R/msk Flashcards
What is Metachromatic Leukodystrophy?
Arylsulfatase Deficiency. This will be in a child who presents like MS
What is Ataxia Telangiectasia?
This is an IgA Deficiency, patients have Spider Veins
What do you see in Friedreich’s Ataxia?
Retinitis pigmentosa Scoliosis
What is Adrenal Leukodystrophy?
Carnitine Shuttle (CAT-1), defective adrenal failure (XR linked), long chain fatty acid stuck in cytoplasm
What is Guillain-Barre?
Antibodies damage multiple peripheral nerves, (Acute inflammatory Polyneuropathy), patients present with ascending paralysis 2 weeks after a UTI
What is ALS?
Descending Paralysis seen in middle aged males with fasciculations, there are no sensory problems
What is Werdnig-Hoffman?
Fasciculations in a newborn due to failure of the anterior horns to develop
What is Polio?
Asymmetric fasciculations in Kids present 2 weeks after Gastroenteritis
What is Choreoathetosis?
Dance like movements, wringing of the Hands, quivering / unsteady voice
What is Atonic Cerebral Palsy?
No Muscle Tone - floppy
What is Seborrheic keratosis?
Tan-brown-black stuck on appearance (indicative of adenocarcinomas)
What is Stucco Keratoses?
Barnacles, white-flesh colored stuck on papules
What is Dermatosis Papulosa Nigra?
Variant of SK on the face/neck of dark-skinned (removal causes high risk of hypo pigmentation or keloids)
What are Cutaneous Horns?
Hard, conical projection of keratin (retained keratin on SK or wart)
What are Keratoacanthomas?
Smooth, dome-shaped, red papule with central filled keratin crater (precursor to SCC)
What are Skin Tags (Acrochordon)?
Flesh colored outgrowth of skin pedunculated lesion (short stalk)
What are Skin polyps?
Flesh colored outgrowth of skin pedunculated lesion (long stalk)
What is Dermatofibromas?
Deep papule or nodule with Retraction sign
What is Hypertrophic scar?
Remains within the borders of wound site
What is Keloid?
Extends beyond the borders of wound site
What is Epidermal Nevus?
Group of hamartomas that follow Blaschkos lines
What is Nevus Sebaceous?
Congenital smooth waxy hyperplasia of sebaceous gland
What are Sebaceous Cysts?
Small keratin filled central opening (pore), need to remove cyst wall and culture if infected, (drain and pack)
What is Pilar Cyst (wen)?
Scalp cyst, concentric layers of dried keratin (remove cyst wall)
What are Sebaceous Hyperplasias?
Umbilicated papule with flash white/yellow globules, treat with oral isotretinoin
What are Syringomas?
Sweat duct tumor on lower eyelid
What are Lipomas?
Subcutaneous fat cell tumors (round, mobile)
What is Impetigo?
Honey colored stuck on crusts (common in children); caused by bacteria, treat with topical antibiotics
What is Folliculitis?
Infection of hair follicle, treat with topical antibiotic
What is Furuncle?
Infection of hair follicle and surrounding tissue, treat with topical antibiotic
What is Carbuncle?
Infection of several hair follicles that extend into subacute fat, treat with oral antibiotics
What is Cellulitis?
Inflammatory infection caused by S. aureus or S. progenies. Causes edema, treat with oral antibiotics
What is Erysipelas?
Superficial cellulitis, streak of red along lymph channel, treat with oral antibiotics
What is in-patient diabetic foot infection?
Limb threatening, systemic toxicity, new osteomyelitis, aerobic + anaerobic, treat with oral antibiotics
What is out-patient diabetic foot infection?
Non-limb threatening, contained to foot, treat with oral antibiotics
What is KOH prep?
Visualize branching hyphae
What is a Fungal Culture?
Identify species of dermatophyte, hair and nail only
What is Woods Light?
Fungal infections of hair will flurries greenish, Tinea Versicolor, helps to see hypo pigmented lesions
What is Tinea Pedis/Athletes foot?
Dermatophyte infection of the foot, grows in moist, heat, footwear
What is Interdigital Tinea Pedis?
Infection of toe web space, dry and scaly or Macerated (with bacterial infection), treat with topical antifungals
What is Plantar Hyperkeratotic?
Infection of entire sole, fine silver-white scales
What is Tinea Pedis/Moccasin type?
Treat with topical antifungals
What is Acute Vesicular Tine Pedis?
Vesicular eruption on sole or dorsum of foot, ID reaction causes inflammation in other areas (due to occlusive footwear), Treat with topical anti-fungal, Treat ID reaction with topical steroid
What is Refractory Tinea Pedis?
Treat with oral antifungals
What is the Treatment for Tinea Pedis?
Topical antifungals (first line) Oral antifungals (refractory) Oral antibiotics (secondary infection) Wide shoes Dry area, change socks Wet/dry compresses
What is Tinea Corporis/Tinea Faciei?
Ringworm Annular Lesions, raised advancing Erythematous border and central clearing, on body, treat with topical antifungals
What is Deep Inflammatory Tine Corporis?
Kerion due to Zoophilic Dermatophytes, treat with oral antifungals
Before treatment with oral antifungals, you need?
KOH prep and monitor with CBC and LFT
What is Tinea Manuum?
Infection of the hand dorm: annular lesions Palm: dry diffuse thickened skin Treat with topical antifungals, nails treat with oral
What is Tinea Cruris Jock Itch?
Infection of the groin, red brown scaling, unilateral, half-moon papule and vesicles, treat with topical antifungals
What is Candida of groin?
Bilateral and satellite lesions that extend to perineum
What is Erythrasma?
Uni/bilateral brown scales that fluoresce coral red under woods light
What is Non-Inflammatory Tinea Capitis?
Well Demarcated Alopecia with black dot appearance, treat with oral anti-fungal
What is Inflammatory Tinea Capitis?
Scarring Alopecia, Kerion, treat with oral anti-fungal
What is Pustular type of Tinea Capitis?
Alopecia with pustules (often mistaken for bacterial infection), treat with oral antifungals
What is Tinea Barbae?
Infection of the beard, superficial annular lesions, deep follicular kerion-hair is easy and painless to remove, treat with oral antifungals
What is Tinea Incognito?
Diffuse, scatter erythematous pustules Inflammation after steroids are discontinued. Treat with topical antifungals
What is Monilial Vulvovaginitis?
Caused by Candida Albicans, yeast infection white discharge, can spread via satellite lesions, treat with topical/oral antifungals, (No oral if pregnant)
What is Oral Candidiasis/Thrush?
Candida of Oropharynx, white film over mucous membrane, treat with gentian violet (first) oral antifungals (second), treat breastfeeding mother
What is Candida Balanitis?
Candida of shaft/glans of penis Erythematous papules/pustules with white exudate, treat with topical anti-fungal (first) oral antifungal (second), steroid for inflammation
What is Candida Intertrigo?
Infection of large skin folds, satellite lesions, fissuring, pustule type and Erythematous plaque type, treat with topical antifungals
What is Diaper Candidiasis?
Infection between skin and wet diaper, red base with satellite lesions, treat with topical antifungals, antibiotic ointment for secondary infection
What is Perleche/Angular Cheilitis?
Yeast or staph infection at angle of mouth, due to lip-licking, drooling, aggressive flossing, sore fissures that scale, treat with topical antifungals, avoid lip-licking
What is Tinea Versicolor?
Caused by Pityrosporum species of yeast, common in sebaceous glands, KOH prep spaghetti and meatballs, woods light yellow-white, treat with anti-fungal shampoo (first), topical or oral anti-fungal
What is Scabies?
Parasitic mite that burrows in finger webbing, intense Pruritus, treat with topical anti parasitic (first) oral anti parasitic (second), clean, dispose fomites, hot water
What are Pediculosis/Lice?
Parasite feeds on human blood, lay nits, pubic lice most contagious STD, treat with topical anti-parasitic (first) oral anti-parasitic (second), nit combing
What are Fleas?
Insects that jump from animals onto humans, cause of Bubonic Plague, bites are common on legs and ankles, treat pets, use antihistamines and lotions for itching
What are Cimex Lectularius/Bed Bugs?
Blood sucking insects that hide in furniture, inject saliva into host, forms welts and itching, need to clean and keep good hygiene
What is Black Widow Spider bite?
Female spider, toxin increases Catecholamines, leads to muscle cramping, HTN, tremor, treat with antivenom, ice to constrict vessels
What is Brown Recluse Spider bite?
Causes rapid blue-gray halo, deep ulcer with scarring, can lead to thrombocytopenia, hemolytic anemia, treat with antibiotics for severe necrosis, rest, ice, elevation, manage pain
What is Lyme disease?
Tick borne, B. Burgdorferi, Erythema Migrans (bulls eye), Targetoid Lesion, EKG may show changes, presents with arthritis, treat with oral antibiotics
What is Rocky Mountain Spotted Fever?
Tick borne, R. Rickettsia infects Endothelium of blood vessels, Petechiae rash, leads to decreased platelets, edema, hypotension, treat within one week with oral antibiotics
What are Hymenoptera stings?
Bee/wasp/hornet/yellow jacket/fire ant stings, toxic run (burning, red wheal) or allergic RXN (IgE mediated), Anaphylaxis can lead to death, Epinephrine used for severe RXN
What are Myiasis/Fly larvae/Maggots?
Infest by laying eggs on a blood sucking insect or infest directly thru opening, abscess lesion with central pore, patient feels movement in lesion, need to remove the larvae (can obstruct airway to kill it)
What is Leishmaniosis?
Protozoan disease carried by sandflies, volcano like edges with central crater, ulcer heals with scarring, painless, need punch biopsy, culture and PCR, treat with CDC drug and antifungal
What is Cutaneous Larva Migrans?
Creeping eruption caused by hookworm, wavy appearance, high risk if barefoot on sand or wet soil, treat with oral anti-parasitic
What is Schistosoma Cercarial Dermatitis?
Swimmers itch, caused by larvae of flatworm in fresh water, papules/pustules form after water evaporates, intense pruritus, self-limited, control itching with antihistamines
What are Jellyfish or Man of War stings?
Nematocyst from tentacle discharges poison, causes linear papule or wheals, immediate burning/numbness, treat with baking soda (east coast) or vinegar, alcohol kills toxins
