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Clinical Prep > Dermatology: Wk 2 > Flashcards

Dermatology: Wk 2 Flashcards

1
Q

Acne vulgaris, a disorder of:

A

Pilosebaceous follicles

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2
Q

4 factors involved in formation of acne lesions

A

Inc in sebum
Keratin and sebum plug hair follicle
C. acnes proliferates in follicle
Inflammatory response

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3
Q

Tx for moderate comedonal and inflammatory acne

without scarring

A

Benzoy peroxide + Topical retinoid cream

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4
Q

Refer pts to derm if:

A

Cystic, Scarring, or difficult to control

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5
Q

Adapalene, Tazarotene, and Tretinoin are all forms of

A

Topical Retinoids

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6
Q

Which topical retinoid is category X and contra-indicated in pregnancy?

A

Tazarotene

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7
Q

Topical Abx in the treatment of acne

A

Erythromycin 2%

Clindamycin 1%

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8
Q

How do topical Abx work in the treatment of ACne

A

Reduce number of C. acnes and reduce inflammation

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9
Q

What needs to be added when the acne is moderate- severe

A

Oral abx

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10
Q

SE of Minocycline (an oral abx for acne)

A

Dizziness, ataxia, nausea, vomiting

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11
Q

1st line Oral Abx tx for acne

A

Tetracycylines:

Tetra, Doxy, and Mino

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12
Q

2nd line Oral Abx tx for acne

A

Macrolides

“mycins”

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13
Q

Adverse effects to Tetracycline Abx

  • tetracycline
  • doxycycline
  • minocycline
A

GI upset
Photosensitivity

Minocycline can cause vertigo, dizzy, and hyperpigmentation (GI upset and photosens are less common with Mino)

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14
Q

Tetracyclines are CONTRA in who

A

Pregnant

Children younger than 8

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15
Q

If pt has not responded after 3 mo of oral abx

A

Increase dose
Change abx
Refer to Derm

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16
Q

Minocycline and pigmentation

A

CAUTION

brown or blue/gray
may occur in scars

may not fade after stopping med
if on long term Minocycline, screen. If see on gums or sclerae, stop med

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17
Q

Oral Isotretinoin

A

For severe, nodulocystic acne failing other therapies

SE: xerosis, chelitis, elevated liver enzymes, hypertriglyceridemia

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18
Q

Isotretinoin is NEVER used with what?

A

Tetracycline (tetra, mino, or doxy)

because both have small risk of developing pseudotumor cerebri

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19
Q

Tx for acne in post-teen women

possibly associated with PCOS

A

Spironolactone

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20
Q

Commonly used meds to treat hormonal acne- other than Spironolactone

A

Yaz
Ortho Tri-cyclen
Estrostep

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21
Q

Acne Rosacea

A

looks similar to Vulgaris, but ABSENCE of comedones

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22
Q

Red swollen distorted skin

Easy flushing, redness, telangiectasias, papules, pustules

A

Acne Rosacea

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23
Q

Triggers to Acne Rosacea

A 
Alcohol
Sun
Hot beverage
Spicy food 
Emotional stress

NOT related to hormones

24
Q

Acne Rosacea often also affects the

A

EYES

25
Q

Tx for Acne Rosacea

A

Topical and Oral tx improve the papules and pustules

BUT

will not reverse the underlying redness and flushing

26
Q

Periorificial Dermatitis Tx

around the mouth

A
  • Topical steroid taper
  • Oral Tetracycline (older) or Oral Erythromycin (younger)
  • Topical Metronidazole, Erythromycin, and Pimecrolimus
27
Q

Periorificial Dermatitis

A

No comedones

Papules and pustules with scaling

Around the mouth, nose, eyes

Itching or burning

28
Q

Pts with Periorificial Dermatitis often have history of

A

Steroid use

this acne often flares when steroids are stopped

29
Q

Spreading redness
Non fluctuant
Streaks of lymphangitis spreading from affected area –> lymph nodes

A

Cellulitis

30
Q

Stasis Dermatitis

A

acute flare of chronic venous insufficiency

31
Q

Dryness in a net like pattern

lower legs, not hot, can be oozing, crusting, fissuring

A

Asteatotic Eczema

32
Q

Cellulitis is most often caused by

A

Group A Strep

33
Q

Tx for Cellulitis that is Non purulent

covering for strep

A

Keflex
Amoxicillin
Augmentin
Clindamycin

34
Q

Tx for Cellulitis that is Purulent, IVDU, or penetrating trauma

Cover for MRSA: “B,C,D”

A

Bactrim
Clinda
Doxy

+

Amoxicillin

35
Q

How long for course of Abx to treat cellulitis?

A

5 days

if not better after this, need to possibly revise treatment

36
Q

Abx that treat MRSA

“B,C,D,

L, V”

A 
Bactrim
Clinda
Doxy
Linezolid
Vanco
37
Q

Clinda has what associated risk

A

C-DIFF!!!

“Linda is a bish”

38
Q

Bactrim to treat MRSA

A

need to combine with Amoxicillin

39
Q

Macrolide to treat MRSA (Doxy or Mino)

A

need to combine with Amoxicillin

40
Q

Linezolid to treat MRSA

A

Expensive medication $$

41
Q

Vancomycin to treat MRSA

A

Parenteral DOC to treat severe infections

42
Q

Erysipelas

A

superficial cellulitis
legs and face
pain, bright red, plaque like edema- sharply defined margin

high WBC
chills, fever, HA, vomiting, joint pain

43
Q

SHARPLY DEMARCATED BORDERS

A

Erysipelas

44
Q

Erysipelas tx

A

Empiric Abx therapy
cover Strep

Pen C, Amoxicillin, Clinda, Macrolide

45
Q

Abx tx for Abscesses

“B,C,D” covering for MRSA

A

Bactrim
Clinda
Doxy

46
Q

Most common affects kids age 2-5
contagious, easily spread
most cases d/t Staph aureus

A

Impetigo

47
Q

Lesions start as papules surrounded by erythema–> pustules that enlarge and break down to form thick, adherent crusts w “HONEY CRUSTED APPEARANCE”

A

Non bullous Impetigo

48
Q

Bullous Impetigo

A

flaccid bullae with clear/ yellow fluid that later becomes purulent

ruptured bullae leave thick, brown crust

face, arms/legs, diaper area

49
Q

Ecthyma

A

goes DEEPER
plaque that extendes into dermis

“PUNCHED OUT” ulcers covered w yellow crust surrounded by raised margins

heals slowly, may scar

50
Q

PUNCHED OUT ulcers

A

Ecthyma

51
Q

Tx for Impetigo

“honey crusted”

A

Topical
Mupirocin or Retapamulin ointment

as long as localized infection and pt is otherwise healthy

52
Q

Oral Abx need to be used to treat Impetigo when multiple close contact (like family members) affected or if it’s extensive

A 
Dicloxacillin
Keflex
Erythromycin
Clindamycin*** safe choice
Augmentin

If MRSA: Clinda, Bactrim, or Doxy

53
Q

Rapidly progressing redness, edema, fever, systemic sx, crepitus, skin necrosis

local anesthesia over plaque but over PAIN OUT OF PROPORTION in some cases

A

Necrotizing Fasciitis

54
Q

If you suspect Necrotizing Fasciitis

A

consult Surgery immediately

55
Q

Tx for Necrotizing fasciitis

A

Widespread debridement and broad spectrum Abx

56
Q

deeper form of impetigo that results in ulcers

A

Ecthyma

57
Q

Expanding, dusky, red plaque with blue discoloration and assoc anesthesia

A

Necrotizing Fasciitis

Clinical Prep (41 decks)

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