Dermatology Flashcards
1
Q
- Teenage female presents with blackheads only, mild acne, what do you recommend?
a) Topical benzoyl peroxide gel
b) Topical retinoic acid
c) Accutane
d) Topical clindamycin
- —————————- - Teen with blackheads for two months. Management?
a) Wash face
b) Topical benzoyl peroxide
c) Topical retinoids
d) Systemic antibiotics
- —————————- - Kid with mild comedones. First Rx?
a) Benzoyl peroxide
b) Topical retinoic A
c) Tetracycline
- —————————– - Teenage girl with mild acne: comedones only. What do you do?
a) Benzoyl peroxide
b) Topical retinoin A
c) Accutane
d) Oral antibiotics
- —————————– - Girl with only blackheads. Best treatment?
a) Topical tretinoin
b) Topical benzoyl peroxide
c) Oral antibiotic
d) Accutane
- —————————– - Teenage female presents with blackheads only, mild acne, what do you recommend?
a) Topical benzoyl peroxide gel
b) Topical retinoic acid
c) Accutane
d) Topical clindamycin
A
Topical retinoid
Good for comedones with only mild assoc’d acne
2
Q
- 15 year-old male present with mild papular and comedogenic (? papulopustular, not comedogenic?) acne on face, trunk and back. Previously only using soap to wash his skin. Next step for treatment:
a) Tetracycline PO
b) Erythromycin cream
c) Combination of topical retinoid and benzoyl peroxide
d) Other topical
A
Topical retinoid + BP
3
Q
- What to give to kid that failed topical acne tx?
A. Minocycline
A
PO ABx
4
Q
- Benzoyl peroxide works by:
a) Decreasing antibacterial resistance in p. acne
b) Decreasing the duration of oral antibiotics
c) Decreasing the need for oral antibiotics
- ——————————- - Advantage of benzoyl peroxide?
a) Decrease P acnes resistance to antibiotic
b) Decrease duration for oral antibiotic
c) Inhibits androgen effect of sebum
d) Decrease need for antibiotic
A
Decreases P acne resistance to ABx
- decreases bacteria
- antiinflammatory
5
Q
- What is the mechanism of Accutane?
a) Decreased sebum production
b) Decreased proprionibacterium
c) Comeodolytic
d) Increase follicular cell turnover
- ————————— - What is the mechanism of action of Accutane?
a) Reduces infection with Propionibacterium acnes
b) Decreases sebaceous gland production of sebum
c) Increases follicular cell turnover
A
Decreases propionibacterium acnes?
- Reduces size and secretion of sebaceous glands
- Normalizes follicular keratinization
- Prevents new microcomedone formation
- Decreases the population of P. acnes
- Antiinflammatory effect
6
Q
2. A kid with asthma and eczema has an acute worsening of his eczema. What would you treat him with? (PAGE 9) a) Acyclovir b) Steroids c) Cefazolin d) Vancomycin --------------------- 5. A 3 year old boy has atopic dermatitis with a sudden exacerbation. Photo shown of (likely) impetiginized eczema. What is the treatment? a) IV acyclovir b) IV cefazolin c) IV cloxacillin ----------------------- Boy with history of atopic dermatitis presents with rash similar to that seen in picture. Difficult to discriminate between eczema herpeticum and eczema with impetigo. Best treatment? a) IV cefazolin b) IV acyclovir c) IV clindamycin d) Topical steroids
A
Ancef
7
Q
- Hemangioma over eye, what do you want to do first?
a) Consider starting propranolol
b) Call optho
c) Wait 2 weeks then reassess
A
Call ophtho
Then Propranolol
8
Q
- Vascular Malformation over unilateral upper face. What do you need to worry about?
a) Glaucoma
b) Ipsilateral hearing loss
c) Cerebral malformation
d) Hydrocephalus
A
Glaucoma
Sturge-Weber
- usually only on one side
- V1 distribution: forehead, temple, eyelid
- capillary malformation of skin, eye, brain
1. Port wine stain (UL, V1)
2. Glaucoma
3. Leptomeningeal angioma - Need ophtho Q6mo, consider MRI brain
9
Q
- Picture of 9mo with large plaque hemangioma on the face, what would you NOT do?
a) Echocardiogram
b) MRI head
c) Renal ultrasound
d) Ophthalmology
A
Renal U/S
PHACES
- Posterior fossa brain malformation (cerebellar hypoplasia (same side as hemangioma), Dandy-Walker malformation)
- Hemangioma (segmental, >5cm)
- Arterial lesions (abnormal arteries in head or neck)
- Cardiac abnormalities (CoA, arch problems)
- Eye abnormalities (Morning glory disc, optic nerve hypoplasia, congenital cataracts)
- (Sternal abN)
10
Q
- Kid w hemangioma covering eye, what to do?
a) Refer to surgery for resection
b) Reassess in few months
c) Start propranolol
A
Start propranolol
refer to ophtho
11
Q
- 6 mo old kid with vascular malformations of upper face. Complication you need to monitor?
a) Ipsilateral hearing loss
b) Cerebral AVM
c) Glaucoma
- ———————— - Child with vascular malformation of upper face. What do you investigate for?
a) Glaucoma
b) AV malformation in brain
c) Hydrocephalus
A
Glaucoma
Most likely Sturge Weber
12
Q
- Child with large port wine stain overlying the upper 2/3 of his face. What complication do you anticipate?
a) Ipsilateral cerebral AVM
b) Glaucoma
- ———————— - Child with port-wine-stain on face over V1 distribution. What needs to be followed for?
a) Ipsilateral hearing loss
b) Glaucoma
- ———————— - Child with large port wine stain in a distribution of the 1st trigeminal nerve. What do you work him up for?
a) Optic glioma
b) Cerebral arteriovenous malformation
c) Glaucoma
d) Liver disease
A
Glaucoma
13
Q
- Strawberry hemangiomas, which is true:
a) Not present at birth
b) Equal sex predilection
c) Chew up platelets
d) Begin to involute in 2nd decade
- ————————— - What is true of strawberry hemangiomas?
a) Involution after the second decade of life
b) They are usually not present at birth
c) There is never an indication to treat
A
Not present at birth
Strawberry hemangioma = superficial hemangioma
- not present at birth, become apparent in first 2mo
14
Q
- Baby with large congenital (melanocytic?) nevus on face. What is she at risk for?
A
?Large congenital pigmented nevi -> at risk for leptomeningeal involvement + malignant melanoma
15
Q
- Term with forceps delivery, presented with jitteriness, has a red firm plaque on hand, what blood work is most likely to be found (likely talking about subcutaneous fat necrosis)
a) Hypercalcemia
A
Hypercalcemia
