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Clinical Medicine > Exam 1 Bolded Words Only > Flashcards

Exam 1 Bolded Words Only Flashcards

1
Q

Dermatitis means

A

inflammation of the skin

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2
Q

Atopic dermatits: “the itch…”

A

that rashes

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3
Q

Atopic triad

A

atopic dermatitis, allergic rhinits, asthma

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4
Q

Atopic dermatitis occurs where in children and adults

A

children - cheeks, scalp, extensor surfaces

adults - feet, hands, flexural surfaces

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5
Q

Essential features of Atopic Dermatitis

A

pruritis, eczema - morphology, chronic or relapsing history

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6
Q

First line of treatment for atopic dermatitis

A

hydrate skin with emollients

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7
Q

Where should you avoid putting high potency steroids?

A

on face, in skin folds

results in skin atrophy

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8
Q

Side effects of topical steroids

A

pigment changes, atrophy, striae, bruising, telangiectasias

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9
Q

Second line of treatment for atopic eczema

A

topical calcineurin inhibitors for face

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10
Q

Tapioca like

A

dyshidrotic eczema

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11
Q

Dyshidrotic eczema is

A

intensely pruritic

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12
Q

Tx for dyshidrotic eczema

A

reassurance, topical steroids

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13
Q

Allergic contaxt dermatitis

A

delayed type (type 4)

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14
Q

Irritant contact dermatitis

A

hands in water, detergents, etc; 80% of all contact dermatitis

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15
Q

Alleric contact derm main symptom

A

itch

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16
Q

Poison ivy, oak, sumac

A

allergic contact derm

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17
Q

Allergens for contact derm

A

nickel, rubber, latex, perservatives, neomycin

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18
Q

Drug eruptions

A

morbilliform or exanthematous (95%)
Uticaria or angioedema (5%)

most are type 4

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19
Q

Drug eruptions develop within how many days of exposure?

A

5-14 days

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20
Q

Drug eruptions are:

A

morbilliform; red macules, papules

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21
Q

Drug hypersensitivity syndrome

A

high fever, rash - morbilliform, internal organs affected

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22
Q

SJS

A

life threatening

mucocutaneous reactions

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23
Q

SJS is:

A

medication induced

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24
Q

SJS total body surface area

A

less than 10%

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25
Q

TEN total body surface area

A

greater than 30%

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26
Q

SJS?TEN has a positive ____ sign.

A

Nikolsky

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27
Q

How to estimate TBSA?

A

Rule of 9s

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28
Q

SJS/TEN tx

A

discontinue offending medication

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29
Q

Complications of SJS/TEN

A

acute phase - fatal complications

long-term sequelae - cutaneous, mucosal, ocular, pulmonary complications

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30
Q

Species responsible for seborrheic dermatitis

A

Malessezia fur fur

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31
Q

Characteristics of seborrheic dermatitis?

A

mild dandruff to more extensive inflammatory dermatitis

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32
Q

Cradle cap

A

seborrheic dermatitis; yellow greasy scales

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33
Q

Adult seborrheic dermatits

A

erythematous coalescing macules, patches or plaques with yellow greasy looking scales

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34
Q

treatment for blepharitis and cradle cap

A

olice oild, warm H2O

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35
Q

treatment for scalp seborrheic dermatitis

A

antifungal agents and topical corticosteroids

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36
Q

tx for face seborrheic dermatitis

A

low potency topical corticosteroid cream, antifungal, or combo

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37
Q

Pityriasis Rosecea characteristics

A

christmas tree pattern, viral skin exanthem, common in teens and young adults, herald patch with secondary rash 1-2 weeks later, cigarette paper on some plaques, collarette scale

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38
Q

Tx for pityriasis rosecea

A

goes away on own

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39
Q

Lichen planus is ______-______.

A

immune mediated

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40
Q

Licehn planus is usually

A

idiopathic

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41
Q

Koeber phenomenon is associated with what skin diseases

A

lichen planus

psoriasis vulgaris

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42
Q

Koebner phenomenon is what

A

development of lesions in sites of trauma

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43
Q

4 Ps of Lichen Planus

A

pruritic, purple, polygonal papules

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44
Q

Wickham’s striae

A

tiny white lines running through papules

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45
Q

What disease is wickham’s striae associate with?

A

lichen planus

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46
Q

Tx for lichen planus

A

topical steroids/intralesional - triamcinolone

high potentcy on trunk/extremities

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47
Q

Characteristics of Psoriasis

A

thickened, dry rasied patches covered in silveru white scale

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48
Q

chronic plaque psoriasis - aka:

most common

A

psoriasis vulgaris

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49
Q

Clinical presentation of psoriasis?

A

well-demarcated, red violent plaque covered with thick adherent white silvery scale

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50
Q

Auspitz is what? What disease is it associated with?

A

specks of blood; psoriasis

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51
Q

_____ proceeds guttate psoriasis.

A

Strep

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52
Q

Can you use oral steroids to treat psoriasis?

A

No. it will get better but will worsen upon discontinuation

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53
Q

Tx of psoriasis?

A

group 1/2 corticosteroids, synthetic vit D, coal tar, topical retinoids, topical calicneurin inhibitors

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54
Q

Limited disease of psoriasis tx:

A

less than 5%, does not affect hands feet or genitials is typically tx with super high potency steroids

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55
Q

Steroid sparing ages may be used in _____ with topical steroids

A

combination

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56
Q

Psoriatic arthritis

A

inflammatory arthritic associated with psoriasis

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57
Q

Moderate to severe psoriasis should be treated by whom?

A

derm - requires phot therapy or systemic therapy

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58
Q

Prevalence of psoriatic arthritis?

A

30% of pts with psoriasis

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59
Q

____ joints and spine are affected in half the cases of Psoriatic arthritis?

A

DIP

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60
Q

Psoriatic arthritis lab findings

A

Elevated sedimentation rate and leukocytoris, positive HLA-B27 association

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61
Q

Tx for psoriatic arthritis

A

coordination with rheumatologist and derm

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62
Q

Acne vulgaris is a disease of:

A

the pilosebaceous unit

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63
Q

_____ is considered the precursory for the clinical lesions of acne vulgairs

A

microcomedo

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64
Q

Accumulation of sebu and kertinous material converts ____ into a _____.

A

microcomedo, closed comedo

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65
Q

Follicular orifice is opened with continued distension forming

A

open comedo - black head

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66
Q

Follicular rupture contribues to development of

A

inflmmatory lesion

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67
Q

Immune system sends white blood cells to fight infection and creates pus in pore

A

white head

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68
Q

Tx for comedonal and inflammatory lesions?

A

topical retinoids

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69
Q

Tx for inflammatory lesions

A

topical antimicrobial

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70
Q

Tx for severe inflammatory acne

A

oral antibiotics

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71
Q

What does benzoyl peroxide do

A

decreases emergency of antibiotic resistant bacteria

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72
Q

Some acne meds are

A

teratogenic

73
Q

Acne rosacea

A

chronic skin disorder of central face

74
Q

four types of rosacea

A

erythematotelaniectatic
papulopustular
phymatous
ocular

75
Q

First line treatment for erythematotelangiectatic rosacea?

A

behavior modification - avoid triggers, sun protection, gentle skin care

76
Q

First line tx/second line tx for midl to moderate papulopustular rosacea

A

metrondiazole, azelaic acid

tentra/mio/doxy cyclines

77
Q

Tx for phymatous rosacea?

A

isotretinoin, surgical debulking

78
Q

Scorpion stings/venom works how?

A

complex mixtures which includes potent neurotoxin that inactivates sodium channels causing membrane hyperexcitability –> excessive NT activity and autonomic dysfunction

79
Q

Grade 1 envenomation produce

A

local pain and paresthesias

80
Q

Grade 2 envenomation produce

A

local symptoms and remote pain and paresthesias

81
Q

Grade 3 envenomations produce either

A

cranial nerve or somatic skeletal neuromuscular dysfunction

82
Q

Grade 4 envenomations produce

A

both cranial nerve and somatic skeletal neuromuscular dysfunction

83
Q

Bee stings most commonly result in

A

local reaction

84
Q

Bee stings anaphylactic reaction

A

treated with IM epinephrine

85
Q

Widow causes ____ release

A

catecholamine

86
Q

Vitiligo

A

acquired skin depigmentation via an autoimmune process directed against melanocytes

87
Q

Vitiligo characteristics

A

milk-white macules with homogenous depigmentation and well-defined borders

88
Q

Hidradenitis Suppurativa is

A

chronic skin disorder involving hair follicle

89
Q

Hidradenitis Suppurativa results from cycle of

A

follicular occlusion, rupture, associated immune response

90
Q

Hidradenitis Suppurativa starts with

…. then what happens

A

single, deep-seated inflammatory nodule

more nodules form as disease progresses
may form abscess that opens to skin
purulent drainage occurs if ruptured

91
Q

Lymphangitis

A

inflammation of lymphatic channels due to inflammation/infection
tender, red streaks extending proximally

92
Q

Folliculitis caused by

A

staph aureus

93
Q

Hot tub folliculitis caused by

A

pseudomonas

94
Q

Folliculitis symptoms

A

itching, occasional pain

95
Q

How can folliculitis progress

A

furuncle –> carbuncle

96
Q

Tx for folliculitis - staph

A

self-limited usually

if moderate/severe: mupirocin, cephalexin

MRSA: sulfa, clindamycin, doxy

97
Q

Tx for folliculitis - pseudomonas

A

self-limited

98
Q

Impetigo - three kinds

A

nonbullous - more common
papules –> vesicles –> pustules –> honey colored crusting
bullous - vesicles enlarge and form flaccid bulla
ecthyma - punhced out ulcers with overlying crust

99
Q

Impetigo tx

A

nonbullous/bullous:
mild: topical antibiotics
moderate/severe: oral antibjotics covering staph and step dicloxicillin, cephalexin
ecthyma - always tx with oral therapy - ducloxicilin, cephalexin

100
Q

Cellulitis - two types

A

nonpurulent - cellulitis, erysipelas

purulent - cellulitis, abscess

101
Q

Erysipelas is caused by

A

B hemolytic streptococci

102
Q

Characterisitcs of erysipelas

A

sharply demarcated border/well-defined margin

103
Q

SLE: consider what possibility?

A

drug-indeuced cutaneous lupus

104
Q

Erythema Multiforme

A

target-like lesions

105
Q

Cause of erythema multiforme

A

herpes simplex

106
Q

Erythema multiform major and minor differences

A

major - mucous membranes

107
Q

Dermatitis herpetiformis

A

gluten sensitivity autoimmune skin condition

108
Q

Pemphigus - mucosal involvement

A

flaccid bullae begin in oropharynx

109
Q

Pemphigus - Nikolsky sign

A

gentle application of lateral pressure in an uninvolved area causes superficial layer to slough

110
Q

Hallmark finding of pemphigus

A

acantholysis

111
Q

Pemphigus perilesional biopsy

A

direct immunofluorescence

112
Q

How to treat pemphigus

A

systemic corticosteroids, immunosuppressive agents are mainstay

113
Q

Pemphigoid - two kinds

A

bullous pemphigoid, mucous membrane pemphigoid

114
Q

Pemphigoid - what kind of bullae

A

tense bullae

115
Q

Pemphigoid dx

A

direct immunoflourescence is gold standard

116
Q

Pemphigoid tx

A

topical and or systemic corticosteroids

117
Q

Pressure injury stages:

A

1 - redness, intact skin
2 - exposed dermis, no fat
3 - full loss of skin, rolled edges, adipose
4 - fat, thickness, full exposure, bone, muscle, tendon, fascia

118
Q

Bull’s eye appearnance

A

erythema migrans - lyme’s

119
Q

Pathogen - erythema migrans

A

borrella burgdorferi

120
Q

Pathogen - rocky mountain spotted fever

A

rickettsia rickettsia

121
Q

Measles etiology

A

Paramyxovirus

122
Q

How long is measles incubation period?

What are symptoms?

A

2-3 weeks

Asymptomatic

123
Q

Measles prodrome

A

anorexia, malaise, fever of over 105 followed by 3 Cs

124
Q

3 Cs associated with which disease?

A

Measles

125
Q

What are the three Cs of Measles

A

couch, coryza, conjunctivitis

126
Q

What are Koplik spots and what disease are they associated with

A

Measles.

“Grains of salt” inside mouth

127
Q

What is the enanthem of Measles?

How long before the rash do they appear?

A

Koplik spots; 48 hours

128
Q

Exanthem of measles

A

rash: blanching, maculopapular

129
Q

Spreading pattern of measles rash

A

Head to toe, spares palms and soles

130
Q

How long are you infectious with measles before and after rash?

A

5 days before, 4 days after

131
Q

What complications are associated with measles?

A

diarrhea and otitis media are the most common

pneumonia - common cause of death in childlren
encephalitis
Subacute scierosing Panencephalitis - 7-10 years later - FATAL

132
Q

Can you get MMR when pregnant?

A

No.

133
Q

How to treat measles?

A

symptomatic tx only

134
Q

Another name for erythema infectiosum

A

fifth disease

135
Q

Etiology of erythema infectiosum/fifth disease?

A

parvovirus B-19

136
Q

When does fifth disease usually occur? How does it spread?

A

school-aged children; respiratory secretions

137
Q

How long do symptoms of fifth disease last?

A

weeks, months, or years; new occurence of rash following heat, exercise, hot bath

138
Q

Clinical stages of fifth disease?

A

incubation: 7-14 days
prodrome - non-specific, flu-like, low-grade fever
Rash: “slapped cheek”; malar rash
Body rash follow facial rash 2-3 days later

139
Q

Description of body rash

A

lacy pink macular rash of trunk and extremeties (extensor surfaces)

140
Q

Tx of fifth’s disease

A

symptomatic/reassurance

141
Q

Rubella - German Measles - etiology

A

Rubella virus

142
Q

Clinical stages of german measles

A

Incubation: 12-23 days
Prodrome (maybe) - 1-5 days prior to rash but also may be concurrent with rash
Low grade fever, enlarged lymph nodes
Rash

143
Q

What does German Measles rash look like?

A

3-day measles
pinpoint pink maculopapules
head to to progression
contagious 7 days before and after rash

144
Q

German Measles complications

A

encephalitis, thrombocyctopenic purpura, GI hemorrhage

birth defects in pregnant women - congenital rubella syndrome - LETHAL

145
Q

What is blueberry muffin associated with?

A

German measles

146
Q

Tx of Measles?

A

Symptomatic tx only

147
Q

Roseola infantum etiology

A

herpes virus 6

148
Q

Typical progression of roseola infantum

A

high fever of 102-105 –> resolves abruptly –> rash appears

149
Q

Clinical presentation of roseola infantum

A

incubation: 9-10 days
prodrome: febrile phase - high fever
rash: blanching pink/erythematous maculopapular

150
Q

How does roseola infantum spread around the body?

A

from neck/trunk initially then to face/extremity

151
Q

Describe roseola infantum itch and appearance?

A

nontoxic, nonpruritic except in immunocompromised

152
Q

How to treat roseola infantum?

A

supportive tx only

153
Q

Hand foot and mouth disease etiology?

A

Cozsackle A16 virus

154
Q

Clinical presentation of hand foot and mouth

A

incubation: 3-5 days

155
Q

Clinical presentation of hand foot and mouth

A

incubation: 3-5 days
prodrome: 12-24 hours - typically absent, fever, fussiness, emesis, abdominal pain
oral enanthem/exanthem: sore throat, vesicles on buccal mucosa, tongue (ENANTHEM) and vesicles on hands, feet, and butt - vesicles may create ulcers

156
Q

Tx for hand foot and mouth

A

symptomatic relief only

157
Q

Molluscum Contagiosum seen in what population

A

children and adults/immunocompromised

158
Q

Self-spreading of molluscum contagiousum

A

self-spreading by touching, scratching shaving

159
Q

Etiology of molluscum contagiosum?

A

poxvirus

160
Q

Molluscum contagiosum presentation

A

lesions - umbilication, flesh-colored, pearly papulas, 2-5mm, located everywhere but palms and soles

161
Q

Tx for molluscum contagiosum?

A

none

162
Q

Mucosal HPV name

A

condyloma acuminata

163
Q

HPV presentation

A

cauliflower-like lesions, perianal growth, pruritis

164
Q

HPV Common Warts

A

common in children, young adults, transmitted by skin to skin contact, spontaneous resolution in 1-2 years; reoccurence common

165
Q

HPV Common warts may have _____ capillaries

A

pigmented, black “seeds”

166
Q

Treatment required for common warts

A

none

167
Q

Varicella etiology

A

Varicella Zoster virus

168
Q

Varicella transmission

A

contagious

169
Q

Clinical stages of Varicella

A

incubation period of 10-21 days
prodrome: 2-5 days - fever malaise, pharyngitis, anorexia
Rash - generalized vesicular rash
Very itchy
Lesions occur at different stages over 4 days and are typically crusted over by 6 days. Look for lesions at different stages in healing in dx.

170
Q

Another name for herpes zoster

A

shingles

171
Q

How does shingles reoccur?

A

reactivation of latent VZV from dorsal root ganglia

172
Q

Pathogenesis of herpes zoster (shingles)

A

virus dormant in sensory ganglia –> immunity to VZV diminishes –> virus travels along sensory nerve –> skin lesions appear

173
Q

Shingles usually on:

A

trunk

174
Q

Clinical stages of shingles/herpes zoster?

A

prodrome: acute neurotic pain precedes eruption by 3-5 days - throbbing, stabbing, burning + pruritis, fever, headache, allodynia
Active disease: Rash - dermatomal, unilateral, thoracic distribution most common

175
Q

What nerve does herpes zoster ophthalmicus affect?

A

trigeminal nerve

176
Q

Hutchinson’s sign:

A

vesicles on nose; can lead to vision loss due to retinal necrosisand link to trigeminal ganglion activation

177
Q

Tx with shingles

A

START EARLY within 72 hours

Antiviral! Valcyclovir is preferred

178
Q

Types of Herpes Simplex Virus

A

HSV-1 and HSV-2

Clinical Medicine (5 decks)

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