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Fam1Module1 > Module 6 Derm > Flashcards

Module 6 Derm Flashcards

1
Q

Which is not a pharmacological treatment for impetigo (choose all that apply):

a) Cephalexin/Keflex
b) Erythromycin
c) Topical Prednisone
d) Ceftriaxone
e) Cefadroxil

A

Answer: c & d

Topical prednisone and ceftriaxone are not used in treating impetigo.

First line agents are: Cephalexin/Keflex & Cefadroxil
PCN allergy/2nd line: Macrolides (“mycin”)

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2
Q

If MRSA is suspected as the causative agent for impetigo, what is the treatment to use in conjunction with the oral agent?

a) Topical Cephalexin/Keflex
b) topical Erythromycin
c) topical Ceftriaxone
d) topical mupirocin

A

Answer: d) topical mupirocin

If MRSA suspected use the oral agent, chlorehexidine wash Q7days and mupirocin in nares

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3
Q

When is systemic treatment of impetigo indicated?

a) always
b) never
c) when it involves sensitive areas of the skin which cannot tolerate topical corticosteroids
d) when a large area is affected

A

Answer: d) when a large area is affected

Corticosteroids are not used in managing impetigo.

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4
Q

What is the causative organism for impetigo?

A

S. aureus & S. pyogenes

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5
Q

True or false, any patient with a superficial partial-thickness burn or greater should receive a tetanus shot?

A

True

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6
Q

A newborn has 6+ cafe au lait spots (brown macules) present on her body. You tell the mother that:

a) they are benign and she has nothing to worry about
b) they should resolve by age 3, and if not they should be investigated at that time
c) they should be investigated
d) they are only concerning if in the axillae

A

Answer: c) they should be investigated

6 or more cafe au lait lesions can correlate with neurofibromatosis and should be evaluated/monitored.

If found in the axillae–>diagnostic for neurofibromatosis

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7
Q

A pregnant woman presents to the office with cat scratch fever, you tell her:

a) she needs to clean the wound twice a day
b) as long as she is up to date with her tetanus shot there is no concern for her or the baby
c) if she develops flu-like symptoms she needs to call you
d) she is at risk for miscarriage

A

Answer: d) she is at risk for miscarriage

Cat scratch fever in pregnancy can lead to miscarriage.

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8
Q

Which is not part of the diagnostics for cat scratch fever?

a) Leukocytosis
b) lymphadenopathy
c) lymph node biopsy reveals bacilli/necrosis
d) Bartonella henselae positive

A

Answer: a) leukocytosis

The diagnostic criteria for cat scratch fever is that 3 out of the 4 must be met: lymphadenopathy, lymph node biopsy reveals bacilli/necrosis, Bartonella henselae positive, and recent cat contact at site of pustule/papule

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9
Q

True or false, cat scratch fever treatment is usually suppportive.

A

True

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10
Q

A patient presents with an abrupt high fever, sore throat, yellow vesicles surrounded by a halo in the throat, and drooling. What is the likely diagnosis?

a) erythema multiforme
b) strep throat
c) oral candidiasis
d) herpangina

A

Answer: d) herpangina

Herpangina is characterized by lesions in the oropharyngeal area. Treatment is usually supportive and can include analgesics, anesthetics, benadryl, and sucralfate. The infection should clear in 7-10 days.

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11
Q

Complications of herpangina can include (choose all that apply):

a) encephalopathy
b) paralysis
c) meningitis
d) myocarditis
e) stroke

A

Answer: b,c,d

While the illness usually resolves in 7-10 days, complications include paralysis, meningitis, and myocarditis

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12
Q

Recurrent oral candidiasis may be the first sign of what disease/illness?

A

HIV

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13
Q

Side effect of “azole” medications include (choose all that apply):

a) blood dyscrasias
b) renal dysfunction
c) fetal malformations
d) longer QT

A

Answer: b,c,d

Fetal malformations can occur if used in the 1st trimester

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14
Q

A patient presents with a green painful change in their nail texture. They likely have paronychia. What should be included in their treatment?

a) salicylic acid nail soak
b) vinegar nail soaks
c) removal of the nail
d) tetanus shot

A

Answer: b&d

Other treatment options include abx, topical steroids, topical antifungal, oral antifungal, and I&D if abscessed

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15
Q

What degree burn leads to loss of sensation?

A

3rd

Skin will appear charred & leathery

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16
Q

A burn which is red, tender, and blistered is considered what degree?

A

2nd

Note: if deep partial burn the skin will not blanch and pressure perception only is maintained

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17
Q

What is inappropriate for managing 1st degree burns:

a) apply ice
b) silver sulfadiazine cream
c) debride the wound
d) NSAIDs

A

Answer: b,d

1st degree burns are superficial: use cool tap water and silver sulfadiazine cream (AVOID if sulfa allergy), give NSAIDs for pain relief

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18
Q

What are the percentages for the rule of nines with burns?

A

9% for each upper extremity, each lower extremity (18% adult & 14% child), anterior trunk 18%, posterior trunk 18%, head and neck (10% adult & 18% child)

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19
Q

What is the only drug with an FDA indication to treat hidradenitis suppurativa?

A

adalimumab (Humira)

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20
Q

A man presents with nodules & pustules which drain in his groin and axilla, he describes the nodules/pustules as painful. What is the likely diagnosis?

a) contact dermatitis
b) hidradenitis suppurativa
c) herpes zoster
d) seborrhea

A

Answer: b) hidradenitis suppurativa

21
Q

Which medication potentially contributed to the patient developing psoriasis?

a) ace inhibitors
b) TCAs
c) biologics
d) lithium

A

Answer: d) lithium

Other meds which place the patient at risk are: beta-blockers, antimalarials, systemic steroids

22
Q

Which medication has not been found to correlate with the development of psoriasis?

a) beta blockers
b) antimalarials
c) topical steroids with high potency
d) lithium

A

Answer: c) topical steroids with high potency

Meds which place the patient at risk are: beta-blockers, antimalarials, SYSTEMIC steroids, and lithium

23
Q

Treatment of psoriasis may include:

a) topical steroids
b) terbinafine
c) tar
d) retinoids

A

Answer: a,c,d

Treatment can include: topical steroids, tar, retinoids, methotrexate, biologic/immuno drugs

24
Q

An indicative sign of psoriasis is when lesions are scraped and bleed, what is this termed?

A

Auspitz sign (think about the Owl spitting)

25
Q

What are the ABCDEs of melanoma?

A 
A-asymmetry
B-irregular border
C-color variation
D-diameter greater than 6 mm
E-evolution/elevation
26
Q

True or false, the most common type of skin cancer is squamous cell?

A

False. Basal cell is the most common.

27
Q

True or false, the highest death rate in skin cancer is seen from melanoma?

A

True.

28
Q

Which type of skin cancer rarely metastasizes?

a) squamous cell
b) basal cell
c) melanoma

A

Answer: b) basal cell

29
Q

SPF is an indication of protection against:

a) UVA
b) UVB
c) both

A

Answer: b) UVB radiation

SPF does not address UVA

30
Q

Marginal benefits are seen in protection against sunburn beyond which SPF?

a) SPF 15
b) SPF 30
c) SPF 40
d) SPF 50

A

Answer: a) SPF 15

SPF 15=93% protection and SPF 30=96%

31
Q

New FDA rules require that sunscreens include which of the following on the labels?

a) UV protection range
b) SPF
c) degree of sweat resistance
d) degree of water resistance

A

Answer: all of the above

32
Q

Organic sunscreens are also known as:

a) chemical screens
b) physical screens

A

Answer: a)chemical screen

They absorb UV radiation and dissipate it as heat

33
Q

Inorganic sunscreens are also known as:

a) chemical screens
b) physical screens

A

Answer: b) physical screens

They scatter UV radiation

34
Q

Titanium oxide and zinc oxide are commonly found in:

A

inorganic sunscreens (they provide a physical screen)

They are now available in clear formulations

35
Q

Which area would be an appropriate site for high potency steroids?

a) face
b) axillae
c) groin
d) hand

A

Answer: d) hand

High potency steroids are not suited for the face, axillae, or groin

36
Q

What is a common indicated use for VERY high potency steroids?

a) facial psoriasis
b) hand eczema
c) axillae hidradenitis suppurativa
d) jock itch

A

Answer: b) hand eczema

Also hand psoriasis. These VERY high potency steroids should be used in caution, usually for 14 days followed by a rest period. They are not appropriate for the face, axillae, groin, or under breasts.

37
Q

What is the maximum duration of use for low-to-medium potency steroids?

A

3 months or less and then a break

38
Q

What type of skin cancer presents with round/pearly domed nodules which have a central ulceration and telangiectatic vessels?

a) squamous cell
b) basal cell
c) melanoma

A

Answer: b) basal cell

39
Q

True or false, actinic keratosis can turn into cancer?

A

True. AK can turn into squamous cell carcinoma.

40
Q

An older man presents to the office with rough plaques which are varied in color (fleshy, brown, yellow). He states that he used to work as a gardener. What is a likely diagnosis?

a) basal cell carcinoma
b) actinic keratosis
c) eczema
d) seborrhea

A

Answer: b) actinic keratosis

This is the likely diagnosis as actinic keratosis presents in those aged 40+, in sun exposed areas and presents in the manner in which the patient described.

41
Q

Management of actinic keratosis includes:

a) referral to dermatology
b) Retin-A or other keratolytic
c) medium potency topical steroid
d) shave biopsy

A

Answer: a) referral to dermatology

These patients need to be monitored closely as AK can turn into cancer (specifically squamous cell).

42
Q

Which of the following is not a lowest potency (class VII) steroid (choose all that apply):

a) hydrocortisone 2.5%
b) Desonide 0.05%/Desowen
c) Halcinide 0.1%/Halog
d) hydrocortisone 1%

A

Answer: b & c

The only lowest potency steroid creams are hydrocortisone 2.5% and hydrocortisone 1%

43
Q

Which is a low (Class VI) potency topical steroid?

a) hydrocortisone 2.5%
b) Desonide 0.05%/Desowen
c) Halcinide 0.1%/Halog
d) Diflorasone diacetate 0.05%/Apexicon

A

Answer: b)

The only class VI low potency steroid (in the lecture) is Desonide 0.05%/Desowen

44
Q

True or false, class I steroids are lowest potency and class VII are very high potency.

A

False. Class I steroids are VERY HIGH potency, and class VII are the lowest potency.

45
Q

Which is not a very high potency steroid (class I) (may be more than one correct answer)?

a) Ametinonide 0.1%
b) augmented betamethasone dipropionate 0.05%/Diprolene
c) Clobetasol propionate 0.05%/ Temovate
d) Mometasone furoate 0.1%/Elocon

A

Answer: a&d

Amentinonide 0.1% is a Class II high potency and Mometasone furoate 0.1%/Elocon is a class II medium potency

46
Q

Desonide 0.05%/Desowen

A

Low potency-Class VI

47
Q

Medium potency acronym for steroids?

A

Mom Bet Fluti Trix

“Mometasone furoate 0.1%; Betamethasone dipropionate 0.05%; fluticasone propionate 0.05%; triamcinolone acetonide 0.1%”

Note: Triamcinolone acetonide 0.5% is actually a class II high potency med!!! Don’t confuse them.

48
Q

Very high potency acronym for steroids?

A

Au Clouds Didi Hale?

Fam1Module1 (5 decks)

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