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PANCE > 11. Dermatology > Flashcards

11. Dermatology Flashcards

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1
Q

Redden + swelling with broken skin (bite, puncture wound, ulcer) + warmth + not demarcated

Name/Cause/Dx/Tx

A

Name: Cellulitis

Cause: GAS, Staph A

Dx: clinical

Tx: Cephalexin, dicloxacilin

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2
Q

abrupt onset of fever, chills, and malaise + warmth on face + well demarcated margins

Name/Cause/Tx

A

Name: Erysipeals

Cause: GAS (Streptococcus pyogenes)

Tx: IV Penicillin (Vanco if allergy to penicillin)

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3
Q

Honey colored crust

Name/Cause/Dx/Tx/Complication

A

Name: impetigo

Cause: Staph A

Dx: Clinical, gram stain/culture

Tx: Mupirocin Tid x 10 day

System Abx (fever involve or wide spread) - Cephalexin PO

Complication: poststreptococcal glomerulonephritis

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4
Q

Drink hot water or ETOH cause redness facial flushing

Name/Trigger/Distinguish/Tx/prevention

A

Name: Rosacea

Trigger: hot drink, ETOH

Distinguish: absence of comedones

Tx: Metronidazole

Prevention: sunscreen, avoid trigger

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5
Q

Comedones + inflammatory + nodular or cystic acne

Name/4 main path/Dx/Tx

A

Name: Acne Vulgaris

Patho

  1. increase sebum
  2. clogged sebaceous gland
  3. P acne (normal flora) overgrowth
  4. inflammatory response

Dx

  • Mild: comedone small amount
  • Moderate: comedone large amount
  • Severe: nodular (>5mm)

Tx

  • Mild: retinoid cream/benzoyl peroxide
  • Moderate: topical + Oral abx (Doxy, or clinda)
  • Severe: Isotretinoins (Retin A) *teratogenic*
    • Must obtain at least 2 pregnancy test
    • Must commit to use 2 pregnancy protection
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6
Q

Nikosky sign positive + Oral lesion + Flaccid blullae (break easy)

Name/Mortality/Dx/Tx/Related dz

A

Name: Pemphigus vulgari

*High Mortality*

Dx: Punch biopsy

Tx: High dose corticosteriod (1st), MTX

Related: MG, Thymoma

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7
Q

Nikosky sign Negative + RARELY Oral lesion + Tense Bullae (do not extend)

Name/Dx/Tx

A

Name: Bullae Pemphigoid

Dx: Clinical (tense bullae)

Tx: corticosteriod

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8
Q

Target lesion + Palms or soles + no mucosal membrane

Name/Minor vs Major/Cause/Tx

A

Name: Erythema multiforme

EM minor - skin only, EM Major - eye, mouth, anus, vargina

Cause: HSV

Tx: Underlying cause (acyclovir), if mucous membrane involve - System corticosteriod

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9
Q

Fever + Mouth mucous membrane sloughing + hx of taking abx or NSAID

Name/Cause/PE/Tx/Admission/TEN

A

Name: SJS (steven Johnson syndrome)

Cause: MC iatrogenic abx(sulfa or PCN), NSAID, anticonvulsant

PE: Nikolsky sign (slough off skin) + involve in mucous membrane

Tx

  • Treat like burn
  • Remove medication

Admission: if eye involvement Must be hospitalize due to possible blindness

TEN (toxic epidermal necrolysis): Surface more than 30%, Less than 10% SJS

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10
Q

hx of asthma and seasonal allergy + excoriated flexor creases + has been there earlier in life

Name/PE/Tx

A

Name: Atopic dermatitis

PE: Pruritius, hx of allergy and asthma

Tx: Emollient(1st),Topical corticosteriod

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11
Q

Contact with plant or water (irritant) + pruritus

Name/Cause/TX

A

Name: Contact Dermatitis

Cause: contact irritant such as posion ivy, detergents, chemical, diaper rash

Tx

  • remove and avoid irritant + topical corticosteroid (if oral - taper them down)
  • If diaper rash - Zinc or petroleum
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12
Q

Tapioca like tense vesicles (pompholyx)

Name/Trigger/Tx/Prevention

A

Name: Dishidrosis

Trigger: sweating, stress, warm weather

Tx: Topical steriod

Prevention: avoidance of long exposure of the hands to water

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13
Q

Skin thickening due to scratching (eczema) + scaly + well demarcated with skin lines

Name/Tx

A

Name: Lichen simplex chronicus

Tx: avoid scratching the lesion, topical steroid

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14
Q

rash + spares the vermillion border

Name/Risk/Tx/Avoid

A

Name: perioral dermatitis

Risk: hx of corticosteriod usage, young women

Tx: Topical metronidazole or erythromycin

*Avoid corticosteriod*

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15
Q

Raised scaly thick silver and white appearance at extensor surface (extremity)

Name/PE/Tx

A

Name: Psoriasis

PE: Auspitz sign (punctate bleeding with removal of plaque/scale), Nail pitting

Tx: Topical steriod (betamethasone, clobetasol), MTX, UVB

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16
Q

Salmon colored macule + christmas tree pattern

Name/Pathogen/PE/Dx/Tx

A

Name: Pityriasis rosea

Pathogen: HHV7

PE: herald patch (salmon colored macule) + christmas tree pattern (scaling along cleavage lines)

Dx: scrapping off skin

Tx: self-limited, Triamcinolone or histamine for itching

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17
Q

legion in mouth, skin, scalp + purple, pruritic, papule, polygonal

Name/Related/PE/legion in mouth/Tx

A

Name: lichen planus

Related: Hep C

PE: 5 p’s (lesions appear at the site of mechanical or thermal trauma)

  • purple
  • polygonal
  • planar
  • pruritic
  • papule

if legion is in mouth - wickham striae

Tx: triamcinolones, mometasone (corticosteriod)

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18
Q

Raised scaly patch shows up and disappear several times

Name/Cause/Tx

A

Name: Fixed drug eruption

Cause: abx, anticonvulsant, NSAIDS

Tx: Avoid cause, symptomatic tx

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19
Q

Dry, rough, Sandpaper skin legion + hyperpigmented + hx of prolong exposure

Name/Related/PE/Dx/Tx

A

Name: Actinic keratosis

Related: precancerous (squmous cell carcinoma)

PE: Auspitz sign

Dx: Punch or shave biopsy

Tx: Cryosurgery, Topical - (5-fluorouracil, imiquimod, diclofenac)

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20
Q

hx of sun exposure + velvety warty + stuck on appearance (Pasted on)

Name/Type of malignant/PE/Dx/Tx

A

Name: seborrheic keratosis

Type of malignant: benign tumor

PE: velvety, suck on appearance (pasted on)

Dx: Shave biopsy

Tx: no tx need, cryosurgery for cosmetic

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21
Q

hx of thyroid dz + short hairs broken off a few mm from the scalp

Name/Related/Tx

A

Name: alopecia areata

Related: autoimmune disorder (thyroid)

Tx: intralesional triamcinolone (corticosteriod)

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22
Q

tempolar scalp hair loss + hair thinning

Name/Tx

A

Name: Anderogenic alopecia

Tx: Minoxidil, finasteride

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23
Q

Fungal infection nail

Name/Tx

swelling side nail margin

Name/Cause/Progress/Tx

A

Name: Onychomycosis

Tx: topical antifungal, systemic steriod, nail removal

Name: Paronychia

Cause: Staph A

Progress: Felon (fingertip pulp (swelling)) - Paronychia may progress to felon

Tx: I&D w/o abx

  • abx is only for severe case
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24
Q

Pruritis + white oval-shaped egg capsules at the base of the air shafts

Name/Other name called?(female)/Caution/Dx/Tx/Prevention

A

Name: Lice

Called: pediculosis/females lay eggs called as NITS

Caution: Transmitted person to person (Sharing hat, clothese)

Dx: clinical (locatd at the base of hair shaft)

Tx: Permethrin, Lindane (too toxcix -> seizure)

Prevention: retreat in 7 days to kill nits, treat sex partner

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25
Intense pruritis + Burrows + blue dot at web spaces Name/Patho/PE/immuno-suppressant/Dx/Tx
Name: Scabies Patho: female release egg under skin -\> hatch -\> excrete feces -\> location reaction (type 4 allegergic reaction) PE: blue dot finding at webspaces, axillae, wrist flexor Immunosupression person: norweigan (crusted) scabies - cause hyperkeratotic Dx: Microscopic, skin scraping Tx: Permethrin, Ivermectin oral for crusted
26
Multiple Painless bite upon awakening + blood on mattress Name/Bugs located/PE/Dx/Tx/Prevention
Name: Bed bug bugs Located: couches, matress PE: blood stained bedding, allegeric skin reaction Dx: H & P Tx: supportive Prevention: new mattress
27
Painful bite + muscle cramping/spasm/rigidity Name/found/fatality/Tx/Disposition
Name: black widow spider bite Found: woodpiles, out hourses, hidden spaces Fatality: Never FATAL Tx: Wound care + pain control (opioid/benzo), Antivenom reserved Dispositon * admission for pain contorl 48-72 hrs * observe 6 hrs if antivenom given
28
Painless bite + slow healing progress Name/location/PE/Dx/Tx
Name: Brown spider (3 pairs of eyes) Located: southeast/midwest PE: **Painless bite**, redness, possible necrotic Dx: Clinically Tx: supportive care
29
bee stung/fire ants + redness Name/type reaction/fatality/PE/Dx/Tx
Name: Bee stings Type of reaction: IgE Fatality: if anaphylaxis can be fatal PE * Local: pain, edema, redness * Systemic: SOB, Angioedema, tachycardia, urtcaria Dx: Clinically Tx: Epi 0.3mg 1:1000 IM, if cardiac involve Epi 1mg 1:10000 IV
30
Pearly & waxy + rolled borders + central ulceration Name/Characteristic/Dx/Tx
Name: Basal cell carcinoma Characteristic: MC skin cancer in US/slow growth Dx: punch/shave biopsy Tx * electrodesiccation (nonfacial) * Moh micrographic surgery for facial
31
hx of HPV infection + red, elevated thicken nodule + blood margins + bleed easy upon pressure + center ulceration Name/Characteristic/Dx/Tx
Name: Squamous cell carcinoma Characteristic: slow growth/preceded by actinic keratosis Dx: Biopsy Tx: local surgical excision
32
irregular borders + variation color + diameter \>6mm + asymmetry + rapid change in appearance Name/characteristic/MC Type/Dx/Tx
Name: malignant melanoma Characteristic: MC skin death related/MET early MC type: Superficial spreading melanoma Type: superficial spreading MC type PE: ABCDE * asymmetric * border * color * diameter * evolution Dx: full thickness + lymph node biopsy Tx: wide surgical excision + biopsy lymph node or dissection
33
Hx of HHV8 + plaque like brown/pink/red Name/MC common type/related/Tx
Name: kaposi sarcoma MC type: AIDS related type Related: HHV8, HIV Tx: HAART therapy
34
involve skin fail to tan within sun exposure (hyper/hypopigmentation) + oval macules with find scaling Name/cause/Dx/Tx
Name: Pityriasis versicolor Cause: overgrowth of the yeast (malassezia furfur) - normal flora Dx * KOH prep (hyphae/spores) spaghetti & meatball * wood lamp (yellow/green) Tx: selenium sulfide, topical antifungal (calamin lotion, zinc oxide may help)
35
cradle cap infants + dandruff + greasy/yellow scaling Name/Tx
Name: Seborrheic dermatitis Tx: selenium sulfide, ketoconazole
36
Wheals or plaques + angioedema Name/type/Tx
Name: Urticaria (hives) & angioedema Type: Type 1 (IgE) Tx: Oral histamine
37
irregular discrete macules & patches of total depigmentation + hx of endocrine dz (thyroid) Name/Patho/Cause/Dx/Tx
Name: Vitiligo Patho: destruction of melanocytes (autoimmune) Cause: hx of endocrine dz (thyroid) Dx: Wood Lamp Tx: topical corticosteriod 1st (Topical tacrolimus 0.1%), Systemic - UVB
38
* Tinea pedis - appearance/Tx * Tinea corporis - appearance/Tx * Tinea capitus - appearance/Tx * Tinea cruris - appearance/Tx All Tinea cause pathogen name/Dx
* athlete's foot/Tx: topical antifungal * Circular rash with clear central + scales/Tx: topical antifungal * kerion present (inflamed + pustules) + alopecia/Tx: PO griseofulvin * Griseofulvin SE: No alchohol (disulfiram like) hepatotoxicity - need to check LFT * rash groin/scrotum/Tx: topical antifungal Pathogen: trichophyton Dx: KOH/wood's lamp
39
Painless + soft, fleshy cauliflower like lesion Name/Dx/Tx/Prevention
Name: HPV infection (Condyloma acuminata) Dx: acetic acid application - whitening Tx: Resolve its own in 2 years, Trichloroacetic acid (1st - ok for pregnancy), imiquimod (2nd - not for pregnancy) Prevention: Gardasil vaccination (6 11 16 18)
40
Folliculitis vs furuncle vs carbuncle Clinical presentation/Tx
* Folliculitis - small papules or pustules with surrounding redness * Tx: topical mupirocin, clinda, erythro * Furuncle: abscess with central plug * Tx: I & D * Carbuncle: abscess with multiple openings * Tx: I & D
41
Dome shape + central umbilication Name/Cause/Contagious/Tx
Name: Molluscum contagiosum Cause: Poxvirus Contagious: high Tx: No tx need
42
hx of sun exposure + hyperpigmentation Name/Risk/Dx/Tx
Name: Melasma Risk: OCP, pregnancy, SUN EXPOSURE Dx: Wood's lamp Tx: sunscreen, hydroquinone (not for pregnancy)
43
Obese woman with DM + abscess at axilla, groin, under breast Name/Tx/Prevention
Name: Hidradenitis suppurativa Tx * Mild - topical cindamycin * Painful abscess - I&D Prevention: Smoking makes worse/Stop smoking
44
Mobile mass + has been there for long time + cottage cheese like substance Name/Patho/Tx
Name: Sebaceous cysts Patho: blockage gland Tx: No need tx
45
Burns Rules/Minor VS Major/Tx/other complication
* Rules of nine - * Head F+B =9% * Arm F+B=9% x 2 * Chest F+B=18% * Abd F+B=18% * Leg F+B=18% x 2 * Genital area=1% * Minor = 10%\> * Major = 25%\< * Tx * IV Lactated ringer - 4ml/kg first 24 hours * ABC intact * Debridement - death skin remove * Blister - ruptured blister remove * Pain control * Abx - silver sulfadiazine (CI: if Sulfa allegic) * Dressing + cleaning * Other complication: hypothermia
46
Burn degree explain
* 1st degree - superficial burn (sun burn) * 2nd degree - blister shows * Partial thickness burn - Most painful burn, capillary refill postivie * Deep partial thickness burn - Painless, No capillary refill - **sacarring** * 3rd degree - Full thickness burn - Doesn't heal well
47
hx of celiac dz + pruritic Name/Tx
Name: dermatitis herpetiformis Tx: gluten free diet, Dapsone
48
hx of crohn, UC + painful necrotic ulcer Name/Risk/Dx/Tx
Name: Pyoderma gangrenosum Risk: hx of crohn, UC, RA Dx: clinical Tx: topical corticosteriod (high potency)
49
Soft, symetrical painless easily mobile mass Name/Tx
Name: Lipoma Tx: None
50
AA with grossly exaggeratred scar Name/Risk/Tx
Name: Keloids Risk: MC AA Tx: Corticosteriod injections
51
Friable red(raspberry like) nodule or papule + pregenancy Name/Risk/Tx
Name: Pyogenic granuloma Risk: pregnancy Tx: Surgical removal (pedunculated - shave, nonpedunculated - excision)
52
Bright red + circular oval shape Name/Patho/Tx
Name: Cherry angioma Patho: benigm small blood vessel Tx: No Tx
53
7 year old less + mouth, throat pain + Vesicles w/ erythmatous halo on buccal & tongue + rash on feet and hand Name/pathogen/transmission/Tx
Name: Hand, Foot, mouth disease Patho: coxsackies Transmission: fecal-oral (**Contagious)** Tx: Self-limits
54
Laceration explain Types/Assessment/Prevention/Surgical consult
Type * Primary - clean wound (like surgical) * Secondary - dirty wound (infection) * Tertiary - delayed close wound (open for 4-5 days) Assessment * Check nerve/muscle/vessel * Machanism or time of injury * possible foreign body * Golden time - close wound by 18 hours/face 24 hours Prevention: Tetanus - 10 years Surgical consult * involve with face, nerve, bone, arteries * contaminated wound * unknown depth of wound
55
Hyperpigmentation + edema + hx of chronic insufficiency Name/related/tx
Name: stasis dematitis Related: chronic insufficiency Tx: compression stocking, elevation
56
Spider web like vessel on face + blanch when pressure on Name/Related/Tx
Name: Telangiectasia Related: aging, pregnancy, rosacea Tx: No Tx need
57
thickened, velvety, darkly pigmented plaques on the neck or axillae + Obese Name/Dx
Name: Acanthosis Nigricans Dx: DM test if not yet to screened
58
HyperSensitivity 4 type explain
1. Type I - IgE - anaphylaxis, urticaria, angioedema 2. Type II - IgG, IgM antibody- autoimmune 3. Type III - IgG, IgM immune complex - Serum sickness, SLE, RA 4. Type IV - T cell - contact dematitis, TB skin test
59
HIV with finger pain + abscess on finger tip Name/Pathogen/Dx/Tx
Name: Herpetic whitlow Pathogen: HSV 1,2 Dx: Clinical, viral culture or Tzank smear (scrapping) Tx: Acyclovir \*DO NOT I&D - may lead to viral dissemination or bacterial superinfection.\*
60
Eating tuna + sudden rash Name/Related fishes/Tx
Name: histamine fish toxicity Related fishes: Tuna/Blue fish/Mackerel Tx: Supportive, antihistamines

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