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Clin Med II - Exam 5 > Greg Larsen - Derm Review > Flashcards

Greg Larsen - Derm Review Flashcards

1
Q

what is pediculosis

A

lice

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2
Q

how are pediculosis transmitted

A

through direct contact or fomites

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3
Q

can pediculosis jump/fly

A

no!

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4
Q

sx of pediculosis

A

constant itching

+/- eczema or lichen simplex chronicus

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5
Q

what do these heads have?

A

pediculosis

can look like eczema

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6
Q

first line tx for pediculosis according to CDC

A

permethrin 1% lotion

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7
Q

brand name for permethrin

A

Nix

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8
Q

what do you think when you see: burrows or s shaped erythematous tracts on the skin in inertriginous zones

A

scabies

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9
Q

who is at risk for scabies

A

houseolds/communities w. close intimate contact and overcrowding

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10
Q

sx of scabies

A

intense itching

can be worse at night

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11
Q

what do these people have

A

scabies

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12
Q

what question should you ask a patient w. suspected scabies

A

are any family members or close contacts experiencing sympsoms?

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13
Q

tx for scabies

A

permethrin cream and another application 1 week later

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14
Q

2 skin and soft tissue infections that are commonly associated w. erythema, edema, pain

A

cellulitis

erysipelas

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15
Q

deeper infection involving the dermis and subcutaneous tissue

A

cellulitis

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16
Q

superficial skin infxn involving lymphatic streaking

A

erysipelas

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17
Q

cellulitis and erysipelas are mc caused by

A

GAS

s. aureus

H.flu

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18
Q

erisypelas is commonly seen on the

A

face

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19
Q

what does this person have

A

erisypelas

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20
Q

what does this person have

A

cellulitis

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21
Q

cellulitis is commonly seen on the

A

legs

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22
Q

cellulitis and erysipelas are commonly missed; what is the ddx for these conditions

A

stasis dermatitis

eczema

DVT

osteomyelitis

ulcerations

pressure sores

fungal infxns

intertrigo

erythrasma

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23
Q

whether or not cellulitis and erysipelas are purulent, you should

A

drain and culture!

always!

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24
Q

gold standard op empiric tx for cellulitis and erysipelas

A

cephalexin (keflex)

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25
Q

what is the more realistic op tx for cellulitis and erysipelas

A

doxycycline

bc it covers MRSA

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26
Q

tx for hospitalized pt w. cellulitis/erysipelas

A

IV abx → ex Vanco

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27
Q

“pathetic version of cellulitis”

A

impetigo

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28
Q

what do you think when you see “tiny fragile yellow to honey colored crusted vesicles”

A

impetigo

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29
Q

mc pathogens associated w. impetigo

A

s.aureus

streptococcus pyogenes

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30
Q

what does this kid have

A

impetigo

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31
Q

impetigo can also present as

A

small fluid filled vesicles that crust over after the bullae ruptures

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32
Q

what do these kids have

A

impetigo

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33
Q

tx for localized/limited impetigo

A

topical mupirocin

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34
Q

does topical mupirocin cover mrsa

A

yes!

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35
Q

tx for widespread/non responding impetigo

A

doxycycline

only for kids >8 yo

not for pregnant

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36
Q

what do you think when you see: mild exanthem that is generally self resolving; slapped cheek rash followed by rash over cheset, back, buttocks, extremities

A

erythema infectiosum

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37
Q

erythema infectiosum is same-same

A

parvovirus

5th disease

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38
Q

what does this kid have

A

erythema infectiosum (parvovirus)

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39
Q

primary cause of transient aplastic crisis

A

erythema infectiosum (parvovirus)

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40
Q

what do you think when you see: coxsackievirus A 16 and enterovirus 71

A

hand-foot-and-mouth dz

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41
Q

what does this kid have

A

hand food mouth dz

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42
Q

how does hand food mouth dz present

A

vesicular palmoplantar eruptive rash

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43
Q

is this hand food mouth dz

A

no! it is syphilis

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44
Q

always be wary of vesicles on the

A

palms and soles

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45
Q

what does this person have

A

measles (rubeola)

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46
Q

contagious viral exanthem via droplet spread and direct contact; single stranded RNA morbillivirus

A

measles (rubeola)

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47
Q

prodrome of measles (3)

A

cough

coryza/rhinitis

conjunctivitis

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48
Q

2 classic signs of measles

A

nose and eyes run continuously

koplik spots

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49
Q

what are koplik spots

A

blue to white lesions with a red halo

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50
Q

what are these

A

koplik spots → blue to white lesions with a red halo

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51
Q

rare group of blistering AI disorders that tend to involve skin and mucosal membranes

A

pemphigus

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52
Q

what do you think when you see desmoglein antibodies Dsg1 and Dsg3

A

pemphigus

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53
Q

what is desmoglein

A

adhesion molecule that helps keep structural integrity to the epidermis

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54
Q

what does this person have

A

pemphigus

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55
Q

mc/dominant form of pemphigus

A

pemphigus vulgaris

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56
Q

how does pemphigus vulgaris present

A

painful oral erosions

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57
Q

what do you think when you see: exceptionally brittle bullae/blisters; positive nikolsky sign

A

pemphigus vulgaris

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58
Q

what is nikolsky sign

A

sloughing of epidermal tissue w. pressure

59
Q

what does this patient have

A

pemphigus vulgaris

60
Q

shallow erosions/abrasions w. erythema and scaling

+/- blister formation

A

pemphigus foliceus

61
Q

what does this patient have

A

pemphigus foliaceus

62
Q

dx for pemphigus

A

perilesional punch bx w. skin adjacent to blister

63
Q

what do you think when you see Michel’s medium

A

direct immunofluorescence (DIF) for pemphigus

64
Q

Michel’s medium helps to

A

improve shelf life of processing tissue

65
Q

tx for pemphigus

A

no official clear tx guidelines

reduce inflammatory response w. immunosuppressants → prednisone

66
Q

mc AI blistering skin dz

A

bullous pemphigoid

67
Q

bullous pemphigoid is considered a dz of

A

advanced age

60 yo +

68
Q

what does this pt have

A

bullous pemphigoid

69
Q

how does pemphigoid present

A

localized erythema or urticarial plaques that worsen over time → hives

70
Q

how do blisters of pemphigoid differ from pemphigus

A

pemphigoid blisters appear more structurally intact → negative nikolsky sign

71
Q

rubbing of skin results in sloughing of epidermal tissue

A

nikolsky sign

72
Q

nikolsky sign is positive in __

and negative in __

A

pemphigus

pemphigoid

73
Q

what does this pt have

A

pemphigoid

74
Q

dx for pemphigoid

A

perilesional punch bx w. skin adjacent to blister

75
Q

DIF including michel’s medium is used for

A

pemphigus

AND

pemphigoid

76
Q

initial serum tests for pemphigoid

A

BP 180

BP 230

77
Q

mainstay tx for pemphigoid (and pemphigus)

A

prednisone

78
Q

common acute and recurrent inflammatory/hypersensitivity dz that often follows viral infxn/bacterial infxn or in pregnant pt

A

erythema multiforme

79
Q

what do you think when you see: targetoid lesions often on extremities, hands, feet

A

erythema multiforme

80
Q

pathology of erythema multiforme involves

A

immune complexes

81
Q

erythema multiform often presents w. __ targetoid lesions

A

uticarial

82
Q

what do these patients have

A

erythema multiforme

83
Q

tx for erythema multiforme

A

self limiting

+/- prednisone

84
Q

immune complex mediated desquamative hypersensitivity d.o; extreme form of erythema multiform

A

stevens-johnson syndrome/toxic epidermal necrolysis (TEN)

85
Q

__ are almost always involved in stevens johnson syndrome

A

oral mucosa → lips

86
Q

stevens johnson is mc seen in what 2 pt pops

A

kids

young adults

87
Q

what do these patients have

A

stevens johnson syndrome

88
Q

primary dx test for Stevens Johnson syndrome

A

punch bx

89
Q

epidermal necrosis and apoptosis of keratinocytes

A

punch bx finding for stevens johnson

90
Q

in stevens johnson, nikolsky sign will be

A

positive

91
Q

tx for stevens johnson

A

d/c meds!

admit to burn unit

fluid/lytes

wound care

consult all the specialists

92
Q

what pharm is contraindicated in stevens johnson

A

oral steroids

93
Q

pigmentation d.o frequently associated w. pregnancy and women taking OCP

A

melasma

94
Q

melasma frequently appears on the

A

forehead

molar cheeks

upper lip

chin

95
Q

acquired loss of pigmentation

A

vitiligo

96
Q

who is this?

A

michael jackson duh!

he has vitiligo

97
Q

flat hypopigmented 2-5 mm macules in sun exposed areas

A

idopathic guttate hypomelanosis

98
Q

what does this patient have

A

idiopathic guttate hypomelanosis

99
Q

hair loss on any are of the body where hair would normally be present

A

alopecia

100
Q

alopecia is divided into

A

scarring/cicatricial

non-scarring

101
Q

scarring alopecias

A

central centrifugal cicatricial alopecia

lichen planopilaris

frontal fibrosing alopecia

dissecting cellulitis

acne keloidalis nuchae

102
Q

non scaring alopecias

A

alopecia areata

traction alopecia

genetic pattern hair loss

telogen effuvium

103
Q

central scarring alopecia that spreads outward

A

central centrifugal cicatricial alopecia

104
Q

what does this patient have

A

central centrifugal cicatricial alopecia

105
Q

type of alopecia that presents w. patchy erythema and perifollicular scarring on the front-central scalp and crown

A

lichen planopilaris

106
Q

what does this patient have

A

lichen planopilaris

107
Q

lichen planopilaris should make you consider

A

syphilis

108
Q

is lichen planopilaris painful?

A

yes → pain, stinging, burning in active areas

109
Q

exam of scalp shows spinous hyperkeratotic follicular papules w. perifollicular erythema

A

lichen planopilaris

110
Q

what does this pt have

A

lichen planopilaris

111
Q

variant of lichen planopilaris that involves hair loss in other locations (eyebrows/upper extremities)

A

frontal fibrosing alopecia

112
Q

what does this pt have

A

frontal fibrosing alopecia

113
Q

patchy pustular eruptions of the scalp; chronic in nature; leads to inflammation and permanent scalp scarring

A

folliculitis decalvans

114
Q

what does this pt have

A

folliculitis decalvans

115
Q

wide spread folliculitis w. atrophic patchy scarring and perifollicular crusts

A

folliculitis decalvans

116
Q

mechanical form of folliculitis/inflammation which causes scarring alopecia; typically affects darker skinned men w. curly hair

A

acne keloidalis nuchae

117
Q

what does this pt have

A

acne keloidalis nuchae

118
Q

asymptomatic loss of complete hair in one or more patches of any hair bearing surface

A

alopecia areata

119
Q

what does this pt have

A

alopecia areata

120
Q

3 types of alopecia areata

A

areata

totalis

universalis

121
Q

alopecia areata

A

partial hair loss

122
Q

alopecia totalis

A

100% hair loss of scalp

123
Q

alopecia universalis

A

100% hair loss of whole body

124
Q

what is this and what does it make you think of

A

exclamation point hairs

alopecia areata

125
Q

what are exclamation point hairs

A

broader/wider distal shaft and narrow proximal shaft/base

126
Q

alopecia 2/2 to prolonged mechanical tension like grooming and styling

A

traction alopecia

127
Q

what does this pt have

A

traction alopecia

128
Q

androgenetic alopecia in men that is a physiologic response 2/2 to androgens

A

genetic patterned hair loss

129
Q

what do you think when you see hamilton patterns

A

classification for genetic patterned hair loss

130
Q

tx for genetic patterned hair loss

A

minoxidil, finasteride (rogaine)

131
Q

temporary shedding brought on by stimulus → ex stress

A

telogen effluvium

132
Q

inflammation of nailfold tissue; usually infectious

A

paronychia

133
Q

what do you think when you see chronic paronychia w. green nail

A

pseudomonas

134
Q

chronic paronychia is > __ weeks

A

6

135
Q

what is this

A

green nail syndrome/chloronychia

pseudomonas

136
Q

fungal infxn of the nails

A

onychomycosis

137
Q

4 types of onychomycosis

A

distal subungual

white superficial

proximal subungual

candida onychomycosis

138
Q

white superficial onychomycosis typically requires __ for dx

A

oral tx rather than topical → itraconazole, fluconazole, terbinafine

139
Q

mc type of onychomycosis

A

distal subungual

140
Q

type of onychomycosis seen in immunocompromised pt

A

proximal subungual onychomycosis

141
Q

candida onychomycosis is caused by

A

candida albicans

142
Q

candida onychomycosis generally involves

A

all the fingernails

143
Q

what does this pt have

A

onychomycosis

144
Q

oral med for onychomycosis that can cause liver dz

A

terbinafine

Clin Med II - Exam 5 (23 decks)

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