test 1 deck 5 Flashcards
pt. presents w/ oval/violacous patch that is slowly expanding on ant. tib/fib. It has a waxy surface, prominent telangiectasias, red advacing border, and a yellow brown central border. In some areas the skin has begun to develop ischemic changes. The skin appears to have a woody induration. DX__ trx__ concerns__
necrobiosis lipoidica,
steroids (topical/oral), trental, ASA
DM, squamous cell carcinoma (developing)
MC type of xanthoma?
xanthalasma
patient presents w/ buffalo hump, central obesity and moon facies. they have pruple striae, atrophic changes, and hirstutism. You know this is either caused by dysfunction of the adrenal axis or administration of PO steroids/topical steroids. DX__ trx__
cushings disease/syndrome, discontinue roids, endocrine w/up for underlying cause
what is the difference between type A/ B vitiligo?
symmetric pattern type A/associated w/ halo nevi, type B asymmetric and follicles depigmented
lab for cushings?
oernight dexamethasone suppresion test
pt presents w/ symmetrical, brown thickening of skin. It has a velvety texture. They’ve had it for a while and parts have become leathery, warty and papillomatous. They have it in their axilla (MC), flexor surf. of neck, belt line, dorsal fingers, and around areola. DX__ TRX__ CONCERNS__
acanthosis nigricans, ammonium lactate cream, tretinoin cream, treat malignancy or endocrine issue. insulin resistant states, hyperandrogenic, malignancy (gastric MC)
patient presents w/ yellow plaques around eyes. trx__ concern__
xanathalasma, CV death
treatment for vitiligo?
stiumlate melanocytes wi/in hair follicle to migrate to depigmented skin. camoflage (dihydroacetone self tanner), calc-
complications associated w/ sarcoidosis?
ocular dz, pulm dz, heart dz,
what are concerns associated w/ vitiligo?
uveitis/ depigmented retinal epithelium, hearing issues w/ depigmented labrinth, and aseptic meningitis. pernicious anemia, DM1, melanoma, hypothyroid
patient presents w/ hyperhidrosis, plamar erythema, soft/fine/thinning hair, bronze tint to skin, digital clubbing, plummer’s nail changes. DX__ tx__
hyperthyroid, surgical ablation/radioactive iodine/anti-thyroid (PTH, methimazole)
patient presents w/ smooth deeply situated nodules attached to their tendons. You know for this deformity the achilles is MC. DX__ Trx__ Concern__
tendinous xanthoma, treat dyslipidemia, trichloroacetic acid, hyperlipidemia/biliar cirrhosis.
what is the MC tumor in AIDS patients?
kaposi’s sarcoma
patient presents w/ 1-4 mm papules w/ red halo that suddenly appeared. They are on butt, extensor arms/legs. Dx__ sign of __ when will they resolve___
eruptive xanthoma, hypertriglyceridemia, decrease when lipid levels decrease
patient presents w/ flat affect, large clumsy tongue, increased wrinkles, yellow tinto to palms/ soles, dry/course/brittle hair. DX__ trx__
hypothyroid, levothyroxine
pt. presents w/ hyper/hypo thyroid (MC graves) and bilateral, asymetric, firm nonpitting nodules on front of shins, Over time they have have come together and have an orange peel appearance. DX__ trx__
pretibial myxemdema, topical steroids underocculsion, compression stocking, intralesional triamcinolone
what is associated w/ kaposis besides aids?
HHV-8 w/ in oral cavity for men that have sex w/ men
pt. presents w/ skin colored papules, brownish/purple plaques on face, extremities, buttocks, trunk. Under glass slide there appears to be an apple jelly appearnace. the patient also has diffuce violaceous, soft, doughy infilrate of nose, cheeks and earlobes (lupus pernio). on her shin there is a non specific red node like lesion w/ ill defined borders (erythema nodosum). DX__ workup__ trx__
sarcoidosis,
oral steroids, intralesional steroids (triamcinolone), methotrexate
bonchoscopic bx/lesion bx of skin/lymph nodes confirms dx, CXR=hilar lymphadenopathy/infiltrates, eye exam, hypercalcemia, ECG
necrobiasis lipoidica
what are you concerned about with generalized granuloma annulare?
HIV or diabetes
patient presents w/ slowly evolving yellow papules, nodules, or tumors on extensor surfaces of arms and legs. They are painless. dx__ trx__ additional info__
tuberous xanthoma, treat dyslipidemia, trichloroacetic acid, stop smoking
child or young adult female presents w/ small, firm, flesh colored ring. It’s localized to the lateral and dorsal surfaces of her hands and feet. She said that over time it has undergone central involution and the diameter increased over months. dx__ treat__
granuloma annulare, no treatment, unless troubled by appearance then roids. if generalized PUVA, remember DM and HIV
pt presents w/ history of being gay. they have lesions that started on hands and feet headed centrally. The lesions are on the trunk, head, and neck. The lesions are rust colored slightly raised, and some have become a red or purplish color. With pressure they decrease in size. You perform a biopsy and see that they have neoplastic endothelial cells (vascular neoplasm). dx__ trx__
kaposi’s sarcoma, liquid nitrogen, excisional surgery, intralesional chemotherapy >1 cm, HAART for extensive dz
