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FRCPC Dermatology Review > FRCPC Dermatology Review > Flashcards

FRCPC Dermatology Review Flashcards

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Dermatology Board Prep flashcards
1
Q

List 4 things associated with acanthosis nigricans

A
  • Obesity with insulin resistance
  • Drugs: nicotinic acid
  • Endocrinopathies: most commonly DM and , hyperandrogenic or hypogonadal syndromes
  • Genetic disorders with mutation in FGFR gene
  • Ethnicity: more common in hispanic and african american kids
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2
Q

How to treat acanthosis nigricans?

A
  • Treat underlying disorder
  • Weight loss for obese kids
  • 40% urea cream
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3
Q

What is the first line treatment for uncomplicated comedonal acne?

A
  • Topical retinoid
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4
Q

List three treatment options for mild to moderate papulopustular acne

A
  • Topical retinoid + benzoyl peroxide
  • Benzoyl peroxide + topical antibiotic
  • Benzoyl peroxide + oral antibiotic
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5
Q

List two treatments for severe papulopustular acne

A
  • Topical retinoid + benzoyl peroxide + oral antibiotic

- Isotretinoin 1mg/kg/day

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6
Q

List 4 possible hormone issues related to acne

A
  • PCOS
  • Menstruation
  • Adrenal tumour
  • Ovarian tumour
  • Steroid use
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7
Q

What is the mechanism of action for retinoids?

A
  • Inhibit formation and number of comedones, reduce mature comedones, reduce inflammation, encourage normal desquamation of follicular epithelium
  • Side effect: irritation and dryness
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8
Q

What is the mechanism of action for benzoyl peroxide?

A
  • Antimicrobial agent
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9
Q

What is one benefit of benzoyl peroxide?

A
  • Does not enhance antibiotic resistance
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10
Q

List three systemic antibiotics used in the treatment of acne

A
  • Tetracycline
  • Minocycline
  • Doxycycline
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11
Q

When to think about using systemic antibiotics to treat acne?

A
  • When there is no response to topical therapy for 6-8 weeks

- For moderate to severe papulopustular acne

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12
Q

List three side effects of tetracycline

A
  • Not used in pregnancy or children < 8 because can stain teeth
  • Vaginal candida
  • GI irritation
  • Phototoxic reaction
  • Brown discolouration of nails
  • Esophageal ulceration
  • Inhibition of fetal skeletal growth
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13
Q

List three side effects of minocycline

A
  • Raised ICP
  • Dizziness
  • Blue discolouration to skin
  • Hepatitis
  • Pneumonitis
  • Lupus like syndrome
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14
Q

What is the mechanism of action of isotretinoin/accutane

A
  • Reduces size and secretion of sebaceous glands, normalizes follicular keratinization, prevents new microcomedone formation, decreases P. acnes and anti-inflammatory effect
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15
Q

What is the chances that accutane will work?

A
  • 40% cured
  • 45% still need topical therapies
  • 20% need repeat course
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16
Q

List three side effects of isotretinoin

A
  • Teratogenic
  • Cheilitis
  • Xerois
  • Epistaxis
  • Blepharoconjunctivitis
  • Arthralgias
  • Thinning of hair
  • Increased risk of sunburn
  • Pyogenic granulomas
  • Colonization of skin with staph aureus: impetigo, infected dermatitis, folliculitis
  • Increased TG and cholesterol: need to rule out underlying liver disease before starting
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17
Q

List 5 features of fetal isotretinoin syndrome

A
  • Facial asymmetry
  • External ear malformations
  • Micrognathia
  • Flat nasal bridge
  • Ocular hypertelorism
  • Conotruncal malformations
  • Hydrocephalus, microcephaly
  • Intellectual and learning disability
  • Thymic aplasia/ parathyroid abnormalities
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18
Q

What is one acne medication that cannot be combined with isotretinoin?

A

Tetracycline because it can cause benign intracranial hypertension

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19
Q

List 5 dugs that can cause acne

A
  • Corticosteroids
  • Isoniazid
  • Phenytoin
  • Phenobarbitol
  • Lithium
  • Anabolic steroids
  • Vitamin B12
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20
Q

List 5 differentials for angular cheilitis

A
  • Dry lips
  • Contact dermatitis from lip licking
  • Hypervitaminosis A
  • Iron deficiency
  • Zinc deficiency
  • Malabsorption syndromes
  • Crohn disease
  • Anorexia nervosa
  • Accutane
  • Oral thrush
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21
Q

How to manage contact dermatitis due to poison ivy exposure?

A
  • Wash skin up to 2 hours after exposure with gentle detergent or soap formulated specially for contact dermatitis
  • Oatmeal baths and cool compresses for symptomatic relief
  • Antihistamines
  • Topical steroids with 0.05% clobetasol propionate
  • Oral steroids for severe cases or face/genital involvement
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22
Q

What type of immunodeficiency is seen in kids with anhidrotic ectodermal dysplasia?

A

Dysgammaglobulinemia

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23
Q

Why are congenital melanocytic nevi removed?

A
  • For cosmetic reasons

- To decrease the chance of malignant transformation

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24
Q

List 5 ways to prevent skin cancer

A
  • Sunscreen with SPF > 15-30
  • Hat, long sleeves, pants
  • Avoid direct sunlight from 1000-1600
  • Avoid tanning beds
  • Routine yearly skin examination for changing nevi
  • Review ABCDEs with patients
  • Baseline medical photography for congenital or atypical lesions
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25
Q

What is the natural history of a halo nevus?

A
  • Subsequent disappearance of the central nevus over months

- Depigmented area may or may not repigment

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26
Q

List 5 things about a skin finding that would make you worried about malignancy

A
  • Rapid increase in size
  • Satellite lesions
  • Change in colour, especially red, brown, gray, black, blue
  • Change in texture with scaling, erosion, ulceration, induration
  • Irregular borders
  • Regional lymphadenopathy
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27
Q

What are the ABCDEs?

A
  • Asymmetry
  • Border irregularity
  • Colour variability
  • Diameter > 6mm
  • Evolution: changes
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28
Q

List 5 treatments for common warts

A
  • Duct tape: leave on for 6 days, repeat weekly for 2 months
  • Liquid nitrogen
  • Podophylin 25%: leave on for 4-6 hours
  • Imiquimod: for genital warts
  • Daily salicylic acid: slow but painless, need to apply daily for 5 days then take 2 days off
29
Q

For how long is olluscum contagiosum contagious?

A

For the entire duration that the rash is present

30
Q

List 5 differentials for erythema nodosum

A
  • GAS infection
  • TB
  • Mycoplasma
  • Yersinia
  • EBV
  • Sarcoidosis
  • IBD especially Crohn disease
  • Behcet disease
  • Pregnancy
  • Leukemia/lymphoma
  • Medications: sulfonamides
31
Q

How to manage erythema nodosum?

A
  • Supportive care with NSAIDs

- If infection related will heal within 7 weeks; if related to active disease process can last up to 18 weeks

32
Q

What is the pathogen that causes tinea versicolour?

A

Malassezia furfur

33
Q

List three treatments for tinea versicolour

A
  • Selenium sulfide topical therapy
  • Imidazole or terbinafine cream BID
  • Ketoconazole or fluconazole
34
Q

List 4 risk factors for the development of dermatophytoses

A
  • Immunosuppression
  • DM
  • Lymphoid malignancies
  • High cortisol level
35
Q

What is the treatment for tinea capitis?

A
  • Terbinafine (lamisil) 5mg/kg/day for 6-8 weeks
  • Draw baseline LFTs before starting terbinafine
  • Can also do oral itraconazole
  • Selsun blue shampoo or nizoral shampoo
  • Oral steroids if severely inflamed kerion
36
Q

What is the natural history of trichotillomania?

A
  • Remits spontaneously in most kids
37
Q

List 5 conditions that are associated with alopecia areata

A
  • Hashimoto thyroiditis
  • Atopy
  • Nail pits/ridges/opacification
  • Cataracts/lens opacification
  • Addison disease
  • Pernicious anemia
  • Ulcerative colitis
  • Myasthenia gravis
  • Collagen vascular disease
  • Vitiligo
38
Q

What is the treatment for ringworm?

A
  • Usually will clear spontaneously within several months

- If not can give a topical antifungal: terbinafine, ketoconazole, miconazole, cotrimazole BID for 2-4 weeks

39
Q

What is the natural history of alopecia areata?

A
  • Spontaneous resolution in 6-12 months
  • High potency topical steroids
  • Intradermal injection of steroids
  • Systemic steroids
40
Q

List 4 poor prognostic factors in alopecia areata

A
  • Alopecia universalis
  • Alopecia totalis
  • Extensive and rapid hair loss
  • Young age at onset
  • Numerous episodes
41
Q

List 5 things that can precipitate telogen effluvium

A
  • Childbirth
  • Fever
  • Surgery
  • Acute blood loss
  • Severe weight loss
  • Physical/emotional stress
  • Stopping OCP or steroids
42
Q

What is the natural history of infantile hemangiomas (previously called strawberry hemangiomas)?

A
  • Usually not present at birth
  • Rapid growth in the first few weeks of life followed by plateau of growth by 12-18 months then slow regression
  • 95% involute by age 9
  • 50% involute without a trace and 50% will leave a scar (these can be lasered)
43
Q

List 5 indications for treatment of a hemangioma

A
  • Concerning area
  • Vision or airway threatening
  • Impairing function
  • CHF
  • Kasabach Merritt Syndrome
  • Rapidly growing
  • Recurrent bleeding/ulceration/infection
44
Q

List the 6 components of PHACES syndrome

A
  • Posterior fossa malformations: Arnold Chiari and Dandy Walker malformations
  • Hemangioma: large segmental on face
  • Arterial anomalies: esp carotid, cerebral, vertebral
  • Cardiac anomalies: esp AoC
  • Eye abnormalities: hemangiomas, cataracts, amblyopia, proptosis, ptosis, heterochromia, refractive error
  • Sternal or abdominal clefting
45
Q

List 3 complications of a hemangiom

A
  • High output CHF
  • Ulceration
  • Infection
  • Bleeding
  • Compression
  • Beard distribution associated with upper airway involvement
  • Kasabach Merritt Syndrome
46
Q

See a child with nevus flammeus in the V1 distribution. What referral do you need to make and what complication are they are risk for?

A
  • Ophthalmology

- Glaucoma

47
Q

8 mo old child brought in with several brown lesions on the back. Parents say when they rub one a wheal forms. What is the condition?

A
  • Urticaria pigmentosa

- Mastocytosis

48
Q

Which metabolic abnormality is associated with subcutaneous fat necrosis?

A

Hypercalcemia

49
Q

List 5 disorders that have cafe au lait macules

A
  • NF1
  • McCune Albright syndrome
  • Ruberous Sclerosis
  • Russell Silver Syndrome
  • Turner syndrome
  • Ataxia-telangiectasia syndrome
50
Q

List 4 cutaneous manifestations of tuberous sclerosis

A
  • Ask leaf spots
  • Shagreen patch
  • Periungal fibroma
  • Angiofibromas
51
Q

List 5 diseases associated with vitiligo

A
  • Addison disease
  • Hashimoto thyroiditis
  • Pernicious anemia
  • Diabetes
  • Hypoparathyroidism
  • IgA deficiency
  • Alopecia
52
Q

List 3 treatments for vitiligo

A
  • Potent topical corticosteroid
  • Topical tacrolimus or picrolimus
  • UVB light
  • Spontaneous remission in a small percentage
53
Q

Which medication causes pseudoporphyria?

A

Naproxen

54
Q

What is the typical presentation for pityriasis rosea?

A
  • Herald patch presents first, can be anywhere, 1-10cm big, round with raised border and fine scale
  • 5-10 days later get generalized eruption of round/oval lesions < 1cm in a christmas tree pattern on the back
  • Can be asymptomatic or itchy
55
Q

Is pityriasis rosea contagious?

A

No

56
Q

List 2 treatment options for pityriasis rosea

A
  • Observation
  • Lubricating lotion
  • Antihistamine or topical steroid for itching
57
Q

Which individuals are you more likely to offer treatment for pityriasis rosea?

A
  • Dark skinned individuals as there is a chance that there will be post inflammatory hyper/hypopigmentation
58
Q

What is the typical presentation of psoriasis?

A

Erythematous papules that coalesce to form plaques with sharply demarcated irregular borders with thick silvery scale

59
Q

What is Auspitz sign?

A
  • Removal of scale that causes pinpoint bleeding
60
Q

Picture shown of nail pitting. What is the diagnosis?

A
  • Psoriasis
  • Nail pitting seen in 40%
  • In some patients this may be the only manifestation
61
Q

List 4 treatments for psoriasis

A
  • Topical therapy: corticosteroids, retinoid, vitamin D analog (calcipotriene), tar preparations, phenol and saline solution with tar shampoo
  • Phototherapy: narrowband UVB light
  • Systemic treatment: MTX, cyclosporine, oral retinoids
  • Biologic response modifiers: TNF a inhibitors
62
Q

What is the treatment for seborrheic dermatitis?

A
  • Mineral oil followed by Selenium sulfide shampoo daily
63
Q

In a child with a facial nevus flammeus who presents with a seizure, what would the expected finding be on head MRI?

A

Leptomeningeal venous angioma

64
Q

List 3 complications associated with Sturge Weber syndrome

A
  • Glaucoma
  • Hemiparesis contralateral to facial lesion
  • Seizures
  • Developmental delay
65
Q

What is the typical presentation of Klippel Trenaunay syndrome?

A
  • Vascular malformation present at birth with hypertrophy of affected limb
66
Q

What is the most common cause of erythema multiforme?

A
  • HSV infection

- Mycoplasma infection also a common cause

67
Q

List 5 medications that cause toxic epidermal necrolysis

A
  • Sulfonamides
  • Amoxicillin
  • Phenobarbitol
  • Hydantoin
  • Allopurinol
  • Ibuprofen
  • Infections like mycoplasma
68
Q

List 4 drugs associated with Steven Johnson Syndrome

A
  • Sulfonamides
  • NSAIDs
  • Anticonvulsants
  • Antibiotics

FRCPC Dermatology Review (1 decks)

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