Derm

Question 1

red, tender, indurated skin lesion with sharply demarcated borders

Answer 1

erysipelas, GAP –> IV cefazolin

superficial skin infx

Question 2

measles (for C’s)

Answer 2

cough, corzya, conjunctivitis, (k)coplik spots
+diffuse maculopapular rash
+high fever!!

give vit a to prevent complications!

Question 3

tinea versicolor

Answer 3

doesn’t tan
“spaghetti and meatballs” on KOH prep
tx with selenium sulfide

Question 4

scabies

Answer 4

affects skins, wrists, ankles, interdigital folds

• very pruritic
• worse at night
• tx= permethrin

Question 5

do you treat molluscum contagiousum?

Answer 5

no

Question 6

treatment of tinea capitis

Answer 6

griseofulvin

Question 7

who gets molluscum contagiosum

Answer 7

young kids and immunosuppressed patients

its a pox virus

Question 8

bullous impetigo

Answer 8

staph a expholiative toxin a

• very contagious/common in kids
• causes puriritc rash on trunk with flaccid bullae and +Nikolsky
• brownish crust

tx with first gen ceph

Question 9

bullae in bullous pemphigoid=

Answer 9

tense, - nikolsky –> because epithelium is intact over hemidesmosomes/BM

Question 10

bullae in pemphigus vulgaris=

Answer 10

flaccid, + Nikolsky –> because desmosomes between cells are above BM and can easily break apart

Question 11

what causes plantars warts

Answer 11

HPV

Question 12

ringworm

Answer 12

tinea corporis

tx with miconazole

Question 13

parasthesias, hypopigmented skin, sensory neuropathy

Answer 13

leporasy –> rifampin + dapsone

Question 14

non healing skin ulcer should be concerned for…

Answer 14

marjolin ulcer

Question 15

parkland formula

Answer 15

4 x %burned x kg

first half over first 8 hours,

Question 16

disseminated gonoccocal arthritis

Answer 16

migratory polyarthritis

Question 17

epidermoid cyst

Answer 17

slow growing,

Question 18

acral, lentiginous melanoma

Answer 18

palms, soles, nail beds, mucus membranes

mostly darker skinned or asian ppulations

Question 19

how should you manage lichen sclerosus

Answer 19

punch bx to confim dx and r/o SCC, then high dose steroids

Question 20

how to resect melanoma

Answer 20

if deeper than >1mm, automatically breslow II –> resect with 1-2 cm margin and sentinel lymph nodes

Question 21

pruritic, gneralized erythematous rash in VARYING stages

Answer 21

vzv, chicken pox

macules, papules, crusts

Question 22

pearly, indurated, rolled borders with central depression

Answer 22

basal cell carcinoma

Question 23

how do you manage chemical skin burns

Answer 23

warm water irrigation!! (unless its K or Mg)

Question 24

indications for Moh’s in BCC

Answer 24

> 6mm with high likelihood of recurrence (keratinizing features)

a full excisional bx would probably be the first step

Question 25

who gets treated for VZV chicken pox?

Answer 25

immunosuppressed (HIV, cancer, kids on steroids, lung disease)

Question 26

t/f: drug induced hypersensitivity (ie carbamezapine) can cause LAD

Answer 26

true. facial edema, LAD, accentuation of hair follices.

Question 27

presentation of rosacea

Answer 27

chronic inflammatory skin do characterized by central facial erythema with talengiectasias, pustules that gets worse with triggers (sun, stress, alcohol)

first line tx= avoid triggers and topical metronidazzole

Question 28

how does pyoderma grangrenosum evolve?

Answer 28

extraintestinal manifestation of chron’s that can rapidly progress from small trauma (ant bite) to large wound with purple borders and necrotic center

Question 29

how do bugs implicate burn victims?

Answer 29

<5 days= g+ (staph a)

> 5 days= g- (PSA), fungi (candida)

**signs of burn sepsis: tachy, hypotension, thrombocytopenia, hyperglycemia

Question 30

tetrad of HSP

Answer 30

• LE palpable purpura
• LE arthralgias
• abd pain/ intussuecption
• renal dz –>hematuria

IgA mediated vasculitis

Question 31

pitaryasis

Answer 31

self limiting viral prodrome that begins with HERALD PATCH followed by clusters of erythamatous oval patches in “christmas tree” pattern along lines of tension

Question 32

ichthyotosis vulgaris

Answer 32

inherited skin disorder with diffuse dermal scaling that is worse in winter months

tx= emollients, topical reitnoids