Miscellaneous Flashcards
Dermatology, Immunizations, Rheumatology
1
Q
Features of this genetic condition include:
- micrognathia, abnormal external ears, clenched hands with overlapping fingers, increased muscle tone, low birth weight, single umbilical artery, short palpebral fissures, nail hypoplasia, and congenital heart defects (ventricular septal defect, atrial septal defect, and patent ductus arteriosus)
A
Trisomy 18
2
Q
sloping forehead with holoprosencephaly, microphthalmia, cleft lip or palate, and polydactyly
A
Trisomy 13
3
Q
Hemangioma involution
A
50% by 5 years
70% by 7 years
90% by 9 years
4
Q
GLUT-1 positive
A
Hemangiomas
5
Q
- Tufted Angiomas
- Thrombocytopenia
- Consumptive Coagulopathy
- Microangiopathic Hemolytic Anemia
A
Kasabach-Meritt (KHE, Tufted Angioma)
6
Q
- Multiple hemangiomas of skin
- GI, Pulmonary, CNS, Liver Angiomas
A
Neonatal Hemangiomatosis
7
Q
- Posterior fossa CNS abnormalities
- Hemangioma in V1 facial distribution
- Arterial anomalies –> seizures/stroke
- Cardiac defects
- Eye abnormalities (microphthalmia)
- Sternal clefting
A
PHACES Syndrome
- 90% F
- Ulceration of softe tissue
8
Q
- Port Wine Stain in V1
- Hypertrophic soft tissue
- Glaucoma
- Meningeal Angioma
A
SWS
9
Q
Lumbosacral hemangiomas
A
Tethered cord, intraspinal lipomas
10
Q
Liver hemangiomas
A
HM, CHF, anemia and thrombocytopenia
Hypothyroidism
11
Q
- Most common vascular birthmark
- On face and nape of neck, symmetrical about midline
- Present at birth
- Facial lesions usually resolve within one year
- Nuchal lesions persist in 50%
A
Salmon Patch
12
Q
- Present at birth
- Grows with the child, darkens with age, becomes cobblestoned with soft tissue hypertrophy
A
Port Wine Stains (Nevus flammeus)
Rx: Pulse Dye Laser
13
Q
- PWS
- Limb hypertrophy
- Venous and lymphatic malformations
- GI and bladder angiomas
A
Klippel Trenaunay
14
Q
- Acquired vascular lesion
- Common on extremities, face
- Red papule that bleeds easily
- Need to remove
A
Pyogenic Granuloma (Lobular Capillary Hemangioma)
15
Q
- Benign melanocytic lesion
- Dome-shaped, red to yellow to brown color
A
Spitz Nevus
- Very low risk of malignancy, but a malignant melanoma can mimic a spitz nevus
16
Q
- Not present at birth, appears at 24 hours of age
- Papule or pustule with urticarial base
- Lasts 2-3 weeks
- See eosinophils if examine content of vesicle
A
Erythema Toxicum
17
Q
- Presents with 2-3mm vesicles
- Vesicles rupture within hours, leaving a collaret of scale, followed by a hyperpigmented macule that lasts for months
- More common in African Americans
- Neutrophils without bacteria seen inside vesicle
A
Transient Neonatal Pustular Melanosis
18
Q
Normal mottled response to cold
A
Cutis Marmorata
19
Q
- Developmental disorder of capillaries and veins
- Often localized to one extremity, coarser texture
- Associated with glaucoma, cleft lip, mental retardation, syndactyly, hypothyroidism and dystrophic teeth
A
Cutis Marmorata Telangiectatica Congenita
20
Q
- Indurated, non-tender plaque with patchy erythema appearing in the first few weeks of life
- Probably 2/2 trauma
- Resolves spontaneously
- May have associated hypercalcemia, leading to irritability, constipation, FTT, seizures
A
Subcutaneous Fat Necrosis
21
Q
- Onset at 2-4 weeks of age, resolves by 3 months
- Papules and pustules without comedomes
- No treatment needed
- Some cases of “acne” are actually a folliculitis caused by Pityrosporum
A
Neonatal Acne
Acne that has a later onset or is prolonged, may be severe and require evaluation of androgens, Infantile acne
22
Q
Dermatitis on interdigital/arch of foot
A
Tinea pedis
23
Q
Dermatitis on weight-bearing surface of foot
A
Juvenile Plantar Dermatosis
24
Q
Dermatitis on dorsum of foot
A
Contact dermatitis
25
Why should you not use oral ketoconazole?
Risk of fatal hepatitis
26
1st line treatment for onychomycosis
Itraconazole or Terbinifine x 4-6 months
27
- Adolescents
- Warm, humid weather
- Confluent macules of varying color with mild scale, upper body and occasionally on face
- KOH = spaghetti and meatballs
Tinea versicolor
- Treat with topical selenium or zinc shampoos
- Oral ketoconazole, itraconazole or fluconazole can be used
28
Looks like tinea without superficial scale
Granuloma Annulare
| - No treatment needed
29
Two serious rare side-effects of Minocycline
Autoimmune hepatitis and SLE
30
Normal amount of hair loss/day
50-100 scalp hairs/day
31
Anagen Effluvium
- Marked decrease in production of new hairs (anagen phase) leading to profound hair loss
- 2/2 chemo or radiation
32
Telogen Effluvium
- Diffuse thinning of hair
- Increased % of telogen hair
- Hair grows back completely within months
33
- Congenital, focal absence of skin (any skin structure)
- Most common on scalp, but also on face, trunk and extremity
- Deep lesions can extend to dura or meninges
Aplasia Cutis Congenita
**membranous appearance with a ring of long, coarse, dark hair ("Hair collar sign") associated with underlying CNS malformations**
34
Two syndromes often associated with aplasia cutis
Trisomy 13 and 4p-
35
- Present at birth or develops in infancy
- Sharply defined, unilateral or localized, hypopigmented patch
- 2/2 inadequate melanin production or transfer
Nevus Depigmentus
36
- White forelock/piebaldism
- Iris heterochromia
- Dystopia canthorum
- SNHL
- Hirschsprung Disease
Waardenburg Syndrome
37
Erythema Multiforme precipitating factors
HSV, Mycoplasma, drugs
38
Drugs associated with SJS
NSAIDs
Anticonvulsants
Antibiotics
Allopurinol
Started typically 1-8 weeks prior to onset of disease
39
Erythema Nodosum associations
- GAS, TB, Mycoplasma, EBV, coccidiomycosis, yersinia
| - IBD, Behcet disease, sarcoidosis
40
These vaccines contain egg antigen
Influenza
| Rabies
41
This vaccine contain yeast protein
Hepatitis B
42
These vaccines contain neomycin
MMR
IPV
Varicella
43
This vaccine contains streptomycin
IPV
44
These are live vaccines
MMR
| Varicella
45
- Acute febrile illness
- Prior allergic reaction to same or related vaccine
- Prior serious reaction to same vaccine
Vaccine Contraindications
46
Immunosuppressive therapy or immunodeficiency disorder is a general contraindication for _____
Live vaccines
47
Pregnant women cannot get this type of vaccine
Live vaccines
48
Recent IVIG, plasma or blood administration are contraindications for ____
MMR & Varicella vaccines
49
This age group has a poor response to polysaccharide vaccines
<2 years of age
50
Hepatitis A Immune Globulin needs to be given within __ days of exposure
14 days
51
Measles Immune Globulin needs to be given within __ days of exposure
6 days
52
Wound plus <3 past tetanus immunizations
- Immunize
| - TIG for "dirty" wounds early
53
Wound plus >= 3 past tetanus immunizations
- Dirty wounds - Immunize if >5yrs after last dose
- Clean wounds - Immunize if >10yrs after last dose
- TIG not indicated
54
Efficacy of DTaP vaccine against pertussis
80-95% after 3 doses
55
Preterm infants and Hepatitis B vaccine
- Reduced immune response to birth dose
| - Give when 2kg or 30 days of age
56
Serogroups in the MCV vaccine
A, C, Y, W-135
57
This vaccine may contain latex
MCV
58
What types of HPV are high risk for cervical cancer
16, 18 >70% cases
59
Types of HPV --> genital warts
6, 11 ~90%
60
The currently licensed Haemophilus influenza type B (Hib) vaccine is a ____
Polysaccharide-protein conjugate
61
This vaccine is associated with rare transient thrombocytopenia
Measles vaccine
62
This vaccine contains gelatin and neomycin
Measles vaccine
63
Reason to give a newborn VZIG
Maternal onset 5 days before or 2 days post-delivery
64
Most common manifestations of lupus
Nephritis, arthritis and dermatitis
65
Sensitive marker of SLE
ANA
| - Also low C3, C4, CH50
66
Best lupus marker
dsDNA
67
Most specific Ab for lupus
Anti-Sm
68
anti-RNP
Mixed Connective Tissue Disease
69
Anti-SSA/SSB
Sjogren's syndrome
70
Anti-histone
Drug induced SLE
71
This organ involvement establishes overall prognosis of lupus
Kidneys
| - decreased complement or increased anti-dsDNA suggests worsening renal disease
72
12y/o with arthralgias, fever, pleural effusions and pericarditis. CBC shows a Hbg of 8. Urinalysis shows microscopic hematuria and proteinuria. What is the most likely diagnosis?
SLE
73
Most common manifestations of neonatal lupus
```
54% heart block
37% rash (E. annulare)
8% hepatitis
6% cytopenias
- Most women have no symptoms of lupus
- Linked to anti-Ro or anti-La antibodies
```
74
Evanescent, salmon-colored rash with Koebner phenomenon, associated with fever spikes
Systemic JIA (Still's DIsease)
75
- Aphthous and genital ulcers
- Uveitis
- Arthritis
- Mediterranean, Japanese and Middle Eastern populations
Behcet's SYndrome
76
- Periodic fever episodes associated with arthritis, serositis or rash during episodes
- Mediterranean populations
FMF
| - Colchicine is highly effective and response virtually diagnostics
77
The likelihood that a diseased patient has a positive test
Sensitivity
78
The likelihood that a healthy patient has a negative test
Specificity
79
Gymnast + low back pain worsened by hyperextension
Spondylolysis
80
When you think there is a significant difference when there really isn't
Type I Error (probability of type I error = p value)
81
When you could not reject the null hypothesis, but in reality, there is a difference
Type II error
