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Step Uno > MSK, Derm, Connective > Flashcards

MSK, Derm, Connective Flashcards

1
Q

Classic sle presentation

A

endocarditis (wart like sterile on both sides of valve),
hilar adenopathy,
raynauds.
Fever, fatigue, weight loss

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2
Q

Nephritis of sle

A

Diffuse proliferative glomerulonephritis = nephritic

Membranous glomerulonephritis = nephrotic

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3
Q

Antibody tests for lupus

A 
Antiphospholipid - false positive syphilis test cause cross reactivity with cardiolipin
Antinuclear - sensitive, primary screen
Anti dsDNA - very specific 
Anti smith
Anti histone- drug induced lupus
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4
Q

Lupus pneumonic

A 
IM DAMN SHARP
Ig
Malar rash 
Discord rash 
Antinuclear 
Mucositis (oropharynegal ulcers) 
Neurological disorders
Serositis(pleuritis and pericarditis)
Hematological disorders
Arthritis
Renal disorders
Photosensitive
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5
Q

Classic person to get SLE

A

14-15 year old black girls

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6
Q

What is sarcoidosis and who does it affect?

A

Immune mediated widespread noncaseating granulomas and elevated ACE levels. Black women.

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7
Q

Sarcoidosis presentation

A

Often asymptomatic except enlarged lymph node, cxr shows bilateral hilar adenopathy, reticular opacities.

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8
Q

sarcoidosis associations

A

restrictive lung disease, erythema nodosum, bells palsy, epithelial granulomas, uveitis, hypercalcemia

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9
Q

sarcoidosis treatment

A

steroids

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10
Q

what is polymyositis

A

progressive symmetric proximal (shoulder) weakness due to CD8 cells. positive ANA and anti Jo-1

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11
Q

what is dermatomyositis

A

similar to polymyositis with proximal weakness, but also malar rash, papules, heliotrope rash (under eyes), shawl and face rash, and mechanics hands. Due to CD4

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12
Q

treatment for polymyositis/dermatomyositis

A

steroids

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13
Q

Myasthenia gravis. Mech. Signs. Rxn to AChE inhib?

A

1 NMJ disorder, antibodies against ACh recptor, weakness with muscle use, ptosis, diplopia, weakness. reversed with AChEsterase inhib fixes.

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14
Q

Lambert-Eaton Myasthenic syndrome. Mech. Signs. Rxn to AChE inhib?

A

Antibodies to Ca channel presynaptic so no ACh release. proximal weakness improves with use, and insisitive to AChE inhib

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15
Q

Myasthenia gravis association

A

Thymoma, thymic hyperplasia

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16
Q

Lambert Eaton association

A

small cell lung cancer

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17
Q

myositis ossificans

A

benign outgrowing of bone near site of trauma (surgery)

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18
Q

Scleroderma

A

excessive fibrosis/collagen. skin is puffy and tight, sclerosis of renal, cardio, gi and lungs (most likely to kill)

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19
Q

diffuse scleroderma. signs and antibody

A

widespread scleroderma which is rapid. anti Scl-70 antibody (topoisomerase)

20
Q

CREST syndrome. signs and antibody

A

Calcinosis, Raynaud’s, Esophageal Dysmotility, Sclerodactyly, Telangiectasia. Limited skin involvement (just fingers and hands. Not as bad as diffuse sclero. Anti-centromere antibody

21
Q

Albinism

A

normal melanocytes, but no tyrosinase activity = hitlers dream. (or abnormal neural crest migration)

22
Q

Melasma

A

normal hyperpigmentation due to pregnancy

23
Q

vitiligo

A

decreased melanocytes

24
Q

verrucae

A

HPV wart. soft, tan color, cauliflower-like.

25
Q

Urticaria

A

hives. aka post mast cell degranulation

26
Q

Ephelis

A

freckle

27
Q

Atopic dermatitis

A

Eczema. puritic eruption on flexor surfaces

28
Q

allergic contact dermatitis

A

Type IV hypersensitivity. poison ivy, neomycin

29
Q

psoriasis

A

papules and plaques with silvery scaling on knees and elbows. basically incomplete apical differentiation (like p53 and p63 knockout mouse)

30
Q

seborrheic keratosis

A

flat, greasy, pigmented with kerytin cysts. basically lauren’s face. it is benign but if multiple appear can signal malignancy

31
Q

Pemphigus vulgaris

A

IgG against desmoglein. Reticulate staining

32
Q

Bullous pemphigoid

A

IgG against hemidesmasome on epidermal basement. Eosinophils inside. Not oral

33
Q

Dermatitis herpetiformis

A

Celiac disease blisters. Puritic papules, vesicles, and bullae. IgA

34
Q

Erythema multiforme

A

Blistering skin with rings of red surrounding dusky dry center. Caused by

  • infxn(mycoplasma pneumo, hsv)
  • drugs (sulfa, b lactams, phenytoin)
  • Cancer
  • Autoimmune
35
Q

Steven Johnson Syndrome

A

Fever, bulla formation and necrosis with high mortality. type two mucus membranes (eyes and lips) plus skin lesions which look like erythema multiforme. Caused by drugs (antibiotics, NSAIDs, allopurinol, sulfa drugs).

Worse version is toxic epidermal necrolysis

36
Q

Acanthosis nigricans

A

hyperplasia and darkening of skin flexor surfaces due to hyperinsulinemia, and visceral malignancy

37
Q

actinic keratosis

A

premalignant SCC. small rough red

38
Q

erythema nodosum

A

inflammaotry subcut fat (normally on shins). caused by : sarcoidosis, coccidiodomycosis, histoplasmosis, TB, strep, leprosy, crohns

39
Q

Lichen Planus

A

6Ps. pruriic, purple, polygonal, planar, papules, plaques. hepatitis C association.

40
Q

Impetigo

A

superficial skin infection caused by S. aureus or S. pyogenes. contagious and “honey colored”. bullous = S aureus

41
Q

Cellulitis

A

baiscally deeper impetigo. acute, painful, spreading infxn of dermis and subcut. from S. pyogenes and s. aureus. starts with break in skin.

42
Q

necrotizing fasciitis

A

“flesh eating bacteria”. S pyogenes or anaerobe. crepitus from methane and CO2. bulla and purple skin

43
Q

Scalded Skin Syndrome

A

Staphylococcal. Exotoxin mediated which destroys attachments and stratum granulosum. skin sloughs off but will heal completely.

44
Q

difference between SSSS and Toxic Epidermal Necrolysis?

A

SSSS only stratus granulosum while TEN (more severe SJS) destroys Epidermal - Dermal Junction and wont heal.

45
Q

BCC

A

pink pearly nodules with telegiectasis rolled boarders, and central crusting or ulcers. histo has palisading nuclei

46
Q

SCC

A

sun, immunosuppresion, arsenic. ulcerative red lesions with scaling. chronic sinus drainage. histo: keratin pearls.

47
Q

Melanoma

A

S-100 marker, deeper = met, BRAF V600E, vemurafenib

Step Uno (30 decks)

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