Derm Flashcards

1
Q

Pink, Pearly/waxy, rolled border, bleeding, ulceration

A

BCC = no mets but invades

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2
Q

Invasive cluster of spindle cells surrounded by palisaded basal cells

A

BCC –> wide resection 1mm

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3
Q

Chronic scar –> non-healing, painless, bleeding ulcer?

A

SCC –> punch bx

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4
Q

Non-healing ulcer on arm, scaling plaque w/ central ulceration, polygonal cells

A

SCC = UV exposure

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5
Q

Hyperpigmented lesion, non-healing ulcer

A

SCC = Marjolin ulcer

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6
Q

Invasive cords of squamous cells with keratin pearls, partially encrusted ulcer

A

SCC –> wide resection 0.5-2cm + LN dissection d/t mets

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7
Q

Precursor to SCC

A

Actinic keratosis

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8
Q

Hyperpigmented lesion, asymmetric, irregular, >5mm, NO HAIR

A

Melanoma –> mets a lot, refractory to chemo/rad, relapsing & remitting

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9
Q

Tx for malignent melanoma

A

Breslow’s depth - local resection; 1-2mm wide + LN

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10
Q

Malignant melanoma >4mm tx

A

Mets, resection and supportive care, poor prognosis

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11
Q

Volcano-like nodule w/ central keratotic plug

A

Keratoacanthoma

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12
Q

Scabies tx

A

Permthrin cream

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13
Q

Intergidital, groin pruritic, thread-like burrows

A

Scabies = 5% permethrin

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14
Q

Tx Lice

A

Permethrin 1% cream rinse

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15
Q

Centrally umbilicated papules on face, neck, anogential regions

A

Molluscum contagiosum - Poxvirus = impaired cellular immunity

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16
Q

Dome w/ central umbilication tx

A

Molluscum –> obs, liq-N, extrode plug or canthardin 0.9%

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17
Q

Thin hair in pre-term

A

Lanugo

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18
Q

Thick, white creamy skin in newborn

A

Vernix caseosa

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19
Q

Benign, small and dry vesicles

A

Pustular melanosis

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20
Q

Salmon patch

A

Nevus simplex

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21
Q

Port wine stain, IC calcifications

A

Nevus flammeus

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22
Q

Shallow fibrin-coated ulcer w/ mononuclear infiltrate

A

Aphthous ulcer

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23
Q

Whitish macules w/ hyperpigmented borders, mouth, breasts

A

Vitiligo = destruction of melanocytes

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24
Q

Hypopigmentation + anesthesia

A

Leprosy = get skin bx

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25
Q

Velvety pink or whit macules, less pigmentation

A

Fungal infection

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26
Q

Acanthosis nigricans assoc

A

GI malignancy, PCOS, DM

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27
Q

Skin tags assoc

A

DM, pregnancy, crohn’s

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28
Q

Vitiligo, hypotension, dehydration, hyperpigmented areas assoc

A

Addison’s disease

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29
Q

Tx for human bites

A

Augmentin or erythromycin + open

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30
Q

Sharp edge, head & neck spot, orange

A

Subcutaneous nevi

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31
Q

Present at birth, PITS, ecchymoses, subsides w/in 1 day, Hematoma crosses sutures

A

Caput succedanuem

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32
Q

Few days after birth, no pitting, Hematoma NOT cross sutures = 1 cranial bone, no discoloration

A

Cephalohematoma –> resorbs on its own

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33
Q

Pulsations on scalp, inc pressure w/ crying

A

Cranial meningocele

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34
Q

“Ping-pong ball,” rickets –> resolves

A

craniotabes

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35
Q

Lateral neck cysts

A

Brachial cleft, cystic hygromas

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36
Q

Anterior edge SCM, base of neck mass

A

Brachial cleft cyst

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37
Q

Base of neck, large, mushy, ill-defined mass

A

Cystic hygroma –> CT b4 excision

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38
Q

INC COSTOCHONDRAL JUNCTIONS, craniotabes, sciolosis, pigeon breast, hyperpigment, genu varum

A

Rickets

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39
Q

Cough, pink eyes, bluish spots in mouth, blanching, erythematous macropapular rash

A

Measles = live vaccine, supportive, VitA if hospitalized

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40
Q

Cough, coryza, conjunctivitis + High fever and red-brown macropapular rash for 9 days

A

Measles –> Vit A reduces M&M

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41
Q

Rash face –> extermities, cough, conjuctivitis, white spots on tonsils

A

Measles

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42
Q

Clustered white lesions in mouth –> rash on forehead –> trunk –> limbs

A

Measles

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43
Q

Rash starting on face –> chest and limbs, occipital and post. Cervical LAD

A

Rubella

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44
Q

Congestion, low fever, pink rash on face –> trunk, cervical adenopathy, patchy palate erythema

A

Rubella

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45
Q

Fever, sore throat –> rash on face/neck –> trunk –> limbs

A

Rubella

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46
Q

URI –> erythema on face sparing nose, orbits –> lacy pruritic body rash for 1-2wk, resp spread

A

B-19 “fifths disease”

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47
Q

B19 in sickle cell; pregnancy

A

aplastic crisis; hydrops fetalis

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48
Q

Fever/URI + rash on cheeks, worse in sun

A

Erythema infectiosum (5ths) –> aplastic crisis, arthopathy, hydrops

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49
Q

High fever 3d –> red blanching macules, papules on trunk –> limbs, sparing face

A

Roseola (HHV-6) = supportive tx

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50
Q

High Fever –> rash - trunk –> limbs/head

A

Roseola (HHV6,7)

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51
Q

Impetigo or pharyngitis –> tiny blanching rash on trunk to limbs

A

Scarlet fever - late desquamation

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52
Q

Pharyngitis –> neck, axilla, groin rash finely papular erythematous rash blanches, circumoral pallor

A

Scarlet fever –> PCN V or erythromycin

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53
Q

Sore throat, fever –> 2d later rough raised rash upper trunk –> limbs & tongue

A

Scarlet fever (strep)

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54
Q

Tx for strep

A

PCN or cephalosporins or macrolides –> fever free 24hrs = return to work

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55
Q

Fever 5d, B/L conjuctivitis, mucositis, swelling and erythema on palms and soles

A

Kawasaki - cervical LN >1.5cm

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56
Q

Hx strep + amoxicillin, 103, strawberry tonuge, B/L conjunctivitis, cervical LN 1.5cm

A

Kawasaki –> Aspirin + IVIG

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57
Q

B/L conjunctivitis, SWOLLEN LIPS, high fever no relief from tylenol

A

Kawasaki –> Aspirin + IVIG

58
Q

“Flea bites,” on trunk/limbs + EOSINOPHILS

A

Erythema toxicum

59
Q

Scattered erythematous macules, papules, pustles everywhere, No sx

A

Erythema toxicum neonatorum = ressurance

60
Q

Vesicular clusters

A

HSV or VZV –> acyclovir

61
Q

Targetoid (pale center) papule or plaque on palms–arms–face, Niloksy (-)

A

Erythema multiforme - follows HSV infection

62
Q

Sudden symmetric erythematous target lesions

A

Erythema multiforme (?recent HSV)

63
Q

Flu-like sx –> erythematous macules –> necrosis/sloughing, involves mucous membranes

A

Steven-Johnson syndrome –> IVIG

64
Q

Hx atopic dermatitis + vesicles on erythematous base on face

A

Eczema herpeticum

65
Q

Painful subcutaneous skin lesions on anterior leg —> next step?

A

CXR = Erythema nodosum —> benign or TB, Sarcoid, IBD, Histo

66
Q

Crops of small tender, erythematous nodules over shins & calves

A

Erythema induratum = TB

67
Q

Erythematous rash, Nilosky (+), perioral crusting

A

Scalded skin syndrome

68
Q

Fever, irritable –> blistering, exfoliation

A

Scalded skin syndrome

69
Q

Tender skin, bullae, large sheets slough after illness

A

SSSS

70
Q

Diffuse red macular rash + peeling of palms and soles

A

TSS (SA)

71
Q

Recent nasal packing –> rapid hypotension, rash, fever, thrombocytopenia, mouth hyperemia

A

TSS (tampons, sinusitis, septorhinoplasty, surgical wounds)

72
Q

Complications of GABHS

A

PSGN, RF, arthritis, PANDAS = OCD (SSRIs) or tic

73
Q

Abx do NOT prevent which GABHS complications

A

PSGN, arthritis

74
Q

Vesiculopustules on face, arms, crusted golden-yellow, warm, moist climate

A

Impetigo

75
Q

Impetigo Tx

A

Topical mupirocin, oral dicloxacillin, clinda, cephalexin

76
Q

Tender, erythematous skin w/ distinct border, scalp, face

A

Eryipelas –> cephalexin, diclox, clinda, bactrim –> IV if fever present

  • pyogenes
  • –> GN but not rheumatic fever
77
Q

Erythema, warmth, tenderness w/ INDISTINCT borders

A

Cellulitits = pyogenes or SA –> cephalexin, zosyn

78
Q

Unimmunized kids, blue cheeks, febrile

A

Buccal cellulitis = Hib –> cefuroxime or taxime

79
Q

Constipation, perianal cellulitis bug

A

Pyogenes

80
Q

Pain out of proportion w/ findings, crepitus, bullae

A

Necrotizing fasciitis –> IV Abx + debridement

81
Q

Recent trauma, surg, sudden pain, swelling, purple, serosanguineous discharge & skin bullae

A

Necrotizing fasciitis

82
Q

S/P laparotomy, fever, hyperglycemia, cloudy-gray discharge, friable tissue, no sensation

A

Necrotizing surgical infection –> surgery and debridement

83
Q

Recurrent, eczematous, pruritic, scaling red papules over flexor/extensors surfaces

A

Atopic dermatitis

84
Q

Itchy rash face, hands chest –> erosion, scaling, excoriated plaques and papules

A

Atopic dermatitis

85
Q

Patchy, fine, white, adherent waxy scales

A

Sebhorreic dermatitis –> dandruff, anti-fungal, moisturizers

86
Q

Yellow papules, some scaling/plaques on eyebrows, nose, head better w/ shampoo

A

Sebhorreic dermatitis –> dandruff, anti-fungal, moisturizers

87
Q

Sebhorreic dermatitis cause?

A

Malessezia furfur

88
Q

Vesicles, erythema in linear pattern, weepy, crusted, edema

A

Allergic contact dermatitis –> cell-mediated type IV HS

89
Q

Pruritic papules and vesicles over extensor surfaces

A

Dermatitis herpetiformis = Celiac (anti-endomysial)

90
Q

Erythematous papules, vesicles, bullae on butt, extensor surfaces, intense pruritis

A

Dermatitis herpetiformis —> DAPSONE

91
Q

anti-endomysial abs

A

Dermatitis herpetiformis = celiac

92
Q

Rosy hue w/ telangiectasias, flushing w/ hot drinks, heat, emotion, 30-60 y/o

A

Rosacea

93
Q

Sudden blisters, oral blisters/erosions that rupture easily, Ab to desmoglein, ACE inhibitors

A

Pemphigus vulgaris –> prednisone or MTX –> Aza to get off steroids

94
Q

Salmon colored patches, silvery scales over extensor surfaces & scalp

A

Psoriasis

95
Q

Numerous oval, scaly lesions over back, crinckled, cigarrette paper apperance

A

Pityriasis rosea

96
Q

Pale, velvety white/pink, scale w/ scraping, doesn’t tan

A

Tinea versicolor –> selenium sulfide or ketconazole

97
Q

Ring lesions w/ scaly border & central clearing

A

Tinea corporis –> terbinafine or griseofulvin

98
Q

Pruritic, erythematous, scaly, red ring w/ central clearing, swimming

A

Tinea corporis –> terbinafine

99
Q

Recurrent oral ulcers, genital ulcers, anterior uveitis, hyper-pigmented red skin lesions

A

Behcet syndrome –> steroids but still –> dementia, blindness

100
Q

Anti-Rho/SSA or Anti-La/SSB Abs

A

Sjogren syndrome

101
Q

Women, 50s, dry eyes, mouth, dental caries, dysphagia, B/L submand swelling

A

Sjogren syndrome

102
Q

Winter, Spring papules, vesicles on erythematous base –> erosions, different stages

A

Varicella –> acyclovir shortens if older than 2, given w/in 24hrs

103
Q

Dx varicella

A

Tzanck smear or PCR

104
Q

Varicella vaccination ages

A

12-18mo + 4-6yrs, live attenuated

105
Q

Zoster vaccine ages

A

60

106
Q

Lesions of all different stages

A

Chicken Pox

107
Q

Macropapular rash on trunk, palms and soles, painless chancre

A

Syphilus —> Benzathine PCN x3

108
Q

Macules, papules, pustules at same stage

A

Small pox (Variola)

109
Q

Vesicular on tongue/lips/mouth, macoluvesicular on hands, feet, butt, groin

A

Hand-foot-mouth (Coxsackie)

110
Q

Erythema marginatum, serpiginous macules w/ pale centers, polyarthritis, sydenham corea

A

Rheumatic fever

111
Q

Petechial rash –> ecchymoses, fever, N/V, myalgias, shock

A

Meningococcemia

112
Q

Maculopapular rash on lower chest + rose spots on abd, diarrhea, HSM

A

Typhoid fever

113
Q

Macrocytic anemia w/o hypersegment, low Retic + congenital syndrome (Turner etc)

A

Diamond-Backfan anemia (congential hypoplastic anemia) –> steroids or transfusion

114
Q

Bright red plaque, compressible, well-defined borders, 3mo old

A

Strawberry (capillary) hemangioma

115
Q

Small bright red papules in adulthood, do not regress

A

Cherry hemangioma

116
Q

Lobulated compressible mass on neck, lymph lined by epithelium

A

Cystic hygromas

117
Q

Dec growth, inc bone growth, inc ICP, puruitis, irritable, alopecia, sebhorreic lesions, mouth fissures

A

Vit A excess

118
Q

Impaired night vision, dry skin, dry eyes, cloudy cornea, hyperkeratosis

A

Vit A deficiency

119
Q

Sebhorreic dermatitis, photophobia, cracking lips, mouth, atrophic tongue, pallor, pale

A

Riboflavin (B2) deficiency

120
Q

Diarrhea, erythematous rash in sun exposed areas - arms, legs, beefy red tongue

A

Pellagra –> Niacin (B3)

121
Q

Niacin –> NAD, NADP, inc w/ corn eating, diarrhea

A

Pellagra

122
Q

Abd pain, diarrhea, corn-based diet, difficulty w/ memory, malar rash worse w/ UV

A

Pellagra (3Ds) - Niacin deficiency - carcinoic, corn, Hartnup, etOH

123
Q

Flushing, pruritis

A

Niacin toxicity

124
Q

Neuropathy, altered mental status

A

B6 excess

125
Q

Depression, dermatitis, stomatitis, irritable, NEUROPATHY

A

B6 deficiency –> inc homocysteine, embolic events

126
Q

Goat milk deficiency

A

Folate

127
Q

Ecchymoses, petechiae, bleeding gums, arthralgias, weakness, depression, coiled hair, joint swelling

A

Vit C deficiency

128
Q

Stone, diarrhea, cramps

A

Vit C excess

129
Q

Diarrhea, polyuria, polydipsia, calcification

A

Vit D excess

130
Q

Phimosis

A

Can’t retract foreskin

131
Q

Paraphimosis tx

A

Tournequet

132
Q

Balanitis bugs

A

Candida or GNs

133
Q

CIs to circumcision

A

Hypospadias, bleeding, pre-me

134
Q

1st teeth to develop and when

A

3-16mo, 1st = lower incisor

135
Q

Secondary teeth erupt

A

6-8y/o

136
Q

Mandibular central incisors erupt early indicates?

A

Hyperthyroid, Inc GH, precocious puberty

137
Q

Causes of delayed teeth eruption

A

Hypothyroid, pituitary, Down

138
Q

Pitting teeth, brown/gray, white streaks

A

No fluoride - need more 2-4 y/o

139
Q

When to supplement Fl-

A

Breast fed, >6mo, water <0.3ppm

140
Q

1 caries place and bug

A

Maxillary; Strep mutans

141
Q

Teeth avulsions tx

A

Store in milk, more time = bad prognosis

142
Q

Acne treatments

A
  1. Mild –> benzoyl peroxide –> clinda or erythromycin
  2. Moderate –> vit A –> oral doxy or minocycline
  3. Severe –> isotretinoin (hyperlipemia)