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WolfPacc Rheumatology/MSK > R/msk > Flashcards

R/msk Flashcards

1
Q

What is Cat-Scratch Disease?

A

Caused by Bartonella species, red macule or vesicles that can crust over (may need to drain pus), treat with antibiotics.

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2
Q

What are the causes of infections from animal bites?

A

Caused by Pasteurella species, dog bites are more common but cat bites get infected more.

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3
Q

What are the risks associated with human bites?

A

Higher risk of infection than animal bites, caused by aerobic and anaerobic species.

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4
Q

What should be considered with human bites?

A

Occlusive teeth sunk into skin, clenched fist tooth penetrates hand, consider joint/bone/tooth.

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5
Q

What is the treatment protocol for human bites?

A

Never suture punch wound, bites should heal open, use antibiotics to treat infection or if wound is sutured, irrigation is important.

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6
Q

What is Measles (Rubeola)?

A

Very contagious virus, report cases to CDC, Maculopapular rash on chest/abdomen/face, Check IgG and IgM, treat with supportive therapy, MMR vaccine.

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7
Q

What is Hand-Foot-and-Mouth Disease?

A

Viral illness that presents as vesicular eruption, caused by Coxsackie virus, contagious in children, treat with supportive therapy.

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8
Q

What is Scarlet fever?

A

Group A strep. Scarlatiniform bright red rash and strawberry tongue, fever, sore throat, malaise, treat with antibiotics.

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9
Q

What is the goal of treating Scarlet fever?

A

Prevent rheumatic fever, reduce spread, and shorten illness.

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10
Q

What is Rubella?

A

Communicable disease, multiple Erythematous Maculopapular all over body, adults can develop arthritis and TTP, treat with supportive therapy, IVIG for TTP, MMR vaccine.

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11
Q

What are Erythema Infectiosum/Fifths Disease?

A

Slapped cheek appearance, caused by Parvovirus, lacy/reticular pattern, clears and reoccurs with stress/overheating, treat with supportive therapy.

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12
Q

What is Roseola?

A

Childhood disease caused by Herpesvirus 6, Pink Morbilliform rash, causes very high fever/seizures, need CSF exam, treat with supportive therapy.

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13
Q

What are Enterovirus infections?

A

Virus shed from GI or upper respiratory tract, Polio, Coxsackie, and Enterovirus is common, Bulbar Polio is worst, involves cranial nerves, treat with supportive therapy.

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14
Q

What is Kawasaki Disease?

A

Acute Febrile Syndrome, risk of coronary artery aneurysm, Strawberry tongue, treat with IVIG, prevent HF.

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15
Q

What is Toxic Shock Syndrome?

A

Toxin Mediated Illness, caused by bacterial build up S. aureus or S. pyogenes, commonly due to tampons, leads to multi-organ failure, Desquamation, labs prolonged PT and PTT, treat with antibiotics.

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16
Q

What is Drug eruption?

A

Adverse skin RXN to drug, Morbilliform Rash is common, treat with steroids, Epinephrine used in emergency, discontinue offending drug.

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17
Q

What is Erythema Multiforme?

A

Acute hypersensitivity RXN to drug or infection, Sulfa/Allopurinol, Targetoid lesions, no illness, need HSV culture and biopsy, discontinue offending drug, antiviral for HSV.

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18
Q

What is Steven Johnson Syndrome TEN?

A

Immune complex hypersensitivity RXN, Sulfa/Allopurinol/Bactrim, Bullous Lesions, Desquamation, SJS <10% of skin, TEN >30% skin sloughs off, + Nikolsky Sign, treat with steroids, discontinue offending drug.

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19
Q

What is Erythema Nodosum?

A

Inflammatory Immunologic RXN of Panniculus (subacute fat), caused by strep or contraceptives, large, deep nodules, treat with compression stockings, steroids for inflammation.

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20
Q

What is Hypersensitivity Vasculitis (LCV)?

A

Vasculitis with palpable purpura, non-blanchable, common on lower legs and feet, need ANA to rule out SLE, biopsy, elevate leg and use compression stockings.

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21
Q

What is Henoch Schonlein Purpura?

A

Vasculitis with palpable purpura on legs of children, may follow bacterial infection, treat with antibiotics.

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22
Q

What is Granulomatosis with Polyangiitis (Wegener’s)?

A

Autoimmune disease, palpable purpura, digital necrosis, ulceration, labs BUN and creatinine levels, elevated ESR, treat with steroids.

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23
Q

What is Churg-Strauss Syndrome?

A

Allergic granulomatous angitis. Related to Wegeners. Skin nodules/urticaria’s/digital necrosis/eosinophilia. +ANCA antibodies. Treat with steroids.

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24
Q

What is Schaumberg’s disease?

A

Blood vessels rupture and cause edema, patches of orange-brown rust colored pigment on lower limbs, need biopsy, treat with compression stockings and leg elevation.

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25
Q

What is Pyoderma grangrenosum?

A

Diagnosis of exclusion, ulcerative condition usually on legs and hands, culture may reveal secondary infection, treat with topical and oral steroids.

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26
Q

What is Urticaria’s/wheals/hives?

A

Transient Erythematous swellings due to release of histamine, acute <30 days, chronic >30 days, IgE mediated, can use allergy meds, prevent trigger.

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27
Q

What is Angioedema?

A

Urticaria involving deep dermis and subcut tissue, caused by drug reaction, IgE mediated, can be life-threatening.

28
Q

What is Prurigo Gravidarum?

A

Pregnancy related dermatoses, occurs in last month of pregnancy, no risk to fetus, intense pruritus, papule on extensors, treat with antihistamines, delivery in severe cases.

29
Q

What is Dermatitis Herpetiformis?

A

Autoimmune blistering disorder with gluten sensitivity, grouped papule or vesicles on extensors, punch biopsy, avoid gluten.

30
Q

What is Linear IgA Dermatosis?

A

Autoimmune blistering disorder, typically drug induced, common around mouth, pruritus prior to lesions, need DIF and biopsy, treat with antibiotics, discontinue offending drug.

31
Q

What is Cutaneous B cell Lymphoma?

A

Cancerous condition with nodules, soft and friable, gene study to differentiate between B-cell and T-cell, treat with oral antibiotics.

32
Q

What is Cutaneous T cell Lymphoma?

A

Cancerous condition, presents like eczema, patch/plaque/tumor, gene study to differentiate between B-cell and T-cell.

33
Q

What is Diabetic Bullae?

A

Blistering condition of acral skin, common in DM pts, need DIF biopsy, self-limited, treat with topical antibiotics for secondary infection.

34
Q

What is Bullous Pemphigoid?

A

Autoimmune blistering disease, does not involve mucous membranes, - Nikolsky’s sign, need DIF biopsy, treat with oral steroids.

35
Q

What is Pemphigus Vulgaris?

A

Autoimmune blistering disease, does affect mucous membranes, can affect eyes and genitals, need DIF biopsy, treat with steroids.

36
Q

What is Pemphigus Foliaceus?

A

Autoimmune blistering disorder, variant of pemphigus vulgaris, affects trunk, face, chest, need DIF biopsy, treat with topical or oral steroids.

37
Q

What is Pemphigus Erythematous/Senear-Usher syndrome?

A

Blistering disorder, overlap b/w Lupus and Pemphigus Foliaceus, lesions on sun exposed areas, photosensitivity is common, need DIF biopsy, treat with topical or oral steroids.

38
Q

What is Epidermolysis Bullosa?

A

Congenital bullous disorder, blisters form due to mechanical trauma, affects skin and mucosa, need DIF biopsy, treat with antibiotics to reduce infection, risk of developing SCC.

39
Q

What is Discoid Lupus Erythemasus?

A

1-5% develops SLE, need ANA to rule out SLE, scarring Alopecia, bright red scaling over lesions, treat with steroids, retinoid, wear sunscreen.

40
Q

What is Systemic Lupus Erythemasus (SLE)?

A

Disease involving connective tissue and blood vessels, Macular/Butterfly Lesion on face, need ANA to diagnose, associated with arthritis, treat with topical steroids.

41
Q

What is Dermatomyositis?

A

Inflammatory Lupus on the hands, Heliotrope rash (on upper eyelids), purple lesions on PIP and DIP joints, hair loss, Arthritis, treat with steroids.

42
Q

What is Scleroderma?

A

Systemic disease with skin thickening, progressive burning of skin, skin tightness, claw hand appearance, +ANA in most pts.

43
Q

What are Verruca Vulgaris (common wart)?

A

Epidermal neoplasm caused by HPV, cauliflower with black dot appearance, common on hands, treat with freezing liquid nitrogen, electrocautery and blunt dissection, imiquimod cream, apple cider vinegar.

44
Q

What are Plantar Warts?

A

Warts on soles of feet, may need debridement before treatment, treat with blunt dissection, laser, cryosurgery, apple cider vinegar.

45
Q

What is Molluscum Contagiosum?

A

Poxvirus spread by auto inoculation, Umbilicate, flesh-colored, dome shaped papule (if on genitals of children, consider abuse), self-limited, treat with curette, cryosurgery, laser.

46
Q

What is Herpes Simplex Virus (HSV)?

A

HSV-1 Oral lesions, HSV-2 Genital lesions, vesicles on Erythematous base, lesions are uniform in size and are contagious until crust over, phase1 initial infection, Phase2 recurrent infection, virus is established in nerve ganglion, labs serology, IgG and IgM, viral culture, PCR, treat with oral antivirals (first), topical antivirals (second), topical steroid for inflammation.

47
Q

What is Eczema Herpeticum?

A

Atopic dermatitis and HSV infection, emergency in infants, rapid onset of HSV, treat with IV antivirals, oral antibiotic for secondary infection.

48
Q

What is Varicella/chickenpox?

A

Viral infection caused by HHV 3, virus becomes latent in ganglia, dew drop on a rose petal, Umbilicate papule crusts overs and falls off in 7 days without scarring, treat with oral antivirals.

49
Q

What is Herpes Zoster/Shingles?

A

Varicella virus, pre-eruptive pain, red swollen plaques of varying sizes, dermatomal distribution, lesions crust over and fall off in 2-3 weeks, can have pain without lesions, post herpetic pain is due to scarring of dorsal root, treat with oral antivirals.

50
Q

What is Herpes Zoster Ophthalmicus?

A

Involves CN V dermatome, medical emergency if Hutchinson’s sign, lesion on tip or side of nose (near the eye), treat with oral antivirals.

51
Q

What is Herpes Zoster Ramsay syndrome?

A

Involves peripheral facial nerve palsy, rash on ear or mouth, medical emergency if infects entire ear canal, can lead to hearing loss.

52
Q

What is Sacral Herpes Zoster?

A

Affects dermatomes S2/S3/S4, emergency if neurogenic bladder.

53
Q

What is Photo aging?

A

UVB causes mutations in skin, leads to benign and malignant neoplasms in sun-exposed areas, Telangiectasia, irregular pigment, atrophy, wrinkling, treat with topical retinoids, avoid sun.

54
Q

What is Porphyria’s?

A

Congenital disorder caused by defect in heme pathway, deposits of porphyrin in skin, causes pigment changes to red brown, can lead to skin breakdown, photosensitization, avoid triggers, eliminate porphyrin.

55
Q

What is Vitiligo?

A

Autoimmune disorder of hypopigmentation, due to absence of melanocytes, woods light can detect, check for other autoimmune disorders, no treatment but can depigment to make even skin color.

56
Q

What is Tuberous Sclerosis?

A

Autoimmune disorder, oval, ash leaf shape hypo pigmented macules, woods light can detect.

57
Q

What is Lentiginous/Age Spots?

A

Occur in sun-exposed areas, hyper pigmented or skin thickening, biopsy irregular spots, treat with cryotherapy, laser, topicals.

58
Q

What is Melasma (Chloasma)?

A

Mask of pregnancy, caused by pregnancy, contraceptives, common on face and neck, symmetrical hyperpigmented lesion, treat with triple combo therapy, laser, Sunscreen.

59
Q

What is Cafe Au Lait spots?

A

Congenital disorder, pale brown macule, can lead to neurofibromatosis.

60
Q

What is Seborrheic Dermatitis?

A

Erythematous scales on forehead, eyebrows, central face, due to overproduction of yeast on oil-producing skin, flakes behind ear, treat with topical steroids or topical antifungals and antidandruff shampoo.

61
Q

What is Acne Vulgaris (common acne)?

A

Disease of sebaceous glands, follicular thickening plugs pores that rupture and cause papule/pustule/cyst/nodule, type1 comedonal acne, type2 superficial papule, type3 nodular cysts, treated by topical antibiotics (superficial), oral antibiotics (deep), proper face washing.

62
Q

What is Rosacea?

A

Adult onset of acne, no comedones present, Erythema and Telangiectasia’s, Rhinophyma (hyperplasia of nose), treat with topical antibiotics (first) oral antibiotics (second) Accutane or isotretinoin (third) Avoid triggers, laser treatments.

63
Q

What is Atopic Dermatitis?

A

The itch that rashes, type of eczema, present with asthma or allergic rhinitis, leads to xerosis or dry skin, commonly on extensors in infants but flexors as child or adult, treat with topical steroids, antibiotics for bacterial infection, warm baths, mild soaps, moisturizers.

64
Q

What is Allergic Contact Dermatitis?

A

Delayed hypersensitivity reaction, due to drugs, metals, cosmetics, and onset occurs on eyelids, patch testing may be needed, treat with topical steroids, oral steroids for acute flare-ups, avoid offending agent.

65
Q

What is Rhus allergy?

A

Allergic reaction to poison ivy or poison oak, leaves of three - let them be, rash occurs in linear arrangement, treat with topical steroids, oral steroids for severe cases, antihistamines for pruritus.

66
Q

What is Pityriasis Rosea?

A

Eruption of viral rash on trunk ‘Christmas tree pattern’, self-limited.

WolfPacc Rheumatology/MSK (3 decks)

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