Integumentary 2 Flashcards
soft, wartlike, fleshy growths in the trunk that are located mostly on the back
seborrheic keratosis
xanthelasma
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
xanthelasma - pt under 40, r/o what
hyperlipidemia
xanthelasma - if located on the fingers, it is pathognomonic for
familial hypercholesterolemia
xanthelasma order what
fasting 8-12 hour lipid profile
vitiligo - advise patients to
use sunscreen and avoid prolonged sun exposure
loss of epidermal melanocytes
vitiligo
acanthosis nigricans
diffuse velvety thickening of the skin that is usually located behind the neck and on the axilla
avoid what combination of topical ointments in fungal conditions
avoid antifungal/topical steroid combos in cases of suspected fungal etiology because they can risk incomplete resolution of the fungal infection
what can occurs with excessive or prolonged use of topical steroids (>2 weeks)
hypothalamic-pituitary-adrenal HPA axis suppression that can cause striae, skin atrophy, telangiectasia, acne, and hypopigmentation
class 7 topical steroid (least potent)
hydrocortisone
mild acne first line treatment includes
3
topical retinoids
benzoyl peroxide
topical abx
what is considered moderate acne
presence of papules and pustules (inflammatory lesions) with comedones
moderate acne tx
2
topicals plus abx
what can cause permanent discoloration of growing tooth enamel so don’t give during pregnancy or to children under 8
tetracyclines
for patients with severe, extensive nodular acne, what tx is recommended
isotretinoin
numerous dry, round, and pink to red lesions with a rough and scaly texture that do not heal
actinic keratoses
gold standard dx for actinic keratoses
refer to derm for biopsy
actinic keratoses tx ranges from
surgery, cryotherapy, topical meds (fluorouracil cream 5% 5-FU)
advise patient taking 5-FU cream that
inflammation may appear as erythema, oozing, crusting, scabs, and soreness that disappears in a few weeks
patients with what condition are at higher risk for developing postglomerular nephritis
scarlet fever
patients on what biologics are at higher risk for melanoma and squamous cell skin cancer
anti tumor necrosis factor TNF
most common pathogen in cat and dog bites
Pasteurella multocida (gram neg)
treatment plan for human and animal bites - abx
- augmentin 875/125 mg BID x 10 days
- if penicillin allergy - doxy BID, bactrim BID + coverage for anaerobes combine with metronidazole BID or clindamycin TID
do not suture wounds at high risk for infection which include
4
puncture wounds
wounds >12 hours old
infected bite wounds
cat bites
bites - tetanus vaccine
give if last dose > 5 years ago; use Tdap vaccine if never had Tdap in patients older than 7 years
rabies - if dog bite, check if dog got vaccine within
the last year
anthrax post exposure prophylaxis
doxy 100 mg BID or cipro
superficial thickness burns
only epidermal layer
red only
no blister
superficial thickness burn tx
mild soap and water, cold packs, topical OTC anesthetic such as benzocaine if desired or aloe vera gel; no dressing
partial thickness burn involves the
epidermis and portions of the dermis
partial thickness burn tx
3
water with mild soap or normal saline (no hydrogen peroxide)
topical antibiotic like Polysporin
topical zinc oxide to protect area from sunlight
partial thickness dressing
nonadherent dressings
full thickness burns appearance
waxy white to leathery gray to charred and black
