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DERM > hair & digit d/o > Flashcards

hair & digit d/o Flashcards

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Dermatology Board Prep flashcards
1
Q

rapid, painless, not itchy smooth, discrete circular patches of total hair loss over period of weeks (rapid); immune-mediated

A

alopecia areata

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2
Q

hair loss condition commonly associated with thyroid dz, pernicious anemia, addisons, SLE, (autoimmune dz)

A

alopecia areata

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3
Q

alopecia areata prognosis

A

regrowth in 1 to 3 months; new hair is same color and texture

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4
Q

nail changes often seen with alopecia areata

A

pitting or transverse lines

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5
Q

which condition has exclamation point hair? what causes it?

A

alopecia areata
follicles prematurely entering telogen causing fractures as they reach the surface

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6
Q

short hair broken off few mm from scalp with tapering near proximal hair shaft

A

exclamation point appearance

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7
Q

observation + (4 tx )used in alopecia areata

A

Intralesional injection w/ kenalog (first line)
IV methylpredinisolone for 3 days
anthralins once daily
immunomodulators

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8
Q

which tx used in alopecia areata causes itching

A

anthralin

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9
Q

genetically predetermined progressive loss of terminal hairs on scalp in characteristic pattern; elevated DHEAS level

A

androgenetic alopecia

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10
Q

which part of the scalp has androgen-sensitive follicles?

A

crown

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11
Q

sign of male pattern androgenic alopecia

A

frontotemporal recession followed by vertex

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12
Q

3 medications that should be avoided with hair loss

A

warfarin
anti-seizure meds
gemfibrozil

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13
Q

2 tx for male androgenic alopecia

A

finasteride (oral)
minoxidil (topical)

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14
Q

indication for finastride

A

men over 18 with androgenic alopecia

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15
Q

with which two tx should you wait 12 mo before making decision about efficacy in androgenic alopecia

A

minoxidil
finastride

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16
Q

which medication is category X and causes defects in male fetuses

A

finastride

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17
Q

which medication can be used for both male and female androgenic alopecia & the differences in strength

A

minoxidil– 2% in female, 5% in male

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18
Q

discontinuation of finastride vs. minoxidil will cause loss of effect in _____ months

A

finastride: 1 year
minoxidil: 4-6 months

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19
Q

which androgenic alopecia medication carries reversible sexual SE of less libido and ED?

A

finastride

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20
Q

which medication can cause painful gynecomastia that resolves with continued use or after stopping tx?

A

finastride

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21
Q

medication that causes initial telogen effluvium 2-8wks after initiation but is self limiting with continued use

A

minoxidil

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22
Q

ADR of scalp irritation, dryness, scaling, itching, redness

A

minoxidil

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23
Q

female pattern androgenic alopecia

A

thinning between frontal and vertex without affecting frontal hairline

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24
Q

female pattern androgenic alopecia

A

thinning between frontal and vertex without affecting frontal hairline

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25
Q

medication that blocks DHT receptors and androgen biosynthesis to prevent further hair loss; used in FEMALE androgenic alopecia

A

spironolactone

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26
Q

why is pregnancy a contraindication for spironolactone

A

risk of feminization of male fetus

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27
Q

which medication for female androgenic alopecia causes liver cancer & hepatitis with higher doses?

A

spironolactone

28
Q

premature termination of anagen stage causing high # of normal hairs to enter telogen phase & affects 50% of hair

A

telogen effluvium– follicle is NOT diseased

29
Q

etiologies include acute blood loss, childbirth, crash diets, meds, thyroid dz, stress

A

telogen effluvium

30
Q

removing hair manually causing reduced density NEVER baldness

A

trichotillomania

31
Q

what triggers trichotillomania

A

stress and maybe OCD

32
Q

tx of trichotillomania

A

behavioral health/counseling
clomipramine (TCA) short term
+/- fluoxetine

33
Q

d/t variation in proper fit of nail plate in usual nail groove; sharp spicules of nail margin develop as foreign body in nail groove

A

onychocryptosis (ingrown nail)

34
Q

3 top causes of onychocryptosis

A

nail plate forced out of groove by too small shoe
trauma
cutting nail in curvilinear way

35
Q

3 sx of stage one of onychocryptosis and how its tx

A

redness, edema, focal tenderness
tx: change shoes & nail education

36
Q

stage 2 of onychocryptosis and how its tx (2)

A

crusting and purulence at nail fold
tx: stretch tissue away from nail & elevate nail; warm soaks

37
Q

stage 3 of onychocryptosis & tx (2)

A

chronic infection with protuberant granulation tissue
tx: nail margin removal; matrix ablation if chronic

38
Q

is abx necessary with onychocryptosis

A

some say yes some say no

39
Q

spontaneous separation of nail plate form distal free margin, progressing proximally

A

onycholysis

40
Q

what causes discoloration with onycholysis

A

secondary yeast infection

41
Q

how is onycholysis tx (1) and what happens if untreated

A

tx: address thing that exacerbates it
if untreated can cause nail bed scarring

42
Q

complete nail shedding from proximal portion

A

onychomadesis

43
Q

tho onychomadesis is mostly idiopathic, what 3 things could contribute

A

hand, foot & mouth dz
intensive hygienic measures causing maceration
candida or allergic contact dermatitis

44
Q

most common cause of onychonmycosis

A

dermatophyte (Trichophyton rubrum)

45
Q

___ rarely causes onychomycosis

A

candida

46
Q

how to differentiate tinea unguium from other onychomycosis

A

tinea starts at distal corner of nail and involves nail & bed junction then spreads proximally as a streak in nail

47
Q

4 risk factors of onychomycosis

A

fam hx
old
poor health; prior trauma
warm climate

48
Q

before doing direct microscopy of KOH in DMSO to screen for fungi, you must first ____

A

clip & clean nail w/ alcohol first

49
Q

drug of choice to treat onychomycosis

A

terbinafine (oral)

50
Q

second drug for onychomycosis that covers candida with hepatotoxicity & drug interations

A

Itraconazole

51
Q

when can you start tx for onychomycosis

A

+ KOH or PAS

52
Q

bacterial inflammation of lateral & proximal nail fold causing rapid with erythema, edema, pain within 2-5 days of biting nail or pulling nail (minor local trauma)

A

paronychia

53
Q

closed space bacterial infection of fingertip pulp (subQ) causing abscess, edema and rapid increasing pressure

A

felon

54
Q

consequence of felon if not tx? (2)

A

the rapid increased pressure could compromise blood flow and lead to necrosis of skin and pulp
osteomyelitis or osteitis

55
Q

HSV of finger tip which appears as a verrucous mass or bacterial infection; in healthcare workers esp dental

A

herpetic whitlow

56
Q

tx of paronychia

A

drain the pus
Abx is not needed

57
Q

tx of felon

A

surgical incision/ I&D

58
Q

tx of herpetic whitlow (include dose)

A

acyclovir 400mg PO TID x 10 days

59
Q

Brownish, thickening of nails d/t tight fitting shoes or trauma; usually one direction; tx with removal or sanding

A

nail hypertrophy

60
Q

secondary to nail manipulation or mild trauma; disappears with nail growth

A

nail bands/leukonychia punctata

61
Q

secondary to biting or picking at proximal nail fold; longitudinal bands w/ yellow discoloration

A

habit-tic deformity

62
Q

painful, inward folding of lateral edges needing surgical removal of nail

A

pincer nail

63
Q

transverse depressions in all nails weeks after stressful event; also in DM, measles, myocarditis; resolve & regrows normally

A

beau lines

64
Q

two nail signs of internal disease

A

beau lines
terrys nails

65
Q

white or light pink proximal with normal pink distal band; Associated w/ CHF, cirrhosis, DM or aging

A

Terrys nails

DERM (13 decks)

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