish/purplish because it is more vascular than other forms of skin cancer. It can also be found in the GI tract and in the lung.

A

Kaposi Sarcoma

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7
Q

These are premalignant skin lesions from high-intensity sun exposure in fair-skinned people. They have a very small risk of squamous cell cancer for each individual lesion.

A

Actinic Keratoses

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8
Q

These lesions are extremely common in the elderly. They are hyperpigmented lesions commonly referred to as liver spots. They give a “stuck on” appearance. Although they may look like melanoma to some people, they have no premalignant potential.

A

Seborrheic Keratoses

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9
Q

This is a common skin disorder associated with overactivity of mast cells and the immune system. There will most probably be a history of asthma, allergic rhinitis, family history of atopic disorders, onset before age 5, very rare to start after age 30.

A

Atopic Dermatitis (Eczema)

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10
Q

These are used in acute flares of atopic dermatitis.

A

Topical Corticosteroids

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11
Q

These are T cell-inhibiting agents that provide longer-term control and help get the patient off steroids. They are systemically in organ transplant recipients to prevent organ rejection and keep patients off steroids. They are used topically for atopic dermatitis because this disorder is a form of immune system hyperactivity.

A

Tacrolimus and Pimecrolimus

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12
Q

What will you give when impetigo occurs in the presence of atopic dermatitis?

A

Cephalexin
Mupirocin
Retapamulin

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13
Q

This is a treatment option for severe recalcitrant disease in atopic dermatitis.

A

Ultraviolet light (phototherapy)

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14
Q

This is characterized by silvery, scaly plaques that are not itchy most of the time.

A

Psoriasis

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15
Q

These are topical high-potency steroids used in Psoriasis.

A

Fluocinonide
Triamcinolone
Betamethasone
Clobetasol

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16
Q

These agents help patient with Psoriasis get off steroids.

A

Vitamin A and Vitamin D

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17
Q

What should you do before using TNF inhibitors (etanercept, adalimumab, infliximab) in Psoriasis?

A

Screen with PPD ; agents can reactivate tuberculosis

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18
Q

This is an idiopathic, transient dermatitis that starts out with a single lesion (herald patch) and then disseminates. It can look like secondary syphilis but it spares the palms and soles.

A

Pityriasis Rosea

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19
Q

It is a hypersensitivity reaction to a dermal infection with noninvasive dermatophyte organisms.

A

Seborrheic Dermatitis (Dandruff)

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20
Q

This has both an idiopathic autoimmune form and a drug-induced form. It is associated with ACE inhibitors, Penicillamine, Phenobarbital, Penicillin.

A

Pemphigus Vulgaris

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21
Q

This is the loss of “denuding” of skin from just mild pressure.

A

Nikolsky sign

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22
Q

Nikolsky sign is a characteristic finding of this disease.

A

Pemphigus Vulgaris

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23
Q

This is the most accurate diagnostic test for Pemphigus Vulgaris.

A

Biopsy

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24
Q

These are agents you can use to wean off patient with Pemphigus Vulgaris on steroids.

A

Azathioprine or mycophenolate

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25
Q

What shall you give patients with Pemphigus Vulgaris in refractory.

A

Rituximab or IVIG

26
Q

Autoantibodies split the epidermis resulting in bullae that easily rupture, with the involvement of the mouth, fluid loss and infection if widespread disease. What is the diagnosis?

A

Pemphigus Vulgaris

27
Q

This disease presents with bullae that stay intact and less loss of fluid and infection. Mouth involvement is uncommon and nikolsky sign is absent.

A

Bullous Pemphigoid

28
Q

This is the most accurate test for Bullous Pemphigoid.

A

Biopsy with immunofluorescent stains

29
Q

This is the best initial therapy for Bullous Pemphigoid.

A

Prednisone

30
Q

This is a blistering skin disease of sun-exposed areas in those with history of liver disease (hepatitis C, alcoholism), estrogen use, iron overload (hemochromatosis)

A

Porphyria Cutanea Tarda

31
Q

This disease is most frequently tested in association with PCT.

A

Hepatitis C

32
Q

This is the most accurate diagnostic test for Porphyria Cutanea Tarda.

A

Increased uroporphyrins in a 24-hour urine collection

33
Q

Porphyria Cutanea Tarda is a hypersensitivity of the skin to abnormal ________ when they are exposed to light.

A

porphyrins

34
Q

How would you treat Porphyria Cutanea Tarda.

A

Stop alcohol
Stop estrogens
Remove iron with phlebotomy

35
Q

This is the most superficial of the bacterial skin infections caused by staphylococcus and streptococcus invading the epidermis, resulting in weeping, crusting, oozing, and draining of the skin.

A

Impetigo

36
Q

How would you treat mild impetigo?

A

Mupirocin
Retapamulin
Bacitracin

37
Q

How would you treat severe impetigo?

A

Dicloxacillin or cephalexin

38
Q

How would you treat impetigo with community-acquired MRSA?

A

Doxycycline
Clindamycin
Trimethoprim/sulfamethoxazole (TMP/SMX)

39
Q

This skin disease invades dermal lymphatics and causes bacteremia, leukocytosis, fever, and chills. It is more often from Streptococcus than Staphylococcus.

A

Erysipelas

40
Q

This presents most commonly as a bright, red, hot swollen lesion on the face.

A

Erysipelas

41
Q

How would you treat mild Erysipelas?

A

Dicloxacillin, cephalexin, cefadroxyl
Penicillin allergic: erythromycin, clarithromycin or clindamycin
MRSA: doxycycline, clindamycin, Trimethoprim/sulfamethoxazole (TMP/SMX)

42
Q

How would you treat severe Erysipelas?

A

Intravenous medications:

Oxacillin, Nafcillin, Cefazolin
Penicillin allergic: clindamycin, vancomycin
MRSA: vancomycin, linezolid, daptomycin, tigecycline, ceftaroline

43
Q

This is an infection of the soft tissue of the skin. It extends from the dermis into the subcutaneous tissue. The skin is warm, red, swollen, and tender.

A

Cellulitis

44
Q

What is the most common etiology of Cellulitis?

A

Staphylococcus aureus

45
Q

What will you use if the reaction to penicillin is a rash?

A

Cephalosporins

46
Q

What will you use if the reaction to penicillin is anaphylaxis?

A

Mild: macrolides, clindamycin, doxycycline, or TMP/SMX
Severe: vancomycin, linezolid, daptomycin, tigecycline, or ceftaroline

47
Q

What is the best initial test for Fungal Infections?

A

KOH preparation

48
Q

The most accurate test for fungal infections?

A

Fungal culture

49
Q

What is the best initial therapy for fungal infections?

A

Topical antifungal agent if no hair or nails are involved.

50
Q

What is the best initial therapy for hair (tinea capitis) and nail (tinea unguium) infections?

A

Terbinafine

51
Q

What is the adverse effect of oral ketoconazole?

A

Gynecomastia

52
Q

This is the mildest reaction in drug reactions. Skin stays intact without mucous membrane involvement.

A

Morbilliform rash

53
Q

This is a widespread drug reaction, presenting with small “target” lesions, most are on the trunk. No mucous membrane involvement. May also be from herpes or mycoplasma.

A

Erythema multiforme

54
Q

This is a very severe drug reaction that involves mucous membranes. Sloughs off respiratory epithelium and may lead to respiratory failure.

A

Stevens-Johnson syndrome

55
Q

How would you treat SJS and TEN?

A

IVIG

56
Q

This is a drug reaction with rash and mucous membrane involvement with positive Nikolsky sign.

A

Toxic epidermal necrolysis (TEN)

57
Q

This is a skin reaction to a toxin in the surface of Staphylococcus as well as hypotension, renal dysfunction (elevated BUN and creatinine), liver dysfunction, CNS (delirium).

A

Toxic Shock Syndrome (TSS)

58
Q

These are the most effective medications for SSSS and TSS in the absence of penicillin allergy.

A

Oxacillin and Nafcillin

59
Q

This drug is interchangeable to Oxacillin and Nafcillin in the treatment of SSSS and TSS.

A

Cefazolin

60
Q

Treatment for mild acne.

A

Use topical antibacterials such as benzoyl peroxide

If ineffective, Clindamycin or Erythromycin

61
Q

Treatment for moderate acne

A

Add topical vitamin A derivatives such as tretinoin, adapalene, or tazarotene

If no response, add minocycline or doxycycline

62
Q

Treatment for severe acne

A

add oral vitamin A, isotretinoin

Medicine (15 decks)

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