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Dermatology Flashcards

1
Q

[diagnose]

Erythematous papules and predominantly open and closed comedones of the face, chest, back.

Pustule and post-inflammatory macules

A

Dx: Acne vulgaris
Hallmark: Comedone
DOC for mild non-inflammatory acne: Topical retinoids
DOC for severe nodulocystic acne unresponsive to other therapy: synthetic retinoid isotretinoin

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2
Q

what is the clinical hallmark of acne vulgaris?

A

comedones

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3
Q

[diagnosis

22/M, rash on the extensor surface of his elbow and gluteal area.

PE: Well demarcated small and large erythematous plaques with adherent silvery scales, nails present as pitting

A

Dx: Psoriasis
Etiology: T-cell mediated disorder leading to epidermal hyperproliferation

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4
Q

What is the most common variety of psoriasus?

A

plaque-type

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5
Q

What is the treatment for localized psoriatic lesion?

A

mid-potency topical steroids

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6
Q

What is the treatment for widespread psoriatic lesion ?

A

UV light

Start treating if >30% body surface area

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7
Q

What agent should not be used for the treatment of psoriasis?

A

Oral sterids

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8
Q

____ phenomenon is the development of lesion to the site of an epidermal injury

A

Koebner phenomenon

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9
Q

[diagnose]

small erythematous, scaling papules, frequently after the upper respiratory tract infection with beta hemalytic streptococci

A

Guttate or eruptive psoriasis

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10
Q

___ sign

removal of the scale causes pinpoint bleeding

A

Auspitz sign

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11
Q

The classic form of psoriatic arthritis involves this joint?

A

DIP predeominant

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12
Q

[Diagnose]

Sausage digits, telescoping fingers due to resorption of bones in hands and wrist

A

Arthritis mutilans

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13
Q

A vitamin D analogue that is used as an alternative treatment to psoriasis?

A

calcipotriene

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14
Q

A retinoid used as an alternative treatment for psoriasis

A

tazarotene

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15
Q

DMARD that is effective in patients with psoriatic arthritis

A

Methotrexate

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16
Q

[diagnose]

20/M history of brinchial asthma presents with intensely pruritic rash on his forearms and back of the knee.

PE: antecubital fossae, lichenified and hyperpigmented

A

Dx: Atopic dermatitis
Pathogenesis: Impaired epidermal barrier

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17
Q

What is the most prominent characteristic of atopic dermatitis?

A

Pruritus

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18
Q

What treatment regimen is commonly employed in patients with atopic dermatitis?

A

low to mid-potency glucocorticoids

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19
Q

What topical immunosuppressants in atopic dermatitis can be used to decrease dependence on steroid use?

A
  1. Tacrolimus

2. Pimecrolimus

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20
Q

[diagnose]

18/M intensely pruritic rash on both hands and on her left chee

PE: vesicles and erythematois plaques arranged linearly with slight crusting. no history of eczema.

A

Dx: Allergic Contact Dermatitis

Type of hypersensitivity rection: Type IV

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21
Q

Wha tis the definitive diagnostic test for contact dermatitis?

A

patch testing

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22
Q

What is the most appropriate treatment for allergic contact dermatitis?

A

avoid exposure of of allergen

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23
Q

[Irritant vs Allergic CD]

hands, burning, pruritus, dry fissured skin, less distinct border

A

irritant

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24
Q

[Irritant vs Allergic CD]

exposed areas of the skin, pruritus, vesicles and bullae, distinct angles, lines, border

A

allergic

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25
[diagnosis] 40F dishwasher; fluid filled rash forming on her hands that are painful and sometimes itchy. Noted deep-seated vesicles on palms and lateral fingers
Dx: Dyshydrotic Eczema Tx: Identify irritant or allergen exposure
26
[diagnosis] highly pruritic vesicles on the sides of the fingers, thenar and hypothenar eminence
dyshydrotic eczema
27
[diagnose] 30M, pruritic rash on the face, scalp, back of the ear. PE: erythema and yellowish scale in the nasolabial folds and eyebrows,
Dx: Seborrheic dermatitis Tx: topical antifungal (ketoconazole)
28
What is the more common location of seborrheic dermatitis?
scalp
29
[diagnose] scaly, greasy, flaky skin fpund on a red base of the scalp, around the eyebrown, and nasolabial fold
seborrheic dermatitis
30
[diagnose] 60M with a history of DVT, multiple scaly, erythematous oozing patches with non-tender ulcers on the right ankle area
Dx: Stasis dermatitis Typical location: Medial aspect of the ankle Tx: leg elevation and compression stockings
31
[diagnose] 32F presents with flulike symptoms, mouth sores, and rash on the chest and arm. Recently took co-trimoxazole for UTO. PE: febrile, symmetric erruption of targetoid patches, with central vesicle, over the chest, arms and face
Dx: SJS | Diagnostic test: Frozen section skin biopsy
32
Wha tis the most common cause of all drug-induced reactions (SJS)?
morbilliform or maculopapular eruption
33
[diagnose] fever >39 deg C, sore thriat, conjunctivitis, acute onset of painful dusky atypical, target-like lesions blister and mucosal/epidermal detachment <10% surface area
SJS
34
[diagnose] fever >39 deg C, sore thriat, conjunctivitis, acute onset of painful dusky atypical, target-like lesions blister and mucosal/epidermal detachment >30% surface area
TEN
35
the most severe form of EM is
SJS
36
The most severe form of SJS
TEN
37
Drugs that commonly cause SJS or TEN
1. Sulfonamides 2. Allopurinol 3. Anticonvulsant 4. NSAID (oxicam) 5. Lamotrigine 6. Nevirapine
38
What is the second most common type of cuteaneous drug reaction presentation?
Urticaria red wheals of varying size Most comon: Morbilliform rash
39
What is the drug of choice of morbilliform or maculopapular eruptions?
antihistamine and emollients
40
What is the mainstay therapy for urticaria/angioedema?
Epinephrine
41
[diagnose] 19/M few bumps on his lips that are painful; burning sensation progressing to small group of bumps on the same area. PE: small groups of vesicles in an erythematous base
Dx: Herpes simplex Next step: start antiviral treatment Inital test: Tzank smear
42
What is the most accurate test for HSV?
viral culture
43
What is the drug of choice for acyclovir-resistant herpes?
Foscarnet
44
[diagnose] 60M severe pain on the right side of his chest and back; rash on the same side PE: group vesicles on an erythematous base in a unilateral dermatimal distribution
Dx: Herpes zoster or shingles Next step: antiviral treatment Initial test: tzank smear Accurate test: viral culture
45
What is the initial presenting symptom of shingles?
pain
46
What is the most common debilitating complication of shingles?
1. Pain with acute neuritis | 2. Postherpetic neuralgia
47
Blindness due to zoster infection of the trigeminal nerve
zoster ophthalmicus
48
___ syndrome 1. Pain and veiscle of the external autditory canal 2. Loss taste in anterior 2/3 of the tongue 3. Ipsilateral facial palsy
Ramsay Hunt Syndrome
49
What is the antiviral preferred for herpes zoster virus?
1. Acyclovir 800mg 5x per dat for 7-10 days
50
[Diagnosis] dewdrops on a rose petal
Varicella zoster/chickenpox
51
[diagnosis] "herald" patch Erythematous and salmon colored skin with fine scales (cigarette paper) christmas tree pattern on the back
pityriasis rosea
52
What is the treatment of choice for mild pityriasis rosea?
Topical steroid and antihistamine
53
What is the treatment of choice for refractory pityriasis rosea?
UVB phototherapy
54
What disease will you also rule out for patients with pityriasis rosea?
Syphilis by RPR/VDRL
55
What is the best initial test for primary syphilis?
Dark field microscopy
56
What is the best initial test for secondary syphilis?
VDRL/RPR
57
[Diagnosis] scaling erythematous papules, few linear burros, extremely pruritic at night
Dx: Scabies Initial therapy: permethrin, ivermectin Diagnostic testing: scrape organsism after mineral oil is applied to burrow
58
What is the drug of choice for hyperkeratotic/norweigian scabies?
Ivermectin
59
[Diagnose] Hypo/hyperpigmented skin patch spaghetti and meat-balls
Dx: Tinea versikolor Etiology: Malassezia furfur Test: KOH preparation Tx: Antifungal
60
[diagnose] circular patches with advancing red, sharp, irregular border with central scaling, pruritic eruptions
Dx: Tinea corporis Etiology: dermatophytes diagnostics: KOH Tx: Itraconazole or terbinafine
61
The most aggressive and most common life-threatening dermatologic disease
melanoma
62
[Diagnose] central ulceration, pearly, rolled, telangiectatic tumor border, locally aggressive but rarely metastatic
Basal Cell CA Dx: skin biopsy Tx: ecision
63
What is the most common skin cancer?
basal cell CA`
64
[diagnosis] crusting, ulcerated nodule or erosion with ill-defined margins; can potentially metastasis
Dx: Squamours cell CA Diagnostics: skin biopsy Tx: excision
65
What is the second most common skin cancer?
squamous cell CA
66
{diagnose] dotted or coiled vessels
Squamous cell CA
67
[diagnose] multiple violaceous papules on the neck, back, face
Kaposi sarcoma

Internal Medicine (10 decks)

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