Miscellaneous Flashcards

Dermatology, Immunizations, Rheumatology

1
Q

Features of this genetic condition include:
- micrognathia, abnormal external ears, clenched hands with overlapping fingers, increased muscle tone, low birth weight, single umbilical artery, short palpebral fissures, nail hypoplasia, and congenital heart defects (ventricular septal defect, atrial septal defect, and patent ductus arteriosus)

A

Trisomy 18

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2
Q

sloping forehead with holoprosencephaly, microphthalmia, cleft lip or palate, and polydactyly

A

Trisomy 13

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3
Q

Hemangioma involution

A

50% by 5 years
70% by 7 years
90% by 9 years

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4
Q

GLUT-1 positive

A

Hemangiomas

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5
Q
  • Tufted Angiomas
  • Thrombocytopenia
  • Consumptive Coagulopathy
  • Microangiopathic Hemolytic Anemia
A

Kasabach-Meritt (KHE, Tufted Angioma)

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6
Q
  • Multiple hemangiomas of skin

- GI, Pulmonary, CNS, Liver Angiomas

A

Neonatal Hemangiomatosis

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7
Q
  • Posterior fossa CNS abnormalities
  • Hemangioma in V1 facial distribution
  • Arterial anomalies –> seizures/stroke
  • Cardiac defects
  • Eye abnormalities (microphthalmia)
  • Sternal clefting
A

PHACES Syndrome

  • 90% F
  • Ulceration of softe tissue
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8
Q
  • Port Wine Stain in V1
  • Hypertrophic soft tissue
  • Glaucoma
  • Meningeal Angioma
A

SWS

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9
Q

Lumbosacral hemangiomas

A

Tethered cord, intraspinal lipomas

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10
Q

Liver hemangiomas

A

HM, CHF, anemia and thrombocytopenia

Hypothyroidism

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11
Q
  • Most common vascular birthmark
  • On face and nape of neck, symmetrical about midline
  • Present at birth
  • Facial lesions usually resolve within one year
  • Nuchal lesions persist in 50%
A

Salmon Patch

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12
Q
  • Present at birth

- Grows with the child, darkens with age, becomes cobblestoned with soft tissue hypertrophy

A

Port Wine Stains (Nevus flammeus)

Rx: Pulse Dye Laser

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13
Q
  • PWS
  • Limb hypertrophy
  • Venous and lymphatic malformations
  • GI and bladder angiomas
A

Klippel Trenaunay

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14
Q
  • Acquired vascular lesion
  • Common on extremities, face
  • Red papule that bleeds easily
  • Need to remove
A

Pyogenic Granuloma (Lobular Capillary Hemangioma)

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15
Q
  • Benign melanocytic lesion

- Dome-shaped, red to yellow to brown color

A

Spitz Nevus

- Very low risk of malignancy, but a malignant melanoma can mimic a spitz nevus

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16
Q
  • Not present at birth, appears at 24 hours of age
  • Papule or pustule with urticarial base
  • Lasts 2-3 weeks
  • See eosinophils if examine content of vesicle
A

Erythema Toxicum

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17
Q
  • Presents with 2-3mm vesicles
  • Vesicles rupture within hours, leaving a collaret of scale, followed by a hyperpigmented macule that lasts for months
  • More common in African Americans
  • Neutrophils without bacteria seen inside vesicle
A

Transient Neonatal Pustular Melanosis

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18
Q

Normal mottled response to cold

A

Cutis Marmorata

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19
Q
  • Developmental disorder of capillaries and veins
  • Often localized to one extremity, coarser texture
  • Associated with glaucoma, cleft lip, mental retardation, syndactyly, hypothyroidism and dystrophic teeth
A

Cutis Marmorata Telangiectatica Congenita

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20
Q
  • Indurated, non-tender plaque with patchy erythema appearing in the first few weeks of life
  • Probably 2/2 trauma
  • Resolves spontaneously
  • May have associated hypercalcemia, leading to irritability, constipation, FTT, seizures
A

Subcutaneous Fat Necrosis

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21
Q
  • Onset at 2-4 weeks of age, resolves by 3 months
  • Papules and pustules without comedomes
  • No treatment needed
  • Some cases of “acne” are actually a folliculitis caused by Pityrosporum
A

Neonatal Acne

Acne that has a later onset or is prolonged, may be severe and require evaluation of androgens, Infantile acne

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22
Q

Dermatitis on interdigital/arch of foot

A

Tinea pedis

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23
Q

Dermatitis on weight-bearing surface of foot

A

Juvenile Plantar Dermatosis

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24
Q

Dermatitis on dorsum of foot

A

Contact dermatitis

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25
Q

Why should you not use oral ketoconazole?

A

Risk of fatal hepatitis

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26
Q

1st line treatment for onychomycosis

A

Itraconazole or Terbinifine x 4-6 months

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27
Q
  • Adolescents
  • Warm, humid weather
  • Confluent macules of varying color with mild scale, upper body and occasionally on face
  • KOH = spaghetti and meatballs
A

Tinea versicolor

  • Treat with topical selenium or zinc shampoos
  • Oral ketoconazole, itraconazole or fluconazole can be used
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28
Q

Looks like tinea without superficial scale

A

Granuloma Annulare

- No treatment needed

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29
Q

Two serious rare side-effects of Minocycline

A

Autoimmune hepatitis and SLE

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30
Q

Normal amount of hair loss/day

A

50-100 scalp hairs/day

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31
Q

Anagen Effluvium

A
  • Marked decrease in production of new hairs (anagen phase) leading to profound hair loss
  • 2/2 chemo or radiation
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32
Q

Telogen Effluvium

A
  • Diffuse thinning of hair
  • Increased % of telogen hair
  • Hair grows back completely within months
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33
Q
  • Congenital, focal absence of skin (any skin structure)
  • Most common on scalp, but also on face, trunk and extremity
  • Deep lesions can extend to dura or meninges
A

Aplasia Cutis Congenita

membranous appearance with a ring of long, coarse, dark hair (“Hair collar sign”) associated with underlying CNS malformations

34
Q

Two syndromes often associated with aplasia cutis

A

Trisomy 13 and 4p-

35
Q
  • Present at birth or develops in infancy
  • Sharply defined, unilateral or localized, hypopigmented patch
  • 2/2 inadequate melanin production or transfer
A

Nevus Depigmentus

36
Q
  • White forelock/piebaldism
  • Iris heterochromia
  • Dystopia canthorum
  • SNHL
  • Hirschsprung Disease
A

Waardenburg Syndrome

37
Q

Erythema Multiforme precipitating factors

A

HSV, Mycoplasma, drugs

38
Q

Drugs associated with SJS

A

NSAIDs
Anticonvulsants
Antibiotics
Allopurinol

Started typically 1-8 weeks prior to onset of disease

39
Q

Erythema Nodosum associations

A
  • GAS, TB, Mycoplasma, EBV, coccidiomycosis, yersinia

- IBD, Behcet disease, sarcoidosis

40
Q

These vaccines contain egg antigen

A

Influenza

Rabies

41
Q

This vaccine contain yeast protein

A

Hepatitis B

42
Q

These vaccines contain neomycin

A

MMR
IPV
Varicella

43
Q

This vaccine contains streptomycin

A

IPV

44
Q

These are live vaccines

A

MMR

Varicella

45
Q
  • Acute febrile illness
  • Prior allergic reaction to same or related vaccine
  • Prior serious reaction to same vaccine
A

Vaccine Contraindications

46
Q

Immunosuppressive therapy or immunodeficiency disorder is a general contraindication for _____

A

Live vaccines

47
Q

Pregnant women cannot get this type of vaccine

A

Live vaccines

48
Q

Recent IVIG, plasma or blood administration are contraindications for ____

A

MMR & Varicella vaccines

49
Q

This age group has a poor response to polysaccharide vaccines

A

<2 years of age

50
Q

Hepatitis A Immune Globulin needs to be given within __ days of exposure

A

14 days

51
Q

Measles Immune Globulin needs to be given within __ days of exposure

A

6 days

52
Q

Wound plus <3 past tetanus immunizations

A
  • Immunize

- TIG for “dirty” wounds early

53
Q

Wound plus >= 3 past tetanus immunizations

A
  • Dirty wounds - Immunize if >5yrs after last dose
  • Clean wounds - Immunize if >10yrs after last dose
  • TIG not indicated
54
Q

Efficacy of DTaP vaccine against pertussis

A

80-95% after 3 doses

55
Q

Preterm infants and Hepatitis B vaccine

A
  • Reduced immune response to birth dose

- Give when 2kg or 30 days of age

56
Q

Serogroups in the MCV vaccine

A

A, C, Y, W-135

57
Q

This vaccine may contain latex

A

MCV

58
Q

What types of HPV are high risk for cervical cancer

A

16, 18 >70% cases

59
Q

Types of HPV –> genital warts

A

6, 11 ~90%

60
Q

The currently licensed Haemophilus influenza type B (Hib) vaccine is a ____

A

Polysaccharide-protein conjugate

61
Q

This vaccine is associated with rare transient thrombocytopenia

A

Measles vaccine

62
Q

This vaccine contains gelatin and neomycin

A

Measles vaccine

63
Q

Reason to give a newborn VZIG

A

Maternal onset 5 days before or 2 days post-delivery

64
Q

Most common manifestations of lupus

A

Nephritis, arthritis and dermatitis

65
Q

Sensitive marker of SLE

A

ANA

- Also low C3, C4, CH50

66
Q

Best lupus marker

A

dsDNA

67
Q

Most specific Ab for lupus

A

Anti-Sm

68
Q

anti-RNP

A

Mixed Connective Tissue Disease

69
Q

Anti-SSA/SSB

A

Sjogren’s syndrome

70
Q

Anti-histone

A

Drug induced SLE

71
Q

This organ involvement establishes overall prognosis of lupus

A

Kidneys

- decreased complement or increased anti-dsDNA suggests worsening renal disease

72
Q

12y/o with arthralgias, fever, pleural effusions and pericarditis. CBC shows a Hbg of 8. Urinalysis shows microscopic hematuria and proteinuria. What is the most likely diagnosis?

A

SLE

73
Q

Most common manifestations of neonatal lupus

A
54% heart block
37% rash (E. annulare)
8% hepatitis
6% cytopenias
- Most women have no symptoms of lupus
- Linked to anti-Ro or anti-La antibodies
74
Q

Evanescent, salmon-colored rash with Koebner phenomenon, associated with fever spikes

A

Systemic JIA (Still’s DIsease)

75
Q
  • Aphthous and genital ulcers
  • Uveitis
  • Arthritis
  • Mediterranean, Japanese and Middle Eastern populations
A

Behcet’s SYndrome

76
Q
  • Periodic fever episodes associated with arthritis, serositis or rash during episodes
  • Mediterranean populations
A

FMF

- Colchicine is highly effective and response virtually diagnostics

77
Q

The likelihood that a diseased patient has a positive test

A

Sensitivity

78
Q

The likelihood that a healthy patient has a negative test

A

Specificity

79
Q

Gymnast + low back pain worsened by hyperextension

A

Spondylolysis

80
Q

When you think there is a significant difference when there really isn’t

A

Type I Error (probability of type I error = p value)

81
Q

When you could not reject the null hypothesis, but in reality, there is a difference

A

Type II error