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Simmons NURP 532 Exam 2 > 3: Derm 2 > Flashcards

3: Derm 2 Flashcards

1
Q

Clinical presentation: possible prodrome of malaise and fever or may be asymptomatic. Diagnosis: 1–5 cm herald spot with central clearing.

A

Pityriasis rosea

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2
Q

What is the treatment for acute urticaria (4)?

A
  1. Benadryl 1 mg/kg/dose q 6-8 hours or hydroxyzine 0.5 mg/kg/day.
  2. Stop all ABX and determine offending agent.
  3. Epi 0.01 mg/kg up to 0.3 ml sub-q for angioedema/anaphylaxis.\
  4. Consider prednisone 1-2 mg/kg/day x 1 week to be tapered.
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3
Q

Clinical findings:erythematous, annular raised wheals with pale centers, and scattered lesions that coalesce. Can cause edema of eyelids, tongue, hands, feet, etc.

A

Urticaria

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4
Q

What are DDx of erythema multiforme (4)?

A
  1. Urticaria
  2. Staph scalded skin syndrome
  3. Kawasaki
  4. Lupus
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5
Q

What are complications of untreated Kawasaki dz (4)?

A
  1. Cardiovascular (20-25%)
  2. Myocarditis
  3. Pericarditis
  4. Aneurysm formation in coronary arteries infarction
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6
Q

Description:acute febrile illness, turning into systemic vasculitis.

A

Kawasaki dz

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7
Q

What is the treatment for erythema multiforme minor (4)?

A
  1. Mild analgesics
  2. Cool compresses
  3. Antihistamines
  4. Steroids (short course)
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8
Q

Brown or black spots that require derm referral if large.

A

Raised nevi

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9
Q

Clinical manifestations: fever for more than 5 days. Bilateral nonexudative conjunctivitis, inflammation of mucous membrane, cervical lymphadenopathy, rash over trunk and extremities. Rhinorrhea and diarrhea. Extremely irritable.

A

Kawasaki dz

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10
Q

Can result in complete hair loss that occurs in frontal or parietal region. Absent erythema, scaling, or lesions.

A

Alopecia areata

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11
Q

What age is Kawasaki dz most common?

A

Under age 5

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12
Q

What causes seborrhea (2)?

A
  1. Overproduction of sebum within sebaceous glands.

2. Malassezia furfur

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13
Q

What is the treatment for chronic urticaria?

A

H1 and H2 blockers

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14
Q

Polyarthralgias of the ankle and knee. Edema of hands, feet, scalp, and periorbital regions.

A

Henoch-Schonlein purpura

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15
Q

Erythema multiforme with brief prodrome, widespread cutaneous and mucous membrane involvement.

A

Stevens Johnson syndrome

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16
Q

Alopecia areata can be familial and usually lasts more than _____ years.

A

2

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17
Q

Acute or chronic inflammatory or hypersensitivity response to a substance that irritates the skin. Often a reaction to jewelry, snaps, cosmetics, medications, poison ivy, oak, and sumac.

A

Contact dermatitis

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18
Q

What is the management for Kawasaki dz (3)?

A
  1. Prevention of thrombosis and aneurysm via hospitalization.
  2. High doses of IV immunoglobulin and ASA for 2-3 months.
  3. Close follow-up to monitor potentially permanent CAD.
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19
Q

What is the treatment for dandruff or seborrhea (3)?

A

Selenium shampoos
Antifungal meds
Low-potency steroid creams

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20
Q

T/F Urticaria has strong ties to genetics, family hx of hives, and atopy.

A

True

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21
Q

Where is seborrhea often present, esp in adolescent boys and adult men?

A

Hair, neck and ears

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22
Q

T/F Never burn a poison ivy plant.

A

True

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23
Q

What are potential triggers of erythema multiforme (6)?

A
  1. Sulfonamides
  2. Anticonvulsants
  3. Barbiturates
  4. Infx
  5. Malignancies
  6. Immune disorders
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24
Q

A seasonal, possibly viral condition that is commonly seen in siblings and is most common in older children and adolescents.

A

Pityriasis rosea

25
Q

T/F Those with urticaria should wear a medical alert bracelet.

A

True. Risk of angioedema and anaphylaxis.

26
Q

Rash, red lips, red tongue, red eyes, red/swollen hands, red/swollen feet, high fever.

A

Kawasaki dz

27
Q

Alopecia areata is sometimes differentially diagnosed as _____.

A

Trichotillomania (impulse control disorder of hair pulling)

28
Q

An antigen and antibody response to a release of histamine. Can be in response to foods, drugs, insects, pollen, animal dander.

A

Urticaria

29
Q

Characterized by flaky thick crusts of yellow and greasy scales on the head of infants.

A

Seborrhea (cradle cap)

30
Q

What labs should be done in Henoch-Schonlein purpura?

A 
CBC (normal)
Bleeding time (normal)
UA (look for protein and heme)
Creatinine or stool analysis (could be positive for blood)
ASO titer (elevated)
IgA (elevated)
Throat culture (rule out strep)
31
Q

The petechial rash in Henoch-Schonlein purpura begins where?

A

Lower extremities

32
Q

Symptoms: small vesicles in center of lesion, urticaria, conjunctivitis.

A

Erythema multiforme minor.

33
Q

Patients with exposure to poison ivy should do what (2)?

A
  1. Wash resin off skin and scrub nails for 10-15 minutes.

2. Wash clothes in nonchlorinated bleach to remove resin.

34
Q

Henoch-Schonlein purpura is the result of _____ 75% of the time.

A

Strep infection

35
Q

Usually not present at birth but grow during first year, then disappear. Sometimes large and present at birth (Require immediate plastic surgery). Present beneath skin as well as above.

A

Hemangioma

36
Q

T/F Henoch-Schonlein purpura has a good long-term prognosis and is self-limited.

A

True

37
Q

Define acute and chronic urticaria.

A 
Acute = <6 weeks
Chronic = >6-8 weeks
38
Q

Henoch-Schonlein purpura has a maculopapular rash that changes to a purpuric rash on _____, _____, and _____.

A

Elbows
Ankles
Buttocks

39
Q

What is the treatment for alopecia areata?

A

Treatable by dermatologist or with steroid cream.

40
Q

What are the 2 major forms of erythema multiforme?

A
  1. Stevens Johnson syndrome (SJS)

2. Toxic epidermal necrolysis (TEN)

41
Q

If a hemangioma is near the eye, what is the referral?

A

Ophthalmologist

42
Q

What are some major concerns with Stevens Johnson syndrome and toxic epidermal necrolysis?

A

Fluid and electrolyte imbalances.

5-25% mortality rate.

43
Q

Most common type of soft tissue growth in infancy.

A

Hemangioma

44
Q

When is henoch-schonlein purpura most common?

A

Ages 2-7 following URI.

45
Q

Complications of Henoch-Schonlein purpura are usually mild in children under _____ but can cause nephritis and abdominal complications d/t hemorrhage and edema of small intestine.

A

2 years old

46
Q

What is the treatment for hemangioma?

A

Medication or surgery (depending on lesion)

47
Q

What is the treatment for cradle cap?

A

Can apply mineral oil, baby oil, or vaseline for 15 minutes before washing with gentle shampoo and soft brush.

48
Q

Characterized by erythema, vesicles, weeping. Sometimes mistaken for atopic dermatitis, candida, or bacterial infx.

A

Contact dermatitis

49
Q

Tan to light brown macules, oval or irregular, that can increase in number with age and are present in childhood.

A

Cafe-au-lait spots

50
Q

Acute, mucocutaneous hypersensitivity reaction that is self-limited in its minor form.

A

Erythema multiforme

51
Q

Called cradle cap in infants and dandruff in adults.

A

Seborrhea

52
Q

An IgA-mediated leukocytoclastic inflammatory reaction. Sometimes an antigen response to hemolytic strep, viruses, drugs, food, insects, chemical toxins.

A

Henoch-Schonlein purpura

53
Q

Erythema multiforme with sunburn-like erythema, necrosis, sloughing of skin.

A

Toxic epidermal necrolysis

54
Q

Henoch-Schonlein purpura is Ig_____ mediated.

A

IgA

55
Q

What is the treatment for pityriasis rosea (5)?

A

Usually disappears on its own within 6-8 weeks.

  1. Calamine
  2. Aveeno
  3. Topical antipruritics
  4. Sun
  5. Topical steroids
56
Q

Treatment for contact dermatitis (6).

A
  1. Avoid causative agents.
  2. Oatmeal baths and Burrow’s solution.
  3. Petrolatum or lanolin to restore moisture.
  4. Topical steroids (main form of treatment).
  5. Antihistamines for itching.
  6. Prednisone for severe poison ivy.
57
Q

What is the treatment for Henoch-Schonlein purpura (3)?

A
  1. Treatment not necessary for mild cases.
  2. Steroid therapy for GI or joint symptoms.
  3. ASA for arthritis.
58
Q

Vasculitis of the small vessels affecting the skin, GI tract, and kidneys.

A

Henoch-Schonlein purpura

59
Q

How do you diagnose urticaria?

A

Consult allergist

Simmons NURP 532 Exam 2 (25 decks)

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