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Dermatology Boards > Gen Derm/Med Derm > Flashcards

Gen Derm/Med Derm Flashcards

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1
Q

Madarosis

A

can be associated with hypothyroidism

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2
Q

Follicular thyroid carcinoma

A

Cowdens

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3
Q

Most common thyroid carcinoma

A

papillary thyroid carcinoma

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4
Q

Cutaneous PAN

A

Hepatitis C > B

Classic PAN is B>C

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5
Q

IBD associations

A

PG

EBA

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6
Q

Antibody in primary biliary cirrhosis

A

Anti-mitochondrial antibody

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7
Q

Mechanism in Scleroderma

A

TGF-B, endothelin-1, PDGF, IL-4

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8
Q

Wilson’s disease mutation

A

ATP7B

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9
Q

Chromophode renal carcinoma

A

Birt-Hogg-Dube

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10
Q

Lindsay’s nails

A

half and half

renal disease

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11
Q

Acquired angioedema

A

Decreased C1-INH activity
Decreased C1q and C2/C4
AAE type 1: lymphoproliferative disorder
AAE type 2: autoimmune disease

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12
Q

Bazex tumor

A

upper aerodigestive

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13
Q

Antiepiligrin cicatricial pemphigoid; cancer

A

adenocarcinoma (GI and lung> other)

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14
Q

Carcinoid tumor details

A

must have met to liver for carcinoid syndrome (for mid-gut)
bronchial and gastric do not need mets
Increased 5-HIAA in urine

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15
Q

Dermatomyositis and malignancy

A

most common: ovarian cancer

Other: lung, colorectal, pancreatic, non-Hodgkin lymphoma

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16
Q

Erythema Gyratum repens: cancer type

A

lung cancer > esophageal or breast

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17
Q

EMPD

A

CK7+, GCFDP-15+, CK20-

perianal has 5x risk of internal malignancy

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18
Q

Familial Atypical mole and multiple melanoma syndrome

A

CDKN2A, AD
p16, p14
ultimately inhibit p53 (tumor suppressor)

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19
Q

hypertrichosis lanuginosa acquisita: cancer

A

lung, colorectal, and breast cancer

F>M

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20
Q

Leser-Trelat: cancer

A 
gastric adenocarcinoma (most common)
colon, breast, others
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21
Q

malignant acanthosis nigricans: cancer

A

GI cancer

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22
Q

Multicentric Reticulohistiocytosis

A

malignancy (no specific)

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23
Q

Necrolytic Migratory Erythema

A

glucagonoma (pancreatic islet cell carcinoma, a2-glucagon)

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24
Q

NXG

A

IgG-k gammopathy

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25
Q

Pagets disease of the breast

A

ductal breast CA

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26
Q

Paraneoplastic Pemphigus: cancer

A

non-hodgkin lymphoma or CLL
Castleman (children-most common), thymoma, sarcoma

They can die of bronchiolitis obliterans

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27
Q

Pityriasis Rotunda Association

A

HCC

Other: TB, leprosy, liver, lung disease, gastic and esophageal carcinoma

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28
Q

plane xanthoma

A

paraproteinemia, myeloma, lymphoproliferative

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29
Q

Most common skin with POEMS

A

hyperpigmentation, hypertrichosis, sclerodermoid

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30
Q

Schnitzler

A

urticaria+ IgM-k

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31
Q

Scleromyxedema

A

IgG lambda

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32
Q

Sweets

A

IBD

Malignancy (AML most common)

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33
Q

Tripe Palms

A

lung cancer

If associated with acanthosis nigricans (gastric cancer)

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34
Q

HLA-B13, HLA-B17

A

guttate and erythrodermic psoriasis

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35
Q

Drugs associated with psoriasis

A

Lithium, B-blocker, TNF-a,

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36
Q

Impetigo Herpetiformis

A

pregnancy associated pustular psoriasis

early delivery recommended

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37
Q

pityriasis amiantacea

A

psoriasis is # 1 cause

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38
Q

Most Common PSA

A

Oligoarthritis, DIP and PIP involvement

Other types
Asymmetric DIP 
RA like
Anklylosing spondy
Arthritis mutilans: telescoping
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39
Q

PRP vs Psoriasis

A

No nail pits in PRP

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40
Q

Nail changes in psoriasis

A

pits: proximal matrix
leukonychia: distal matrix
oil spots, salmon patches, onycholysis: nail bed

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41
Q

PRP Types

A

1: generalized adult
2: atypical adult, chronic course
3: juvenile, generalized (1st 2 years and adolescence)
4: juvenile, localized
5: atypical juvenile: sclerodermoid changes, early onset

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42
Q

Drug induced PR

A

ACE, B-blockers, gold
older population
no herald
resolved in 2 weeks after stopping drug

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43
Q

Definition of erythroderma

A

> 90% BSA
M>F
age=50

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44
Q

Most common cause of erythroderma

A

psoriasis

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45
Q

Most common drugs implicated in erythroderma

A

allopurinol, sulfa, antiepileptics, HAART

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46
Q

Pseudoatrophoderma coli

A

variant of CARP on neck, responds to mino

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47
Q

Atopic derm resolution

A

60% resolve by age 12

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48
Q

Atopic Dermatitis Inflammatory Profile

A

TH2 (acute)
IL4, 5, 12, 13
TH1 (chronic)
IFN-y

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49
Q

Atopic Dermatitis, Ocular Involvement

A

atopic keratoconjunctivitis
posterior subcapsular cataracts
keratoconus

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50
Q

Progesterone dermatitis

A

occurs during luteal phase
1 week before menses

RX: OCP

Estrogen dermatitis: also a thing, but chronic and worse with menses

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51
Q

Allergic Contact Dermatitis

A

Type IV hypersensitivity

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52
Q

Phytophotodermatitis, type of dermatitis

A

irritant (fucocoumarins+ UVA)

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53
Q

Nail products implicated with eyelid dermatitis

A

tosylamide> acrylates

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54
Q

Delayed patch test positives

A

metals (gold, palladium), corticosteroids

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55
Q

Which causes a worse burn/irritation: alkali or acid

A

alkali

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56
Q

Non-immunologic urticaria

A

Urtica dioica (nettle)

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57
Q

Chemical ICD causes

A

Calcium oxalate: daffodil (amaryll/Lilacea); dumb cane (Dieffenbachia); pineapple

Bromelin: pineapple (Anana cosmosus)

Capsaicin: peppers (Solanaceae)

Phorbol Esters: Croton (Euphorbia), buttercups (ranunculin)

Thiocyanates: Alliacea (garlic), Brassicaceae (black mustard, radish)

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58
Q

Phytophoto causes

A

Apiaceae, Umbelliferae: hogweed, cow parsley, parsnips, carrots

Rutaceae: citrus, bergamot
Moraceae: fig, mulberry
Fabaeae: Balsam of peru

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59
Q

Photoallergic contact dermatitis

A

Allergen+ light (UVA)

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60
Q

Rhus dermatitis

A

Anacardiaceae, Toxicodendron

poison ivy, poison oak, poison sumac

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61
Q

Asteraceae

A

Same as Compositae

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62
Q

Autosensitization

A

= id reaction (secondary sites, distant to primary exposure)

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63
Q

Contact urticaria

A

raw vegetables or meats
birch pollen allergy (apples, pears, cherries)
potato is #1

Latex (health care workers, most common)
50% cross reactivity with (Bananas, avocados, chestnuts, kiwi, passion fruit)

Other: hair bleach, ammonium persulfate, bacitracin

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64
Q

Non-immunologic contact urticaria

A

lower risk of anaphylaxis

Urticaceae (nettles, #1)
DMSO

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65
Q

EM with Erythema nodosum

A

classic for histoplasma

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66
Q

SJS

A

Granulysin felt to mediate apoptosis
FasL (CD95L) also associated with apoptosis

1-2 weeks after med

Ocular sequelae most common (80%)

Mortality SJS < 5%
TEN 30%

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67
Q

HLA B1502

A

SJS associated with carbamazepine in asians and E. Indians

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68
Q

HLA B3101

A

Carbamazepine in europeans

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69
Q

HLA B5701

A

abacavir

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70
Q

HLA B5801

A

allopurinol Han chinese

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71
Q

SCORTEN

A

TAMEBUG (tachycardia > 120, age >40, malignancy, epidermal loss >10%, bicarbonate >20, BUN > 27, glucose > 250

SCORTEN mortality 
0-1: 3.2%
2: 12.1
3: 35.3
4: 58.3
5+: > 90
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72
Q

Cross-reactive SJS: Carbamazepine

A

Phenytoin, Phenobarbital +/- Lamotrigine

Valproic acid does not cross-react
Levetiracetam does not cross react

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73
Q

Mucha-Haberman

A

PLEVA+ fever+ LAD

associated with increased TNF-a

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74
Q

PLEVA/PLC Path

A

No eosinophils!!

CD8+ T-cells predominate

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75
Q

Drugs associated with fixed drug eruption

A

1-2 weeks after initial exposure
patch test within a prior site of involvement

sulfonamides (#1 cause of genital)
NSAIDs
Phenolphthalein

Non-pigmented
Pseudoephedrine
NSAIDs
tetrahydrozoline

76
Q

Frictional Lichenoid eruption

A

1-2mm lichenoid papules on the extensor surfaces in spring and summer; young boys

77
Q

Most common US ACD

A

Rhus

78
Q

Most common world wide ACD

A

Nickel

79
Q

Contact Dermatitis

A

80% ICD

20% ACD

80
Q

Clothing Dermatitis allergens

A

Formaldehyde and Releasers

Dispersion Blue dye

81
Q

Shoe Dermatitis

A

Adhesives (colophony, p-tert-butyl)
Rubber accel (Mercaptobenzothiazole)
Leather (chromates)
Dyes

82
Q

Adhesive dermatitis

A

ICD> ACD

rubber, resin, acrylate

83
Q

Alkali Dermatitis Causes

A

Ca/Na/K hydroxides, ammonia, lye, soap, detergent, bleaches?, depilatories

Rx: weak acid, lemon juice or vinegar

84
Q

Acid Dermatitis Causes

A

Sulfuric Acid: brown discoloration
Nitric Acid: yellow
Hydrofluoric Acid (used for etching glass): neutralize with calcium gluconate

85
Q

Phenol

A

glomerulonephritis and arrhythmias

neutralized with 65% ethyl alcohol or isopropyl alcohol

86
Q

Green Felt/Tattoo

A

Chromate
Also Leather and Cement, chromic gut

cross react with nickel and cobalt

87
Q

Blue Green Pottery/Tattoo

A

Cobalt
Also: cement, leather?, cosmetics

Cross-Reacts with Chromate and Nickel

88
Q

Most frequent persistent positive patch test

A

Gold

89
Q

Most common glove allergy

A

Thiuram

Co-Reacts with Disulfuram

90
Q

Bleached Elastic Allergen

A

Carbamate

Must do use test, may not have positive patch

91
Q

Wet Suit Dermatitis

A

Dialkyl thioureas (Neoprene)

92
Q

Hair Dye, Black Henna

A

P-phenalenediamine (PPD)

Also in black rubber and photo developing solution

93
Q

adhesive, Hair wax, chewing gum, violin

A

Rosin (colophony and abietic acid)

94
Q

Glue for Leather

A

p-tert-butylphenol formaldehyde resin (PTBP)

95
Q

PVC, plastic, paint, and sculpture

A

epoxy (Bisphenol A)

only a problem when wet

96
Q

Cyanoacrylates

A

Ethyl-> Krzy glue
Butyl -> Glu Stitch
Octyl -> Dermabond

97
Q

Methylacrylates

A 
Rigid Plastic (Ortho/Dental)
Bone Cement

Diffuses through rubber and polyvinyl gloves

98
Q

GVHD in solid organ transplant

A

small intestine>liver> kidney> heart

99
Q

Risk factors for GVHD

A

Occurs in 50% of HSCT

MOST IMPORTANT IS HLA COMPATIBILITY
HLA matched 40%
HLA unmatched 60-70%

matched unrelated donor
female donor> male donor
older age

Stem cell source: peripheral blood> bone marrow>cord blood
Myeloablative Pre-Treatment increases risk (more damage to host tissues)

100
Q

Most commonly affected organ in GVHD

A

skin

101
Q

GVHD pathophys

A

donor lymph recognize HOST protein-APC

102
Q

Time of acute GVHD

A

< 100 days
usually 2-6 weeks (peak at day 30)

Acral erythema, perifollicular erythema

+ GI (severity based on diarrhea) + Liver (severity based on bilirubin)

103
Q

Timing chronic GVHD

A

> 100 days

80% lichenoid

104
Q

Novel treatment for visceral GVHD

A

miraviroc (CCR5 antagonist): decreases CD8 recruitment to liver and gut

105
Q

Lichen Planus: Frequency of Forms

A

4% adults affected by oral LP

1% cutaneous

106
Q

HCV association with LP

A

oral, erosive LP

107
Q

Allergens associated with LP

A

mercury, copper, gold, cinnamates

108
Q

Drug Induced LP: Drugs

A

HCTZ, ACE, B-Blockers; anti-malarials, quinine; penicilliamine, gold; TNF-1; NSAIDs

109
Q

Graham-Little-Piccardi-Lasseur

A

LPP + non-scarring alopecia

110
Q

Drug-Induced LP

A

often spares mucosa
sun exposed areas
more eczematous or psoriasiform
LATENCY PERIOD: 12 months

111
Q

LP DIF

A

shaggy fibrinogen along BMZ, + IgM (> IgA, IgG, C3)

112
Q

Lichen Sclerosus Disease Association

A

Auto-Immune thyroid disease

Also 80% have circulating antibodies to ECM-1

113
Q

Balanitis Xerotica Obliterans

A

male penile LSA

114
Q

HLA associated with LS

A

HLA-DQ7

115
Q

Risk of SCC in LS

A

5% risk in anogenital LS

116
Q

Fogo Selvagem

A

PF in Brazil, associated with Simulium (black fly)

117
Q

BP HLA

A

HLA DBQ 0301

118
Q

PNP antibodies

A

desmoplakin, BPAG-1, pelctin, periplakin, envoplakin, DSG &3

119
Q

Drug Induced BP

A

Furosemide, ACE, Ceph, B-lactam, penicillamine

120
Q

Mucous Membrane Pemphigoid, Treatment of Choice

A

Dapsone

121
Q

Anti-p200

A

Form of BP

target laminin y1, associated with psoriasis; dermal side on SSS

122
Q

Anti-p105

A

Form of BP

looks like SJS/TEN, Dermal side on SSS

123
Q

Drug Induced Linear IgA

A

Vancomycin> PCN/CSN, captopril, LITHIUM, Nsaids> phenytoin

124
Q

EBA target

A

NC1 domain of col VII (anchoring fibril)

125
Q

IgA pemphigus target

A

desmocollin1

126
Q

Pemphigus Vulgaris, Other Disease Associations

A

Autoimmune: myasthenia, thymoma, autoimmune thyroid

127
Q

TTG2, TTG3

A

TTG-2 is target for gut involvement with DH

TTG-3 is target in skin

128
Q

Darier’s mutation and location

A

ATP2A2 (SERCA2- Ca), AD

Endoplasmic reticulum

129
Q

Hailey-Hailey mutation and location

A

ATP2C1 (hSPCA1), Golgi

NO MUCOSAL INVOLVEMENT

spares hair on histology

130
Q

ANA: homogenous

A

dsDNA, histone

131
Q

ANA: peripheral

A

dsDNA

132
Q

ANA: speckled

A

Ro/La, U1RNP, Sm, RNAPoly, Scl-70

133
Q

ANA: nucleolar

A

U3RNP, ant-PM/Scl

134
Q

ANA: discrete speckled

A

Centromere

anti-centromere antibodies

135
Q

False positive DIF

A

rosacea, telangiectasias, PMLE

136
Q

Type of light associated with worsening of chronic cutaneous lupus

A

UVR (UVB> UVA)

137
Q

HLA associated with SCLE

A

B8, DR3

138
Q

Drugs Associated with SCLE

A

HCTZ (most common), terbinafine, griseofulvin, NSAIDs, CCB, anti-histamines, PPI, docetaxel, ACE, and TNF (etanercept)

139
Q

Neonatal Lupus Systemic Involvement

A

Cardiac: 30-40% with heart block
Hepatobiliary
Hematologic

140
Q

Most common hereditary complement disorder

A

C2
only 10-20% risk of SLE with homozygous
Still most common cause of complement deficiency associated SLE

141
Q

Other complement deficiencies associated with SLE risk

A

C1q (90%)> C1 r/s > C4

C1, 2, 4 associated with SLE and infection risk

142
Q

Acquired anti-C1q antibodies

A

30-50% of patients with SLE, associated with severe renal disease

143
Q

Target in Bullous Lupus

A

NC1, NC2 of Col VII
More common in AA
Must have SLE

144
Q

SLE Inflammatory signature

A

IL-6, IL-17, TNFa

Type 1 IFN (IL-18-> IFN-y)

145
Q

Number of items for SLE criteria

A

4 (including one immunologic)

146
Q

Minocycline DILE

A

+ ANCA

- histone antibodies

147
Q

TNF-a DILE

A

anti-dsDNA

prominent skin involvement

148
Q

Drugs associated with DILE

A

hydralazine, procainamide> methyldopa, isoniazid, penicillamine, PTU

149
Q

Jessners

A

CD8+ cells

150
Q

REM, DIF

A

negative

151
Q

Most common malignancy associated with DM

A

Ovarian
GI

Detected within 1-2 years

152
Q

Brunsting variant of DM

A

Classic Juvenile DM
90%
gradual onset, calcinosis cutis

153
Q

Banker variant of DM

A 
Vasculopathic/Ulcerative JDM
10% 
rapid onset with severe muscle disease
vasculitis
cutaneous ulcerations
154
Q

Wong Type DM

A

clinical features of PRP with DM

155
Q

anti-Fodrin antibodies

A

Sjogren syndrome

70%, most sensitive and specific

156
Q

Antibody agains Type II collagen

A

Relapsing polychondritis

157
Q

MAGIC syndrome

A

Behcets + relapsing polychondritis

MTX most effective Rx

158
Q

Felty syndrome

A

seropositive RA
neutropenia, splenomegaly
refractory leg ulcers
a/w risk of lymphoma/leukemia

159
Q

Morphea

antibodies

A

anti ss-DNA antibodies
Anti-topoisomerase II

None have scl-70 or anti-centromere

160
Q

Parry Romberg Syndrome

A

progressive hemifacial atrophy

161
Q

Melorheostosis

A

roughening long bone surface under area of linear morphea

162
Q

Atrophoderma of Pasini and Pierini

A

brown-gray hyperpigmented plaques with cliff-drop edge

Type of morphea
decreased thickness of skin compared to normal

163
Q

Antibodies in Scleroderm

A

Anti-Scl
Anti-RNA Pol III
Anti-centromere (LCSS)

164
Q

Scleroderma most common cause of mortality

most common site of visceral involvement

A

mortality: pulmonary
common: GI-> GERD

165
Q

CXCL4

A

marker of skin and lung fibrosis, as well as PAH

166
Q

Eosinophilic Fasciitis

A

Excellent response to steroids

Metalloproteinase inhibitor 1 = serologic marker of disease

167
Q

Paraneoplastic syndrome with skin sclerosing

A

POEMS

Carcinoid (legs)

168
Q

Ingestions associated with scleroderma like presentation

A

Toxic Oil Syndrome (Rapeseed oil, flu-like symptoms)
L-tryptophan infegestion (fever, eosinophilia, myalgia, fasciitis)
Polyvinyl chloride

Meds:
Taxanes, Bleomycin
Vitamin K

169
Q

Isomorphic response

A

new lesions in areas of trauma

170
Q

Isotropic response

A

new dermatosis that favors a prior site of trauma/disease

171
Q

linear red to skin colored cords

A

Interstitial Granulomatous Dermatitis and Arthritis

Most commonly associated with GA

172
Q

umbilicated skin-colored to violaceous papules digits and elbows

A

PNGD

LCV + basophilic collagen degeneration, palisaded granulomas

SLE
ANCA+ Vasculitis
RA

173
Q

Perforating calcific elastosis

A

multiparous black women, periumbilical

174
Q

MAD PORES

A

EPS

Marfans
Acrogeria
Downs
Penicillamine, PXE
Osteogenesis Imperfecta
Rothmund-Thompson
Ehlers Danlos 
Scleroderma
175
Q

Interstitial Granulomatous Drug Eruption

A

CCB
ACE
TNFa

Photodistributed
Histo: may also have interface

176
Q

EBA

A

IBD is most common cause

177
Q

Drug Induced Sarcoid

A

IFN-a, ribavirin (Hep C)
HAART
TNF

178
Q

Darier-Roussey

A

subcutaneous sarcoid

179
Q

Lupus Pernio

A

beaded nasal rim and lung sarcoid

180
Q

Lofgren

A

EN, LAD, white men; good prognosis

181
Q

Heerfordt

A

parotid, uveitis, cranial nerve palsy

182
Q

Blau

A

early onset < 5 yo sarcoid like, associated with NOD2 mutation

183
Q

Red Necrobiosis Causes

A

Rheumatoid Nodule

Necrobiosis Lipoidica

184
Q

P Acnes and Acne Pathophys

A

lipases TAG -> FFA
TLR2 activation -> IL-1, 8, 12, TNF-a
Coproporphyrin III

185
Q

Neonatal Acne

A

weeks-months

malassezia or stimulation by maternal androgen

186
Q

Increased total testosterone

A

ovarian source

187
Q

Increased DHEAS or 17-hydroxyprogesterone

A

Adrenal source

21- hydroxylase or 11-hydroxylase defect

Dermatology Boards (7 decks)

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