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Specialty Medicine > Atopy > Flashcards

Atopy Flashcards

1
Q

What is healing by delayed primary intent?

A

Contaminated or devitalized tissue demarcates by 4 days

clean wound and repair

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2
Q

What type of healing is done with wounds that have dehisced?

A

Secondary–surgical wounds

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3
Q

What is the care for partial thickness wounds?

A

No closure, skin care only–will reepithelialize fine

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4
Q

What is the major difference in the healing process between primary and secondary intent?

A

Primary has a much smaller plug than secondary

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5
Q

How long is the inflammatory stage of wound healing?

A

6 days ish

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6
Q

What are the three major stages of wound healing?

A

Inflammatory
Granulation/proliferation
Remodeling/maturation

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7
Q

When does a wound reach its final strength?

A

12 weeks out

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8
Q

Should you use abx with wounds? Why or why not?

A

No–just breeds resistance

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9
Q

Why is smoking bad for wound healing?

A

Vasoconstriction

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10
Q

Atopic dermatitis usually develops by what age, and resolves by what age?

A

Develops by 5 years, and resolves by adolescence

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11
Q

What is the primary symptom of atopic dermatitis?

A

itch that rashes

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12
Q

What are the skin findings with AD?

A

Erythematous papules, which then coalesce to form erythematous plaque that may weep

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13
Q

Where is the rash commonly found with AD in infants and toddlers?

A

cheeks, forehead, and extensor surfaces

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14
Q

Where is the rash commonly found with AD in older children and adolescents?

A

Lichenified rash in flexural areas of the neck, elbows, wrists, and ankles

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15
Q

What does lichenified mean?

A

Plaque formation in reponse to chronic scratching

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16
Q

Where is the rash commonly found with AD in adults?

A

Lichenified rash in flexural regions and in feet / face

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17
Q

What is the common characteristics of AD rash in all ages?

A

Xerosis

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18
Q

What percentage of children with atopic dermatitis also have or will develop asthma or allergic rhinitis?

A

50-80%

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19
Q

What is the atopic triad?

A

Asthma
Atopic dermatitis
Allergic rhinitis

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20
Q

What is samter’s triad?

A

Aspirin Exacerbated Respiratory Disease (AERD), also known as Samter’s Triad or Aspirin Sensitive Asthma, is a chronic medical condition that consists of asthma, recurrent sinus disease with nasal polyps, and a sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).

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21
Q

What are the factors that are thought to play a role in the development of atopic dermatitis? (4)

A
  • Genetics
  • Skin barrier dysfunction
  • Impaired immune response
  • Environment
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22
Q

What is the treatment for atopy?

A

Gentle cleansing,. pat dry, and emollients

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23
Q

What should be used for anti-inflammation with itching?

A

Mild steroid

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24
Q

What should be used as an antipruritic for atopy?

A

Antihistamine

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25
Q

What type of moisturizer should be used for itchy skin?

A

greasy without smells

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26
Q

What abx should be used for itchy skin?

A

Anti staph

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27
Q

What is the medium that should be used for mild steroids on the face?

A

hydrocortisone ointment

28
Q

What is filaggrin? What is its function, and role in atopy?

A
  • protein found in the stratum granulosum cell layer of the epidermis
  • Retains water within keratinocytes
  • Mutations cause AD
29
Q

What is harlequin baby?

A

a severe genetic disorder that mainly affects the skin. Infants with this condition are born with very hard, thick skin covering most of their bodies. The skin forms large, diamond-shaped plates that are separated by deep cracks (fissures)

lethal

30
Q

What is pityriasis alba?

A

Variant of atopic dermatitis that causes irregular, white patches

31
Q

What are the characteristics of pityriasis in the summer and winter?

A 
Summer = hypopigmentation
Winter = dry/scaly
32
Q

How do you differentiate pityriasis alba from fungi?

A

Woods lamp - and mycology -

33
Q

What is the treatment for pityriasis alba?

A

Emollients and mild steroid ointment

34
Q

What type of hypersensitivity reaction is allergic contact dermatitis?

A

Tpye IV

35
Q

What is the treatment for allergic contact dermatitis?

A

Topical steroids, oral antihistamine

36
Q

How long does it take for s/sx to appear with contact dermatitis?

A

12-48 hrs

37
Q

What is urticaria? What layer of the skin is affected?

A

a vascular reaction of the skin, characterized by wheals surrounded by a red halo or flare

Swelling of the uppe dermis

38
Q

what is the cardinal symptom of urticaria?

A

Pruritis

39
Q

Wheal and flare = ?

A

Urticaria

40
Q

What, generally, is angioedema?

A

deep dermis and SQ swelling

41
Q

What are the s/sx of angioedema?

A
  • Face edema

- Painful or burning, but NOT pruritic

42
Q

what is the appearance of angioedema?

A

Like water filled skin

43
Q

How fast does urticaria present?

A

Within minutes, and disappear within hours

44
Q

What is the difference between acute and chronic urticaria

A
  • Acute = less than 6 weeks

- chronic = more than 6 weeks

45
Q

Do urticaria blanch?

A

Yes

46
Q

True or false: most urticaria is acute, and will resolve

A

true

47
Q

True or false: many patients with chronic urticaria have physical factors that contribute

A

True

48
Q

What is dermatographism?

A

fast development of urticaria following scratching

49
Q

What is the major effector cell in urticaria?

A

Mast cell

50
Q

What is immunologic urticaria?

A

Antigen binds to IgE on the mast cell surface, crosslinking it, and releasing histamine

51
Q

What is the pathogenesis of non-immunologic urticaria?

A

Drugs directly cause histamine release, no IgE crosslinking needed

52
Q

What are the three major forms of non-immunologic urticaria?

A
  • Dermographism
  • Samter’s triad
  • Morphine
53
Q

Morphine is a direct histamine releaser. How do you differentiate between histamine release d/t morphine, and an actual allergic reaction?

A

If distal to site of injection, then probably allergic rxn

54
Q

Does contact dermatitis have a wheal and flare rxn?

A

No–very superficial

55
Q

What is the role of allergy testing with chronic urticaria?

A

High false positive rate, and not that useful

56
Q

true or false: chronic urticaria is a continuous and lifelong disorder

A

False–episodic and limited

57
Q

What is the rate of spontaneous remission with chronic urticar at one year?

A

30-50%

58
Q

What is the treatment for chronic urticaria?

A

Oral antihistamines

59
Q

What is the inheritance pattern of C1 inhibitor deficiency?

A

AD

60
Q

What are the s/sx of angioedema?

A

Swelling of the hands, feet, and GI tract

61
Q

What is the treatment for angioedema?

A

FFP +

62
Q

True or false: angioedema is unresponsive to usual anaphylaxis treatment

A

True

63
Q

What is the type of swelling that is had with angioedema

A

Non pitting

64
Q

What antiepileptic drug is known for SJS?

A

Lamotrigine

65
Q

What are the s/sx of TEN/SJS?

A

bullous rash with sloughing off of the skin. Respiratory compromise from sloughing off of skin

66
Q

What is the treatment for TEN/SJS?

A

Admit to burn unit, and stop meds

Specialty Medicine (36 decks)

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