Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANCE > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Acne vulgaris
Path:
Pt:
Tx:

A

Path: Blockage of follicular opening from hyperkeratinization; Increased sebum production: inflammation

Pt:

  • Noninflammatory: closed comedones (white heads); open comedones (black heads)
  • Inflammatory: papules, pustules, nodules cysts
  • Nodulocystic: inc chance of permanent scarring

Tx: skin care
topical retinoids
topical antimicrobials (benzoyl peroxide, dapsone)
oral abx (tetracycline, doxycycline)
hormonal therapy (combo OCPs, spironolactone)
isotretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Folliculitis
Path:

Tx:

A

Superficial hair follicle infection
S aureus MC

Tx: Topical mupirocin, clinda, erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rosacea
Path:
Tx:

A

Path: Inflammatory d/o of flushing erythema, papules, pustules
Exacerbated by: UV light, heat, spicy foods, ETOH, stress, exercise, hormonal

Tx:
Topical metronidazole, sulfacetamide, ivermectin
BB suppress flushing
Isotretinoin for severe, refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Erythema multiforme
Path:
Pt:
Dx:
Tx:
A

Path: Type IV hypersensitivity reaction
Associations: Herpes
Major rxn associated w/ drugs: sulfa, beta-lactams, phenytoin, phenobarbital

Pt: Skin lesions evolve over 3 -5 days and persist about 2w

Dx: 
Target lesions
Dull dusty-violet red
Purpuric macules/vesicles or bullae in center surrounded by pale edematous rim and peripheral red halo 
Pt often febrile

Tx: self limiting, tx symptoms
D/C offending agents
steroid/lidocaine/diphenhydramine mouthwash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q 
Stevens-Johnson syndrome
Path:
Pt:
Dx:
Tx:
A

Path:
Carbamazepine #1 med to cause this type of drug eruption
2nd MC cause-> mycoplasma pneumoniae infection

Pt: basal layer dusky, looks like erythema multiforme
Sloughing skin
Hemorrhagic erosions w/ a grayish white membrane on mucous membranes

Dx: <10% BSA
+nikolsky sign

Tx: Stop all meds
Burn unit
F/U oral, ophthalmology-> at risk for losing vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
Toxic epidermal necrolysis
Path:
Pt:
Dx:
Tx:
A

Path:
Carbamazepine #1 med to cause this type of drug eruption
2nd MC cause-> mycoplasma pneumoniae infection

Pt: full-thickness sheets of skin
Sloughing skin
Hemorrhagic erosions w/ a grayish white membrane on mucous membranes

Dx: >30% BSA
+nikolsky sign

Tx: Stop all meds
Burn unit
F/U oral, ophthalmology-> at risk for losing vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Alopecia
Path:
Pt:
Tx:

A

Alopecia areata
Path: Immune-mediated disorder that causes recurrent, non-scarring hair loss

Pt: Autoimmune disease ; Complaining of hair loss
PE: patches of smooth, non-scarring hair loss w/ patches of smaller hairs termed exclamation hairs

Dx: Positive pull test: individual hairs are easily dislodged

Tx:
Corticosteroids creams or injections
Minoxidil
Phototherapy
Topical immunotherapy

Androgenic
Path: Genetic predisposition; ‘male pattern baldness’

Pt:
Men: Gradual thinning in temporal areas producing a reshaping of anterior part of hairline
Women: Diffuse thinning on crown; Frontal fringe remains

Tx: Minoxidil (rogaine); Finasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Onychomycosis
Path:
Dx:
Tx:

A

Path: Nail infection by various fungi:
-Tinea
-Candida
MC occurs on great toes

Dx:
KOH
Nail clipping (culture or PAS stain)

Tx: Itraconazole, terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Paronychia
Path:
Pt:
Tx:

A 
Acute: 
S aureus, GAS
rapid onset erythema, edema, pain of proximal and/or lateral nail folds following trauma/manipulation 
Tx:
I&D
Anti-staph topical/oral abx
Chronic 
Frequent hand washing, water work
Absence of cuticle + erythema and edema of nail folds
Yeast (candida)
Tx:
Topical antifungals (azoles)
Topical steroids
Proper hand/nail care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q 
Erythema infectiosum
Path:
Pt:
Dx:
Tx:
A

(fifth disease; slapped cheek syndrome)
Path: Parvovirus 19

Pt:
Hx of URI 3-4 days prior to rash
Rash progression
1. Slapped cheek -> erythematous facial flushing
2. Diffuse macular erythema on trunk and proximal extremities -> lacy, reticulated appearance w/ central clearing of macular lesions
Fever AND rash

Dx: Clx

Tx:
Supportive

F/u:
Aplastic crisis in sickle cell
Hydrops fetalis if in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q 
Hand-foot-mouth dz
Path:
Pt:
Dx:
Tx:
A

Path: Coxsackie A

Pt:
Mild fever, URI sx, decrease appetite
Oral enanthem: vesicular lesions w erythematous halos in oral cavity -> exanthem 1-2d afterwards: vesicular, macular or maculopapular lesions on distal extremities (often includes palms and soles)

Dx: Clx

Tx: Supportive: antipyretics, topical lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Measles
Path:
Pt:
Dx:
Tx:
A

Rubeola
Path: paramyxovirus; Measles virus
Portal of entry is through respiratory tract or conjunctivae following contact w/ large droplet or small-droplet aerosols in which the virus is suspended

Pt: 
High fever AND Rash
Exanthem -> Koplik spots: pinpoint grey spots 
Cough
Coryza
Conjunctivitis 
Prominent exanthem 
Maculopapular rash first appear on face and spreads down truck, begins to coalesce and becomes confluent

Dx: Clx

Tx: Supportive

Complications:
Diarrhea
Pneumonia 
Acute disseminated encephalomyelitis 
Subacute sclerosing panencephalitis -> nearly always fatal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
Mumps
Path:
Pt:
Dx:
Tx:
A

Path:
Mumps virus, rubulavirus
Incubation 16-18 days
Prior to MMR vaccine, MC affected school-aged children

Pt:
1-2 day prodrome: Low-grade fever, HA, malaise, vomiting
Followed by
tenderness, occasionally associated w/ earache
swelling of unilateral or bilateral salivary glands (usually parotid glands)
Parotid swelling can last up to 10 days

Dx:
Presence of parotitis, unvaccinated
Parotid swelling may obscure angle of mandible
Orifice of Stensen’s duct is erythematous and enlarged
Labs:
-Leukopenia w/ relative lymphocytosis
-Elevated serum amylase

Tx:
Supportive-> ibuprofen, acetaminophen

Complications:
Viral meningitis, encephalitis
Unilateral acquired sensorineural deafness
Orchitis (epididymoorchitis), oophoritis -> sterility
Pancreatitis
Arthritis
Thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Rubella
Path:
Pt:
Dx:
Tx:
A

German measles
Path: Rubivirus

Pt:
Prodrome: generalized, tender Lymphadenopathy-> sub-occipital, post-auricular and anterior cervical
Low-grade Fever AND Rash
Rash begins on face and neck as small, irregular pink macules that coalesce, spreading centrifugally to involve the torso and extremities lasting generally 3 days
Oropharynx may reveal tiny rose colored lesions-> Forchheimer spots
sore throat, red eyes +/- eye pain, HA, malaise, anorexia

Dx: Clx

Tx: Supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
Roseola
Path:
Pt:
Dx:
Tx:
A

Path: HHV-6

Pt:
6m to 3y/o
High fever THEN rash
Abrupt onset fever lasting 3-4 days
Fever resolved with the appearance of a faint pink or rose-colored, nonpruritic morbilliform rash on trunk
Rash: blanching maculopapular rash w/ distribution that begins at neck/trunk region and spread to face and extremities
Mild pharyngeal injection, enlarged suboccipital lymph nodes
Nagayama spots-> red papules on soft palate
ulcers at uvulopalatoglossal junction

Dx: Clx

Tx: Supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Varicella-Zoster infections
Path:
Pt:
Tx:

A

Path:
VZV reactivation along one dermatome of the dormant virus in spinal root and cranial nerve ganglia +/- disseminated in HIV
HHV 3

Pt:
Rash: Pain-> burning, throbbing, stabbing
Erythematous papules, grouped vesicles or bullae-> pustular
Within a single dermatome or several continuous dermatomes
-Herpes zoster ophthalmicus: shingles involving 1st division of trigeminal nerve (CN V)
-Hutchinson’s sign: lesions on nose usually heralding ocular involvement
-Dendritic lesions: seen on slit lamp exam if keratoconjunctivitis is present
-Herpes zoster Oticus (Ramsay-Hunt syndrome)
Facial nerve (CN VII)
otalgia, lesions on ear, auditory canal and tympanic membrane, facial palsy
-Auditory sx: tinnitus, vertigo, deafness, ataxia
-Post herpetic neuralgia: pain >3m, hyperesthesia or decreased sensation

Tx:

  • Shingles: acyclovir, valacyclovir, famciclovir (given within 72hrs to prevent PHN)
  • HZO: Po antivirals +/- trifluridine, acyclovir or vidarabine ophthalmic
  • Ramsay Hunt syndrome: Oral acyclovir + corticosteroid
  • PHN: Gabapentin or TCAs, topical lidocaine gel, capsaicin
17
Q

Seborrheic keratosis
Path:
Pt:
Tx:

A

Path: Common, benign, hereditary
Pt: Light tan, almost opaque macules to dark-colored “warty” like plaques
Tx: Curettage or liquid nitrogen
No chance of malignancy

18
Q

Actinic keratosis
Path:
Pt:
Tx:

A

Path: MC pre-cancerous skin lesion
Pt: Rough, scaly patch of skin
pink, red, brown
Tx: monitor vs remove-> can progress to SCC

19
Q

Basal cell carcinoma
Path:
Pt:
Tx:

A

Path: Basal layer
Pt: Pearly lesion
Tx: Face-> mohs

20
Q

Squamous cell carcinoma
Path:
Pt:
Tx:

A

Path: Malignant keratinocytes
Can mets
Locally invade

Pt: Either:

  • well defined red papules or
  • ulcer, non-healing, lower lip hyperpigmentation no paraneoplastic

Tx:
Face-> mohs
Limb mild-> excision
Limb aggressive-> amputate

21
Q

Melanoma
Path:
Pt:
Tx:

A

Path: Melanocytes
Can mets
Locally invade

Pt: Jet black lesions w/o hair 
OR
Asymmetric
Borders
Color
Diameter >5mm
Evolving

Tx: Lesions size/ margin size
<0.5mm= excision/ 0.5cm
1-2mm= excision/ 1cm
2-4mm= excision/ 2cm
* + sentinel lymph node dissection if tracer is +
>4mm-> metastatic; chemo + radiation; palliative debulking

22
Q

Melanoma subtypes

A

Superficial spreading (50-60%): Long horizontal growth phase before vertical growth phase-> better prognosis

Lentigo maligna (4-10%): Lentiginous proliferation indicates the tumor remains at the junction
Best prognosis
AKA “Hutchinson freckle”

Acral lentiginous (2-3%): Typically found in subungual (under nail), sole or palm location
Common in ethnic groups of color
Not related to UV exposure

Nodular (10-30%): Worst prognosis
Rapid vertical growth, increased metastatic potential

23
Q

Cellulitis
Path:
Pt:
Tx:

A

Path: SubQ
Staph-> burrow in, abscess
strep A-> spread out, no abscess

Pt: Red, hot tender
Well-demarcated portal of entry
Dx-> clx

Tx: Demarcate w/ pen after initiation of abx
Nontoxic:
Strep-> 1st gen ceph (po)
Staph-> tmp-smx (po), clinda
Toxic:
Strep-> pip/tazo, amp/clavulanate
Staph-> vanc, linezolid (IV), clinda then transition to po

F/U: diabetic foot ulcer, osteomyelitis

24
Q

Erysipelas
Path:
Pt:
Tx:

A

Path: Strep

Pt:Adult
Dark red, well-defined, indurated
“climbing”
dx-> clx

Tx: Amoxicillin

25
Q 
Impetigo
Path:
Pt:
Tx:
Complications:
A

Path: Highly communicable (auto-inoculation) cutaneous infection w/ S aureus or GAS

Classifications: 
Nonbullous- MC
Impetigo contagiosa: vesicles, pustules -> characteristic “honey-colored” crusts 
Associated regional lymphadenopathy
Path: S aureus (MC), GABHS

Bullous - rare usually seen in newborns/young children
Vesicles form large bullae (rapidly)-> rupture -> thin “varnish-like crusts”
Fever, diarrhea
S aureus (MC)

Ecthyma- not common
Ulcerative pyoderma caused by GABHS
Heals with scarring

Pt: <6yrs; non-painful, pruritic, honey-colored, weeping lesions on face

Tx:
Topical mupirocin TID x10d 
Extensive disease or systemic sx-> oral abx
Cephalexin 
Dicloxacillin, clinda
erythromycin, azithro, clarithromycin

Complication:
Post-streptococcal glomerulonephritis

26
Q

Tinea capitis
Pt:
Tx:

A

Pt: “ringworm”
Annular scaling lesions & brown hair shafts
Inflamed plaques with multiple pustules (kerion) w/ scarring and alopecia

Tx:
PO griseofulvin 1st line
PO terbinafine, itraconazole, fluconazole

27
Q

Tinea Barbae

Pt:

A

Pt: Papules, pustules & hair follicles

28
Q

Tinea pedis
Pt:
Tx:

A

Pt: “athlete’s foot”
Pruritic, scaly eruption rash between toes

Tx:
Topical antifungal (PO griseofulvin is ineffective)
Clean shoes w/ antifungal spray, keep cool and dry

29
Q

Tinea Cruris
Pt:
Tx:

A

Pt: “jock itch”
Diffusely red rash on groin or scrotum

Tx: Topical antifungals (PO griseofulvin is ineffective)

30
Q

Tinea Corporis
Pt:
Tx:

A

Pt: Erythematous plaques (circular rash w/ clear center & defined borders), scaling, cracking and vesicles
The presence of scales in tinea corporis distinguished it from erythema migrans

Tx: Topical antifungals (PO griseofulvin is ineffective)

31
Q

Tinea versicolor
Pt:
Dx:
Tx:

A

Pt: Scaly, salmon-colored, well demarcated papules and plaques with variable pigmentation
Typically located on trunk, neck, upper extremities

Dx:
KOH+ for Malassezia furfur (spaghetti and meatballs)
Wood’s lamp

Tx:
Selenium sulfide shampoo
Ketoconazole shampoo

32
Q

Lice
Path:
Pt:
Tx:

A

(pediculosis capitis “head lice”)
Path: Infestation w/ pediculus capitis, obligate human parasite that cannot survive off host for more than 10 days

Pt: Child complaining of itching on their head w/ nits (eggs) or actual lice

Tx: Permethrin (2nd treatment 9 days after 1st treatment to ensure eradication)

33
Q 
Scabies
Path:
Pt:
Dx:
Tx:
A

Path:
Sarcoptes scabiei-> mites transmitted through
-Prolonged, close skin contact
-Fomites (clothing, bedding)
Cannot survive off human body >4 days
Female mites burrow into skin to lay eggs, feed and defecate

Pt:
Intensely pruritic lesions (papules, vesicles) & linear burrows
Intertriginous zones: Web spaces between fingers/toes, Scalp, Usually spares neck and face
Increased intensity at night

Dx:
Clx
Skin scraping of burrows w/ mineral oil to ID mites/eggs under microscopy

Tx:

  • Permethrin : Apply topically from neck to soles of feet for 8-14 hrs then shower; Repeat in 1 week
  • Lindane : Cheaper; DO NOT use after a shower-> seizures; Teratogenic-> do not use in breastfeeding women, children <2y
34
Q 
Condyloma acuminatum 
Path:
Pt:
Dx:
Tx:
A

Path: HPV genital wart

Pt:
Wart-like papules resembling a rooster’s comb
tiny, painless papules evolve into soft, fishy cauliflower-like lesions rating from skin-colored to pink or red; occurring in clusters in genital regions and oropharynx. Lesions persist for months and may spontaneously resolved, remain unchanged or grow if not treated

Dx: Inspection; Histology; Typing HPV

Tx: Tx sexual partner at the same time
Curettage
Podophyllin
Electrocoagulation 
Laser
Chemical 
Salicylic acid
Cryotherapy
35
Q

Molluscum contagiosum
Path:
Pt:
Tx:

A

Path: pox virus

Pt: Umbilicated papules

Tx: no tx vs Curettage/ Electrocoagulation

36
Q

Verrucae
Path:
Pt:
Tx:

A

Path: Cutaneous HPV
Pt:
-Common and plantar warts: firm, hyperkeratotic papules between 1-10mm w/ red-brown punctuation (thrombosed capillaries are pathognomonic); common on hands
-Flat warts (verruca plana): numerous, small discrete, flesh-color papules measuring 1-5mm in diameter and 1-2mm in height, typically seen on face, hands, shins

Tx:
topical OTC salicylic acid and plasters
Cryotherapy 
Electrocautery
CO2 
Laser
Intralesional bleomycin
37
Q

Kaposi sarcoma
Path:
Pt:
Tx:

A

Path
HHV-8 + immune suppression (usually HIV)
AIDS defining illness

Pt: Multiple, spongy, compressible, vascular nodules in the skin, mucosa and other organ systems
Indolent (skin involvement) to fulminant (internal organ and lymphatic system)

Tx:
Identify and rectify (if possible) source of immunosuppression
Surgical removal, laser therapy
Radiotherapy or chemo

PANCE (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions