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clin med > skin 1.3 > Flashcards

skin 1.3 Flashcards

1
Q

Dermatofibrosarcoma protuberans pe

?

A

Slow growing tumor on shoulders or chest
Continued growth, irregular borders
Common in 20-50 yo

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2
Q

Dermatofibrosarcoma protuberans

dx

A

Punch or excisional biopsy

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3
Q

Dermatofibrosarcoma protuberans

trmt

A

Excision via MOHS surgery

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4
Q

Keloid?

A

Inc fibroblast activity

Common in darker skinned ppl

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5
Q

Keloid pe

A

Firm, plaque like papule or nodule that extends beyond trauma borders

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6
Q

Keloid trmt

A

1 is intralesional steroids: Kenalog 40

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7
Q

Dermatofibrosarcoma protuberans ?

A

Rare
Malignant dermal neoplasm
Don’t metastasize often

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8
Q

Lipoma ?

A

Benign tumor of subcutaneous fat

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9
Q

Lipoma sx

A

Asymptomatic

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10
Q

Lipoma pe

A

Skin colored
Elevation, Rubbery and movable
MC on trunk, neck, extremities

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11
Q

Lipoma dx

A

Biopsy if suspicious

Elliptical excision or punch biopsy to get all fat cells

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12
Q

Lipoma trmt

A

None

Cosmetic

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13
Q

Neurofibroma?

A

Proliferation of neural tissue in dermis

Benign

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14
Q

Neurofibroma pe

A

Skin colored papule or nodule

Buttonhole sign

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15
Q

Dx for NFM1- 2+ of following

A 
6+ café au lait macules
2+ neurofibromas or 1 plexiform neurofibroma
Axillary or groin freckling
Optic nerve glioma
2+ lisch nodules (iris hamartomas)
Osseous lesions
1st degree relative with NFM 1
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16
Q

Neurofibroma trmt

A

Excision

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17
Q

xanthoma ?

A

Collection of lipids in dermis or tendons

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18
Q

Tendon xanthomas

A
  • stoney hard nodules on achilles tendon on extendor tendons of finger from high TC
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19
Q

Tuberous xanthomas-

A

potato like on butt and elbows from high TC or TG

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20
Q

Eruptive xanthomas-

A

on extensor surfaces from high TG

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21
Q

Xanthelasmas

A
  • on eyelids from high TC
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22
Q

Xanthoma trmt

A

Diet
Statins
Excision

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23
Q

Kaposi sarcoma

?

A

Malignant vasc tumor assoc with HHV8

Inc risk of malignant neurofibrosarcoma if involves mucous membranes

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24
Q

Kaposi sarcoma

types

A

Classic- old men eastern europe
Lymphadenopathic- young men in africa
AIDS associated

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25
Q

Kaposi sarcoma

cause

A

AIDS, immunosuppression → must test for AIDS

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26
Q

Kaposi sarcoma

pe

A

Purple macules, papules, dermal plaques, nodules
MC on legs in Classic KS
Can be anywhere

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27
Q

Drug eruptions

?

A

Systemic rash of sudden onset from drug

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28
Q

Drug eruptions

pe

A

hives
Bright red macules or papules
Start proximal then go distal

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29
Q

Drug eruptions

trmt

A

DC drug

May take 1-2 wks to clear

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30
Q

Viral exanthem

A

Virus spreads through the blood to the skin

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31
Q

Koplik spots-

A

tiny white papules with red base on buccal mucosa pathognomonic for measles

32
Q

measles/rubeola

A

3 C’s: cough, coryza, conjunctivitis
Begins on head then goes to extremities
Can cause encephalitis

33
Q

German measles/rubella

A

Begins on head then goes to extremities

34
Q

Herpesvirus 6/roseola

A

Rose red macules

Fever goes away right before rash

35
Q

Parvovirus B19/erythema infectiosum/ fifth disease

A

Slapped cheek then spreads to arms and legs and has reticular/lacy look

36
Q

Enterovirus (echo and coxsackie virus from hand foot and mouth disease)

A

Vesicles on palms, soles, and mouth

Almost always have fever

37
Q

Mono

A

Trmt with ampicillin or amoxicillin triples rash

38
Q

Most have fever and constitutional sx before they appear

A

viral xanthems

39
Q

SLE is mc in

A

MC women of childbearing age

40
Q

SLE

sx

A

Fatigue, fever, arthralgia, weight change, alopecia, raynaud’s (white→ blue → red)

41
Q

Dx american rheumatism association criteria- need 4+

A 
Butterfly (malar) rash
Discoid rash
Photosensitivity
Oral ulcers
Arthritis
Renal (worse prognosis), neuro, heme, or immunological disorders
ANA
42
Q

SLE

dx

A

ANA
Anti ds DNA
Anti sm a and b

43
Q

SLE

trmt

A

Sunscreen
Topical steroids
Antimalarial hydroxychloroquine DOC

44
Q

Cellulitis

cause

A

Staph, strep, H influenzae

45
Q

Cellulitis

sx

A

Ill, febrile

46
Q

Cellulitis

pe

A 
4 signs of inflammation:
Rubor- red
Calor- hot
Tumor- swelling/edema
Dolor- pain
47
Q

Cellulitis

pe

A

Skin and blood culture

48
Q

Cellulitis

trmt

A

Systemic ATB

Facial cellulitis needs IV trmt

49
Q

Erysipelas

A
  • sharp demarcated borders in strep infection
50
Q

Abscess and furuncle

?

A

Pus filled nodules in dermis

Furuncle- from infected hair follicle; abscess isnt

51
Q

Abscess and furuncle

cause

A

S aureus is MC

52
Q

Abscess and furuncle

sx

A

Painful, spongy red hard nodules
Abscesses are larger and deeper
No fever

53
Q

Abscess and furuncle

dx

A

Culture

54
Q

Abscess and furuncle

trmt

A

Incision and drain is gold std

Antiseptic skin cleansers and topical mupirocin

55
Q

Hidradenitis suppurativa-

A

recurrent scarring and draining of nodules in axillae, groin, and under breasts

56
Q

Erythema nodosum

?

A

Inflammation of subcutaneous fat on lower legs

57
Q

causes Erythema nodosum

A

Post strep, sarcoidosis, IBD, pregnancy

58
Q

Erythema nodosum

pe

A

VERY tender red nodules 1-2 cm wide on lower legs

Self limiting, resolve in 3-6 wks

59
Q

Erythema nodosum

dx

A

Throat culture if post strep
Anti streptolysin O
CXR if sarcoidosis
Deep punch biopsy

60
Q

Erythema nodosum

trmt

A

Treat cause

NSAIDS for pain

61
Q

Fixed drug eruption

sx

A

Red plaques that come in the same spot every time you get exposed to a new med

62
Q

Fixed drug eruption

causes

A

MC NSAIDS, sulfonamides, tetracyclines, one more got cut off

63
Q

Urticaria/wheals

?

A

Vascular red blanchable swelling skin that itches

Wheals last 30min-24 hrs

64
Q

Urticaria/wheals

causes

A

Acute- resp infections and meds

Chronic- unknown

65
Q

Urticaria/wheals

pe

A

Edematous plaques with pale centers and red borders

66
Q

Urticaria/wheals

dx

A

LFT to r/o hepatitis

CBC to r/o heme causes

67
Q

Urticaria/wheals

trmt

A

Stop meds

Antihistamine fexofenadine

68
Q

MC event that comes before recurrent erythema multiforme

A

Herpes simplex infection is

69
Q

Erythema multiforme

MCC

A

MCC meds and infections

70
Q

Erythema multiforme

pe

A

Itch and burn
Red papules and plaques
Target lesions with 3 zones of color
Usually on palms and soles

71
Q

Erythema multiforme

dx

A

Tzanck prep or viral culture for vesicular lesions

Biopsy is diagnostic

72
Q

Erythema multiforme

trmt

A

Stop meds

Treat herpes with valacyclovir

73
Q

Steven johnson syndrome?

A

Erythema multiforme when mucous memb are involved

74
Q

Drugs assoc with sjs:

A

sulfonamides, quinolones, cephalosporins, tetracyclines, phenobarbital, phenytoin, valproic acid, allopurinol

75
Q

Steven johnson syndrome

pe

A

Vesicle and bullae

Up to 10% BSA

76
Q

Steven johnson syndrome

trmt

A

Hospital
Treat fluid loss
Burn unit

clin med (35 decks)

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