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BL/DD USMLE and Basics > Dermatology Review > Flashcards

Dermatology Review Flashcards

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USMLE® Step 1 flashcards
1
Q

Epidermis layers

A

Stratum corneum
Stratum granulosum
Stratum spinosum
Stratum basalis

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2
Q

Zones of the Dermis

A

Papillary dermis

  • upper layer
  • thin collagen bundles
  • interlocks with epidermal rete
  • increases strength
  • increases surface area

Reticular dermis

  • deeper layer
  • thick collagen bundles
  • visible elastic fibers
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3
Q
  1. Collagen – forms the tensile strength
  2. Elastic fibers – allow for resilience
  3. Ground substance – facilitates diffusion
A

Major constituents of the dermis

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4
Q

Acquired disorder of elastin

A

Solar elastosis

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5
Q

Congenital disorder of elastin

A

Pseudoxanthoma Elasticum

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6
Q

Acquired blistering disorder of DEJ

A

Bullous pemphgoid

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7
Q

Papillary dermis

  • upper layer
  • thin collagen bundles
  • interlocks with epidermal rete
  • increases strength
  • increases surface area

Reticular dermis

  • deeper layer
  • thick collagen bundles
  • visible elastic fibers
A

Zones of the Dermis

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8
Q

Congenital blistering disorder of DEJ

A

Epidermolysis bullosa

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9
Q

Proximal Subungual White Onychomycosis/ Trichophyton rubrum

A

Associated with HIV disease

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10
Q

Major constituents of the dermis

A
  1. Collagen – forms the tensile strength
  2. Elastic fibers – allow for resilience
  3. Ground substance – facilitates diffusion
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11
Q
  • upper layer
  • thin collagen bundles
  • interlocks with epidermal rete
  • increases strength
  • increases surface area
A

Papillary dermis

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12
Q
  • deeper layer
  • thick collagen bundles
  • visible elastic fibers
A

Reticular dermis

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13
Q

Anagen Effluvium

A

Loss of growing hairs- Often due to chemotherapy

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14
Q

Telogen Effluvium

A

Hairs go into resting cycle

May be due to medications, post partum

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15
Q

Nummular Dermatitis

A

distinct, coin-shaped (nummular) or oval sores on their skin

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16
Q

Atopic Dermatitis

A

An itchy inflammation of the skin

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17
Q

Seborrheic Dermatitis

A

A skin condition that causes scaly patches and red skin, mainly on the scalp

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18
Q

Irritant Dermatitis

A

is inflammation of the skin typically manifested by erythema, mild edema, and scaling.

Irritant contact dermatitis is a nonspecific response of the skin to direct chemical damage that releases mediators of inflammation predominately from epidermal cells.

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19
Q

Four Types of Hypersensitivity Reactions

A

Type I: Anaphylactic Reactions
Type II: Cytotoxic Reactions
Type III: Immune Complex Reactions
Type IV: Delayed Type Hypersensitivity Reactions

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20
Q

Involves reactions to circulating antigens
Antibodies bind antigen and form immune complexes which deposit in organs
These immune complexes activate complement and cause damage due to inflammatory cascade
Example: serum sickness reactions

A

Type III: Immune Complex Reactions

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21
Q

Langerhans cells are the antigen presenting cell
Memory T cells then become sensitized to locally deposited antigens
Local reaction occurs and this does not involve antibodies

A

Type IV: Delayed Type Hypersensitivity Reactions

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22
Q

__________ produce IFN-gamma, IL-2 and TNF-beta, evoke cell-mediated immunity and phagocyte-dependent inflammation

A

Th1 cells

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23
Q

______ produce IL-4, IL-5, IL-6, IL-9, IL-10, and IL-13, and evoke strong Ab responses (IgE) with eosinophil accumulation

A

Th2 cells

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24
Q

Impetigo

A

yellow/honey crust

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25
Q

Neurofibromatosis Type 1: Diagnosis requires 2 or more of the following criteria

A
  1. 6+ café au lait macules
  2. 2+neurofibromas, or 1 plexiform neurofibroma
  3. Axillary or inguinal freckling (Crowe’s sign)
  4. Optic glioma
  5. Two or more Lisch nodules
  6. thinning of the long bone cortex
  7. FDR with the disorder
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26
Q

Seborrheic Keratosis“Barnacles of Life”

A

Primary lesion
Color- white to gray to tan to brown to black
Exophytic papule- “stuck-on appearance”
Smooth to verrucous
Often friable
Surface often studded with small pits (pseudohorncysts

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27
Q

Growth patterns of moles

A

Intradermal nevus
Junctional nevus
Compound nevus

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28
Q

Malignant Melanoma

ABCDE Guidelines

A 
A = Asymmetry
B = Border irregularity 
C = Color variation 
D = Diameter greater 	than 6 mm
E = Evolution (or 	change)
The Ugly Ducklin
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29
Q
  1. 6+ café au lait macules
  2. 2+neurofibromas, or 1 plexiform neurofibroma
  3. Axillary or inguinal freckling (Crowe’s sign)
  4. Optic glioma
  5. Two or more Lisch nodules
  6. thinning of the long bone cortex
  7. FDR with the disorder
A

Neurofibromatosis Type 1: Diagnosis requires 2 or more of the following criteria

30
Q

UVR Effects on the Skin

A
  • Damage to DNA, RNA, lipids, proteins
  • Pro-inflammatory effects
  • Immunosuppressive effects
  • Induction of innate defenses
  • Induction of apoptosis
  • Vitamin D synthesis
31
Q

Photodermatoses

A

Connective Tissue Disease

Lupus Erythematosus
Dermatomyositis
Mixed Connective Tissue Disease (MCTD or Sharp’s Syndrome

32
Q

Acanthosis NigricansTREATMENT

A

Treat the underlying disorder

Keratolytics such as ammonium lactate or urea cream

33
Q

Dermatomyositis

CLINICAL

A

Photodistributed, violaceous poikiloderma
Favors scalp, periocular and extensor skin sites
Heliotrope = Eruption on the upper eyelids +/- periorbital edema

34
Q

Samitz sign

A

= ragged cuticles

*DermatomyositisCLINICAL

35
Q

Gottron’s papules

A

lichenoid papules overlying knuckles, elbows, knees

DermatomyositisCLINICAL

36
Q

Dermatomyositis- MALIGNANCY

A

Age appropriate malignancy screen including: mammogram, CXR, colonoscopy, PAP smear, PSA, CBC

37
Q

Skin Defenses Against Ultraviolet Radiation

A
  • DNA Repair
  • Apoptosis of Cells with DNA Damage
  • Defenses Against Reactive Oxygen
  • Melanin
38
Q

Ointments vs. creams

A

To lubricate, creams must be applied every 2 hours; ointments only every 12 hours

Creams require preservatives that may cause contact irritation or allergy

39
Q

Pyoderma Gangrenosum- TREATMENT

A

Conservative wound care

AVOID SURGERY AND DEBRIDEMENT

Oral and topical anti-inflammatory agents such as steroids

40
Q

Purple, polygonal, pruritic papules

Wickham’s striae: an overlying lace-like pattern of white lines on the surface

A

Lichen Planus

41
Q

Inflammatory Bowel Disease relates to?

A

Pyoderma Gangrenosum

42
Q

Acanthosis NigricansASSOCIATIONS

A

Familial: AD, rare, onset in childhood
Obesity
Diabetes mellitus: Insulin Resistance
Endocrinopathies

43
Q

Macule

A

flush

less 1 cm

44
Q

Papule

A

solid
raised
less 1 cm

45
Q

Lichen PlanusASSOCIATIONS

A

Hepatitis C
Prevalence of HCV was 2-13.5 fold higher in patients with LP than with controls
In one study, 12 of 22 pts (55%) with LP were HCV positive

46
Q

Patch

A

flush

>1 cm

47
Q

Acanthosis Nigricans- MALIGNANCY

A

Malignancies include adenocarcinoma of the stomach (60%), lung and breast cancer

48
Q

Wickham’s striae:

A

an overlying lace-like pattern of white lines on the surface

49
Q

Plaque

A

raised

larger than 1 cm

50
Q

Nodule

A

cystic elevation greater 1 cm

51
Q

Bulla

A

circumscribed
elevated
clear/bloody fluid
> 1cm

52
Q

Scale

A

flakes on skin surface

53
Q

Tumor

A

solid/cystic elevation over 2 cm

54
Q

Vesicle

A

circumscribed
elevated
clear/bloody fluid
< 1cm

55
Q

Flat area of color change

Less than 1.0 cm

A

Flat: Macule

56
Q

Atrophy

A

depression on skin surface

loss of epi/dermis

57
Q

Flat area of color change

Greater than 1.0 cm

A

Flat: Patch

58
Q

Discrete, solid, elevated body
Less than 1.0 cm in diameter
May be further classified by surface change
Scale, Crust

A

Papule

59
Q

Erosion

A

depression with loss of epidermis

60
Q

Pustule

A

vesicle containing purulent exudate

61
Q

Ulceration

A

loss of at least some of dermis

62
Q

Crust

A

dried exudate

63
Q

Wheal

A

circumscribed flat top
firm elevation
well demarkated
palpable

64
Q

Solid, flat-topped, elevated area of skin
Greater than 1.0 cm and broader than thick
May be further classified by surface change

A

Plaque

65
Q

Firm and well-defined lesion
May be dermal or subcutaneous
Greater than 1.0 cm

A

Nodule

66
Q

Fluid filled cavity or elevation
Form within or just below epidermis
Less than 1.0 cm in diameter

A

Vesicle

67
Q

Fluid filled “blister”

Greater than 1.0 cm in diameter

A

Bulla

68
Q

Circumscribed elevation that contains pus
Less than 1.0 cm in diameter
Color usually whitish-yellow

A

Pustule

69
Q

Individuals with truncation mutations in the gene coding for filaggrin are strongly predisposed to a severe form of dry skin,________, and/or eczema.

A

ichthyosis vulgaris

70
Q

Guttate psoriasis is associated with _____

A

strep infection

BL/DD USMLE and Basics (55 decks)

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