Diseases Week 3 Flashcards
HSV 2
Recurrent, lifelong w/o cure STD w/ worst outbreak the first time, reoccurence is often Treatment: Initial, episodic, or suppression with acyclovir, famciclovir, and valcyclovir.
Congenital malformation or absence of pec major (unilateral often right). Often including ipsilateral webbing of the fingers.
Poland Syndrome
Tularemia
CA - Franciscella tularensis Vectors: Ticks, deer flies, mosquitoes. Hosts: Rabbits > deer> other rodents exposure Inhalation, fresh blood, or flesh Mortality rate if untreated = 5% Symptoms: Abrupt onset of fever and chills. Headache, myalgias, sore throat, Bite site ulcerates and forms black eschar w/ ulcer. Pneumatic form by inhalation. Typhoideal form has highest morality. Treatments: Strepto, Genta, or Doxy for 7-14 days; Alternative of Cipro, moxifloxacin, chloramphenicol.
Sternocleidomastoid muscle on one side is spasmodic or shortened. Usually present at birth and discovered then or soon after. Cause may be related to small space in the uterus. Common to also have hip dysplasia.
Congenital torticollis
Panniculitis Erythema Induratum
Tender red nodules, lobular panniculitis and vasculitis, POSTERIOR legs. Chronic/recurrent Associated with TB
Marfan syndrome
Connective tissue disorder causes excessive long bone growth. Fibrillin-1-gene mutation long, thin limbs. Can affect heart, vessels, bones, eyes, lungs. Worry about dissecting aneurysms. Look for dislocated lens on eye exam.
Amelia - missing one arm Phocomelia - Flipper limbs. Both caused by thalidomide use in the 50s and 60s to treat morning sickness. Now used to treat leprosy, so be careful.
Amelia and Phocomelia
85% of population is + 90% orofacial lesions called herpes labialis Treatment with oral acyclovir
HSV 1
Contact Dermatitis
Inflammatory rxn of the skin precipitated by an exogenous chemical. Acute - linear streaks of vesicles; Chronic - lichenification, eczematous rxn. Two types: irritant- direct toxic effect on the skin or Allegic - immunologic rxn that causes tissue inflammation (type IV hypersensitivity) Common sensitizers: poision ivy, paraphyenylenediamine (perfumes), nickel, rubber, ethyleenediamine (topical meds) Differential - atopic dermatitis, seborrheic dermatitis, stasis dermatitis, fungal infx, bacterial cellulitis patch testing for allergic contact dermatitis: North American Contact Dermatits Standard Patch Test Series Treatment: prevention/avoidance, symptomatic treatment, psiochemical barriers, tolerance induction
Chronic Cutaneous Lupus
Discoid lupus: scarring lesions of skin Tumid Lupus: erythematous indruated plaques in sun exposed areas Lupus Panniculitis: infiltration and destruction of adipose tissue especially upper extremeties Verrucous Lupus: Very thick hyperketotic discoid lupus like lesions that usually occur on the extensor sun exposed surfaces.
Staphylococcal Scalded Skin Syndrome (SSSS)
Caused by Et-A and Et-B (most common) toxin secreted by Staph Aureus. Can occur in newborns or babies. Starts as skin redness followed by exofoliation of skin 2-5 days later. Sometimes fever. Treat with beta-lactamase resistant penicillin (ampicillin/sulbactam) or nafcillin/diclococillin Differential: viral exanthemas, scarlet fever, themal burns, pemphigus, kawaskai disease, SSSS
Failure of apoptosis leading to fused digits or fusion of bony components.
Syndactly
Fungal growth on or under the nail. Common cause: Trichophyton rubrum or t. mentagrophytes. Treat: terbinafine
Onychomycosis
Chronic, superficial inflammatory process affecting the hairy regions of the body (scalp, eyebrows, and face especially). Bilateral and symmetrical patches and plaques w/ indistinct margins. Hair loss uncommon. Affects infants (first three months) and adults (40-70). Wide range of disease from mild to severe. Common skin manifestation in patients w/ HIV (85% of patients) More common than psoriasis in adults. Men more than women. Unknown cause (malassezia furfur?) Associated w/ oily looking skin but not a disease of the seb gland. Associated w/ parkinson’s and a variety of other neural abnormalities. Treatment: Control not cure. Remove scales and crusts. Inhibition of yeast colonization and secondary infx. Treaty erythema and itching. Antifungals in adults.
Seborrhiec dermatits
Causative Agent: B. burgdorgeri carried by vectors of Ixodes scapularis and Ixodes pacificus. Carried by deer and mouse. Diagnose with exposure history, positive serology/ skin culture/ PCR Look for erythema migrans (bullseye rash), Bell’s palsy, arthralgia, av block, and lymphadenopathy Treatment- Doxycycline Differential diagnosis: human anaplasmosis, babenosis, RMSF, and enterovirus
Lyme’s Disease
Congenital fusion of any cervical vertebrae. Causes brevicollis.
Klippel-Feil Syndrome
Osteogenesis Imperfecta
Defect in type 1 collagen gene in most cases. Extreme bone fragility. Frequent fractures. Hypermobile joints. Thin, curved bones, decreased bone density.
Most common form of dwarfism. Affect long bones. Mutation of FGFR3 gene. Brain growth and intellect usually normal.
Achondroplasia
Inflammatory rxn of the skin precipitated by an exogenous chemical. Acute - linear streaks of vesicles; Chronic - lichenification, eczematous rxn. Two types: irritant- direct toxic effect on the skin or Allegic - immunologic rxn that causes tissue inflammation (type IV hypersensitivity) Common sensitizers: poision ivy, paraphyenylenediamine (perfumes), nickel, rubber, ethyleenediamine (topical meds) Differential - atopic dermatitis, seborrheic dermatitis, stasis dermatitis, fungal infx, bacterial cellulitis patch testing for allergic contact dermatitis: North American Contact Dermatits Standard Patch Test Series Treatment: prevention/avoidance, symptomatic treatment, psiochemical barriers, tolerance induction
Contact Dermatitis
Bullous Impetigo
Clinical presentation: Bullae, blisters occuring in the axillary, groin, folds especially in neonates and older adults. Superficial vesicles progress to rapidly enalarging bullae which rupture resulting in honey-colored crusts Cause: Toxin producing Staph Treatment: hygenic measures, oral and topical AB’s
Post Strep Infx, sudden onset of tear drop shaped scaled spots of trunk and proximal extremities
Psoriasis: Guttate Type
Ehrlichiosis and Anaplasma
Gram naegative bacteria, obligate intracellular organisms, tropism for WBC’s, form intracytoplasmic morulae. Resevoirs are white footed mouse and deer. Infx can be from animal blood or transfusion. Incubation time 2-14 days Mortality rate HME 2% and HGA 1% Tests: CBC non-specific, but often observe leukopenia, granulocytosis w/ maked left shift (need to manaully count blood smear) Mild increase AST/ALT, Thrombocytopenia, Elevated ESR and CRP Differential: Bacterial septicemia, flu, enterovirus, other tick infx, relapsing fever, juvenile RA, Hematological malignancies. Treatment: Doxycycline or Rifampin
Inflammatory seronegative arthritis with a variable course. Asymmetric and involves fingers and toes (doesn’t have RA’s ulnar bend) 1/3 patients with psoriasis
Psoriatic Arthritis
Immune based dermatitis in which UV light alters the antigen to make it an effective immunogen resulting in type IV hypersensitivity. Commonly seen w/ thiazide diuretics and tetracyclines. Therapy: stop med use and use UVA/UVB sunscreen
Photodermatitis
“impetigo contagiosa” - Group A strep pyogenes, Coagulase + Staph Aureus, mixed infx 70% nonbullous. Begins with single red pustule that ruptures to form an erosion that dries to honey-colored crust that may be pruritic.
Impetigo (non-bullous) impetigo contagiosa
Achondroplasia
Most common form of dwarfism. Affect long bones. Mutation of FGFR3 gene. Brain growth and intellect usually normal.
Prune Belly Syndrome
Poor development of ab muscles. Causes skin to wrinkle’ undescended testicles and urinary tract problems. No migration of hypaxial muscles.
Results from a deficiency in heme-synthesizing enzyme Blistering of the skin occurs in sun exposed areas Pts may also exhibit hypertrichosis, skin hyperpigmentation, and urine discoloration) Risk factors: Hep C, Hemochromatosis, and alcoholism
Porphyria Cutanea Tarda
mild form involving one or fewer mucousal sites major cause is post herpes simplex infxs with onset of EM rash at day 10
EM minor
Psoriatic Arthritis
Inflammatory seronegative arthritis with a variable course. Asymmetric and involves fingers and toes (doesn’t have RA’s ulnar bend) 1/3 patients with psoriasis
Type I Hypersensitivity
Characterized by the production of IgE antibodies vs foreign proteins that are commonly present in the environment (pollens, dander, dust mites). Identified by wheal and flare response to skin test within 15min. Anaphalaxis is this.
Polydactly
Extra digits. Most common hand anomaly. Extra digits may be fully formed or only soft tissues.
Erythema Multiforme
Erythemtous iris-shaped papular and vesiculobullous lesions involving extremities and mucous membranes
Recurrent, lifelong w/o cure STD w/ worst outbreak the first time, reoccurence is often Treatment: Initial, episodic, or suppression with acyclovir, famciclovir, and valcyclovir.
HSV 2
Incomplete formation of acetabulum. Legs held in positions that don’t match. Less movement. Uneven leg length. Treat with pavlik harness
Congenital Hip Dysplasia
The neural ectoderm fails to completely seperate from the surface ectoderm. The patient presents with a paramedian pit which may or may not communicate with the spinal cord. Most commonly found in the lumbar region. WORRY ABOUT MENINGITIS!!!!
Congenital Dermal Sinus
Panniculitis
Major focus of inflammation is SQ tissue.Erythemetous or violaceous nodule in the SQ fat. Lobular or septal depending on where disease begins Accurate diagnosis w/ biopsy
Pectus excavatum
Sterum caves inward. Becomes a problem when compression of heart and lungs occurs.
Ectrodactyly
Lobster claw deformity.
Congenital torticollis
Sternocleidomastoid muscle on one side is spasmodic or shortened. Usually present at birth and discovered then or soon after. Cause may be related to small space in the uterus. Common to also have hip dysplasia.
Incomplete closing of spinal cord. Key clinical sign is fawn’s spot on lower back.
Spina Bifida occulta
Congenital fusion of any cervical vertebrae. Causes brevicollis.
Klippel-Feil Syndrome
Inflammatory disease of the pilosebacous unit caused by excessive sebum production, follicular plugging, colonization or sebaceous follicle with Propionibacterium acnes, or immune response with inflammation. May be triggered by stress or steroid use (why we taper steroids to end dosage.) Also by meds like isoniazid, lithium, phenytoin Classified by a few ways: mild, moderate, severe or stage 1,2,3, or 4 Stage 1: Comedones and flesh colored papules Stage 2: Inflammation, papules/pustules -few to several Stage 3: Papules/pustules and a few nodules; little to no scarring Stage 4: Deep/Inflammatory; Extensive nodules, variable degree of stars No labs unless hyperandrogenism is expected. Differential: Acne Rosacea, Gram negative folliculitis, perioral dermatitis, steroid induced acne Treatment: decrease sebaceous gland activity, correct the altered pattern of keratinization, decrease follicular bacterial population, produce anti-inflammatory effect. Topical retinoids, benzoyl peroxide, topical antibiotics, intralesional corticosteroid injections, oral isotretinoin (OCPs for women), Incision and drainage, hormonal therapy (OCPs)
Acne Vulgaris
Pemphigous vulgaris
Autoimmune disease that affects skin and mucous membranes. The predominant skin lesions are flaccid blisters on head, trunk, and intertriginous areas (skin rubbing areas) Typically 40-60 year olds. Associated with Nikolsky sign (skin finding in which the top layers of skin slip away from the lower layers when slightly rubbed and may create blister). Mortality rate of 5-15%
Large aneurysm in spinal column with nerves in it. Very painful.
Myelomeningocele
Psoriasis: Inverse Type
Folds, scale may not appear
Atopic Dermatitis
Chronic, puritic eczemetous condition of the skin that is associated with a personal or family history of atopic disease (asthma, allergic rhinitus) Symptoms: Epidermal edema = spongiosis. Pale epidermis, swelling of keratinocytes, leaky cells, fluid pockets, weeping, vesicles. “the itch that rashes”. Disease of childhood (10% of US children) Uncommon for adults w/o a history of eczema in childhood. Increased prevalence may be due to exposure to pollutants, indoor allergens, and decline in breast feeding. Clinical features: pruritic, facial and extensor papulovesicles in infancy. Flexural lichenification in adults and older children. Chronic-relapsing course. Treatment: Cutaneous hydration, topical glucocorticoids, identify and eliminate flare factors. Tacrolimus, pimecrolimus. Treat pruritis. Complications: bacterial impetigization (staph a), secondary herpetic infection, contact sensitization. prognosis: spontaneous resolution after age 5 in 40%, 84% of children “outgrow” by adolescence. Poor prognosis if wide spread AD in childhood, associated allergic rhinitis or asthma. Family history of AD.
Caused by Et-A and Et-B (most common) toxin secreted by Staph Aureus. Can occur in newborns or babies. Starts as skin redness followed by exofoliation of skin 2-5 days later. Sometimes fever. Treat with beta-lactamase resistant penicillin (ampicillin/sulbactam) or nafcillin/diclococillin Differential: viral exanthemas, scarlet fever, themal burns, pemphigus, kawaskai disease, SSSS
Staphylococcal Scalded Skin Syndrome (SSSS)
Diffuse hair thinning as a complication of an existing medication or medical problem Common causes: chemotherapy, meds, thyroid dz, iron deficiency, Nutritional disorders, renal or hepatic failure, other chronic illness. treatment: remove the cause, minoxidil
Secondary Alopecia
Large aneurysm in spinal column w/o any nervous tissue in it. Benign.
Meningocele
Chronic, superficial inflammatory process affecting the hairy regions of the body (scalp, eyebrows, and face especially). Bilateral and symmetrical patches and plaques w/ indistinct margins. Hair loss uncommon. Affects infants (first three months) and adults (40-70). Wide range of disease from mild to severe. Common skin manifestation in patients w/ HIV (85% of patients) More common than psoriasis in adults. Men more than women. Unknown cause (malassezia furfur?) Associated w/ oily looking skin but not a disease of the seb gland. Associated w/ parkinson’s and a variety of other neural abnormalities. Treatment: Control not cure. Remove scales and crusts. Inhibition of yeast colonization and secondary infx. Treaty erythema and itching. Antifungals in adults.
Seborrhiec dermatits
Discoid lupus: scarring lesions of skin Tumid Lupus: erythematous indruated plaques in sun exposed areas Lupus Panniculitis: infiltration and destruction of adipose tissue especially upper extremeties Verrucous Lupus: Very thick hyperketotic discoid lupus like lesions that usually occur on the extensor sun exposed surfaces.
Chronic Cutaneous Lupus
Antigen-Mediated Occur when IgG or IgM are produced against surface antigens on cells of the body. These can trigger rxns either by activating complement or NK cells. Classic disease: hemolytic anemia
Type II Hypersensitivity
Characterized by the production of IgE antibodies vs foreign proteins that are commonly present in the environment (pollens, dander, dust mites). Identified by wheal and flare response to skin test within 15min. Anaphalaxis is this.
Type I Hypersensitivity
Tender red nodules, lobular panniculitis and vasculitis, POSTERIOR legs. Chronic/recurrent Associated with TB
Panniculitis Erythema Induratum
Fixed Drug Eruption
Localized sharply demarcated erythemetous pathc that can itch, burn, or be asymptomatic. Predisposition of face and genitals. Often heals as hyperpigmented area. Therapy: remove offending drug
Inflammation of nail folds. Can be infectious or noninfectious. Causes acute: trauma, bacteria, contact dermatitis, acute excema flair. Causes chronic: caused by irritant contact dermatitis, eczema, psoriasis, candida
Paronychia
Sternocleidomastoid muscle on one side is spasmodic or shortened. Usually present at birth and discovered then or soon after. Cause may be related to small space in the uterus. Common to also have hip dysplasia.
Congenital torticollis
Extra digits. Most common hand anomaly. Extra digits may be fully formed or only soft tissues.
Polydactly
Causes of immune uticaria and angiodema
A.) Type I IgE mediated hypersensitivity to allergens B.) Autoimmunity C.) Infection
A.) Type I IgE mediated hypersensitivity to allergens B.) Autoimmunity C.) Infection
Causes of immune uticaria and angiodema
Folds, scale may not appear
Psoriasis: Inverse Type
Major focus of inflammation is SQ tissue.Erythemetous or violaceous nodule in the SQ fat. Lobular or septal depending on where disease begins Accurate diagnosis w/ biopsy
Panniculitis
Paronychia
Inflammation of nail folds. Can be infectious or noninfectious. Causes acute: trauma, bacteria, contact dermatitis, acute excema flair. Causes chronic: caused by irritant contact dermatitis, eczema, psoriasis, candida
Sterum caves inward. Becomes a problem when compression of heart and lungs occurs.
Pectus excavatum
Amelia - missing one arm Phocomelia - Flipper limbs. Both caused by thalidomide use in the 50s and 60s to treat morning sickness. Now used to treat leprosy, so be careful.
Amelia and Phocomelia
Onychomycosis
Fungal growth on or under the nail. Common cause: Trichophyton rubrum or t. mentagrophytes. Treat: terbinafine
Poland Syndrome
Congenital malformation or absence of pec major (unilateral often right). Often including ipsilateral webbing of the fingers.
