Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med I > skin conditions 5 and 6 > Flashcards

skin conditions 5 and 6 Flashcards

1
Q

what are the viral exanthams

A
  • measles
  • rubella
  • fifth disease
  • varicella
  • zoster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is another name for measles

A

rubeola

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how is measles spread

A
  • respiratory droplets
  • incubation of 9-12 days
  • clears in 4-7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

si/sx of measles

A
  • prodrome of cough, coryza, conjunctivitis
  • fever
  • descending rash of papules that coalesce
  • rash includes palms and soles
  • koplick spots*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are koplick spots

A
  • white papules 1 mm on buccal mucosa and pharyn

- occurs during measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

treatment for measles

A
  • prevention- vaccine

- supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what another name for rubella

A

german measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is rubella spread

A
  • respiratory droplets
  • incubation- 12-23 days
  • caused by toga virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

si/sx of rubella

A
  • no prodrome
  • 1-5 days fever, malaise, sore throat, h/a
  • pain with lateral upward eye movement
  • lymphadenopathy*
  • pale pink morbilliform macule (smaller ran rubeola)
  • starts of face, spreads to whole body in 23 h
  • forscheimers sign*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is forscheimers sign

A
  • pitechiae on soft palate of uvula

- occurs in rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment of rubella

A
  • prevention- vaccine

- supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how is fifth disease spread

A
  • respiratory droplets
  • viral shedding stopped by the time rash appears
  • incubation of 4-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

whats another name for fifth disease

A

erythema infectiosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

si/sx of fifth disease

A
  • 3 stages
  • 1: aburpt asymptomatic erythema on cheeks (slapped cheek)
  • 2: day four discrete erytematous macules and papules on proximal extermitities and trunk, lacey reticulate pattern
    3: recurring stage d/t heat or light
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

treatment for fifths disease

A

supportive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is pityriasis caused

A
  • unknown

- thought to be previous viral exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

si/sx of pityriasis rosea

A
  • herald patch**
  • oval erythematous patches with fine scaes
  • macular or papular lesions on trunk, neck, extremities following skin folds
  • christmas tree pattern
  • can be pruritic
  • lasts 3-8 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a herald patch?

A
  • 2-5 mm scaly lesion that may mimic tinea corporis

- happens in pityriasis rosea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

treatment for pityriasis rosea

A
  • not needed

- can give antihistamine for pruritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

morbilliform reactions

A
  • most common adverse drug eruption
  • type IV allergic reaction mediated by t helper cells
  • commonly from ampicillin or amoxicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

si/sx of morbilliform rash

A
  • erythema with macules and papules initially on trunk then generalized within 2 days
  • can present within first 2 weeks of exposure up to 10 days after d/c
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

treatment for morbilliform rash

A
  • clears w/ in 2 weeks d/c

- symptomatic relief: antihistamines, low potency topical steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when do fixed drug reactions occur

A
  • usually with meds that need to be taken itermittently
  • NSAIDs
  • sulfonamides
  • barbituates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

si/sx of fixed drug reactiosn

A
  • oval/round erthematous plaque
  • pruritic, burning, or asymptomatic
  • reoccur at same site with each exposure
  • usually 6 or fewer lesions
  • 50% of lesions appear on genitals or oral mucosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

treatment for fixed drug reactions

A
  • symptomatic: antihistamines and topical steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

erythema multiforme

A
  • self limited eruption
  • d/t drug exposure, viral infection, or ideopathic
  • usually sulfa, barbs, phenytoin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

si/sx of erythema multiform

A
  • begins as macules -> papular -> vesicles -> bullae
  • localized to hands and feet, can become more generalized
  • targetoid appearance
  • mucosal lesions are painful and erode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

treatment for erythema multiforme

A
  • avoid target substances

- severe reaction can require systemic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

SJS and TENS

A
  • mucocutaneous blistering reaction from drugs

- thought to be an immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

si/sx of SJS and TENS

A
  • fever
  • mucosal inflammation
  • lesions begin on trunk and may be painful
  • TEN- higher fever, more epidermal sepearation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

treatment for SJS or TEN

A
  • treatment at burn center for fluid and electrolyte imbalance
  • wound care
  • ? steroid treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

bullous pemphigoid

A
  • autoimmune process
  • usually in 60s
  • IgG antibodies bind to basement membrane -> inflammation -> protease release -> blister
  • Ab separate epidermis from dermis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

si/sx of bullous pemphigoid

A
  • prodrome of urticarial lesions
  • bullae are large and can have serous or hemorrhagic fluild
  • axillae, thigh, groin, abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

course of bullous pemphigoid

A
  • usually self limited

- can last 5-6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

differential dx for bullous pemphigoid

A
  • epidermolysis bullosa acquisita

- bullous scabies erruptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

dx of bullous pemphigoid

A
  • biopsy and immunofluroescence

- C3 deposition is almost always present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

treatment for bullous pemphigoid

A
  • potent steroids
  • clobetasol ointment
  • PO prednisone
  • if very severe can give immunosuppressants
  • tetracycline + niacinamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are the 3 types of lice

A
  • pediculus humanis capitis- scapl
  • p. humanis corporis- body
  • phthirus pubis- pubic area, crabs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

p. humanis capitis

A
  • cant live more than 3 days off human head
  • easily dislodged
  • lay eggs on most fabric
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

p. humanis corporis

A
  • lives in human clothes
  • prefers cooler temps
  • can live 10 days off the human body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

p. pubis

A
  • looks like a crab
  • large claws -> grasp to coarser hair in groin, perianal, axillary areas
  • heavy infestations can involve eyebrows, facial hair, eye lashes
  • less mobile
  • can only survive for 1 day off human
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

si/sx of p. capitus

A
  • intense pruritus of scalp
  • posterior cervical lymphadenopathy
  • may see lice, nits, or dung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

p. corporis si/sx

A
  • small pruritic papules
  • progress d/t scratching to rusted and infected papules
  • spares hands and feet
  • usually d/t poor hygiene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

p. pubis si/sx

A
  • intense pruritus in affected areas
  • small blue macules
  • spread by close physical contact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

differential diagnosis of pediuclosis

A
  • scabies
  • eczema
  • delusions of parasitosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

treatment of pediculosis

A
  • OTC Nix cream rinse, RID acticin
  • ovid lotion
  • elimite cream
  • bactrim
  • vasaline
  • wash clothes/sheets etc. and expose to high heat
  • seal objects in plastic bag for 2 weeks
  • ppx treat family members
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

scabies

A
  • infestation of sarcoptes scabiei
  • burrow into epidermis and deposit feces and lay eggs -> irritation
  • type IV hypersensitivity reaction 30 days after infestation
  • should be considered on any pt with pruritus not responding to topical steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

si/sx of scabes

A
  • vesicles, papules, or nodules
  • found between fingers and toes, flexor aspect of wrists, axilla, antecubital area, abdomen, umbilicus, genitals, gluteals, feet
  • spares the face
  • burrows**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

crusted/ norwegian scabies

A
  • immunocompromised pts
  • crusts and scales teem with mites
  • psoriasis like scaling around nails with crusting
50
Q

differential dx for scabies

A
  • bite reaction
  • atopic dermatitis
  • delusions of parasitosis
51
Q

treatment of scabies

A
  • permethrin cream- apply for 8-12 hours, repeat in one week
  • lindane lotion- more toxic
  • precipitated sulfur ointment
  • PO ivermectin
  • after treatment was all clothes, bedding etc..
  • treat family members
52
Q

loxoscelism

A
  • bite from a brown recluse spider
53
Q

where are brown recluse spiders found?

A
  • commonly in midwest and southwest
  • woodpiles, grass, rocky bluffs, barns
  • stings in sell defense
  • has violin shaped markings on body
54
Q

what is in the brown recluse spider venom

A
  • phospholipase enzyme called sphingomyelinase D

- breaks down proteins

55
Q

si/sx of brown recluse spider bite

A
  • localized sx
  • pain after 3 hours
  • extensive necrosis and edema within 8 hours
  • bulla surrounding erythema and ischemia can extend into muscle
  • 1 week- gangrenous and dark
56
Q

treatment for brown recluse spider bite

A
  • rest, ice, elevate bite
  • analgesics
  • tetanus prophylaxis
  • surgical debridement
57
Q

latrodectism

A
  • black widow spider bite
58
Q

where are black widow spiders found?

A
  • continental US
  • caribbean
  • wood piles and outhouses
  • red hourglass shaped markings on abdomen
59
Q

si/sx of black widow spider bite

A
  • central reddened fang puncture site with area of blanching and outer halo of redness- target appearance
  • systemic pain/ cramping in one hour
  • tachycardia
  • HTN
  • pulmonary edema
  • fever, chills, delirium
  • vomitting
  • partial paralysis
  • abdominal pain is severe*
60
Q

treatment for black widow spider bite

A
  • ACLS
  • anti-venom
  • analgesics
  • antihistamines
  • tetanus
61
Q

what is lichen planus

A
  • pruritic inflammatory disease of skin, mucous membranes, and hair follicles
  • mostly affects adults
  • T cell reaction -> keratinocytes undergo apoptosis
62
Q

si/sx lichen planus

A
  • four P’s
  • purple
  • polygonal
  • pruritic
  • papules
  • on flexor aspects of wrists, lumbar area eyelids, shins, scalp
  • reticulate white lesions on buccal mucosa
  • lesions for < 1 year
  • can cause hair loss and nail damage
63
Q

treatment for lichen planus

A
  • potent topical steroid

- intralesional steroid injection

64
Q

seborrheic keratosis

A
  • senile wart
  • basal cell papilloma
  • over 90% of adults over 60 have these
  • occurs in all races
65
Q

presentation of seborrheic keratosis

A
  • “Stuck on” appearance
  • white, flesh colored, tan, brown
  • can be warty or smooth
66
Q

kaposi sarcoma

A
  • vascular neoplasm
  • usually in HIV pts
  • infection with HHV8
  • 4 types but HIV associated is most common
67
Q

si/sx of kaposi sarcoma

A
  • red/purple macules -> infiltrative plaques and nodules or tumors on mucous membranes
  • often on lower extremities
  • presents later on arms and hands
  • lymphedema
  • becomes painful and ulcerated
  • internal involvement possible
68
Q

histology of kaposi sarcoma

A
  • capillaries are large and protrude into lumen
  • proliferation of vessels around existing vessels
  • spindle cells found in nodular lesions
69
Q

clinical course of kaposi sarcoma

A
  • variale
  • progresses slowly with rare lymph node or visceral involvement
  • almost never fatal
  • death usually d/t unrelated cause
70
Q

treatment of kaposi sarcoma

A
  • antiretroviral HIV tx
  • radiation
  • cryotherapy
  • surgical excision of individual nodules
  • topical alitretioin
  • pulsed dye laser
71
Q

actinic keratosis

A
  • in situ dysplasia d/t UV radiation
  • can progress to SCC
  • thick scaly growths
  • most common epithelial precancerous lesion
72
Q

epidemiology of actinic keratosis

A
  • white > darker skin
  • men > women
  • > risk with outdoor occupation or lifestyle
  • most common >50 y/o
73
Q

pathophysiology of actinic keratosis

A
  • atypical keratinocytes at basal layer that can extend upward
  • epidermis shows atypia, hyperkeratosis with inflammatory infiltrate
74
Q

clinical manifestations of actinic keratosis

A
  • found on chronically sun exposed surfaces
  • drivers sides
  • multiple discrete, flat, or elevated verrucous
  • keratotic, red, pigmented, or skin colored
  • may be scaley, smooth, shiny
  • rough sandpaper texture
  • usually felt more easily than seen
75
Q

differential dx for actinic keratosis

A
  • BCC
  • seborrheic keratosis
  • SCC
  • lupus erythematosus
76
Q

dx of actinic keratosis

A
  • clinical/ hx

- biopsy if palpable dermal component, “pearly” appearance or failed tx

77
Q

tx of actinic keratosis

A
  • based on number of lesions, persistence of lesions, and pt tolerability
  • cryotherapy
  • imiquimod
  • 5-FU
  • picato
  • be sure to follow up with pt
78
Q

prognosis of actinic keratosis

A
  • good

- continue to monitor for 2-6 mo depending on number of lesions and maintenance tx

79
Q

basal cell carcinoma

A
  • epithelial tumor of basal keratinocytes
  • invades dermis
  • rarely metastasizes
  • slow growing
80
Q

epidemiology of BCC

A
  • white > dark skinned
  • geography - closer to equator
  • age > 40
  • outdoor lifestyle/ occupation
  • immunosuppression increases risk by 10X
81
Q

pathophysiology of BCC

A
  • immature pluripotent cells associated with hair follicle
  • mutations activate pathway that controls cell growth
  • activates oncogenes and tumor suppressor genes
82
Q

clinical manifestations of BCC

A
  • slowly enlarging lesion that does not heal, bleeds easily
  • mostly on face, head, neck, hands
  • appears as flat, firm, pale area
  • small, raised
  • pink or red, translucent or pearly**
  • rolled edge
  • can become ulcerative- “rodent ulcer”
  • bleeds without significant pain or sx
  • ulceration may burrow deep into subcutaneous tissue
83
Q

types of BCC

A
  • nodular
  • superficial
  • morpheaform (sclerosing)
  • pigmented
84
Q

nodular BCC

A
  • most common type
  • waxy, pearly, semitranslucent nodules or papules
  • rolled edge
  • central depression that may become ulcerated, crusted, or bleed
85
Q

superficial BCC

A
  • dry scaly lesion
  • superficial flat growths
  • can be misdx as eczema or psoriasis
  • threadlike raised boarder
86
Q

morpheaform (sclerosing) BCC

A
  • white sclerotic plaque
  • tenagiectasia
  • scar like appearance
87
Q

pigmented BCC

A
  • similar to nodular
  • brown or black pigmentation
  • usually in darker skin
88
Q

differential dx of BCC

A
  • SCC
  • sebaceous hyperplasia
  • actinic keratosis
  • eczema
  • psoriasis
89
Q

dx of BCC

A
  • biopsy
  • large, oval, or round tumor islands within dermis
  • often epidermal attachment
90
Q

treatment of BCC

A
  • goal= cure with best cosmetic results
  • reoccurrence usually from inadequate tx
  • usually seen in first 4-12 mo after tx
  • surgical, topical, or radiation tx
91
Q

topical tx for BCC

A
  • imiquimod
  • 5-FU
  • best for superficial BCC, less invasive
92
Q

surgical options for BCC

A
  • electrodisseication and Currettage for superfical lesions
  • cryosurgery (not common)
  • excision with margins- high cure rate
  • mohs micrographic surgery- gold standard (takes small layer at a time and checked under microscope until all cancer cells removed)
93
Q

radiation for BCC

A
  • not often used unless lesions are large
  • usually old pts who aren’t candidates for surgery
  • can take 5-25 visits
94
Q

prognosis of BCC

A
  • good if appropriate tx used early
  • recurrent cancers are much harder to cure
  • 100% survival if it has not metastasized
  • can impinge on vital structures
95
Q

squamous cell carcinoma

A
  • many arise from actinic keratoses
  • can metastasize
  • arise from malignant proliferation of epidermal keratinocytes
96
Q

epidemiology of SCC

A
  • > 50 y/o
  • male > female
  • light skin > dark skin
  • tobacco and/or alcohol use
  • geography
  • hx of previous non-melanoma skin cancer
  • immunosuppression
  • HPV
  • chemical carcinogens
97
Q

pathophysiology of SCC

A
  • UVR, PUVA
  • smoking (oral ca)
  • HPV 16, 18, 31, 35
  • irregular nests of epidermal cells invading into dermis
  • TP53 mutation
98
Q

types of SCC

A
  • in situ (bowen’s disease)- full thickness of epidermis

- invasive

99
Q

clinical manifestations of SCC

A
  • begings at site of acitinic keratosis on sun exposed areas
  • superficial papules, plaques, or nodules
  • hard
  • become larger, ulcerated, covered by crust
  • lesions are moveable at first but then become fixed
100
Q

lower lip SCC

A
  • starts as actinic chelitis
  • local thickening on keratosis then firm nodule
  • usually hx of smoking
101
Q

periungual SCC

A
  • signs of swelling, erythema, local pain
  • commonly in nail folds of hands
  • resembles warts
102
Q

differential dx for SCC

A
  • actinic keratosis
  • eczematous rash
  • atopic dermatitis
103
Q

dx of SCC

A
  • biopsy- reveals “keratin pearls”

- lymphadenopathy*

104
Q

treatment of SCC

A
  • excision
  • mohs
  • radiation
105
Q

prognosis of SCC

A
  • Mohs surgery provides best cure rates
  • if metastasized, associated with poor prognosis
  • regular f/u required
106
Q

melanoma

A
  • skin cancer of melanocytes
  • least common skin cancer
  • most deadly
107
Q

melanoma risk factors

A
  • M- mole atypia
  • M moles > 50
  • R red hair and freckling
  • I inability to tan
  • S sunburn, severe/ blistering
  • K kindred/ family history
108
Q

etiology of melanoma

A
  • damage to DNA of melanocytes -> oncogene and tumor suppressor gene mutations
  • UVR
  • genetics
109
Q

pathophysiology of melanomas

A
  • originate from melanocytes via dermoepidermal junction
  • half will dev in preexisting nevi
  • usually prolonged, noninvasive radial growth
  • tumor nodule dev- vertical growth
110
Q

what is the greatest factor risk for metastasis in melanoma

A
  • depth of invasion of melanoma lesion
111
Q

clinical manifestation of melanoma

A
  • macular or nodular
  • color varies
  • lesions boarders are irregular
  • growth is quick or slow
  • distribution can be o non sunexposed spots
112
Q

superficial spreading of melanoma

A
  • does not have a preference for sun damaged skin
  • tends to be multicolored
  • boarders are more sharply defined
113
Q

lentigo maligna

A
  • macular and flat then nodular
  • most common on sun damaged skin
  • insidious slow growth
  • type of melanoma
114
Q

nodular melanoma

A
  • arise without apparent radial growth phase
  • primarily sun exposed areas of head, neck, trunk
  • smooth and dome shaped
  • friable or ulcerated and bleeding
115
Q

acral- lentiginous

A
  • most common in darker skin types
  • light brown uniform pigmentation initially
  • on palms, soles, or nail beds
  • lesion becomes darker and nodular
  • can ulcerate
  • usually delay in dx
  • type of melanoma
116
Q

melanoma metastasis

A
  • early mets via lymphatics and regional lymphadenopathy mya be first sign
  • satellite mets appear as pigmented nodules around site of excision
  • spread via blood mainly to brain and lung
117
Q

what are the markers for melanoma metastasis

A
  • cancer at other organs- usually brain and lungs

- elevated LDH

118
Q

breslow thickness

A
  • total vertical height of melanoma
  • ocular micrometer is used to measure thickness
  • smaller the thickness the better the survival
119
Q

dx of melanoma

A
  • excisional biopsy

- palpate lymph nodes

120
Q

melanoma treatment

A
  • surgery- simply excision for early stage
  • wide local excision with sentinel LN biopsy or elective lymph node dissection = mainstay
  • radiation- usually at metastatic sites as palliative care
  • chemo- not often used
  • frequent follow ups

Clin Med I (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions