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Clinical Dermatology > Gen Derm 4 > Flashcards

Gen Derm 4 Flashcards

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1
Q

spontaneous multiple keloids

A

noonan syndrome

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2
Q

what is emoblia cutis medicamentosa

A

vascular thrombosis from periarterial injection

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3
Q

What drugs cause gingival hypertrophy

A

phenytoin, nifedipine, cyclosporine

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4
Q

drugs that can cause telogen effluvium?

A

heparin, betablocker, IFN, lithium, retinoids

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5
Q

drugs that cause anagen effluvium?

A

chemotherapy, heavy metals

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6
Q

drugs that cause cutaneous lymphoid hyperplasia aka pseudolymphoma

A

anticonvulsants, neuroleptics, ARBS

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7
Q

serum sickness eruption

A

antithymocyte globulin (prevention and treatment of acute rejection in organ transplantation and therapy of aplastic anemia)

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8
Q

SDRIFE

A

betalactams, radiocontrast

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9
Q

Radiation induced erythema multiforme or SJS

A

phenytoin and radiation

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10
Q

first degree burn is

A

sunburn

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11
Q

second degree burn is

A

divided into superfiical (non scarring) and deep (pale anesthetic skin) results in scarring

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12
Q

striate palmoplantar keratoderma is AD or AR? What is the mutation (3)

A

desmoglein 1, desmoplakin, and keratin 1

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13
Q

Oraloculargenital syndrome. Angular chelitis, seb derm, scrotal dermatitis. Deficiency in what?

A

Deficiency in B2 riboflavin

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14
Q

Eruptive onset of multiple new nevi

A

Addison?s disease

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15
Q

druginduced acanthosis nigricans

A

nicotinic acid, niacinamide, vitamin B3, somatotrophin, testosterone, oral contraceptives, insulin, protease inhibitors, and glucocorticoids

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16
Q

Whats the malignancy associated with tripe palms? Tripe palms , acanthosis nigricans?

A

Lung cancer (tripe palms only), gastric cancer (tripe palms , Acanthosis nigricans)

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17
Q

what diseases is anetoderma associated with?

A

50 percent will have antiphospholipid antibodies, lupus, Grave?s disease, scleroderma, hypocomplementemia, hypergammaglobulinemia, autoimmune hemolysis, and HIV

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18
Q

secondary amyloidosis associated protein?

A

serum amyloid A

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19
Q

Interferon alpha can in rare cases cause an exacerbation of what disease?

A

Psoriasis, spastic diplegia (in infants who were treating their hemangiomas)

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20
Q

kwashiorkor is missing what? Marasmus is missing what?

A

Kwashiorkor is missing protein. Marasmus is missing more energy caloric intake

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21
Q

you can get essential fatty acid deficiency if you have fat malabsorption, parental nutrition wo lipids and what other condition?

A

nephrotic syndrome

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22
Q

how does essential fatty acid deficieny present?

A

like zinc and biotin deficiencies

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23
Q

what fatty acids are deficient in essential fatty acid deficiency?

A

linoleic, linolenic, and arachidonic acid

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24
Q

Vitamin A deficiency cutaneous findings?

A

phrynoderma (keratotis follicular papules resembing toadskin), blindness, bitot spots

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25
Q

Vitamin A excess findings?

A

SE with systemic retinoids alopecia, dermatitis, epistaxis, cheilitis

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26
Q

What systemic disease can cause betacarotene deposits in the skin?

A

Diabetes, nephrotic sndrome and hypothyroidism (impaired conversion of beta carotene to vitamin A)

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27
Q

Selenium deficiency causes what skin finding?

A

hypopigmentation of skin hair, leukonychia

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28
Q

vitamin B2 deficiency causes what skin findings?

A

oralgenital syndrome (cheilitis, angular stomatitis seb dermlike rash, tongue atrophy glossitis, genital and perinasal dermatitis)

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29
Q

Name vitamin B1, B2, B3, B6, B9.

A

thiamine 1, riboflavin 2, niacin 3, pyridoxine 6, folic acid 9

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30
Q

vitamin B3 deficiency causes what skin findings?

A

pellagra (casal s necklace, photosensitivity, 3D s (diarrhea, dementia, death))

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31
Q

What diseases and drugs causes vitamin B3 deficiency?

A

Hartnup, carcinoid, alcoholism, Azathioprine, Isoniazid, 5FU

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32
Q

vitamin B6 deficiency causes what skin findings?

A

Seb derm, angular chelitis

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33
Q

who s at highest risk for vitamin B6 deficiency?

A

alcoholics

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34
Q

who s at highest risk for folic acid deficiency? How does deficiency present?

A

goat milk diet. Deficiency presents as hyperpigmentation

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35
Q

Vitamin E excess can cause what?

A

petechiae and ecchymoses

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36
Q

Vitamin K deficiency can cause what?

A

purpura, ecchymoses, hemorrhage

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37
Q

Zinc deficiency SLC39A4 gene is inherited autosomal.

A

Autosomal recesive

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38
Q

Zinc deficiency has what lab value?

A

low alkaline phosphatase

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39
Q

Gouty tophi is an accumulation of what? most common found on the

A

Monosodium urate, Ear helix

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40
Q

Colloid milium stains like what?

A

Amyloid (congored, thioflavin t, crystal violet)

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41
Q

what is the best preservative for gout?

A

ethanol

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42
Q

milia like calcinosis on the dorsal hands face is associated with what disease?

A

down syndrome

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43
Q

Name 3 genetic syndromes that cause cutanous ulcers?

A

Adams oliver (aplasia cutis, CMTC), prolidase deficiency (leg ulcers) and klinefelter syndrome (leg ulcer)

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44
Q

Name 3 drugs that can cause cutaneous ulcers.

A

Hydroxyurea, interferon injection sites, MTX in psoraisis patients

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45
Q

Tx for cutanous small vesel vasculitis?

A

colchicine 0.6 3x day and dapsone 100mg day

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46
Q

Hypocomplementemic form of urticarial vasculitis has low serum levels of what complement? What antibodies do they have?

A

Low serum levels of C1q. They have antiC1Q antibodies

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47
Q

What two autoimmune diseases is Urticarial vasculitits associated with?

A

SLE and Sjogrens

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48
Q

Tx for urticarial vasculitis?

A

Indomethacin, dapsone, colchicine

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49
Q

Triggers of EED (infectious, autoimmune, hemologic)

A

betahemolytic strep, Hep B, HIV, TB, Syphillis, SLE, IBD, IgA paraporteinemia

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50
Q

pANCA stains for what? Describe the staining pattern.

A

Myeloperoxidase. Perinuclear staining

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51
Q

cANCA stains for what? Describe the staining pattern.

A

serine protease 3. granular cytoplasmic staining

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52
Q

which vasculitis has PGlike nodules and strawberry gums?

A

wegeners

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53
Q

which vasculitis is nongranulomatous

A

microscopic polyangiitis

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54
Q

which vasculitis has LCV , necrotizing granulomas with basophilic debris

A

wegeners granulomatosis

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55
Q

tx for wegener s granulomatosis?

A

cyclophosphamide (2mg kg day) , oral steroids (1mg kg per day)

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56
Q

which vasculitis is the most common cause of pulmonaryrenal syndrome? What is PRS?

A

Pumonary hemorrhage with focal segmental necrotizing glomerulonephritis

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57
Q

what are 2 possible drug triggers for churg strauss syndrome?

A

leukotriene inhibitors and omalizumab

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58
Q

which vasculitis has LCV with eosinophilic granulomas?

A

churgstrauss

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59
Q

What are the first symptoms of churg strauss?

A

adultonset asthma, nasal polyps, allergic rhinitis

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60
Q

whats the leading cause of death in churg stauss?

A

endocardiomyopathy

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61
Q

most common cause of death in PAN?

A

renal failure and HTN likely due to microaneurysm which are seen on angiography of mediumsized vessels

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62
Q

diagnosis critera for kawasaki?

A

5 days of fever, conjunctival injection, mucous membrane erythema, rash (perineal desquamation), cervical lymphadenopathy, peripheral edema erythema of hands feet

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63
Q

Tx for kawaskii? When do you have to give it to reduce coronary artery issues? Who doesn t respond well to treatment?

A

Within 10 days, highdose aspirin (100mg kg a day) , IVIG (2g kg) . Kids less than 1 year old do not respond well to treatment

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64
Q

What are the symptoms of temporal arteritis?

A

tenderness and erythema along sclap and temples with unilateral headache and loss of temporal pulse.

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65
Q

What are systemic findings associated with temporal arteritis?

A

Polymyalgia rheumatica with limb and muscle pain as well as vision loss

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66
Q

Describe the immunoglobulin for type 1, 2, 3 cryoglobulinemia

A

monoclonal IgM (1), monoclonal IgM polyclonal IgG, polyclonal IgG and polyclonal IgM

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67
Q

Describe the associations for type 1, 2, 3 cryoglobulinemia

A

lymphoproliferative disorders (type1), hepatitis C and autoimmune disease for type 2 and 3

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68
Q

Describe the histology for type 1, 2, 3 cryoglobulinemia

A

type 1 occlusive vasculopathy, type 2 3 LCV

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69
Q

Describe pathology for antiphospholipid syndrome

A

fibrin thrombi, lacks LCV

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70
Q

Whats the most sensitive ab for antiphospholipid syndrome

A

anticardiolipin

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71
Q

Whats the most specific ab for antiphospholipid syndrome

A

antiB2glycoprotein 1

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72
Q

cutanous collagenous vasculopathy pathology shows what? Stains with what?

A

thick hyalinized BMZ surrouding vessels stain positive with collagen 4 PASpositive

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73
Q

is cutaneous collagenous vasculopathy responsive to laser?

A

no it is not

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74
Q

what drug causes telangiectasias in sunexposied areas?

A

CCBs

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75
Q

erythromelalgia is associated with what possible lab value?

A

thrombocythemia

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76
Q

Cholesterol emboli presenting with what most commonly?

A

livedo reticularis or blue toe

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77
Q

Cholesterol emboli labs will show?

A

Eosinophilia, elevated BUN Cr

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78
Q

levamisoleinduced vasculitis will have what antibodies?

A

pANCA

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79
Q

degos disease presents in who? Clinical picture? Systemic symptomas?

A

young middleaged men as small ivory scars. Prediposed for GI bowel performation

80
Q

Sneddon syndrome presents in who as what?

A

livedo racemosa with labile blood pressure and CNS disease (TIA, stroke, dementia). See in young WOMEN.

81
Q

What is sneddon syndrome associated with? tx?

A

Antiphotopholipid syndrome. Tx with warfarin (INR 23)

82
Q

Livedo racemosa associated with?

A

sneddon syndrom and apls

83
Q

livedo reticularis associated with what drugs? What other syndromes?

A

amantadine

84
Q

auriculotemporal nerve syndrome is the most common complication of what surgery?

A

parotidectomy

85
Q

Drugs that cause erythema nodosum?

A

OCPs, sulfonamides, NSAIDs

86
Q

Tx for IBDassociated EN?

A

TNF alpha inhibitors

87
Q

Schmids Triad

A

pancreatic panniculitis, poly arthritis (intraosseous fat necrosis), eosinophilia

88
Q

Tx for lipodermatosclerosis?

A

danazol, pentoxifylline

89
Q

Cold panniculitis histology?

A

lobular panniculitis with pernio changes

90
Q

type 1 5 alpha reductase is in

A

hair skin sebaceous glands

91
Q

type 2 5 alpha reductase is in

A

prostate, inner root sheath of hair

92
Q

shortened anagen phase and increase fibrous steamers? Name 3. Which of the 3 have the massive catagentelogen shift?

A

AGA, but AA, Trichotillomania has the most massive catagen shift

93
Q

pemphigoid gestationis associated with what HLA?

A

HLA DR3, HLA DR4

94
Q

Dermatosis of pregnancy that spares umbilicus?

A

Polymorphic eruption of pregnancy

95
Q

Polymorphic eruption of pregnancy seen in what type of pregnancies?

A

1st pregnancy (primiparous women), multiple gestation pregnancies

96
Q

tx for intrahepatic cholestasis of pregancy?

A

ursodeoxycholic acid

97
Q

baby consequences for intrahepatic cholestasis of pregancy?

A

premature birth, intrapartum fetal distress, still birth

98
Q

most common pruritc disorder of pregnancy?

A

atopic eruption of pregnancy

99
Q

tx for trichotillomania?

A

Nacetylcysteine, clomipramine

100
Q

What disease associated with AA is a prognostic of poor response?

A

atopic dermaittis

101
Q

temportal triangular alopecia presents when? Look like?

A

Presents at birth or within the first decade as temporal sclap areas that lack terminal hairs

102
Q

Congenital generalized lipodystrophy looks like what?

A

lipoatrophy in face, arms and legs with muscles

103
Q

Familial partial lipodystrophy

A

lipohypertrophy on the face, lipoatrophy on the extremities

104
Q

Acquired generalized lipodystrophy

A

congenital lipodystrophy , loss of fat on palms soles BUT, preserved bone marrow fat

105
Q

Acquired partial lipodystrophy

A

exact opposite of familial partial. Gaunt face, lipohypertrophy lower extremities

106
Q

All the lipodystrophies have an increase riask of diabetes insulin resistance. Which one has risk of hypertrophic cardiomyopathy?

A

congenital generalized

107
Q

All the lipodystrophies have an increase riask of diabetes insulin resistance. Which one has fatal fatty liver and cirrhosis?

A

acquired generalized lipodystrophy

108
Q

Which lipodystrophy has the 30% preceding Autoimmune connective tissue disease and panniculitis?

A

acquired generalized lipodystrophy

109
Q

Which lipodystrophy is associated with membranoproliferative glomerulonephritis and has decrease in C3 complement?

A

Acquired partial lipodystrophy

110
Q

which hairloss disorder has premature desquamation of inner root sheath, concentric lamellar fibroplasia and eccentric thinning of outer root sheath?

A

CCCA

111
Q

LPP interface is at the level of the ?

A

infundibulum

112
Q

LPP vs DLE histology?

A

interface dermatitis in DLE, but not in LPP

113
Q

Structural hair abnormalies assocated with increased hair fragility?

A

bubble hair, moniletrix and the 4T s Trichorhexis invaginata, trichoexis nodosa, Trichothiodystrophy, PiliTorti

114
Q

bubble hair due to

A

traumatic heat styling

115
Q

monilethrix due to

A

Dsg 4 in AR inheritance. Hari cortex specific keratin in AD inheritance

116
Q

moniletrix presents at what age?

A

normal hair at birth. Short brittle hair w perifollicular erythema and follicular hyperkeratosis a few months later

117
Q

Pili tori is seen in what 4 diseases?

A

Cranberry, Blue, citrus, kinky noodles. Menkes kinky hair, Bazex Dupre, Crandall syndrome, Nethertons, urea cycle (cirullinemia, argininosuccinic aciduria)

118
Q

Acquired pili torti seen in ?

A

anorexia nervosa and oral retinoids

119
Q

Crandall syndrome

A

pili torti, hearing loss and hypogonadism

120
Q

Natural history of pili torti?

A

normal hair at birth, replaced by brittle hair, then normalizes at puberty

121
Q

BazexDupre Christol symptoms?

A

Pili torti, bCC, milia, follicular atrophoderma, hypohidrosis, hypotrichosis

122
Q

Menkes Kinky hair?

A

pili torti, trichorrhexis nodosa, mental retardation, cupids bow upper lip, doughy skin, diffuse hypopigmentation (tyrosinase requires copper)

123
Q

trichorrhexis invaginata seen in what disease?

A

nethertons SPINK5)serine protease inhibitor)

124
Q

trichorrhexis nodosa seen in

A

congenital citrullinemia, argininosuccinic aciduria (both with pili torti, trichorrhexis nodosa and vomiting, seizures)

125
Q

Trichothiodystrophy s hair features? Name 3

A

sulfur deficient, trichoschisis (transverse fractures) and alternating light dark under polarized light

126
Q

Acquired progressive kinking of hair is a sign of?

A

AGA

127
Q

Pili annulati

A

Light dark bands what you can see with naked eye (unlike trichothiodystrophy). Due to airfilled spaces

128
Q

medicatoin induced hypertrichosis?

A

minoxidil, phenythoin and cyclosporine

129
Q

hirsuitism on areola, lateral face and neck is likely due to what source?

A

ovarian

130
Q

hirsuitism on abdomen and sterum is likely due to what source?

A

adrenal

131
Q

PCOS labs

A

decreased FSH, increased LH, increased LH to FSH ratio greater than 3

132
Q

onychorrhexis seen in

A

brittle nails. Seen in LP, chronic wet work, nailpolish use

133
Q

onychauxis

A

subungal hyperkeratosis causing thickened nail in psoriasis, onychomycosis, eczema

134
Q

onychocryptosis

A

ingrown nail

135
Q

apparent leukonychia due to

A

nail bed edema

136
Q

muehrcke s nails

A

chornic hypoaluminemia. Transverse white bands parallel to lunula

137
Q

terry s nails

A

leukonychia o nail plate. Liver cirrhosis

138
Q

half and half nails

A

leukonychia of half nail plate due to chronic renal disease

139
Q

longitudinal melanonychia drugs and diseases? Name 4 drugs and 2 diseases

A

AZT, antimalarials, minocycline, gold, LaugierHunziker, Peutz jegher

140
Q

longitudinal melanonychia caused by what onychomycosis bug?

A

Scytalidum

141
Q

black nails

A

proteus mirabilis or trichophyton rubrum

142
Q

green nails from what in the pseudomonas

A

pyocanin from pseudomonas

143
Q

nail patella syndrome

A

traingle shaped lunula and absent patella. Need to see nephrology for possible nephropathy

144
Q

yellow nail syndrome due to

A

lymphedema, pleural effusions, bronchiectasis

145
Q

fordyce granules

A

ectopic sebaceous glands on the vermillion and buccal mucosa

146
Q

geographic tongue

A

psoriasis

147
Q

fissured tongue

A

melkerssonrosenthal (facial nerve paralysis, swelling of face, lips), down syndrome, cowden syndrome

148
Q

necrotizing ulcerative gingivitis due to

A

malnutrition, immunosuppression, poor oral hygiene

149
Q

number 1 tumor of the oral cavity?

A

fibroma along bite line

150
Q

white sponge nevus due to mutation in

A

keratin 4 and 13

151
Q

gingival enlargement due to

A

cyclosporine, phenytoin, CCB

152
Q

orofacial granulomatosis

A

melkerssonrosenthal (facial nerve paralysis, fissured tongue), crohns, sarcoidosis

153
Q

Cheiliis glandularis clinical picture?

A

enlargement of lower lip due to inflammation of secretory ducts

154
Q

risk factor for cheiliis glandularis?

A

adult men with ho sun exposure, hence the increased risk of SCC

155
Q

People with hypomelanosis of Ito have to worry about?

A

CNS, MSK or ophthalmologic abnormalities

156
Q

third degree burn is

A

full thickness skin destroyed, forming an ulcer

157
Q

fourth degree burn is

A

loss of skin and sucutaneous fat

158
Q

Frost bite treatment

A

warm bath rapidly

159
Q

Immediate pigment darking after sun exposure within the 1st 24hrs is due to

A

UVA. Photooxidation of melanin

160
Q

Delayed tanning that develops over many days and lasts months is due to

A

UVB. Resulting in melanin synthesis

161
Q

most common photosensitive dermatosis? due to what type of light

A

PMLE, due to UVA more than to UVB

162
Q

most common cause of solar urticaria? What type of light?

A

visible light

163
Q

Porphyria cutanea tarda due to decrease in what enzyme?

A

uroporphyrinogen decarboxylase (UROD)

164
Q

PCT plasma fluoresces at what nm?

A

620nm

165
Q

Triggers for PCT (5)

A

Hemochromatosis ,Hepatitis C, alcohol abuse, estrogen, HIV

166
Q

homozygous mutation of UROD is what disease?

A

hepatoerythropoietic porphyria (HEP)

167
Q

congenital erythropoietic porphyria due to what mutation?

A

UROS (uroporphyrinogen 3 synthase). Gunther s disease

168
Q

Porphyria with red urine? What fluorescence nm

A

congenital erythropoietic porphyria. Excited by visible light at 410

169
Q

Tx for congenital erythropoietic porphyria?

A

Iron chelation w deferoxamine, ascorbic acid, alphatocopherol

170
Q

most common porphyria in children?

A

erythropoietic protoporphyria (EPP)

171
Q

EPP due to mutatoin in what?

A

ferrochelatase in the mitochondria

172
Q

Besides the skin, what other problems do kids with EPP have?

A

Cholelithiasis (protoporphyrins accumulate in the liver causing hepatotoxicity and progressive hepatic dysfunction)

173
Q

EPP treatment?

A

photoprotection and oral Betacarotene, plasmapheresis, liver transplantation

174
Q

Cauliflower ear

A

due to recurrent trauma to external ear. Often in wrestlers

175
Q

amyloid stains for what 4

A

congo red, crystal violet, thioflavin T, PAS

176
Q

Percent of nodular amyloid that can progress to systemic amyloid?

A

7 percent

177
Q

Tx for biliary pruritus

A

cholestyramine, ursodiol

178
Q

Aquagenic puritus presents as? Tx?

A

itch and pain after contacting water. No visible skin changes. Treat with clonidine and propranolol. (both HTN meds)

179
Q

Meralgia paresthetica due compression of what nerve?

A

Lateral femoral cutaneous nerve as it passes under the inguinal ligament

180
Q

Trigeminal neuralgia due to injury to what?

A

gasserian ganglion that can happen after treatment for trigeminal neuralgia

181
Q

Familial dysautonomia syndrome symptoms

A

autonomic and sensory dysfunction. Cant produce tears, cant taste food, cant salivate, cant feel pain.

182
Q

Aquagenic PPK presents as?

A

Thick clearwhite pebblelike palmar eruption afte rwater immersion

183
Q

Aquagenic PPK associated with?

A

sun burn

184
Q

Circumscribed palmar plantar hypokeratosis presents as? What do we see on histopath?

A

Welldefined pink circular depresson on palm or sole. On histopath, appears as focally decreased statum corneum.

185
Q

malignant polyps in stomach or small intestine

A

Peutz Jegher

186
Q

recurrent epistaxis

A

Osler weber rendu

187
Q

another name for tyrosinemia type 2

A

(Richner Hanhart syndrome)

188
Q

symptoms of richner handhurt

A

ocular findings of keratitis with photophobia, corneal ulceration. Cutaneous manifestations include painful palmoplantar keratosis

189
Q

Genital lentigines and mucosal lentigines and longitudinal melanonychia

A

LaugierHunziker syndrome

190
Q

Lentigines syndrome with endocrinopathies

A

CARNEY LAMB. endocrinopathies (hyperactive endocrine activity due to tumors of the adrenals, pituitary, and other endocrine gland)

191
Q

Muir Torre syndrome is associated with what two cancers?

A

colon and genitourinary

192
Q

what is the first sign of neuro invovlement in XP?

A

decreased or absent deep tendon reflexes and hearing loss at higher frequencies

193
Q

pachydermoperiostosis

A

pachydermia, periostosis, and finger clubbing. Onset is often at puberty

194
Q

CHILD syndrome, ConradiHunermann syndrome, Goltz syndrome, and incontinentia pigmenti are all inherited

A

Xlinked Dominant

195
Q
A

Clinical Dermatology (11 decks)

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