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Internal Medicine > Dermatology > Flashcards

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
Q

[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

A

Dx: Dyshydrotic Eczema
Tx: Identify irritant or allergen exposure

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26
Q

[diagnosis]

highly pruritic vesicles on the sides of the fingers, thenar and hypothenar eminence

A

dyshydrotic eczema

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27
Q

[diagnose]

30M, pruritic rash on the face, scalp, back of the ear.

PE: erythema and yellowish scale in the nasolabial folds and eyebrows,

A

Dx: Seborrheic dermatitis

Tx: topical antifungal (ketoconazole)

28
Q

What is the more common location of seborrheic dermatitis?

A

scalp

29
Q

[diagnose]

scaly, greasy, flaky skin fpund on a red base of the scalp, around the eyebrown, and nasolabial fold

A

seborrheic dermatitis

30
Q

[diagnose]

60M with a history of DVT, multiple scaly, erythematous oozing patches with non-tender ulcers on the right ankle area

A

Dx: Stasis dermatitis
Typical location: Medial aspect of the ankle
Tx: leg elevation and compression stockings

31
Q

[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

A

Dx: SJS

Diagnostic test: Frozen section skin biopsy

32
Q

Wha tis the most common cause of all drug-induced reactions (SJS)?

A

morbilliform or maculopapular eruption

33
Q

[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

A

SJS

34
Q

[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

A

TEN

35
Q

the most severe form of EM is

A

SJS

36
Q

The most severe form of SJS

A

TEN

37
Q

Drugs that commonly cause SJS or TEN

A
  1. Sulfonamides
  2. Allopurinol
  3. Anticonvulsant
  4. NSAID (oxicam)
  5. Lamotrigine
  6. Nevirapine
38
Q

What is the second most common type of cuteaneous drug reaction presentation?

A

Urticaria

red wheals of varying size

Most comon: Morbilliform rash

39
Q

What is the drug of choice of morbilliform or maculopapular eruptions?

A

antihistamine and emollients

40
Q

What is the mainstay therapy for urticaria/angioedema?

A

Epinephrine

41
Q

[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

A

Dx: Herpes simplex
Next step: start antiviral treatment
Inital test: Tzank smear

42
Q

What is the most accurate test for HSV?

A

viral culture

43
Q

What is the drug of choice for acyclovir-resistant herpes?

A

Foscarnet

44
Q

[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

A

Dx: Herpes zoster or shingles
Next step: antiviral treatment
Initial test: tzank smear
Accurate test: viral culture

45
Q

What is the initial presenting symptom of shingles?

A

pain

46
Q

What is the most common debilitating complication of shingles?

A
  1. Pain with acute neuritis

2. Postherpetic neuralgia

47
Q

Blindness due to zoster infection of the trigeminal nerve

A

zoster ophthalmicus

48
Q

___ syndrome

  1. Pain and veiscle of the external autditory canal
  2. Loss taste in anterior 2/3 of the tongue
  3. Ipsilateral facial palsy
A

Ramsay Hunt Syndrome

49
Q

What is the antiviral preferred for herpes zoster virus?

A
  1. Acyclovir 800mg 5x per dat for 7-10 days
50
Q

[Diagnosis]

dewdrops on a rose petal

A

Varicella zoster/chickenpox

51
Q

[diagnosis]

“herald” patch

Erythematous and salmon colored skin with fine scales (cigarette paper)

christmas tree pattern on the back

A

pityriasis rosea

52
Q

What is the treatment of choice for mild pityriasis rosea?

A

Topical steroid and antihistamine

53
Q

What is the treatment of choice for refractory pityriasis rosea?

A

UVB phototherapy

54
Q

What disease will you also rule out for patients with pityriasis rosea?

A

Syphilis

by RPR/VDRL

55
Q

What is the best initial test for primary syphilis?

A

Dark field microscopy

56
Q

What is the best initial test for secondary syphilis?

A

VDRL/RPR

57
Q

[Diagnosis]

scaling erythematous papules, few linear burros, extremely pruritic at night

A

Dx: Scabies
Initial therapy: permethrin, ivermectin
Diagnostic testing: scrape organsism after mineral oil is applied to burrow

58
Q

What is the drug of choice for hyperkeratotic/norweigian scabies?

A

Ivermectin

59
Q

[Diagnose]

Hypo/hyperpigmented skin patch

spaghetti and meat-balls

A

Dx: Tinea versikolor
Etiology: Malassezia furfur
Test: KOH preparation
Tx: Antifungal

60
Q

[diagnose]

circular patches with advancing red, sharp, irregular border with central scaling, pruritic eruptions

A

Dx: Tinea corporis
Etiology: dermatophytes
diagnostics: KOH
Tx: Itraconazole or terbinafine

61
Q

The most aggressive and most common life-threatening dermatologic disease

A

melanoma

62
Q

[Diagnose]

central ulceration, pearly, rolled, telangiectatic tumor border, locally aggressive but rarely metastatic

A

Basal Cell CA
Dx: skin biopsy
Tx: ecision

63
Q

What is the most common skin cancer?

A

basal cell CA`

64
Q

[diagnosis]

crusting, ulcerated nodule or erosion with ill-defined margins; can potentially metastasis

A

Dx: Squamours cell CA
Diagnostics: skin biopsy
Tx: excision

65
Q

What is the second most common skin cancer?

A

squamous cell CA

66
Q

{diagnose]

dotted or coiled vessels

A

Squamous cell CA

67
Q

[diagnose]

multiple violaceous papules on the neck, back, face

A

Kaposi sarcoma

Internal Medicine (10 decks)

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