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My Step 2 CK > Dermatology > Flashcards

Dermatology Flashcards

1
Q

A 30-40 y/o pt presents with oral erosive lesions and bullae that are thin and break easily with positive Nikolsky sign most likely suffers from …

A

Pemphigus Vulgaris

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2
Q

What is the diagnostic test for cutaneous malignancy?

A

Biopsy

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3
Q

What is the treatment for cutaneous malignancy?

A

Surgical removal (except karposi sarcoma)

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4
Q

A pt presents with a skin lesion that is increasing size, uneven color, irregular borders and are asymmetric in appearance most likely suffers from …

A

Melanoma

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5
Q

What is diagnostic test for melanoma?

A

Full thickness biopsy

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6
Q

What is the most common site of metastasis for melanoma?

A

brain

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7
Q

A pt with hx of organ transplant on immunosuppresive drugs that presents with skin lesion on sun-exposed area that can ulcerate most likely suffers from ….

A

Squamous cell carcinoma

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8
Q

A pt presents with waxy, shiny, pearly lesion on skin of sun-exposed area most likely suffers from …

A

basal cell carcinoma (rarely metastasize)

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9
Q

What is the diagnostic test for basal cell carcinoma?

A

shave or punch biopsy

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10
Q

What is treatment for basal cell carcinoma?

A

Mohs microsurgery (can just remove affected skin)

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11
Q

An HIV pt with CD4 count < 100 presents with purplish lesions on skin, GI tract and lung most likely suffers from …

A

Kaposi sarcoma

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12
Q

What organism is associated with Kaposi sarcoma?

A

Human herpes virus B (HHV-8)

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13
Q

What is the diagnostic test for kaposi sarcoma?

A

by appearance (dont biopsy b/c vascular and bleeds alot)

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14
Q

What is treatment for kaposi sarcoma?

A
  1. anti-retrovirals to increase CD4 count

2. liposomal doxorubicin HCL or vinblastine

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15
Q

A light skin colored pt presents with multiple tender lightly colored lesions on sun-exposed skin most likely suffers from ..

A

Actinic keratosis (remove b/c precancerous)

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16
Q

An elderly pt presents with hyperpigmented lesions that have a stuck on appearance on back, chest, shoulders, face and commonly referred to as liver spots most likely suffers from …

A

Seborrheic keratoses

benign; only remove for cosmetic reason

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17
Q

A pt with atopic disorder history (family or personal) present with erythematous plaques, pruritus and scatching that leads to thickened skin (lichenification), elevated IgE levels most likely suffers from …

A

atopic dermatitis (rash that itches)

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18
Q

What is treatment for atopic dermatitis? (5)

A
  1. emollients (moisten skin)
  2. topical steroids
  3. avoid overbathing and irritable detergents/soaps
  4. tacrolimus and pimecrolimus (t-cell inhibitor)
  5. antihistamine
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19
Q

A pt presents with scaly, greasy, flaky skin on a red base on the scalp, eyebrows, and nasolabial fold most likely suffers from….

A

Seborrheic dermatitis

dandruff

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20
Q

A pt presents with silvery, scaly plaques with associated arthritis most likely suffers from …

A

Psoriasis

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21
Q

What organism is associated with Seborrheic dermatitis?

A

Pityrosporum ovale

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22
Q

What is the treatment for localized psoriasis? (4)

A
  1. topical high potency steroids
  2. vitamin A (tazarotene) and vitamin D (calcipotriene ointment
  3. coal tar
  4. pimecrolimus and tacrolimus
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23
Q

What is the treatment for invasive psoriasis? (3)

A
  1. UV light
  2. TNF inhibitors (etanercept, adalimumab, infliximab)
  3. Methotrexate
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24
Q

What are common side effects of methotrexate?

A
  1. liver fibrosis

2. lung fibrosis

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25
Q

What is treatment for seborrheic dermatitis?

A
  1. topical low potency steroids (hydrocortisone)

2. topical antifungal (ketoconazole)

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26
Q

A pt presents with erythematous, salmoned colored lesion that spares palms and soles, usually starts with single lesion (herald patch), characterized as christmas tree appearance on back and has negative VDRL/RPR most likely suffers from…

A

Pityriasis rosea

steroids if very itchy

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27
Q

What is the pathophysiology associated with pemphigus vulgaris?

A

antibodies to epidermal layer

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28
Q

What is Nikolsky sign and what disease is it associated with?

A

loss/ denuding of skin with mild pressure (removal of superficial layer of skin in single sheet); pemphigus vulgaris

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29
Q

What is the diagnostic test for pemphigus vulgaris?

A

biopsy with immunofluorescent showing deposits of IgG and C3 in epidermis

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30
Q

What is treatment for pemphigus vulgaris?

A
  1. oral steroids
  2. azathioprine, mycophenolate
  3. rituximab
31
Q

A 70-80 y/o pt presents with thick walled bullae that remain intact and do not involve oral mucosa most likely suffers from …

A

Bullous pemphigoid

32
Q

What is the most accurate test for bullous pemphigoid?

A

biopsy with immunofluorescent antibodies to dermo-epidermal junction (basement membrane)

33
Q

What is the best initial treatment for bullous pemphigoid?

A

steroids

34
Q

What are other treatments

A
  1. erythromycin or tetracycyline w/ nicotinamide

2. azathioprine, mycophenolate

35
Q

A pt with hx of liver disease/ alcoholism/ OCPs use presents with blistering skin on sun exposed areas (back of hands and face), hyperpigmentation, hypertrichosis of face most likely suffers from …

A

Porphyria cutanea tarda

especially associated with hep C

36
Q

What is the defect in porphyria cutanea tarda?

A

uroporphyrinogen decarboxylase deficiency

37
Q

What is the most accurate test for porphyria cutanea tarda?

A

urinary uroporphyrins (> than coproporphyrins)

38
Q

What is treatment for porphyria cutanea tarda?

A
  1. correct underlying disease
  2. stop drinking
  3. stop estrogens
  4. remove iron (via phlebotomy or deferoxamine)
39
Q

… is hyperpigmentation from hemosiderin buildup in tissue due to venous incompetence of lower extremities

A

Statis dermatitis

40
Q

What is treatment for statis dermatitis?

A

elevate legs and lower extremities

41
Q

What is the definitive diagnostic test for contact dermatitis?

A

patch testing

42
Q

A pt presents with linear, streaked vesicles on skin most likely suffers from ….

A

Contact dermatitis

tx: antihistamines & topical steroids

43
Q

A superficial bacterial skin infection due to Staph and Strep and associated with weeping, oozing, and honey crusting is …..

A

impetigo (topical abx)

44
Q

What is the treatment for MRSA associated impetigo?

A
  1. doxycycline
  2. clindamycin
  3. bactrim
45
Q

A pt presenting with bright red, hot, tender, swollen skin infection with associated with leukocytosis most likely suffers from …

A

Erysipelas

mainly strep with some staph

46
Q

What is the only cephalosporin that covers MRSA?

A

ceftaroline

47
Q

A pt with warm, erythematous, swollen, tender skin infection of subcutaneous tissue most likely suffers from …

A

cellulitis

48
Q

What are the terms for hair follicle infection?

A
  1. folliculitis
  2. furuncles
  3. carbuncles
49
Q

What is the treatment for tinea?

A

topical antifungal (as long as no hair/ nails involved)

50
Q

What is the best intial test for tinea?

A

KOH prep

51
Q

What is the most accurate test for tinea?

A

fungal culture

52
Q

A pt presents with fever, SBP

A

Toxic Shock Syndrome

53
Q

What is the treatment for fungal infection involving hair or nails?

A
  1. terbinafine

2. itraconazole

54
Q

What is treatment for toxic shock syndrome?

A
  1. remove source of infection
  2. fluid resuscitation and pressors
  3. clindamyacin with vancomycin (until cx)
55
Q

An immunocompromised pt presents with loss of superficial skin, positive Nikolsky sign and normal blood pressure and internal organ function most likely suffers from ..

A

Staphylococcal scalded skin syndrome

tx in burn unit w/ oxacillin or vancomycin

56
Q

A pt presents with wheals and hives after exposure to certain medication/ insect bite/ food and has associated intense itching most likely suffers from …

A

urticaria

57
Q

What is the treatment for urticaria?

A

H1 antihistamines (diphenhydramine, hydroxyzine)

58
Q

A pt presents with generalized maculopapular rash that blanches with pressure after exposure to allergic medication and skin stays intact without mucous membrane involvement most likely suffers from …

A

Morbilliform rash

similiar to measles

59
Q

A pt presents with multiple target like lesions, especially on palms and soles that can be confluent and does not have associated mucous membrane involvement most likely suffers from …

A

erythema multiforme

60
Q

What are two infections associated with erythema multiforme?

A
  1. herpes simplex

2. mycoplasma

61
Q

A pt presents with erythema multiforme appearance with mucous membrane involvement leading to sloughing off of respiratory epithelium after allergic medication most likely suffers from ….

A

Stevens-Johnson Syndrome

62
Q

What treatment is used for severe Stevens Johnson syndrome?

A

IV immunoglobulins (IVIG)

63
Q

A pt presents with denuding of skin involving large portion of body surface area, positive Nikolsky, mucous membrane involvement after use of allergic medication most likely suffers from …

A

Toxic epidermal necrolysis (TEN)

64
Q

What is treatment for mild acne?

A
  1. topical antibacterials (benzoyl peroxide)
  2. then add topical antibiotics (clindamycin, erythromycin)
  3. then add topical retinoids
65
Q

What is treatment for moderate acne?

A
  1. benzoyl peroxide with topical retinoids

2. add oral antibiotics

66
Q

What is the treatment for severe acne (recurrent)?

A

oral vitamin A (isotretinon)

67
Q

… is due to antibodies attacking hair follicles thereby destroying hair production

A

Alopecia areata

68
Q

… is loss of hair in response to overwhelming physiologic stress (cancer, malnutrition)

A

Telogen effluvium

69
Q

… is a sore that occurs in the pressure areas of the body where the bone is closer to the skin in a pt who is immoblized or bedridden

A

decubitis (pressure) ulcers

70
Q

What are the 4 stages of decubitus (pressure) ulcers?

A

stage 1: nonblanchable redness
stage 2: superficial epidermis or partial dermal destruction
stage 3: full thickness skin destruction
stage 4: destruction to bone

71
Q

What is the definitive diagnostic tool for microbiologic cause of decubitus ulcer?

A

debridement culture

72
Q

A pt presenting with a round, sharply demarcated lesion that leaves a hyperpigmented spot at the same site after medication use most likely suffers from …

A

Fixed drug reaction

associated with aspirin, NSAIDs, tetracycline, barbituates

73
Q

A pt presenting with multiple painful, red, raised nodules on the anterior surface of the lower extremities (shins) most likely suffers from …

A

erythema nodosum

74
Q

What should be done in a pt presenting with erythema nodosum?

A

Chest X-ray (to exclude sarcoidosis)

My Step 2 CK (21 decks)

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