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Practice Questions > dermatology pance review > Flashcards

dermatology pance review Flashcards

1
Q

a patient presents with smooth discrete circular patches of complete hair loss that has been developing over a period of weeks. on exam, exclamation point hairs and nail pitting are evident. pmhx includes hashimotos disease. what is the diagnosis?

A

alopecia areata

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2
Q

what is the PP of alopecia areata?

A

nonscarring immune-mediated hair loss that targets the anagen hair follicles

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3
Q

a patient presents with smooth discrete circular patches of complete hair loss that has been developing over a period of weeks. on exam, exclamation point hairs and nail pitting are evident. pmhx includes hashimotos disease. what is the treatment?

A

local: intralesional corticosteroids
extensive: topical

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4
Q

a 45 yo man presents with complains of hair thinning of the temporal scalp. what is the primary dx and tx?

A

androgenetic alopecia

minoxidil: if small area

oral finasteride

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5
Q

how does finasteride work and what are common s/e?

A

5-alpha reductase inhibitor (inhibits the conversion of testosterone to dihydrotestosterone)

-decreased libido, sexual/ejaculatory dysfunction

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6
Q

a pt presents with erythematous, ill-defined blisters/plaques/papules with some crusted over scales. located in the antecubital and popliteal folds. pmhx includes asthma and allergic rhinitis. what is the most effective tx?

A

topical corticosteroids (triamcinolone) and antihistamies for itching

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7
Q

what are alternative tx for atopic dermatitis?

A

topical calcineurin inhibitors: tacrolimus, pimecrolimus

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8
Q

what are side effects of calcineurin inhibitors?

A

irritation, possible lymphoma/skin cancer risk

*but to skin atrophy

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9
Q

a pt presents with sharply defined discoid/coin shaped lesion on the dorsum of the hands, feet, and extensor surfaces. what is the most likely diagnosis?

A

nummular eczema

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10
Q

a pt presents with pruritic “tapioca-like” tense vesicles on the soles, palms, and fingers. what is the most likely diagnosis?

A

dyshidorsis, same thing that ben and I have on fingers

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11
Q

pt with hx of eczema presents with scaly, well-demarcated, rough hyperkeratotic plaques with exaggerated skin lines. what is the diagnosis, and treatment?

A

lichen simplex chronicus;

due to repetitive rubbing/scratching

tx with high does corticosteroids

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12
Q

a young woman presents with multiple papulopustules on an erythematous base with satellite leions around the mouth. the vermillion border is spared. what is the tx for this disorder?

A

topical flagyl or erythromycin (tx child with severe infection with oral azithromycin or erythromycin)

can use oral tetracyline (doxy)

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13
Q

a young woman presents with multiple papulopustules on an erythematous base with satellite leions around the mouth. the vermillion border is spared. what medication is linked to this disorder?

A

perioral dermatitis, topical corticosteroid use

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14
Q

a pt presents with multiple small lesions on the wrist, scalp, and mucus membranes. these lesions are described as purple, polygonal, planar, and puritic papules. what is the most likely diagnosis?

A

lichen planus

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15
Q

a pt presents with multiple small lesions on the wrist, scalp, and mucus membranes. these lesions are described as purple, polygonal, planar, and puritic papules. some of the patches a white, lace like lines on them. what are these white lines called?

A

wickham striae

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16
Q

what is the koebner’s phenomenon?

A

new lesions at sites of trauma

17
Q

a pt presents with multiple small lesions on the wrist, scalp, and mucus membranes. these lesions are described as purple, polygonal, planar, and puritic papules. what virus is this skin disease associated with?

A

hepatitis C

18
Q

a pt presents with the atopic triad. what is the pathophysiology behind this disorder?

A

altered immune reaction in genetically susceptible people when exposed to certain triggers

T-cell mediated immune activation and increased IgE production

19
Q

a pt presents with small, pruritic 1 cm round salmon colored papules with collarette scaling along cleavage lines in a christmas tree pattern. reports a hx of a solitary salmon colored macule on stomach about two weeks ago. what is the recommended treatment?

A

none, if itcy, po antihistamines, topical corticosteroids, oatmeal baths

20
Q

a 27 yo sexually active pt presents with small, pruritic 1 cm round salmon colored papules with collarette scaling along cleavage lines in a christmas tree pattern. reports a hx of a solitary salmon colored macule on stomach about two weeks ago. what ddx are you thinking of and what lab should you order too?

A

pityriasis rosea, syphillus

RPR

21
Q

what infections is pityriasis rosea associated with?

A

viral infections like HHV7

22
Q

a pt presents with raised, dark-red plaques/papules with thick silver and white scales on the extensor surface. PE reveals oil spots underneath the nail bed. what is the most likely diagnosis?

A

plaque psoriasis

23
Q

what is the tx for mild-moderate plaque psoriasis?

A

topical steroids; can also use topical retinoids/vitamin A

24
Q

what is the PP of psoriasis?

A

keratin hyperplasia- proliferating cells in the stratum basale and stratum spinosum due to T-cell activation and cytokine release (greater epidermal thickness and increased turnover)

25
Q

what is the treatment for severe psoriasis?

A

phototherapy UVB, meithotrexate,

cyclosporine

26
Q

a pt presents with hyper/hypopigmented, well-demarcated round/oval macules with fine scaling. what diagnostic test should you consider?

A

KOH prep and wood’s lamp

27
Q

a pt presents with tinea versicolor. what is the microbiological cause of this disorder?

A

malassezia furfur- an overgrowth of this yesast

28
Q

a pt presents with tinea versicolor. what would a koh prep reveal? wood’s lamp?

A

hyphae and spores “spaghetti and meatball”

yello-green fluorescence

29
Q

how is tinea versicolor treated?

A

topical antifungals: selemium sulfide, sodium sulfactamids, zince pyrithione

severe: itraconazole, fluconazole

30
Q

what pt education must you give some one who takes fluconazole?

A

don’t shower for 8-12 hours afte taking azoles bc they are delivered to the skin via sweat

31
Q

what are the most common places of seborrheic dermatitis?

A

areas of high sebaceous gland oversecretion

32
Q

what is the tx for seborrheic dermatitis?

A

selenium sulfide, ketoconazole, zinc pyrithione

33
Q

what can you give for cradle cap?

A

baby shampoo, ketoconazole, topical corticosteroids

Practice Questions (6 decks)

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