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DCNP Flashcards

1
Q

A 19yo, 80kg has painful and severe nodulocystic acne with scarring. You start isotretinoin 40 mg BID. This patient should be observed for which potential adverse effect of isotretinoin therapy?

A

Fever and sternal pain

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2
Q

Counseling regarding possible side effects of neurotoxins. You know that eyelid ptosis can be due to injection or leakage into

A

Levator palpebrae superioris

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3
Q

Famciclovir for herpes zoster patient education

A

Take with food

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4
Q

Most common site for distant metastasis of melanoma

A

Lung

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5
Q

Antifungal for onychomycosis. PMH HTN takes metoprolol, simvastatin, baby aspirin. Appropriate dosing and duration of optimal therapy?

A

Intermittent dosing with fluconazole (off-label) 300 mg once weekly for about 3 to 6 months.

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6
Q

Halo (Sutton’s nevus) in a 14-year-old. Parent concern melanoma.

A

Halo nevi usually have an organized area of depigmentation around the periphery of the lesion compared to regressing melanoma which has a disorganized pattern of hypo- or depigmentation.

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7
Q

T/F. Patients with a history of more than five dysplasia nevi have a 50-fold greater risk of developing melanoma.

A

False (10-fold greater risk)

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8
Q

T/F. Superficial spreading melanoma is the most common type of melanoma with the highest incidence in 4th to 5th decade.

A

True

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9
Q

The most common type of skin cancer is:

A

Superficial basal cell skin cancer

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10
Q

What genetic mutation is closely implicated with melanoma?

A

CDKN2A

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11
Q

Drugs a/w SJS and TEN

A

Ace inhibitors
quinolones
aminopenicillins

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12
Q

Rash while on vacation, both hands. Area blistered and is healing slowly but dark areas remain?

A

Phytophotodermatitis

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13
Q

Infantile hemangioma expert referral:

A

5 mm lesion on the left breast

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14
Q

12 yo M reported h/o high fever, pharyngitis, malaise. Reddish-orange, sandpaper-like papillae eruption and a “strawberry tongue” and treat him with oral PCN x 10 days. Complete treatment important to:

A

Prevent rheumatic fever

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15
Q

21M rash x several yrs gets worse in summer. PCP selenium and ketoconazole, but returns. Don’t prescribe:

A

Oral ketoconazole

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16
Q

Tinea versicolor treatment

A

-PO fluconazole 300 mg once weekly for two weeks
-PO itraconazole 200 mg daily for 5-7 days

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17
Q

Most common cause of exfoliative erythroderma:

A

Idiopathic

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18
Q

Laser likely to be most effective for treating Poikiloderma of Civatte?

A

CO2 fractional laser (10,600 nm)

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19
Q

Xanthelasma

A

Order labs for fasting lipids

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20
Q

Type IV skin, depigmented and atrophic plaque on right gluteal region x several years. PMH asthma, atopic dermatitis. Likely cause:

A

Side effects from IM triamcinolone for severe asthmatic event.

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21
Q

6 M purpuric papules buttocks, knees, legs. Complaining of abdominal pain and leg pain. Intermittent fever, joint pain. What order next?

A

Order urinalysis with microscopy

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22
Q

45F Caucasian seeking treatment for persistent redness and small broken blood vessels on her face. Sx worsening with burning, stinging, dryness. Telangiectasia w/o papules/pustules. Recommend:

A

oral beta blocker

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23
Q

Most common site for metastasis of cutaneous SCC of the scalp is to:

A

parotid gland

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24
Q

Diffuse pitting of the fingernail plate a/w which disease?

A

atopic dermatitis

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25
Q

Counseling: 6 mon old before starting oral propranolol for an infantile hemangioma. Important education for prevention and early recognition of side effects

A

propranolol should be given w/ or after meals

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26
Q

33F mutation of STS gene, husband unaffected. Considering pregnancy, would like to know risk of passing on X-linked icthyosis to her son.

A

50% risk for an affected son

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27
Q

Most effective antiviral, decreasing risk of post-herpetic neuralgia:

A

valacyclovir 1 gm every 8 hrs for 7 days

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28
Q

Ehlers-Danlos syndrome (EDS) characteristics:

A

mitral valve prolapse
tissue fragility
hyperextensible joints

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29
Q

Nodular melanoma w/ Breslow thickness of 1.2 mm. Surgical margins with wide local excision?

A

1-2 cm

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30
Q

28F w/ morphea that is spreading. She has an unremarkable past medical history and only medication is VitD. Initial systemic therapy:

A

hydroxychloroquine

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31
Q

54F extremely pruritic vesicles and crusted excoriations on her trunk and extremities for the past 2 mons. Lesions clustered in rosettes (annular). Erosions in mouth. Histopath and DIF c/w linear IgA. 1st-line:

A

oral dapsone

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32
Q

Most common cutaneous eruption in pts w/ sarcoidosis?

A

erythema nodosum

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33
Q

Parents of a child w/ erythema infectiosum should include:

A

Females who are pregnant and exposed to the infection should be referred to their OB for monitoring.

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34
Q

DIF for suspected dermatitis herpetiformis, immunohistochemical reports:

A

granular deposition of IgA at the BMZ

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35
Q

Topical imiquimod for field cancerization, education includes:

A

-can cause severe inflammation and result in hypopigmentation
-can cause flu-like sx
-commonly causes pain, crusting, erythema

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36
Q

Treating field cancerization, in area w/ numerous Aks in a region, purpose:

A

minimizes the formation of multiple primary squamous cell skin cancers

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37
Q

Henoch-Schonlein Purpura (HSP)

A

arthritis, abdominal pain, rash

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38
Q

Pemphigoid gestationis, counseling:

A

risk this can recur w/ subsequent pregnancies, menses, or hormonal contraceptives

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39
Q

Dermatitis herpetiformis (DH), tx w/ oral dapsone and gluten avoidance. Which underlying condition would increase risk of methemoglobinemia?

A

glucose-6-phosphate dehydrogenase deficiency

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40
Q

High-risk SCC characteristics

A

-immunosuppression
-perineural, lymphatic or vascular involvement
-size >2 cm on any body location

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41
Q

Bites that need tx w/ oral abx

A

-cat bite on the hand
-dog bite on the foot
-cat bite after 24 hrs

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42
Q

Nodular BCCs usually occur on:

A

head and neck

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43
Q

Superficial BCCs are found primarily on:

A

torso

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44
Q

Nikolsky sign

A

press on skin adjacent to a blister, skin shears away easily

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45
Q

Skin conditions that increase r/o cellulitis

A

-tinea pedis
-atopic dermatitis
-venous stasis dermatitis

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46
Q

Azathioprine

A

genetically low levels of TPMT (thiopurine methyltransferase) are at increased r/o bone marrow suppression

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47
Q

% of pts w/ DLE go on to develop SLE

A

15

48
Q

Newborn infant w/ erythematous, polycyclic plaques, significant periorbital edema.

A

Check for s/s heart block or bradycardia. (Neonatal lupus erythematosus)

49
Q

Tinea cruris organism

A

Trychophyton rubrum

50
Q

Group A Streptococcus (GAS) complication if untreated:

A

glomerular nephritis

51
Q

Hereditary angioedema is caused by:

A

C1 esterase inhibitor deficiency or dysfunction

52
Q

MRSA infection treatment

A

-doxycycline 100 mg BID x 7 days
-mupirocin 2% top oint TID x 7-10 days
-dicloxacillin 250 mg QID x 7 days

53
Q

Notalgia paresthetica

A

intense focal itch on scapula; linear excoriations and patch of dark brown hyperpigmentation

54
Q

Most common (90%) sx of pts w/ SLE

A

Myalgia and arthralgia (90%)
insidious onset of fatigue
low grade fever
weight loss
hair thinning

55
Q

Mycophenolate mofetil

A

Enrollment in Risk Evaluation and Mitigation Strategies (REMS) program

56
Q

Glycopyrrolate, contraindicated in this condition:

A

pyloric stenosis

57
Q

Classic EDS, most important referral:

A

cardiology

58
Q

45M w/ recent patchy hair loss. W/o scale, erythema, or lymphadenopathy. Labs to order:

A

CBC, ferritin, TSH, ANA titer, RPR

59
Q

Organism, immunocompetent, erysipelas

A

Group A streptococcus

60
Q

Labs to order for chronic pruritus of unknown origin:

A

CBC w/ diff, CMP, TSH, stool/ova and parasites

61
Q

Follicular occlusion triad:

A

pilonidal cyst, HS, acne conglobata

62
Q

Absolute C/I for injection of botulinum toxin:

A

infection at site of injection

63
Q

Bullous pemphigoid drug associations:

A

loop diuretics, NSAIDs, spironolactone, phenothiazines, gliptins, biologics

64
Q

Avoid abobotulinumtoxin toxin A in patient w/ allergy to:

A

milk

65
Q

iPledge labs required:

A

LFTs, Lipid panel or TG, hcg

66
Q

DH disease flare, potential trigger:

A

NSAIDs

67
Q

Hydroxychloroquine

A

-baseline ophtho exam, then q5 yrs
-more frequent if >70 y/o

68
Q

Meds w/ r/f pseudotumor cerebri:

A

doxycycline, isotretinoin, COC

69
Q

Photosensitive drugs

A

doxycycline, minocycline, isotretinoin

70
Q

Common AE a/w neurotoxins:

A

pain, bruising, redness

71
Q

Sudden onset of hundreds of SKs

A

Review age appropriate health screenings and any positive ROS.

72
Q

Laser treatment that involves the dermis and collagen, usually safer for pts w/ dark skin?

A

Nd: YAG 1064 nm

73
Q

Herpes zoster, most commonly affects the ____ spinal region.

A

thoracic

74
Q

Meds to take w/ food, decreased absorption on an empty stomach:

A

-spironolactone
-griseofulvin
-isotretinoin

75
Q

Staphylococcus aureus, involved in:

A

furuncles, carbuncles, folliculitis

76
Q

Black widow spider bite treatment:

A

ice/elevation, tetanus ppx, antiemetics

77
Q

Not a candidate for tx w/ neurotoxin

A

conjunctivitis (active infection)

78
Q

Most difficult tattoo color to remove w/ laser

A

light green

79
Q

Erythrasma treatment:

A

clindamycin lotion

80
Q

Acquired palmoplantar keratoderma

A

Presents in an asymmetric distribution

81
Q

Non-purulent cellulitis tx:

A

dicloxacillin 500 mg QID

82
Q

Periorificial dermatitis

A

erythematous papules around mouth and eyes that sometimes burn. pmh AD, asthma

83
Q

Although rare, anal cancer is more likely to develop in pts who have a h/o:

A

condyloma acuminata

84
Q

Botulinum toxin, a protein derived form C. botulinum

A

inhibits the release of acethylcholine, which reduces the ability of muscles to contract

85
Q

Favre-racouchot disease increased risk:

A

smokers

86
Q

Ablative laser treatments

A

mostly involves the epidermis

87
Q

Ablative laser treatments

A

mostly involves the epidermis

88
Q

Absolute contraindication of TNF alpha inhibitors

A

chronic infections

89
Q

Leading cause of heart disease in children

A

Kawasaki disease

90
Q

MISC vs Kawasaki disease, differentiating lab

A

SARS-CoV-2 IgG

91
Q

FDA approved therapy for pemphigus vulgaris

A

Rituximab

92
Q

Eruption that starts on the infant’s face and then spreads to the trunk and extremities. Well-appearing. Diffusely scattered tiny papules and pustules on head, trunk and extremities.

A

erythema toxicum neonatorum and will resolve in a couple of weeks.

93
Q

Atopic dermatitis pathogenesis:

A

-increase in Th2, Th22, and Th17
-increase in IL-4, IL-10, IL-13
-environmental exposure to smoking can trigger

94
Q

Photosensitive skin reaction like to Hepatitis C and hemochromatosis:

A

Porphyria cutanea tarda

95
Q

First line therapy for patient w/ LPP:

A

Potent TCS

96
Q

Locally advanced BCC, unable to tolerate a surgical procedure, what options?

A

-radiation
-hedgehog pathway inhibitor
-PD1 inhibitor

97
Q

High-risk SCC, follow-up includes:

A

-exam of regional lymph node basins
-clinical exams q6 mons

98
Q

KA treatment options:

A

-commonly found to have features of SCC
-can spontaneously involute and resolve w/o therapy
-most are treated surgically

99
Q

Therapies that can decrease the risk of SCC:

A

-nicotinamide 500 mg BID
-daily sunscreen
-oral acitretin

100
Q

Immunosuppressant with decreased risk in organ transplant recipients (OTRs)?

A

sirolimus

101
Q

Field therapy least likely to result in scarring or abnormal pigmentation:

A

PDT w/ aminolevulinic acid

102
Q

Loss of _____in the bulge is postulated to contribute to permanent loss of hair in cicatricial alopecias.

A

hair follicle stem cells

103
Q

Acute paronychia w/o and abscess treatment options:

A

-warm soaks
-topical mupirocin
-oral dicloxacillin

104
Q

Field cancerization therapy tx w/ lowest recurrence at 1 year and lowest need for a second treatment?

A

topical 5-fluorouracil

105
Q

First-line therapy for lice in a 2 month old infant is:

A

permethrin 1% OTC

106
Q

Sudden onset of a rash, small red, non-follicular pustules that spread from neck to chest and axillae. Severe malaise and fever 103. Recent strep pharyngitis, rxd amoxicillin.

A

Acute generalized exanthematous pustulosis

107
Q

Mastocytosis diagnostic clue

A

Positive Darier’s sign

108
Q

Educating patients of 4 yo w/ mastocytosis include the avoidance of mast cell degranulation:

A

heat and friction

109
Q

Granuloma annulare facts:

A

-affects F>M
-may be a/w DM2 and thyroid dz
-histology: palisading granuloma and mucin deposition
-spontaneous resolution is expected in localized disease

110
Q

FDA approved tx for genital herpes simplex?

A

topical acyclovir 5%

111
Q

Topical dapsone 5% mixed with ____ may cause a temporary orange discoloration of the skin and facial hair.

A

BPO

112
Q

T/F gene expression profiling of melanoma predicts the risk of recurrence and metastasis.

A

True

113
Q

Melanoma tumor characteristics for staging:

A

Tumor: Breslow depth and presence of ulceration
Nodes: early nodal invasion
Metastasis: spread to distant organs or elevated LDH.

114
Q

Genetic mutation involved in ichthyosis vulgaris:

A

Steroid sulfatase (STS)

115
Q

Common side effects of dupilumab

A

-conjuctivitis
-URI
-HSV

116
Q
A

Dcnp (5 decks)

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