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Dermatology Phase II > Test # 1 > Flashcards

Test # 1 Flashcards

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Dermatology Board Prep flashcards
1
Q

Layers of the epidermis

A

*corneum *lucidum *granulosum *spinosum *basal

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2
Q

keratinocytes lose nuclei, continue to flatten

A

Granulosum

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3
Q

dead cells, primary fxn is barrier

A

corneum

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4
Q

keratinocytes connected by desmosomes, langerhan’s cells located here

A

spinosum

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5
Q

appear lucent, very thin, only in thick skin

A

Lucidum

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6
Q

dividing keratinocytes and melanocytes

A

Basal

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7
Q

Description of lesions

A
  • Number
  • Size
  • Color
  • Primary/Secondary Lesions
  • Distribution
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8
Q

a circumscribed, flat, discoloration

A

Macule

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9
Q

Referred to a macule that is greater than 1 cm as a ___

A

Patch

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10
Q

An elevated solid lesion up to 0.5 cm in diameter

A

Papule

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11
Q

A circumscribed, elevated, superficial, solid lesion more than 0.5 cm in diameter. ( Confluence of papules)

A

Plaque

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12
Q

a circumscribed, elevated, solid lesion more than 0.5 cm in diameter

A

Nodule

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13
Q

A large nodule is referred to as a _______

A

Tumor

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14
Q

A circumscribed collection of leukocytes and free fluid that varies in size.

A

Pustule

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15
Q

a circumscribed collection of free fluid up to 0.5 cm in diameter

A

Vesicle

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16
Q

A circumscribed collection of free fluid more than 0.5 cm in diameter

A

Bulla

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17
Q

A firm edematous plaque resulting from infiltration of the dermis with fluid.

Transient and last a few hours

A

Wheal Hive (Dermatographism)

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18
Q

develop during evolutionary process of skin Dz or are created by scratching or infection- infers primary dz

A

Secondary lesions

*Scale * crust *Erosion *Ulcer *Fissure *Atrophy * Scar

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19
Q

Excess dead epidermal cells that are produced by abnormal keratinization and shedding

A

scale

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20
Q

A focal loss of epidermis heal w/o scaring. Do not penetrate dermoepidermal junction

A

Erosion

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21
Q

A collection of dried serum and cellular debris (scab)

A

Crust

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22
Q

A focal loss of epidermis and dermis

A

Ulcer

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23
Q

a depression in the skin resulting from thinning of the epidermis or dermis

A

Atrophy

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24
Q

A linear loss of epidermis and dermis w sharply defines nearly vertival walls

A

Fissure

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25
Q

An abnormal formation of connective tissue implying dermal damage

A

Scar

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26
Q

Special Lesions

A
  • Excoriation *Milia *Cyst *Burrow * Petechiae
  • Comedone * Lichenification * Talangiectasia
  • Purpura
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27
Q

A small superficial keratin cyst w no visible opening

A

Milia

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28
Q

A plug of sebaceous and keratinous material lodged in the opening of a hair follicle (dilate or narrow)

A

Comedone

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29
Q

An erosion caused by scratching

A

Excoriation

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30
Q

A circumscribed lesion with a wall and a lumen (Fluid or solid matter)

A

Cyst

31
Q

An elevated tortuous channel produced by a parasite

A

Burrow

32
Q

Dilated superficial blood vessel

A

Talangiectasia

33
Q

An area of thickened epidermis induced by scratching

Accentuated like a washboard

A

Lichenification

34
Q

A circumscribed deposit of blood less than 0.5 cm in diameter

A

Petechiae

35
Q

A circumscribed deposit of blood greater than 0.5 cm in diameter

A

Purpura

36
Q

used to dx pigmented lesions for Malignant Melanoma (MM)

A

Dermoscopy

37
Q

Cytology prep dx for herpes test

A

Tzanck prep

38
Q

Worse in dry winter months. “Winter itch” MC hands and lower legs. skin is rough covered w white scales

progresses to thicker tan or brown scales (crisscrossed and fissured.) severe itching or burning

A

Xerosis (severe dry skin)

39
Q

Xerosis (severe dry skin) Tx

A

Emollients 12 % lactate lotion (Lac Hydrin )

40
Q

valuable aid in treatment of exudative skin dzs

A

Wet dressings (Topical Therapy)

41
Q

Creams are thicker and more lubricating than lotions.
Most effective when applied to damps skin.

Pat dry and apply immediately apply to skin. menthol or phenol added to reduce pruritus (added urea/lactic acid which have special lubricating properties

A

Emollient Creams and lotions

42
Q

Wet to dry dressing technique.

A

use 4-8 layers of clean soft material folded (wring out until sopping wet (Leave in place 30-60 min. 2-4x/day

DC if signs of dryness

43
Q

PA’s use what groups of topical steroids strongest to weakest Group____ to Group ____

A

PA’s Group V - VII

Strongest Group I - Weakest group VII

44
Q

If no response in ______ reevaluate

A

1-4 weeks

45
Q

mix of organic chemicals/oils, water and preservative
slightly greasy. use almost anywhere.

–> Drying effect w long use. best= acute exudative inflammation. and Intertriginous areas.

A

Cream

46
Q

Limited number of organic compounds. primary grease w little / no water. translucent

Great penetration–> increased potency. Too occlusive for intertriginous or acute eczematous inflammation

A

Ointments

47
Q

Mix of propylene glycol and water sometimes alcohol.
Greaseless, and clear. useful for = poison ivy and scalp

Not tangle hair: poison ivy= exudative inflammation

A

Gels

48
Q

Mix of water, ETOH, and other chemicals. clear or milk.
Least Lypophilic can be very drying

most useful in scalp–> penetrate easily through hair stinging and drying may result in intertriginous areas

A

Solutions and Lotions

49
Q

useful for scalp dermatoses. Acute eczematous inflammation poison ivy and plaque psoriasis

not for use > 2 weeks or < 12 YOA. Suppresses hypothalamus.

A

Foams (mousse)

50
Q

skin Dz that Increases barrier and decreases absorption

A

Thick scale

Lichenification

Thick skin areas (Soles and palms)

51
Q

Side effects of steroids

A
  • Burning or itching
  • Hypopigmentation
  • Atrophy
  • easy bruising
  • Striae Inection IM = short needle= Atrophy
  • Rosacea
  • Elevate sugar in Diabetics
  • Pregnancy (avoid in trimester)
52
Q

Number 1 steroid MC mistakes

A

Steroid too weak for process and area

53
Q

Steroid dosing in general

A

Fingertip units= 0.5 gm /5mm diameter (One hand area)

Group I- QD BID, pulse therapy 2 wks on 1 week off
Group II- VI BID x 2-6 weeks

54
Q

Tinea cruris treated w topical steroid –> what?

A

Tinea incognito

55
Q

water cover enhances absorption increases potency by 100Xs

A

Occlusion

56
Q

Worse in winter. develop lesion related to trauma “Koebnerize” phenomenon. Increases risk

thick adherent silvery-white scale. Begins as red then Discrete oval plaques auspitz sign. Extensor surfaces

pitting or Oil spots on nail

A

Chronic Plaque Psoriasis

57
Q

Psoriasis management

A

Mod-Severe : Methotrexate

Mild-Moderate: Clobetasol or Fluocinonide/ Triamcinolone (Salicylic Acid removes plaque)

Topical Vitamin D (Calcitriol) Calcipotriene Vitamin D3
UVB, Tazarotene retinoid

58
Q

Strep pharyngitis/Viral URI precedes eruption. 1-2 wks
sudden appearance of scaling papules trunk/extrem.

Teardrop scattered red papule w thick scale. May have classic plaques on elbows and knees.

A

Guttate Psoriasis

59
Q

Guttate Psoriasis management

A

Throat Cx to r/o Strep and UVB 6-8 weeks (1st Line)

Empirical Tx w PCN or erythromycin 10days

60
Q

Serious and sometimes fatal. Pt toxic, febrile and leukocytosis. Pts is smoker w plaques

Tiny sterile pustules that coalesce on middle of pal, or sole of foot. Pustules dry up and fall off not burst

A

Pustular Psoriasis

61
Q

Pustular Psoriasis Management

A

Clobetasol- wean off (Consider plastic occlusion)

NO PO Steroids- Abx for 2ndary infx

Retinoid and Cyclosporine/Methotrexate

62
Q

Common, chronic inflammatory dz. peaks In infancy, maternity, teens (High hormones).

Winter, stress, hygiene changes. MC in aids: Greasy flakes,eye braws/lashes, ext ear canals

A

Seborrheic Dermatitis

63
Q

Seborrheic Dermatitis

A

Shampoos

  • Head N shoulder, T/Gel, Selsun -Tar based
  • Sulfur/zinc -Selenium sulfide -Ketoconazole 2%
  • Hydrocortisone 1% -Triamcinolone -Fluocinolone
  • Itraconazole 200mg /day
64
Q

Chronic pruritic dz. Always begins in childhood. Recurring improves w age. Bilat Flexor creases

Cold/Dry weather, hot humid weather, pollens, stress, illness. Flaking, xerosis, cracking, fissures patchy
(Itch rashes- Itchiness that is eruptive)

A

Atopic Dermatitis

65
Q

Atopic Dermatitis Management

A

Tepid baths, wash less often, moisturize w/I 3 min post shower (Thick Emollient). Hydroxyzine or Benadryl

Inflammation: Triamcinolone or GRP V Fluticasone
Tracrolimus (If all failed)

Infx: Abx Dicloxacillin, Cephalexin, Erythromycin

66
Q

Eczema w Thickened skin- excoriations, fissuring, accent skin line Top steroids, AH1, Abx, Emollients

A

Eczema Chronic

67
Q

Eczema w Erythema, scaling, fissuring. parched app. scaled app. moderate itch/pain/burning.

Steroids (Occlusion), emollients after, AH1 abx

A

Eczema Subacute

68
Q

Eczema w Vesicles, bullae, intense erythema and itch
Contact allergy “Rhus” Contact derm.

Cold wet compress, PO or topical steroids AH1, abx

A

Eczema Acute

69
Q

Eczema w symmetric vesicular hand and foot dermatitis. Mod-Severe itching before vesicles.

MC in teens: Unknown etiology. Tapioca lesions. hands and lateral aspects of fingers and hands. Pts have hyperhidrosis

A

Dyshidrotic Eczema (Pompholyx)

70
Q

Dyshidrotic Eczema (Pompholyx) management

A

Avoid water, irritants, trauma. emollients

Potent steroid then wean- Hydroxizine Diclox, Erythro, Cpehalexin

Methotrexate- If all fails

71
Q

Eczema that occurs after excess drying in winter/ and the elderly. Long hot showers

Lower legs become dry and scaly. Xerosis red plaques w horizontal fissures. “Cracked porcelain”

A

Asteatotic Eczema (Craquele)

72
Q

Eczema occurs on same spot q winter. round coin-shape red plaque. Back of hand MC.

Often dx as ring worm. Tx Potent steroids 4-6 weeks, correct dryness

A

Nummular Eczema

73
Q

Created by habitual scratching. Great pleasure in relief from frantically scratching. Nerve entraps= Super itch

Occurs in convenient areas to scratch. Prurigo nodularis. Tx break itch Intra lesion steroids, Clobetasol, Betamethasone 1st Gen AH1

A

Lichen Simplex Chronicus

Dermatology Phase II (1 decks)

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