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clin med > skin 1.4 > Flashcards

skin 1.4 Flashcards

1
Q

Toxic epidermal necrolysis

sx

A

Fever
Epidermal separation
Over 30% BSA
Sheetlike loss of epidermis

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2
Q

Toxic epidermal necrolysis

trmt

A

Hospital
Treat fluid loss
Burn unit

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3
Q

Staphylococcal scalded skin syndrome (SSSS)

A

Epidermal shedding from s aureus in kids under 5

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4
Q

Assoc with lyme disease

A

Erythema migrans

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5
Q

MC arthropod borne disease in US

A

Erythema migrans

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6
Q

Erythema migrans

cause

A

Borrelia burgdorferi, ixodes tick

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7
Q

Erythema migrans

pe

A

Starts 3-30 days after tick bite
Fever, myalgia, arthralgia, ha, malaise, fatigue
At least 5 cm wide and central punctum where bite was
At sites favored by ticks like waistband

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8
Q

Early disseminated days to wks after

Erythema migrans

A

Skin, CNS, musculoskeletal
HA, stiff neck, fatigue, malaise
Cardiac and neuro sx

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9
Q

Persistent months to yrs after

Erythema migrans

A

Musculoskeletal- joint pain

CNS- encephalopathy, axonal polyneuropathy

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10
Q

Erythema migrans

dx

A

Dx fpr lyme disease
ELISA IgM and IgG Ab- may not come until 2-4 wks after exposure
Must do western blot (test)

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11
Q

Must do western blot to dx this

A

Erythema migrans

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12
Q

Erythema migrans

trmt

A

Remove tick within 24 hrs with forceps only
GOLD std doxycycline
Amoxicillin if allergic

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13
Q

Rocky mountain spotted fever

cause

A

Rickettsia rickettsii transmitted by wood, dog, or lone star tick

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14
Q

Rocky mountain spotted fever

PE

A

Fever, chills, nausea, HA, vomiting, myalgia

Maculopapules on wrists and ankles then spread to trunk

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15
Q

Rocky mountain spotted fever

dx

A

+ fluorescent Ab stain

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16
Q

Rocky mountain spotted fever

trmt

A

Treat fast with doxycycline or chloramphenicol

20% mortality without trmt

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17
Q

Cutaneous larva migrans cause

A

Cat or dog hookworm, parasite, in their poop and humans step on it

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18
Q

Cutaneous larva migrans PE

A

Creeping eruption-in epidermis and superficial dermis

Pink papule

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19
Q

Cutaneous larva migrans trmt

A

None

Goes away on own

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20
Q

“Swimmers itch”

“Clamdigger’s itch”

A

Cercarial dermatitis

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21
Q

Cercarial dermatitis cause

A

Organisms in aquatic settings

We get infected after going in freshwater

22
Q

Cercarial dermatitis pe

A

Prickling after bug enters
Red macules, urticaria
Everywhere but bathing suit areas

23
Q

Cercarial dermatitis trmt

A

None

Resolves on own

24
Q

Actinic purpura?

A

Purple macules on sun exposed areas

Common in old ppl

25
Q

Actinic purpura

pe

A

Round or oval ecchymosis on hand or forearm

26
Q

Actinic purpura

trmt

A

none

27
Q

Sarcoidosis ?

A

Bilateral hilar lymphadenopathy
Noncaseating granulomas
In aa

28
Q

Sarcoidosis pe

A

Lupus pernio- purple donut on nose, cheeks, ears

Apple jelly yellow brown color on diascopy

29
Q

Sarcoidosis dx

A

Angiotensin converting enzyme

Biopsy is diagnostic

30
Q

Sarcoidosis trmt

A

Hydroxychloroquine

31
Q

Heliotrope rash-

A

red/purple on eyelid

32
Q

Gottron papules-

A

purple papules on hand

33
Q

Shawl sign-

A

red and atrophy on neck and shoulders

34
Q

Dermatomyositis pe

A

Heliotrope rash- red/purple on eyelid
Gottron papules- purple papules on hand
Shawl sign- red and atrophy on neck and shoulders
Periungual erythema
Affects proximal muscles- hard to rise from chair, raise hands above head, climb

35
Q

Dermatomyositis dx

A

High muscle enzymes like cpk and aldolase

Abnormal muscle biopsy

36
Q

Dermatomyositis trmt

A

Methotrexate

Azathioprine

37
Q

Scleroderma pe

A

Raynaud’s → white blue red
Sausage digits- painless edema
CREST

38
Q

3 stages of Generalized scleroderma

A

Edematous- edema of face and digits
Indurative- skin is hard and restricts mvmts
Atrophic- distal finger become small and pointed with ulcers, mask like facies
Also affects GI, renal, derm, pulm, myopathic

39
Q

2 forms of Localized scleroderma

A

Morphea- sharp demarcated plaques

Linear scleroderma- en coup de sabre are linear malformations on face

40
Q

Scleroderma trmt

A

Raynaud’s- nifedipine to open BV

Localized “burns out” over time and softens

41
Q

Granuloma annulare

sx

A

Asymptomatic

42
Q

Granuloma annulare

PE

A

Cosmetic concern
Shiny papules and annular plaques that are skin colored, red, or purple
Pebbled surface

43
Q

Granuloma annulare

dx

A

Biopsy confirms

44
Q

Granuloma annulare

trmt

A

Heals on own over months

45
Q

Looks like ringworm but asymptomatic

A

Granuloma annulare

46
Q

Necrobiosis lipoidica

PE

A

Plaques ulcerate over yrs and are painful
Atrophic with yellow hue, telangiectasia, and defined borders
Symmetry on both shins

47
Q

Necrobiosis lipoidica

dx

A

Glucose intolerance

Biopsy confirms

48
Q

Necrobiosis lipoidica

trmt

A

Control DM

Topical and intralesional corticosteroids

49
Q

Necrobiosis lipoidica is assoc with this condition

A

dm

50
Q

Factitious ulcers-

A

geometric weird shape

51
Q

Pyoderma gangrenosum-

A

rapidly growing painful ulcer

52
Q

Venous insufficiency-

A

lower leg edema with brown color

clin med (35 decks)

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