Skin Terminology and exam Flashcards
1
Q
What are some aspects of the history taking that are specific to derm complaints?
A
- How has it spread
- How have lesions changed
2
Q
What are the components of the atopic triad?
A
- Asthma
- Allergies
- Atopic Dermatitis
3
Q
What are the family history bits that should be obtained with derm complaints?
A
Skin CA
Autoimmune conditions
4
Q
What are the major indications for a total body skin exam?
A
- personal h/o skin CA
- Increased risk for malignancy
- new rash
- f/u for extensive skin lesions
5
Q
What should be done besides just inspecting a skin lesion?
A
Palpate it
6
Q
What are the five major characteristics that should be used to describe a skin lesion?
A
- Palpability
- Color
- texture
- Size
- Location
7
Q
Are scratches or trauma skin lesions primary or secondary?
A
secondary
8
Q
What is the definition of a macule?
A
Flat, Less than or equal to 1 cm
9
Q
What is the definition of a patch?
A
flat, More than 1 cm
10
Q
What is a papule?
A
raised solid lesion measuring less than or equal to 1 cm
11
Q
What is a nodule?
A
raised solid lesion measuring more than 1 cm
12
Q
What is a tumor?
A
raised solid lesion measuring more than 2 cm
13
Q
What is a plaque?
A
Flat topped area measuring more than 1 cm
14
Q
What are vesicles?
A
Raised, clear fluid filled lesion, measuring less than or equal to 1 cm
15
Q
What is a bullae?
A
Raised, clear fluid filled lesion, measuring more than 1 cm
16
Q
What is a pustule?
A
Raised lesion filled with white fluid or pus
17
Q
What are wheals? how long do they usually last for?
A
Round or flat topped edematous and erythematous lesions that last less than 48 hours
18
Q
What are telangiectasias?
A
Enlarged, superficial blood vessels
19
Q
Are telangiectasias blanchable? Why or why not?
A
Yes–blood is still in vessels, so can move about
20
Q
Are purpura blanchable? Why or why not?
A
No–blood is sequestered
21
Q
What is the difference between an erosion and a ulcer?
A
- Erosion = loss of epidermis in skin and heals without a scar
- Ulcers = epidermis and dermis is involved
22
Q
What are scales?
A
flakes or plates of skin come off
23
Q
What are crusts?
A
Dried plasma or exudate
24
Q
What are excoriations?
A
Traumatized or abraded areas d/t rubbing
25
What is atrophy of the skin?
Thinning or absence of epidermis or SQ fat
26
What are scars?
Fibrosis of skin
27
What are keloids?
Exaggerated scars beyond wound edges
28
What are eschars?
Plaque covering ulcer--implies extensive damage and necrosis
29
What is the difference between a hypertrophic scar and a keloid?
Keloid goes beyond wound edges
30
What are petechiae?
1-2 mm purplish/ reddish macules that are NOT blanchable
31
What are purpura?
3mm - 1 cm urplish/ reddish macules that are NOT blanchable
32
What are ecchymoses?
Purplish or reddish area greater than 1 cm
33
Areas of hypopigmented macules and patches after sunlight exposure = ?
Tinea versicolor by malassezia furfur
34
How do you diagnose tinea versicolor?
- Wood light will show an orange-yellow hue
| - KOH prep will show spaghetti and meatballs appearance
35
KOH prep showing a spaghetti and meatballs appearance = ?
Malassezia furfur
36
What is the treatment for tinea versicolor?
Ketoconazole or topical antifungals
37
What is the MOA of topical steroids?
inhibits NF-kappaB, which suppresses both B and T cell function
-Lowers cytokine transcription
38
What are the side effects of topical administration of steroids?
- skin atrophy
- Telangiectasias
- Striae
- Acne
39
What hematological abnormality can steroids produce?
demargination of PMNs
40
What is the use of class I steroids?
- Severe dermatoses
| - NON facial and NON intertriginous areas
41
What is the length of treatment for class I, classes II-V, and classes Vi-VII?
```
I = less than 3 weeks
II-V = less than 8 weeks
VI-VII = 1-2 week intervals
```
42
What are the areas that you should NOT apply class I steroids to?
Face or intertriginous areas
43
What is the use of class II-V steroids?
Mild to moderate non facial and non intertriginous areas
44
What is the use for classes VI-VII steroids?
large areas, including intertriginous areas and face
45
What class of steroid is: clobetasol propionate?
Super high (class I)
46
What class of steroid is: Fluocinonide?
II
47
What class of steroid is: Triamcinolone?
III - V
48
What class of steroid is: hydrocortisone
VI-VII
49
What class of steroid is: desonide
VI - VII
50
What class of steroid is: Fluocinolone acetonide?
VI-VII
51
True or false: no matter the vehicle, the same medication will have the same potency
False
52
What is the major upside and downside to the use of gels as a vehicle?
```
+ = Stays where you put it
- = EtOH is irritating
```
53
What is the major upside and downside to the use of foams as a vehicle?
+ = Easy to apply and spread rapidly
- = expensive
54
What is the major upside and downside to the use of oils as a vehicle?
```
+ = Less stinging
- = Messy
```
55
What is the major benefit to ointments as a vehicle?
Protective barrier
56
What is the use of benzoyl peroxide? Downsides?
Acne
| Stain pillows
57
What is the major benefit of retinoids?
keratinolytic
58
What is the classic side effect of isotretinoin?
Teratogenic
59
What is the MOA of azoles? Are these fungistatic or fungicidal?
Inhibits 14-alpha demethylase to prevent the conversion of lanosterol to ergosterol--an essential component of the fungal membrane
Fungistatic
60
What is the MOA of allylamines? Suffix?
- Inhibit squalene epoxidase
| - terbinafine, naftifine etc
61
What type of fungal infections are allylamines better suited for?
Dermatophytes more than candida
62
What type of fungal infections are polyenes better suited for?
candida
63
What is the MOA of polyenes? Examples?
- bind to ergosterol in the fungal cell membrane and thus weakens it, causing leakage of K+ and Na+ ions, which may contribute to fungal cell death
- Amp B and nystatin
64
What are the major side effects of imidazoles?
Antiandrogen
| -Hepatotoxic
65
What are the major side effects of allylamines?
hepatotoxic
HA
GI effects
66
What is the MOA of echinocandins? Names?
Inhibit the synthesis of glucan in the cell wall, via noncompetitive inhibition of the enzyme 1,3-β glucan synthase[1][2] and are thus called "penicillin of antifungals
-caspofungin
67
What is the effect of azoles on p450 system?
Inhibits
68
What are the histamine receptors that are inhibited to cause sleepiness? Suppress HCl production?
```
H1 = sleep
H2 = antacid
```
69
What are the major side effects of first generation antihistamines?
Dry and wobbly
70
"Some drugs create awesome knockers" = ?
- Spironolactone
- Digitalis
- Cimetidine
- Alcohol
- Ketoconazole
71
First of second generation antihistamine: diphenhydramine
First
72
First of second generation antihistamine: cetirizine
Second
73
First of second generation antihistamine: hydroxyzine
First
74
First of second generation antihistamine: chlorpheniramine
First
75
First of second generation antihistamine: loratidine
Second
76
First of second generation antihistamine: Fexofenadine
Second
77
What are the two major H2 antagonists used in the treatment of GERD?
Ranitidine
| Cimetidine
78
What are the three major medications that can be used for psoriasis?
Coal tar
Tazarotene
Vit D analogues
79
What is calcitriol (D2 or D3)?
D3
80
What are the three major antibodies that are found with SLE?
Smith
dsDNA
ANA
81
What is the antibody that is found with drug induced SLE?
Antihistone
82
What is antiphospholipid antibody syndrome?
an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. APS provokes blood clots (thrombosis) in both arteries and veins as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, and severe preeclampsia.
83
What are the top three causes of death in SLE pts?
1. CV
2. Infection
3. Renal disease
84
What are the three general drugs used to treat SLE?
NSAIDS
Immunosuppressants
Steroids
85
What are the complement levels that are low in SLE?
C3
C4
CH50
86
What are the components of the RASH OR PAIN mnemonic for the signs of SLE?
- Rash
- Arthritis
- Soft tissue/serositis
- Heme disorders
- Oral/nasopharyngeal ulcers
- Renal disease / Raynaud's
- Photosensitivity
- ANA abs
- Immunosuppressants
- Neuro disorders
87
What are the drugs that cause SLE? (SHIPPE)
- Sulfa
- Hydralazine
- INH
- Phenytoin
- Procainamide
- Etanercept
88
What are the sulfa drugs? ("poplar FACTSSS")?
```
Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazide
Sulfonamides
Sulfasalazine
Sulfonylureas
```
