Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psoriasis > Psoriasis > Flashcards

Psoriasis Flashcards

1
Q

Most common type of psoriasis in children? Followed by ??

A

Plaque psoriasis
Guttate psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Gene involved in psoriasis?

A

HLA-cw6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Marker for sacroiliitis associated psoriasis??

A

HLA-B27

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PSOR1 gene encodes for??

A

Corneodesmosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Target cells in psoriasis?

A

Interfollicular epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does psoriasis induction occur??

A

TNF-a and IFN-a release from plasmacytoid DC via TLR-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the key for entrance?

A

Psoriatic T-cells express a1b1 integrin that interact with BM collagen type 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What cells prominent in active lesions and marginal zones of expanding plaque ??
And what histology is seen??

A

Neutrophils
Spongiform pustules of kogoj +
Munro microabsess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What’s responsible for prominent angiogenesis??

A

VEGF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What IL that decreases in psoriasis??

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which subunit does ustekinhmab work on ??

A

P40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do dendritic cells secrete??

A

TNF-a
IFN-a
IL-23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does IL-23 do ??

A

Stimulates Th-17 = release of IL-17 and 22 leading to keratinocytes proliferation and dermal inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which IL that it’s levels correlate with psoriasis severity ??

A

IL-22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What cells release ?
IFN-a
IFN-gamma

A

a: DC
Gamma: activated T-cells and NK T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What pathway is key feature of psoriasis??

A

IFN-gamma (vasodilation and T-cell accumulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What mediates neutrophilic migration?

A

CXCL8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the anti microbial peptides that increase in psoriasis?

A

Beta-defensin 1
Secretory leukocyte protease inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes keratinocyte proliferation in psoriatic plaques??

A

STAT3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What promotes chemotactic activity ?

A

Human b defensin 2 binds to TLR4 = high CCR6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mention 7 causes of psoriasis ?

A

1- external
2-infection
3-HIV
4-drugs
5-habits
6-psychology
7-endocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

External causes of psoriasis?

A

Sunburn
Morbillifirm drug eruption
Viral exanthem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Infections causing psoriasis?

A

Strep pharyngitis
Dental abscess
Impetigo
Perianal abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Strep pharyngitis induces psoriasis via ??

A

Expression of Il-23R and CLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Endocrine causes of psoriasis?

A

Hypocalcemia (but not abnormal viD levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Drugs causing psoriasis

A

Lithium
Imiquimod
Rapid tapering of steroids
TNFai
B-blocker
Antimalarial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is impetigo herpetiformis ?

A

Pustular psoriasis of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Auzpitz signs ??

A

Pinpoint bleeding after removal of silvery white micaceous scales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What causes auzpitz sign ?

A

Elongated vessels in dermal papillae + thinning of suprapapillary epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What indicates unstable psoriasis?

A

Presence of pinpoint papules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Whats wornoff ring sign ?

A

Pale blanching rings surrounding psoriatic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are 9 types of psoriasis?

A

Chronic plaque, guttate, pustular, nail, oral mucosa, scalp, psa, flexural, erythrodermic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Percentage of genetalia involvement?

A

45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Percentage of remitting plaque psoriasis in 5 years ?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Types of psoriasis?

A

1-type 1: positive family hx and positive HLA-cw6
2-type 2: negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What’s the most common cause of guttate psoriasis ??

A

URTI (> 50% have positive ASI and Anti DNAse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Characteristic of erythrodermic psoriasis?

A

Nail changes
Face is spared centrally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are pustular variants?

A

1- generalized
2-palmoplantar pustulosis
3-acrodermatitis continua of hallopeau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What triggers generalized pustular psoriasis??

A

Pregnancy, steroids tappering? Hypocalcemia, infections, topical irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Genes involved in generalized pustlar psoriasis ?

A

ADAM17, CARD14, DIRA, DITRA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Types of generalized pustular psoriasis?

A

Von zumbach pattern
Annular pattern
Exathemic pattern
Localized pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is von zumbach pattern?

A

Fever + painful erythema and pustules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Gene mutation of von zumbach pattern ?

A

Homozygous IL-35R gene mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is annular pattern?

A

Erythema and scaling with pustulation at advancing edge (central healing )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Exanthemic type ?

A

Follows infection
Acute eruption of small pustules appearing and disappearing over few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the localized pattern pustular psoriasis ??

A

Pustules at the edge of pre existing psoriatic plaque (reflects unstable phase) after application of topical anthralin or tar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Palmoplantar pustulosis ??

A

Sterile pustules + yellow brown macules

More chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What triggers pamoplantar pustulosis ?

A

Smoking
Stress
Local infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Palmoplantar pustulosis is seen in ??

A

SAPHO
SYNOVITIS, acne, pustulosis, hyperostosis, osteitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is acrodermatitis continua of hallupeau ?

A

Pustules on distal portions of fingers and toes and nails
= nail shedding( pustules on nail bed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

acrodermatitis continua of hallupeau is associated with??

A

Annulus migrans of tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Most common sites of scalp psoriasis?

A

Periphery of face
Retroauriculae area
Posterior upper neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Name the scalp psoriasis scales ?

A

Asbestos like (pityriasis amianticia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Causes of pityriasis amiantacea ?

A

Seb dermatitis
Scalp psoriasis
Secondary infected atopic dermatitis
Tinea capitis

55
Q

If scalp psoriasis is associated with alopecia, think of ?

A

TNF-ai induced psoriasis

56
Q

Describe flexural psoriasis ?

A

Shiny pink-red sharply demarcated thin plaques + central fissuring

57
Q

Most common site of flexural psoriasis?

A

Retroauricular
Intergluteal cleft
Inguinal crease
Axilla

58
Q

What causes flexural psoriasis?

A

Localized dermatophyte, candida, bacteria

59
Q

What is the manifestation of oral mucosa psoriasis?

A

Annulus migrans
(Migratory annular erythematous lesion with white scales)

60
Q

Most common site of annulus migrans ?

A

Tongue

61
Q

What causes nail pitting ?

A

Focal parakeratosis of proximal portion of nail matrix

62
Q

Nail parts that are affected in nail psoriasis??

A

Nail bed, matrix and hyponychium

63
Q

What are 7 nail changes in psoriasis??

A

Pitting
Oil drop/salmon patches
Subungual hyperkeratosis
Onycholysis
Leukonychia and loss of transparency
White pourly adherent nail
Splinter hemorrhage

64
Q

What causes subungual hyperkeratosis and onycholysis ??

A

Parakeratosis of distal nail bed

65
Q

What causes leukonychia ??

A

Involvement of midportion of nail matrix and if total matrix is involved = white pourly adherent nail

66
Q

What causes oil drop patch ??

A

exocytosis of WBC beneath nail plate (involving nail bed)

67
Q

What causes splinter hemorrhage??

A

Capillary fragility

68
Q

Wgat could exacerbate nail psoriasis??

A

Trying to remove it

69
Q

What helps the most in nail psoriasis??

A

IL-17
JAKi
MTX

70
Q

Risk factors for PSA ?

A

1- early age
2- female
3- polyarticular involvement
4- positive family history
5-radiologic findings

71
Q

Most common type of PSA ??

A

Mono-asymmetrical-oligoarthritis (DIP)

72
Q

5 major types of PSA ?

A

1- mono-asymmetrical-oligoarthritis
(Sausage digits)
2- DIP arthritis
3- RA-like
4- arthritis mutilans
5- spondylitis and sacroiliitis

73
Q

DIP arthritis presentation??

A

Fixed flexed position joints

74
Q

Arthritis mutilans presentation?

A

Severe rapidly progressive joint inflammation- osteolysis = short wide digits = telescoping phenomenon

75
Q

What are juxta articular manifestations?

A

Tendonitis
Enthesitis
Dactylitis

76
Q

What are other 4 associations with psoriasis??

A

1- skin diseases
2- cancer
3- infection
4- systemic internal disease

77
Q

What are skin diseases that increase in psoriasis??

A

Lichen simplex chrinicus
Seborrheic dermatitis

78
Q

What are skin diseases that decrease in psoriasis??

A

AD, allergic contact, asthma , urticaria

79
Q

What cancer related to psoriasis??

A

Non melanoma skin cancer (SCC)

80
Q

Risk factors to develop skin cancer in psoriasis??

A

PUVA >200
Cyclosporine

81
Q

Common infections in psoriasis?

A
  • onychomycosis
  • candida esp (flexural psoriasis)
82
Q

What reflects risk to develop CVS disease ?

A

CRP

83
Q

Life expectancy of psoriasis?

A

3.5-4.5 years reduction

84
Q

What causes dyslipidemia in psoriasis?

A

IL-6 and TNF-a (target adipocyte)

85
Q

What chronic diseases associated with psoriasis?

A
  • CVS
  • dyslipidemia
  • DVT
  • non alcoholic steatohepatitis
  • crohn disease
86
Q

non alcoholic steatohepatitis is related to ??

A

Obesity, dyslipidemia and PSA
AST:ALT RATIO > 1

87
Q

Other disorders??

A
  • ILVEN
  • Reactive arthritis
  • Sneddon-Wilkinson disease
  • AGEP
88
Q

ILVEN ??

A

Inflammatory linear verrucous epidermal nevus- follows blasckow lines

89
Q

Reactive arthritis triad ?

A

Conjunctivitis + urethritis + arthritis (polyarthritis or sacroiliitis)

90
Q

What causes urethritis in rieters disease?

A

Chlamydia trachomatis
Less shigella and salmonella

91
Q

Ocular changes in reactive arthritis?

A

Conjunctivitis
Iritis
Uveitis with glucoma
Keratitis

92
Q

Skin lesions in rieters syndrome?

A

5%
Keratoderma blennorhagicum
Balanitis circunata

93
Q

Tt of rieter ??

A

Self limited
Antibiotics +NSAID
Steroids

94
Q

Subcorneal pustular dermatosis??

A

Sneddon wilkinson disease

95
Q

Describe sneddon wilkinson disease ??

A

Annular polycyclic lesions on flexural areas + gravity induced demarcation (clear fluid superior and pus filled inferior) in vesiculopustules

96
Q

What is associated with sneddon wilkinson disease ??

A

IgA paraproteinemia

97
Q

Main ddx of sneddon Wilkinson disease ??

A

Subcorneal eosinophilic igA pemphigus

98
Q

Best tt of sneddon Wilkinson??

A

Dapsone

99
Q

AGEP ?

A
  • acute febrile drug eruption starting on the face
100
Q

Causes of AGEP ?

A
  • drugs
  • enteroviral infection
  • mercury
101
Q

Genes responsible for AGEP ??

A

HLA-B5
HLA-DR11
HLA-DQ3

102
Q

Mutation of AGEP ??

A

IL-36R

103
Q

Test prior sensitization ??

A

Skin patch test (0.75% metronidazole)

104
Q

Sign and symptoms of AGEP ??

A

Fever + rash starting on face and intertriginous zones (axilla and groin)
Followed by dissemination

105
Q

Percentage of mucosal involvement in AGEP ??

A

50%

106
Q

Most common involved organ in AGEP ??

A

Liver > kidney > lung

107
Q

Electrolyte abnormalities in AGEP ?

A

Hypocalcemia

108
Q

Drugs causing AGEP ??

A

Aminopenicillin
Cephalosporine
Clindamycin
Diltiazem

109
Q

Tt of AGEP ??

A

Withdrawal of causative agent + topical cs

110
Q

First line tt of psoriasis ??

A

Topical cs

111
Q

How to increase lipophilicity of topical CS ??

A

1- add hydroxyl group
2- add propionate, furuate, valerate (have anti inflammatory effects)

112
Q

Does increase frequency of application makes tt better ?

A

No
Once is same as twice

113
Q

Best topical for maintenance ??

A

Betamethasone dipropionate (for 12w)

114
Q

What is the problem of topical CS in psoriasis ??

A

Fast development of tachyphylaxis and rebounding

115
Q

What is the maximum dise of super potent and potent steroid ??

A

Super : 50g/w
Potent : 100g/w

116
Q

Contraindications of topical steroids ??

A

1- active bacterial, viral, fungal infections.
2- skin atrophy
3- allergic contact
4- pregnancy/ lactation

117
Q

What are the 3 viD analogs ??

A

1- calcipotriene (calcipotriol)
2- calcitriol
3- ta-calcitol

118
Q

Fxn of ViD analog??

A

1- inhibition of keratinocyte proliferation
2- inhibition of neutrophils
3- activation of TGase (enhances cornified lipid envelope)

119
Q

Side effects of overdose ViD analogue??

A

Hypercalcemia

120
Q

What is daivobet ??

A

Calcipotriene + betamethasone dipropionate

121
Q

Dose of anthralin ??

A

Not more than 3x weekly (highly irritant)

122
Q

Fxn of anthralin ?

A

Similar to ViD analog
1- inhibition epidermal proliferation
2- inhibition of mitogen induced T lymphocytes proliferation
3- inhibition of neutrophils

123
Q

Contraindications of anthralin ??

A

1- unstable progressive plaque psoriasis
2- pustular psoriasis
3- erythrodermic psoriasis

124
Q

Which FDA approved psoriasis topical treatment??

A

Tazarotene

125
Q

What are targets of tazarotene ??

A

Inhibitors of K16, and TGase

126
Q

Changes of psoriasis??

A

Increase K6,16
Increase Involucrin

Decrease K10,1
Decrease loricrin
Decrease IL-10

127
Q

Contraindications of topical retinoids ??

A

1- unstable progressive plaque psoriasis
2- allergic contact
3- erythrodermic psoriasis
4- pregnancy/lactation

128
Q

Other topicals ::

A

10% salicylic acid
Coal tar
TCI (face and flexures)

129
Q

AFDA approved systemic 1st line tt of psoriasis??

A

MTX

130
Q

What is the maximum dose of MTX in psoriasis??

A

25mg

131
Q

Systemic tt of psoriasis ??

A
  • MTX
  • cyclosporine
  • retinoid
  • biologics
  • apremilast
132
Q

Dose of acitritin in types of psoriasis ??

A

1- pustular : 1mg/kg/day
2- chronic plaque : 0.5 mg/kg/day
3- erythrodermic: 0.25 mg/kg/day

133
Q

Biological tt of psoriasis??

A

All are human ab except ?
- infliximab (chimeric ab)
- ixekizumab (humanized)

134
Q

What are category B biologics ??

A

1- TNF-ai
2- ustekinumab
3- secukinumab

Psoriasis (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions