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First Aid Step 2 🐰 > Rapid Review Derm > Flashcards

Rapid Review Derm Flashcards

1
Q

Stuck on appearance

A

Seborrheic keratosis

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2
Q

Red plaques with silvery white scales and sharp margin

A

Psoriasis

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3
Q

Most common type of skin cancer

Lesion pearly-colored papule with translucent surface and telangiectasias

A

Basal cell carcinoma

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4
Q

Honey crusted lesions

A

Impetigo

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5
Q

Febrile pt w/ Hx DM presnts with red, swollen, painful LE

A

Cellulitis

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6
Q

Positive Niklosky’s sign

A

Pemphigus vulgaris

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7
Q

Negative Niklosky’s sign

A

Bullous pemphigoid

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8
Q

55 yo obese pt presents with dirty, velvety patches on back of beck

A

Acanthosis nigricans-check FBG to r/o DM

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9
Q

Dermatomal distribution

A

Varicella zoster

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10
Q

Flat topped papules

A

Lichen planus

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11
Q

Iris like target lesions

A

Erythema multiforme

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12
Q

Lesion characteristically occurring in linear pattern in areas where skin comes into contact with clothing or jewelry

A

Contact dermatitis

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13
Q

Presents with herald patch, Christmas tree pattern

A

Pityriasis rosea

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14
Q

Pinkish, scalding flat lesions on chest and back, KOH prep has “spaghetti and meatballs” apperance

A

Tinea (pityriasis) versicolor

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15
Q

4 characteristics of nevus suggestive of melanoma

A

Asymmetry
Border irregularity
Color variation
Diameter increasing

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16
Q

Premalignant lesions from sun exposure that can lead to SCC

A

Actinic keratosis

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17
Q

Dewdrops on rose petal

A

Lesions of primary varicella

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18
Q

Cradle cap

A

Seborrheic dermatitis

Tx conservatively with bathing and moisturizer

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19
Q

Associated with Propionibacterium acnes and changes in androgen levels

A

Acne vulgaris

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20
Q

Painful, recurrent vesicular eruption of mucocutaneous surfaces

A

Herpes simplex

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21
Q

Inflammation and epithelial thinning of anogenital area, predominantly in postmenopausal

A

Lichen sclerosus

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22
Q

Exophytic nodules on skin with varying degrees of scaling or ulceration; 2nd most common skin cancer

A

SCC

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23
Q

Macule

A

flat lesion that differs in color from surrounding skin <1 cm diameter

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24
Q

Patch

A

small circumscribed area differing in color from the surroundings surface >1cm diameter

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25
Q

Papule

A

Elevated solid lesion that is generally small <5mm

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26
Q

Plaque

A

Elevated solid lesion >5 mm

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27
Q

Cyst

A

Epithelial lined sac containing fluid or semisolid material

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28
Q

Vesicle

A

Fluid-filled, very small (<5 mm) elevated lesion

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29
Q

Bulla

A

Large vesicle >5 mm

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30
Q

Wheal or hive

A

Area of localized edema that follows vascular leakage and usually disappears within hours

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31
Q

Erosion

A

Circumscribed, superficial depression resulting from loss of some or all of epidermis

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32
Q

Ulcer

A

Deeper depression than erosion resulting from erosion of epidermis and upper dermis

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33
Q

Scale

A

Abnormal shedding or accumulation of stratum corneum in flakes

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34
Q

Crust

A

Hardened deposit of dried serum, blood, or purulent exudates

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35
Q

LIchenification

A

Thickening and hardening of skin with accentuation of normal skin marking

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36
Q

Scar

A

Healing defect of dermis

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37
Q

Type I hypersensitivity reaction - describe and give mechanism

A

Anaphylactic and atopic
Antigen crosslinks IgE on PRESENSITIZED mast cells and basophils- release vasoactive amines (histamine and LT) – reaction due to preformed ab

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38
Q

Type II hypersensitivity reaction - describe and give mechanism

A

Cytotoxic

preformed IgM and IgG bind antigen an enemy cell - lysis via complement or phagocytosis (MAC)

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39
Q

Type III hypersensitivity reaction - what are 3 types?

A

Immune complex
Serum sickness
Arthus reaction

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40
Q

Immune complex: type of hypersensitivity and mechanism

A

Type III

Ag-Ab complexes activate complement-attract PMN-release lysosomal enzymes

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41
Q

Serum sickness: type of hypersensitivity and mechanism

A

Ab to foreign proteins produce in about 5 d - immune complexes form and deposit in membrane- lead to tissue damage due to complement fixation

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42
Q

Arthus reaction: type of hypersensitivity and mechanism

A

Type III

Local reaction to antigen by preformed Ab charactized by vascular necrosis and thrombosis

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43
Q

Type IV hypersensitivity reaction - describe and give mechanism

A

Delayed/cell mediated
Sensitized T cells encounter antigen and release lymphokines that activate macrophages
Because is cell mediated is NOT TRANSFERABLE BY SERUM

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44
Q

Anaphylaxis, asthma, urticarial drug reaction ,wheal and flare - what type of hypersensitivity run

A

Type I- anaphylactic and atopic

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45
Q

AI hemolytic anemia, erythroblastosis fetalis, Goodpasture, rheumatic fever - what type of hypersensitivity run

A

Type II-cytotoxic

46
Q

Polyarteritis nodosa, immune complex GMN, SLE, RA - what type of hypersensitivity run

A

Type III: immune complex

47
Q

Drug reaction- what type of hypersensitivity run

A

Type III: serum sickness

48
Q

Hypersensitivity pneumonitis- what type of hypersensitivity run

A

Type III: arthus reaction

Rarely occurs 4-12 hrs after vaccination

49
Q

TB skin test, transplant rejection, contact dermatitis- what type of hypersensitivity run

A

Type IV: delayed/cell mediated

50
Q

Psoriasis cause

A

T cell mediated - dermal inflammation and epidermal hyperplasia

51
Q

Tx seborrheic dermatitis

A

Selenium sulfide
Zn pyrithione
Topical steroid
Topical antifungal

52
Q

Tx psoriasis

A

Steroid + keratolytic, tar, anthralin
IV
Methotrexate if bad
Retinoids and D3

53
Q

Rash of extensor surface

A

Psoriasis

54
Q

Rash of flexor surface

A

Atopic dermatitis

55
Q

Associated with psoriasis

A

Seronegative arthritis

56
Q

Tx hives/urticaria

A

Antihistamine

If anaphylaxis: antihistamine, Epi, IVF, airway

57
Q

Tx drug eruption

A

Stop drug, antihistamine, topical steroid

58
Q

Number of days before cutaneous drug reaction seen

A

7-14

59
Q

Major trigger Erythema multiforme

A

HSV lip

60
Q

Total body surface area of exfoliation SJS vs TEN

A

SJS 30%

61
Q

Tx SJS and TEN

A

Tx like burn: IVF, cover skin, watch lytes, careful of infection, thermoregulation problems,
Can use systemic steroids and IVIG in early stages

62
Q

Etiology SJS/TEN vs SSSS

A

SSSS- infection

SJS/TEN- drug

63
Q

Tx erythema nodosum

A

NSAIDs, remove offending agent

64
Q

Tx bullous pemphigoid vs pemphigoid vulgaris

A

Bullous: Steroids, azothioprine
Vulgaris: high dose steroids, + immunomodulator-IVIG, MMF, rituximab; azothioprine, cyclophosphamide

65
Q

Tzanck smear

A

Dx HSV: multinuclear giant cell

Tzanck goodness its not herpes!

66
Q

Tx HSV

A

acyclovir oral or IV
Can use valacyclovir, famciclovir
Daily Tx if > 6 outbreaks per yr

67
Q

Tx VZV

A

Acyclovir

Vaccine available

68
Q

Molloscum contagiosum-type of virus; Dx

A

Poxvirus

Giemsa or Wright stain shows inclusion bodies

69
Q

Tx molloscum contagiosum

A

Freezing, curetting, trichloroacetic acid

70
Q

Tx verrucae

A

Cryotherapy, podophylllin, trichloroacetic acid, imiquimod, 5FU

71
Q

Tx eryspelas

A

Penicillin (usu. GAS infection)

72
Q

Tx impetigo

A

Abx w/ staph coverage- cephalosporins, erythromycin, topicals
Topical usu good enough but oral to prevent spread

73
Q

Scarlet fever, cause, Tx

A

Strep pyogenes

Penicillin

74
Q

Tx salmonella typhi

A

Fluoroquinolone and 3rd cephalosporin

If chronic carrier consider cholecystectomy

75
Q

Ludwing angina- what; presentation?

A

What: bilateral cellulitis of submental, submaxillary, sublingual spaces that results from infected tooth
S/S: dysphagia, drooling, fever, red warm mouth- can asphyxiate

76
Q

Most common cause cellulitis

A

GAS, Staph (MRSA)

77
Q

Tx cellulitis

A

7-10 oral abx if mild; 10-14 d cephalosporin or beta lactamase resistant abx
IV abx if DM, bad, old, hand or eye, etc
If MRSA: vanc or linezolid

78
Q

Necrotizing fasciitis
Causes
Signs
Tx

A

S pyogenes
Mixed: S aureus, E coli, C perfringens

S/S: tissue necrosis, putrid discharge, bullae, pain, gas production

Tx: Strep 1. Pen G 2. Clinda
Anaerobic: Metronidazole or 3rd ceph

79
Q

Folliculitis - causes, hot tub

A

Staph, Strep, Gram N, sometimes Candida

Pseudomonas- hot tub

80
Q

Furuncle vs carbuncle

A

Furuncle deep infection of hair follicle, progressed from folliciltis
Carbuncle many furuncles

81
Q

Tx 1. comedonal acne

  1. pustulocystic or inflammatory
  2. sever cystic
A
  1. topical tretinoin + benzoyl peroxide
  2. benzoyl peroxide + topical abx (erythromycin or clindamycin), oral if resistant to topical
  3. Isoretinoin- test LFT, chol, TG, beta HCG
82
Q

Tx pilonoidal

A

I and D

83
Q

Abx cause serious photosensitivity

A

Tetracycline and doxycycline

84
Q

KOH prep reveals spaghetti and meatballs

A

Tinea versicolor

85
Q

Cause tinea versicolor

A

Malasezia furfur

86
Q

Tx tinea versicolor

A

Ketoconazole or selenium sulfide

87
Q

Candidiasis Tx

  1. oral
  2. skin
  3. diapr
A
  1. oral fluconazole, nystatin swish and swallow
  2. topical antifungal
  3. topical nystatin
88
Q

Dermatophyte - 3 common bugs

A

Trichophyton
Microscporum
Epidermophytin

89
Q

Tx dermatophyte

A

Topical antifungals ok

Capitis must be oral

90
Q

Tx scabies

A

5% permethrin from neck down

can use oral ivermectin

91
Q

Tx lice

A

head: pyrethrin (RID), benzoyl alcohol, remove nits
Body: wash, permethrin or pyrethrin
Pubic: RID

92
Q

Tx rosacea

A

topical metronidazole

93
Q

Tx vitiligo

A

Psoralens, sunlight, PUVA

94
Q

Tx actinic keratosis

A

Cryotherapy
5FU
Imiquinod
Biopsy

95
Q

Commonest causes SCC

A

Sun

Arsenic

96
Q

Examples of macule

A 
Cafe au lait spot
Vitiligo
Freckle
Junction nevi
Ink tattoo
97
Q

Examples of Patch

A

Nevus flammeus
Vitiligo
Tinea corporis

98
Q

Examples of Papule

A 
Acrochordon (skin tag)
Basal cell carcinoma
Molloscum contagiosum
Intradermal nevi
Lichen planus
99
Q

Example Plaque

A 
Bowen disease
Mycosis fungoides
Psoriasis
Eczema
Tinea corporis
100
Q

Examples of Nodule

A 
Rheumatoid nodule
Tendon xanthoma
Erythema nodosum
Lipoma
Metastatic carcinoma
101
Q

Examples of wheal

A

Urticaria
Dermographism
Urticaria pigmentosa

102
Q

Examples of vesicle

A

Herpes simplex
Herpes zoster
Dyshidrotic eczema
Contact dermatitis

103
Q

Examples of bulla

A

Pemphigus vulgaris
Bullous pemphigoid
Bullous impetigo

104
Q

Examples of pustule

A

Follicultis
Impetigo
Acne
Pustular psoriasis

105
Q

Examples of cyst

A

Acne
Epidermoid cyst
Pilar cyst

106
Q

Hidranitis suppurativa - define, bugs, Tx

A

Chronic follicular occlusion and apocrine inflammation 2/2 recurrent abscess
Bugs: Staph
Tx: I and D, cephalosporin

107
Q

Mom pregnant and has chicken pox

A

Give immunoglobulin b/c can transmit to newborn

108
Q

Enzyme def in prophyria cutanea tarda

A

Hepatic uroporphyrinogen decarboxylase

109
Q

Tx porphyria cutanea tarda

A

Phlebotomy
Low dose chloroquie
Sunscreen
Avoid triggers: estrogen, alcohol, tobacco

110
Q

Hereditary angioedema cause

A

Lack of C1 esterase inhibitor

Swelling of kips eyelids, airway, bowel
AD, C4 is low

First Aid Step 2 🐰 (22 decks)

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