Integumentary 2

Question 1

soft, wartlike, fleshy growths in the trunk that are located mostly on the back

Answer 1

seborrheic keratosis

Question 2

xanthelasma

Answer 2

raised, soft, yellow-colored plaques that are usually painless and located symmetrically under the brow or upper/lower lids of the eyes on the medial sides

Question 3

xanthelasma - pt under 40, r/o what

Answer 3

hyperlipidemia

Question 4

xanthelasma - if located on the fingers, it is pathognomonic for

Answer 4

familial hypercholesterolemia

Question 5

xanthelasma order what

Answer 5

fasting 8-12 hour lipid profile

Question 6

vitiligo - advise patients to

Answer 6

use sunscreen and avoid prolonged sun exposure

Question 7

loss of epidermal melanocytes

Answer 7

vitiligo

Question 8

acanthosis nigricans

Answer 8

diffuse velvety thickening of the skin that is usually located behind the neck and on the axilla

Question 9

avoid what combination of topical ointments in fungal conditions

Answer 9

avoid antifungal/topical steroid combos in cases of suspected fungal etiology because they can risk incomplete resolution of the fungal infection

Question 10

what can occurs with excessive or prolonged use of topical steroids (>2 weeks)

Answer 10

hypothalamic-pituitary-adrenal HPA axis suppression that can cause striae, skin atrophy, telangiectasia, acne, and hypopigmentation

Question 11

class 7 topical steroid (least potent)

Answer 11

hydrocortisone

Question 12

mild acne first line treatment includes
3

Answer 12

topical retinoids
benzoyl peroxide
topical abx

Question 13

what is considered moderate acne

Answer 13

presence of papules and pustules (inflammatory lesions) with comedones

Question 14

moderate acne tx
2

Answer 14

topicals plus abx

Question 15

what can cause permanent discoloration of growing tooth enamel so don’t give during pregnancy or to children under 8

Answer 15

tetracyclines

Question 16

for patients with severe, extensive nodular acne, what tx is recommended

Answer 16

isotretinoin

Question 17

numerous dry, round, and pink to red lesions with a rough and scaly texture that do not heal

Answer 17

actinic keratoses

Question 18

gold standard dx for actinic keratoses

Answer 18

refer to derm for biopsy

Question 19

actinic keratoses tx ranges from

Answer 19

surgery, cryotherapy, topical meds (fluorouracil cream 5% 5-FU)

Question 20

advise patient taking 5-FU cream that

Answer 20

inflammation may appear as erythema, oozing, crusting, scabs, and soreness that disappears in a few weeks

Question 21

patients with what condition are at higher risk for developing postglomerular nephritis

Answer 21

scarlet fever

Question 22

patients on what biologics are at higher risk for melanoma and squamous cell skin cancer

Answer 22

anti tumor necrosis factor TNF

Question 23

most common pathogen in cat and dog bites

Answer 23

Pasteurella multocida (gram neg)

Question 24

treatment plan for human and animal bites - abx

Answer 24

1. augmentin 875/125 mg BID x 10 days
2. if penicillin allergy - doxy BID, bactrim BID + coverage for anaerobes combine with metronidazole BID or clindamycin TID

Question 25

do not suture wounds at high risk for infection which include
4

Answer 25

puncture wounds
wounds >12 hours old
infected bite wounds
cat bites

Question 26

bites - tetanus vaccine

Answer 26

give if last dose > 5 years ago; use Tdap vaccine if never had Tdap in patients older than 7 years

Question 27

rabies - if dog bite, check if dog got vaccine within

Answer 27

the last year

Question 28

anthrax post exposure prophylaxis

Answer 28

doxy 100 mg BID or cipro

Question 29

superficial thickness burns

Answer 29

only epidermal layer
red only
no blister

Question 30

superficial thickness burn tx

Answer 30

mild soap and water, cold packs, topical OTC anesthetic such as benzocaine if desired or aloe vera gel; no dressing

Question 31

partial thickness burn involves the

Answer 31

epidermis and portions of the dermis

Question 32

partial thickness burn tx
3

Answer 32

water with mild soap or normal saline (no hydrogen peroxide)
topical antibiotic like Polysporin
topical zinc oxide to protect area from sunlight

Question 33

partial thickness dressing

Answer 33

nonadherent dressings

Question 34

full thickness burns appearance

Answer 34

waxy white to leathery gray to charred and black