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STEP 2 dermal/MSK > Mehlman/Uw acne treatment 11-14 (2) > Flashcards

Mehlman/Uw acne treatment 11-14 (2) Flashcards

1
Q

M. 5 Tx steps

A

.

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2
Q

M. 1st step Tx? what adverse?

A

Topical retinoids (ie topical tertinoin, NOT oral isotretinoin)
adverse: cause photosensitivity (RASH) + desquamation

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3
Q

M. 1st. step. Topical retinoids also used for …

A

for photoaging

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4
Q

M. 1st. step. Topical retinoids mechanism?

A

decreasing sebum production

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5
Q

M. 1st. step. Topical retinoids (NOT oral isotretinoin) is teratogen?

A

NO!!!
It is not a teratogen and does NOT have any effect on pregnancy or male sperm

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6
Q

M. 2nd step Tx?

A

Benzoyl peroxide

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7
Q

M. 2nd step. Benzoyl peroxide used with?

A

often coadministered with TOPICAL RETINOIDS

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8
Q

M. 2nd step. Benzoyl peroxide mechanism?

A

killing of bacteria + clear pores

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9
Q

M. Topical retinoids (ie topical tertinoin, NOT oral isotretinoin) what step?

A

1st step

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10
Q

M. Benzoyl peroxide, what step?

A

2nd step

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11
Q

M. step 3 Tx?

A

Topical clindamycin

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12
Q

M. Topical clindamycin what step?

A

step 3

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13
Q

M. step 4 Tx?

A

Oral tetracycline

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14
Q

M. step 4. Oral tetracycline. what adverse?

A

photosensitivity (BLISTERING)

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15
Q

M. Oral tetracycline what step?

A

4 step

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16
Q

M. Step 5 Tx?

A

Oral isotretinoin

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17
Q

M. Oral isotretinoin what step?

A

5 step

18
Q

M. step 5, oral isotretinoin. what must to do?
what ,,prevention”?

A

do beta-hCG in women
recommend barrier contraception even if on OCP.

19
Q

M. step 5, oral isotretinoin. adverse?

A

can cause elevations in LFTs, dyslipidemia
Main complaint is dry skin+peeling

20
Q

M. step 5, oral isotretinoin. onset?

A

takes several week to really start working but ultra-effective according to most patients

can be commenced earlier in patients with severe nodulocystic acne

21
Q

M. step 5, oral isotretinoin. mechanism?

A

works by diffusely shutting of sebum production

22
Q

M. NBME case.
Girl + starting OCP + same time takes oral isotretinoin. Q - what else should do?

A

recommend barrier contraception

23
Q

M. USMLE what to know mechanism that were mentioned there.

A

.

24
Q

M. USMLE want to know that:
1 and 2nd are initial steps.
5th is the last resort
1st and 4th cause photosensitivity

also mechanism

A

.

25
Q

UW. Drug induced acne.
It is also called steroid-induced folliculitis or steroid acne.

A

.

26
Q

UW. Drug induced acne. Common triggers?

A

*GLUCOCORTICOIDS, androgens
*Immunomodulators (eg azathioprine, EGFR inhibitors)
*Anticonvulsants (eg phenytoin), antipsychotics
*Antituberculous drugs (isoniazid)

27
Q

UW. Drug induced acne. CP?

A

MONOMORPHIC PAPULES or pustules
Lack of comedones, cysts and nodules
Location and age of onset may be atypical for acne

28
Q

UW. Drug induced acne. management?

A

discontinue offending medication
Standard acne therapy unlikely to be effective

29
Q

UW. Drug induced acne. Case (buvo pamineta ,,you got this wrong”).
Girl + use GK + got acne on back, arms, many places + all they were same size (monomorphic)

A

.

30
Q

UW table. Comedonal acne. CP?

A

closed or open comedones on forehead, nose and chin; may progress to inflammatory pustules or nodules

31
Q

UW table. Comedonal acne. Tx?

A

Topical retinoids

also: salicylic, azetaic or glycolic acid

32
Q

UW table. Inflammatory acne. CP?

A

Inflamed papules (<5mm) and pustules, erythema

33
Q

UW table. Inflammatory acne. Tx? mild

A

topical retinoinds + benzoyl peroxide

34
Q

UW table. Inflammatory acne. Tx? moderate

A

add topical abs (clindamycin, erythromycin)

35
Q

UW table. Inflammatory acne. Tx? severe

A

add oral antibiotics

36
Q

UW table. Nodular (cystic) acne. CP?

A

Large (>5 mm) nodules that can appear cystic
nodules may merge to form sinus tracts with possible scarring

37
Q

UW table. Nodular (cystic) acne. Tx? moderate

A

topical retinoid + benzoyl peroxide + topical antibiotics

38
Q

UW table. Nodular (cystic) acne. Tx? severe

A

add oral antibiotics

39
Q

UW table. Nodular (cystic) acne. Tx? unresponsive severe

A

ORAL ISOTRETIOIN

*check for pregnancy

40
Q

M. topical retinoids photosensitivity. how looks, how prevent?

A

HY foto: mazyciai balti taskuciai ant veido, rausvu demeliu fone. atrodo kaip mazi spuogiukai.

Prevent: “avoidance of sun exposure”;
tetracycline photosensitivity, in contrast, tends to be
blistering

41
Q

M. do not choose answers such as “avoidance of spicy/sweet foods” for acne
questions.

A

.

STEP 2 dermal/MSK (24 decks)

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