Dermatology (5%)

Question 1

Multiple target-like lesions - often secondary to herpes simplex infection

Answer 1

Erythema multiforme

Question 2

Erythema multiforme can be due to medications, such as:

Answer 2

ABX
NSAIDs
Anti-epileptics

Question 3

Treatment for erythema multiforme

Answer 3

Self-resolves after 2 weeks

Topical steroids and antihistamines for mild dz

Question 4

Most common cause of SJS/TEN

Answer 4

Medications
Allopurinol
Sulfonamides
Lamotrigine
NSAIDs
Anticonvulsants

Question 5

Second most common cause of SJS/TEN

Answer 5

Infection:
Mycoplasma pneumonia
Cytomegalovirus

Question 6

Signs/symptoms of SJS/TEN

Answer 6

Prodrome of fever, malaise, myalgia

Lesions start on face and trunk and spread

Question 7

Nikolsky sign

Answer 7

Gentle pressure to skin causes sloughing

Seen with SJS/TEN

Question 8

Main cause of death with SJS/TEN

Answer 8

Respiratory failure

Question 9

Treatment for SJS/TEN

Answer 9

Admit to hospital - preferably to burn unit

Supportive care

Question 10

Most common etiology of erysipelas

Answer 10

Streptococci

Question 11

Most common cause of cellulitis

Answer 11

Beta hemolytic streptococci

Staph aureus

Question 12

Erysipelas will have a ____________ between infected and uninfected tissue

Answer 12

Clear line of demarcation

Question 13

Treatment of cellulitis

Answer 13

Drainage: treat for MRSA –> clindamycin, TMP/SMX, doxycycline
Non-drainage: treat for MSSA –> clidaymyclin, cephalexin, dicloxacillin

Question 14

Treatment of erysipelas

Answer 14

Penicillin, macrolide, cephalexin, clindamycin

Question 15

Parkland formula for IV fluid resuscitation with burns

Answer 15

LR 4 mL/kg/%TSA
IV x first 24 hours
1/2 in first 8 hours, remaining half in remaining 16

Question 16

Characteristics of second degree burn - superficial partial thickness

Answer 16

Erythematous, pink, moist, weeping
Blistering
Most painful!
Blanches with pressure

Question 17

Characteristics of second degree burn - deep partial thickness

Answer 17

Red, yellow, pale white, dry
Blistering
Not usually painful
Absent capillary refill 
May need skin graft

Question 18

Characteristics of third degree burn - full thickness

Answer 18

Waxy, white, leathery, dry
Painless
Absent cap refill

Question 19

Characteristics of 4th degree burn

Answer 19

Black, charred, eschar, dry
Painless
Absent cap refill
Into underlying muscle, fat, bone

Question 20

Major risk factor for basal cell carcinoma

Answer 20

Exposure to UV light

Question 21

Signs/Symptoms of basal cell carcinoma

Answer 21

Nodular appearance, occur on face
Pearly papule with telangiectatic vessel
Ulcerates, may be referred to as rodent ulcer

Question 22

Diagnosis of basal cell carcinoma

Answer 22

Shave biopsy

Question 23

Major risk factor for squamous cell carcinoma

Answer 23

Sun exposure

Question 24

Scary erythematous papule or plaque

Answer 24

Squamous cell carcinoma

Question 25

Ulcer that fails to heal and continues to grow

Answer 25

Squamous cell carcinoma

Question 26

Diagnosis of melanoma

Answer 26

Excisional biopsy with 1-3 mm of the surrounding skin and fat

Question 27

Treatment of melanoma

Answer 27

Surgical removal

Adjunctive tx with interferon alpha can prolong survival in high risk groups