Derm Flashcards
(235 cards)
1
Q
What are the four types of tissue?
A
Muscle
Nervous
Epithelial
Connective
2
Q
What type of tissue generates physical force to make the body structure move and is arranged in bundles
A
Muscle tissue
3
Q
What tissue has the poorest capacity for renewal and initiates/transmits nerve impulses that coordinate body activities and maintain homeostasis
A
Nervous tissue
4
Q
What tissue has the best capacity for renewal
A
Epithelial
5
Q
What tissue covers body surface, lines body cavities, hollow organs and ducts and forms glands
A
Epithelial tissue
6
Q
What tissue protects and supports the body and its organs as well as provides immunity
A
Connective tissue
7
Q
What provides contact or adhesion between neighboring cells or between a cell and extracellular matrix. They also maintain paracellular barrier of epithelia and control transport of materials or signals between cells (paracellular transport)
A
Cell junctions
8
Q
What forms a barrier against water and antigens passing between individual epithelial cells
A
Tight junctions
9
Q
What are cell-cell adhesions continuously assembled and disassembled so cells can respond changes in their micro environment
A
Adherens junction
10
Q
What forms stable adhesive junctions between cells
A
Desmosomes
11
Q
What allows various molecules and electrical signals to pass freely between cells
A
Gap junctions
12
Q
What facilitates the stable adhesion of basal epithelial cells to the underlying basement membrane
A
Hemidesmosomes
13
Q
What are the two categories of epithelial tissue
A
Covering and lining epithelium
Glandular epithelium
14
Q
What is the most superficial layer of cells in epithelial tissue anatomy
A
Apical layer
15
Q
What is the deepest layer of cells in epithelial tissue anatomy
A
Basal layer
16
Q
What layer helps bind and support the epithelium and is located between the epithelium and underlying connective tissue layer
A
Basement membrane
17
Q
What are two ways to classify epithelial tissue
A
Morphology - based on shape
Stratification - number of layers
18
Q
What are thin, flat shaped to allow rapid passage of substances through them and can be keratinized or non-keratinized, “wet” or “dry” depending on their location in the body
A
Squamous epithelium
19
Q
What type of epithelium frequently has microvilli at apical surface
A
Cuboidal epithelium
20
Q
Where is cuboid epithelium found
A
Found in areas such as salivary glands and thyroid follicles
21
Q
What type of epithelium protect underlying tissues and the apical surfaces may have cilia or microvilli
A
Columnar epithelium
22
Q
What type of epithelium is useful for organs such as the urinary bladder when it is stretching to a larger size
A
Transitional epithelium
23
Q
What is a single layer of cells that functions in a diffusion, osmosis, filtration, secretion and absorption
A
Simple epithelium
24
Q
What is a simple epithelium that appears be stratified because the cell nuclei lie at different levels and not all cells reach the apical surface
A
Pseudostratified epithelium - single layer
- one specialized type of pseudo stratified cell are goblet cells, which secrete mucus and are an integral part of mucous membranes
25
Cells that do extend to the apical surface may contain what
Cilia
26
In mammals, what helps remove contaminates or move move particles by movin fluids over the cell layers. For example, the lining of the nasopharyngeal and Trachea are covered in it to remove mucus, bacteria and other debris from the lungs as well as the Fallopian tubes
Cilia
27
What increases the surface area of a cell by multiplying the area from 2 dimensions to 3 dimensions
Microvilli
28
What is a highly-insoluble fibrous protein with water proofing qualities and high friction resistance
Keratin
29
What are epithelial cells infused with keratin in the stratum basale of the epidermis called
Keratinocytes
30
Where is non-keratinized stratified epithelium found at
Found on wet/inferior surfaces exposed to considerable wear and tear such as the lining of the mouth, tongue, pharynx, esophagus and vagina
31
What type of tissue is bone, blood, lymph and cartilage
Connective
32
What are the three components of connective tissue
Resident cells -grapes in jello
Extracellular matrix (ECM) - jello
Protein fibers
33
What is the most common cells in connective tissue and is a major component of the reparative capacity of the tissue
Fibroblasts
34
What are fat cells specialized for cytoplasmic storage of lipid as neutral fats or less commonly for production of heat
Adipocytes
35
What is a component of loose connective tissue often located near small blood vessels in the skin and its function is localized release of compounds important to inflammatory response, innate immunity and tissue repair
Mast cells
36
What is the most abundant connective fiber that is very strong and resistant to shear forces
Collagen fibers
37
What are the connective tissue fibers
Collagen
Elastic
Reticular
38
What connective fiber provides strength and support in the walls of the small blood vessels. Stroma supporting framework of many soft organs; most notably the immune system, liver, endocrine glands, spleen and lymph nodes
Reticular fibers
39
What lines the entire GI, respiratory, reproductive and much of the urinary system
Mucous membranes
40
What is the general function of mucous membranes
Prevent cavities from drying out
41
What membrane lines a body cacvity that doesn’t open directly to exterior and covers organs that lie within the cavity
Serous membrane
42
What type of membrane lines the joints and secretes fluid to reduce friction, lubricate and nourish cartilage and removes microbes/debris from the joint cavity
Synovial joints
43
What is the surface layer of the skin that is not alive and comprised of epithelial tissue
Epidermis
44
What lies inferior to the epidermis and comprised of connective tissue. (Is alive)
Dermis
45
What is the top layer of the epidermis where cells consist mostly of keratin and where cells are shed and replaced from below
Stratum corneum
46
What layer of the epidermis is found only on the palms and soles of the hands and feet
Stratum lucidum
47
What layer of the epidermis loses cell organelles and nuclei as well as infusion of waterproofing lipids
Stratum granulosum
48
What layer of the epidermis is where cells begin to look flattened
Stratum spinosum
49
What is the bottom layer of the epidermis which is the stem cell layer and new cells arise here
Stratum basale
50
What layer of the skin contains the terminal ending of capillaries, lymph vessels and sensory neurons
Dermis
51
What is within the reticular region of the dermis
Roots do the hair
Sebasceous glands
Sweat glands
Receptors
Nails
Blood vessels
52
What is specialized cells of the epidermis and hair follicle and its primary function is to synthesis and transfer melanin to adjacent keratinocytes
Melanocytes
53
What cells touch and pressure are sensed by four types of mechanoreceptors in the skin and are expanded dendritic endings in epidermis of glabrous skin that responds to sustained pressure and touch
Merkel cells
54
What cells are typically found within the stratum spinosum. These monocyte-derived cells represent a large part of the skins adaptive immunity
Dendritic cells
55
What glands release secretions directly into the bloodstream
Endocrine glands
56
What gland releases secretions onto a epithelial surface via a duct
Exocrine glands - major role in derm
57
What is an exocrine gland in the skin that opens into a hair follicle and secretes an oily/waxy sebum
Sebaceous glands - sebum lubricates the hair in humans and mammals
58
What gland covers nearly the entire body surface and is especially dense on the palms, soles, forehead and upper limbs. It also empty’s directly onto the skins surface but not from the hair follicles
Sudoiferous - Eccrine glands
59
What gland is largely confined to the axillae, perineum and the concentrated hairy areas. it is attached to the hair follicle and empties onto the skin via the follicle opening
Apocrine glands
60
Which gland becomes active at puberty and have a hormonal pattern
Apocrine glands
61
What is the whitish crescent at base of nail plate
Lunula
62
What is the function of the nails
Protects the distal phalanges and surrounding soft tissue from injuries. It also enhances precise and delicate finger movements by exerting counter pressure on the puls of the fingers when grasping and manipulating objects
63
What color will the skin turn with a lack of oxygen
Blue
64
What color will the skin turn due to a buildup of bilirubin
Jaundice/ yellow
65
What color will the skin turn due to an engorgement of capillaries in the dermis with blood
Red
66
What color will the skin turn if someone is in shock or has anemia
Pale
67
What are the three main pigments that influence skin pigmentation
Melanin
Carotene
Hemoglobin
68
What is the primary determinant of skin color, hair color and eye color
Melanin
69
True or false, melanocyte numbers are the same in everyone
True - melanin is different in everyone
70
What will cause carotenemia
Excessive intake of lipid-soluble compounds in red, orange, yellow and green vegetables and fruit
71
What stimulates melanin production
UV light
72
What is a genetic condition characterized by little or no melanin pigment in the eyes, skin or hair
Albinism
73
What is an acquired depigmentation of the skin characterized by a loss of melanocytes
Vitiligo - autoimmune disease
74
What is the function of melanin
Protects against damaging effects of UV light
75
What are the functions of the skin
Temperature regulation
Protection
Sensation
Excrete and absorb
76
What activates the absorption of vitamin D
Exposure to UV radiation
- vitamin D is concerted to Calcitriol which aides in the absorption of calcium and phosphorus
77
What are the five signs of inflammation
Localized hyperthermia
Erythema
Localized edema
Pain
Loss of function
78
What is the inevitable physiological changes of the sin that occur with time and are influenced by genetic and hormonal factors
Intrinsic aging
79
What is the preventable structural and functional changes of the skin that occur with exposure
Extrinsic
80
What are some extrinsic factors that influence aging
Environmental
Lifestyle - tobacco, ETOH, illicit drugs
Social
Extensive cosmetic surgery
81
What is the most preventable extrinsic aging cause
UV radiation exposure
82
What happens during the epidermal aging
Decreased wound renewal capacity
Overall thinning of the epidermis
Decreased melanocytes - increased risk of skin cancer
Reduced responsiveness of langerhans cells - weakened cutaneous immunity
83
What happens during dermal aging
Reduced collagen fiber
Reduced elastin fibers
Decreased skin hydration and characteristic elderly xerosis
84
What are the two processes of tissue repair
Regeneration and replacement
85
What happens with regeneration tissue repair
Damaged tissue is completely restored to its pre-injury/normal state via new growth.
- Regeneration can happen continuously
86
What happens during the replacement phase
Severely damaged or non-regenerable tissues s repaired by the laying down connective tissue, resulting in SCARRING
87
When does the inflammation phase occur and what occurs
1-3 days post injury
- secretes mainly to clear bacteria and debris demotion he wound and prepares wound and environment for repair
88
When does the proliferation phase occur and what is its purpose
2-10 days post injury
- purpose is to construct granulation tissue to fill the defect caused by the wound
89
When does the healing phase occur and what happens in this phase
2- 3 weeks post injury
- early remodel phase
90
When does the healing- late remodel stage occur
Months to > 1 year
91
What is an example of healing by primary intention
Relies on the dermal edges that are close together and easily approximated
- sutures, staples and dermal adhesive
92
What is healing by secondary intention
Natural healing
- relies on formation of granulation tissue to fill the space between the wound opening or edges
93
What is an exaggerated IgE-mediated immune response triggering a histamine response
Atopy
94
What are the components of a skin, hair and nail exam
Inspection
Palpation
95
What are the only essential tools needed for an examination of the skin
The IDC’s eyes and hands
96
What is a quasi-objective metric amount of melanin pigment in the skin rated as I-VI on the scale
Fitzpatrick scale
97
What is the size of skin lesions measured in
Always in mm or cm
98
What is a ring shaped lesion with central clearing called
Annular
99
What is an arc-shaped lesion often a result of incomplete formation of an annular lesion
Arcuate
100
What is elevated, circumscribed, superficial fluid-filled and less than 1cm
Vesicle
101
What is a vesicle greater than 1cm called
Bulla
102
What is an overgrowth of scar tissue that remains confined to the site of initial injury and may be raised or flat
Hypertrophic scar
103
What is an irregular shaped, elevated scar that grows beyond the boundaries of the initial injury or wound
Keloid
104
What is the difference between a callus and wart
Dermatoglyphics are preserved over the surface in calluses and not in warts. Warts will also have thrombosed vessels that appear as black dots
105
What is a bacterial infection around the nail
Paronychia
106
What is the most common infectious etiology of folliculitis
S. Aureus (+/- MRSA)
HOT TUBS - pseudomonas
107
What are the risk factors of folliculitis
Hair removal
Scratching a lot
Occlusive dressing or clothing
Diabetes
Immunosuppressive
Chronic antibiotic use
Tattoo recipient
Poor hygiene
108
What is the clinical hallmark of folliculitis
Hair emanating from the center of the pustule
109
What is the general treatment and prevention for folliculitis
Antiseptic and supportive care
Good hygiene
Wash hands frequently
Wash linens in hot water
Good hair removal practices
Use of witch hazel,ETOH or tend skin
110
What ointment can be used as a therapeutic intervention of folliculitis
Mupirocin ointment TID for 10 days
Also:
Cephalexin 250-500mg
Dicoloxacin
111
What medications can be prescribed for MRSA infections
Bactrim
Clindamycin
doxycycline
112
For pseudomonas folliculitis what medication will be prescribed
Cirpofloxacin
High potent corticosteroid
Antihistamine to control the itching
113
What is the instruction for pseudo folliculitis Barbae
Bupersinst 1000.22C
114
What is a complication of PFB
Scarring and hyperpigmentation
115
How long can a grooming standards waiver be granted for with PFB
60 days
116
What is the most reliable approach for allowing return of grooming standards for PFB
Laser hair reduction
117
When can treatment be counted as successful in someone with PFB
When symptoms improved enough to allow for comfortable shaving
118
What is a contagious, superficial, intraepidermal infection occurring prominently on exposed areas of the face and extremities
Impetigo
119
What is the most common cause of impetigo
S. Aureus
120
What can result from neglected impetigo
Ecthymia - a deeper, ulcerated impetigo infection with lymphadentitis
121
What are the two types of impetigo and how do they present
Bullous - crusting with a brown appearance
Non-bullous - most common, crusting with a golden/honeycomb appearance
122
What are the risk factors of impetigo
Warm,humid environment
Tropical climate
Poor hygiene,poverty, crowding, wartime
Contact sports
Daycare
123
What is the treatment for impetigo
Avoid infection spread
Mupirocin ointment - helps prevent spread
Remove crusts with gentle washing 2-3x daily and clean with antibacterial soap, chlorhexidine, or betadine
124
If the impetigo is MRSA related what is the treatment
Clindamycin
Tetracycline
Trimethoprim-sulfamethoxazole (Bactrim)
Oral for 7 days
125
What is the cause of cellulitis
Streptococci
Staphylococcus aureus
126
What is the most common cause of lower leg cellulitis
Toe web intertrigo with figuring interdigital tinea pedis
127
If someone presents with previous trauma as the portal of entry and pain/itching/burning with fever chills and malaise. there may also be regional lymphadenopathy
Cellulitis
128
What is the treatment for cellulitis
(Decrease swelling and antibiotics)
Demarcate the area with sharpie
Tetanus if needed
Antibiotics
- NonMRSA = cephalexin
- purulent cellulitis(suspect MRSA) = Clindamycin, trimethoprim-sulfamethoxazole or doxy
- animal bites = amoxicillin and augmentin
129
What is the DDX of cellulitis
Necrotizing fasciitis or DVT
130
How does necrotizing fasciitis present
Most frequently occur in extremities
Initially pain, erythema, edema, cellulitis and high fever
Pain is out of proportion, severe and relentless
131
What is the definitive treatment for necrotizing fasciitis
Prompt and wide surgical debridement is the cornerstone of treatment
132
What is the treatment YOU will do for necrotizing fasciitis
Broad spectrum antibiotics -main adjunctive of treatment
133
What is a well circumscribed, painful, suppurative inflammatory nodule at any site that contains hair follicles
Furuncle
134
What is a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicle
Carbuncle
135
Where does a carbuncle most commonly occur at on the body
Back of neck
Upper back
Lateral thighs
136
What is the mainstay of treatment for a carbuncle, furuncle or an abscess
Incision and drainage
137
Systemic antibiotics are needed for extensive cases of carbuncle, furuncle and abscess. what antibiotics are prescribed for MSSA
Dicloxacillian
Cephalexin
Amoxicillin and clavulanate (augmentin)
138
What is the most common benign cutaneous cysts that can occur anywhere on the body
Epidermal cyst
139
How does a stable epidermal cyst present
Firm or fluctuant flesh-to-yellow color solitary nodule 0.5 to 5cm in size and grows slowly overtime commonly on the face, neck, upper back, chest or if due to trauma on the buttocks, palms, or plantar side of feet
140
How do inflamed epidermal cysts appear
Warm, red and boggy with tenderness to palpation. They present very similar to an abscess
141
What is the treatment for epidermal cysts
Asymptomatic - do not require treatment
Remove if;
Inflamed/ruptured
Produces functional deficit
Cosmetic (derm or gen surg does this)
Infected, ruptured or inflamed epidermal cysts are treated like abscess with an extra step
142
What must be removed from the cyst in order to prevent further infection
Remove the capsule
143
What is the complications of epidermal cysts
Recurrence
May rupture creating an acute inflammatory nodule very similar to an abscess
144
What is the most common benign mesenchymal neoplasm in adults and is comprised of mature white adipocytes. They commonly occur on the neck, trunk and extremities and are rarely symptomatic
Lipomas
145
What is the treatment for a lipoma
Treatment is usually not required but may be excised by derm for cosmetic reasons, pain or impedance of duties
146
What is an acute inflammatory process with or without abscess formation that involves the proximal and lateral folds of the nails and has been present for less than 6 weeks. Contributing factors of this include nail biting, thumb sucking, and picking at hang nails
Paronychia
147
What is the most common causative agent of a Paronychia
Staph aureus
148
What develops along the nail margins and pus accumulates behind the cuticle sometimes spreading to the nail folds
Paronychia
149
What is the treatment for a Paronychia
Warm compress/soaks
Antibiotics if warranted
Bactrim/Septra DS if MRSA involved
Visible pus should be drained using scalpel blade inserted between the nail and nail fold
YOU ARE NOT MAKING A SKIN INCISION, YOURE SEPARATING THE NAIL FOLD
150
A patient presents with a painful and swollen digital pulp space following a splinter injury. The patient reports severe pain, tenderness and a tense swelling of the distal digit with erythema. What is this?
Felon
151
What is the treatment for a felon
Prompt incision and drainage with division of the fibrous septa to ensure adequate draining - this is performed by derm
IDC should TREAT WITH ANTIBIOTICS - dicloxacillin or keflex if non-MRSA
- manage the pain with NSAIDs/narcotics may be required
152
What is the complications of a felon
Osteitis and osteomyelitis
- bone infection
153
What are fungal infections caused by
Candida yeast
154
Where does yeast grow best
Warm, moist environments so infection is often confined to mucous membranes
155
A patient reports with a rash that is red, denuded, glistening surface with cigarette paper like scaling and advancing border near the groin and digital web-spaces. What might be the diagnosis
Candidiasis
156
What is the treatment for candidiasis
Keep affected skin dry and exposed to air
Topical azole class antifungal
For vaginal candidiasis, sexual contact should be avoided until infection resolves and give clotrimazole
157
What is lab diagnosis based on for candidiasis
Identification of yeast and PSEUDOHYPAE in potassium hydroxide wet mounts of scrapings from a lesion
158
What is infection of crural folds and gluteal cleft
Tinea cruris - jock itch
159
What is infection involving the face, trunk and or extremities often presenting with ring like lesions
Tinea corporis
160
What is an infection of the scalp and hair and affected areas of the scalp can show characteristic black dots resulting from broken hairs
Tinea capitis
161
What is the treatment for ring worm( tinea corporis)
Antifungal cream
- clotrimazole, miconazole, terbinfine for a minimum of two weeks and continue for at least one week after resolution of the infection
162
What are bilateral lesions around the perineum and appear to be half moon shaped plaques with advancing boarders, and fine scaling. It does not involve the scrotum or the penis (unlike yeast infections)
Tinea cruris
163
What is the treatment for jock itch
Topical antifungal
Absorbent powders to help control the moisture
164
Patient reports with itching, burning and stinging of the interdigital web spaces as well as the plantar surface. Woods lamp does not fluorescence. What is the likely diagnosis
Tinea pedis (athletes foot)
165
What is the treatment for tinea pedis
Open toe sandals
Wear shoes in the shower
Dry between the toes
Antifungal powders
Cotton socks
Powder to absorb excess moisture
Topical clotrimazole, miconazole, or terb
166
A patient presents with a velvet tan, not raised patches of skin on the central upper back, chest, and proximal arms. Patient denies any itching, burning or pain with patching however notices they appear when exposed to excess heat or humidity.
KOH- Positive
Woods - Hypo-pigmented areas. Shows faint yellow-green fluorescence
Tinea versicolor
167
What is the organism that causes tinea versicolor
Pityrosporum orbiculare - part of skins normal flora
168
What is the treatment for tinea versicolor
Topical treatment
Selenium sulfide
Ketoconazole
- oral treatment is used for patients with extensive disease and do not respond to the topical treatment. Oral ketoconazole or fluconazole will be used. Terb is not effective for this condition
169
Patient presents with discoloration of the nail and he is in his 60’s. Splitting of the nail plate as well as nail plate destruction is noted at exam. What might be the diagnosis
Onychomycosis
170
What is the treatment for onychomycosis
Confirmation of infection is required due to potential for liver toxicity of treatment with oral antifungals
- confirm with a postive KOH prep and fungal culture
ORAL ANTIFUNGAL IS CONSIDERED THE GOLD STANDARD OF TREATMENT
171
A patient presents with intense itching of the wrists, sides of hands and feet and is losing sleep due to the itching being worse at night and now her partner is also experiencing similar symptoms. Upon inspection you notice some eczema present on the hands. What might be the cause
Scabies (sarcoptes scabiei)
172
What test shows scabies burrow darker than the surrounding skin when performed
Ink test, because ink accumulates in the burrow after being wiped away
173
What is the treatment for scabies
Kill scabies mites and remove infestation
Controlling the dermatitis and pruritus
- permethrin 5% or lindane 1% applied to the entire body
All clothes and bedding must be washed in HOT water or wrapped in plastic bags and set aside for 14 days
174
What is the treatment for pediculus humans capitis (head lice)
Permethrin rinse (nix) 1%, permethrin 5% (elimite) or lindane
Treat sexual contacts and family members
Last resort - shave head.
Removing the nits is essential
175
What is a home remedy for head lice
Vaseline to scalp overnight and covered with ashower cap to smother the lice
Hair clean 1-2-3 hairspray is an oil that kills lice in 15 minutes
176
A patient presents with malaise, mild fever and a sore throat. Upon examination you note that there is a herald patch on the trunk and there is a Christmas tree pattern on the back. The patient explains there is some mild itching but for the most part it is only the sore throat and fever they notice. What is the likely diagnosis
Pityriasis rosea
177
What is the treatment for rosea
No treatment or symptomatic treatment is all that is required
- antihistamines for the itching
-topical corticosteroids commonly used but logistically drains the Amal
178
What type of HSV is transmitted via mucous membranes and open or abraded skin by kissing or sharing utensils
HSV 1
179
What type of HSV is from oral-genital contact
Hsv 2
180
A patient reports with peri oral tingling, itching, numbness and pain. They state this has happened before and they notice it gets worse when in the sun, they’re stressed out, illness, fatigue, dental work, or menstruation occurs. What might be the diagnosis
Herpes labialis / herpes simplex
181
What is the treatment for HSV 1
Patient education- avoid kissing during episodes
Analgesics and hydration
Antivirals not required due to self limiting nature
182
When would antivirals be prescribed for HSV 1
Frequent outbreaks
Moderate to severe cases
- antivirals reduce duration but do not cure the infection (lifelong latency)
—acyclovir
183
What is diffuse pox-like eruptions complicating atopic dermatitis, sudden appearance of lesions in typical atopic areas such as the upper trunk, neck and head, high fever, localized edema and adenopathy
Eczema herpeticum
- not small pox because small pox has been eradicated
184
What is localized infection of affected finger with intense itching and pain followed by vessicles that may coalesce with swelling and erythema. It mimics progenitor Paronychia
Herpetic whitlow
185
65 y/male presents with a rash that has a deep burning, throbbing, or stabbing sensation. You notice the rash is unilateral and in your history the patient reports a history of chicken pox as a child
Herpes zoster (shingles)
186
What is the treatment for herpes zoster
Goal is to limit extent/duration/severity of pain and rash and prevent disease elsewhere
<72 hour = antiviral therapy - Valcyclovir/ acyclovir
> 72 hours = antivirals if new lesions are appearing. Give NSAIDs and acetaminophen, possibly in conjunction with opioid analgesics
187
What is occurrence of pain for months or years in the same dermatomal distribution that was affected by the herpes zoster
Postherpetic neuralgia (PHN)
188
What type of herpes zoster affects the trigeminal nerve and presents with malaise, fever, headache and perioribtal itching or burning
Herpes zoster opthalmicus
189
What is hutchinsons sign
Vesicles on the tip/side of the nose
190
What virus causes warts
Human papilloma virus
191
What type of warts is found on the hands, periungual skin, elbows, knees, plantar surfaces
Verrucae vulgaris (common wart)
192
What type of wart is slight elevated or flat top and occurs on the forehead, back of hands, chin, neck and legs
Flat(plane) warts
193
What type of warts occur on the points of maximal pressure such as over the heads of the metatarsal bones
Plantar warts
- a cluster is called mosaic wart
194
What is the treatment for warts
Patient education
Salicylic acid (compound W)
Cryotherapy
Duct tape
195
What type of contact dermatitis is caused by chemical agents, alcohol, powders, moisture, friction and extreme temperatures
Irritant dermatitis
196
A patient presents with erythema, dryness,painful cracking and tenderness/burning of the dorsal side of the hands. He states he was at work when the tenderness and burning started. What might be causing his pain
Irritant dermatitis
197
What is the treatment for irritant dermatitis
Early diagnosis and treatment
Topical steroid ointment
Antihistamine
FREQUENT APPLICATION OF BLAND EMOLLIENT TO EFFECTED SKIN IS ESSENTIAL
198
If a patient comes in contact with poison oak and their hands are itchy and swelling. What is this called
Allergic contact dermatitis
199
What is the treatment for allergic contact dermatitis
Remove the agent
Apply wet dressing with burrows solution
Educate on potential source of exposure
200
What is red, greasy, scaling rash that consists of patches and plaques with in distinct margins on the scalp, eyebrows or eyelid margins
Seborrheic dermatitis (dandruff)
201
What is the treatment for seborrheic dermatitis
Shampoos containing:
Zinc pyrithione
Selenium sulfide
Ketoconazole
Salicylic acid
Coal tar
202
What is a chronic inflammatory disorder that is characterized by cutaneous eruthematous plaques with silvery scale and is found on the extensor surfaces of extremities, especially the knees, umbilicus, lower back, inter gluteal cleft and nails.
Psoriasis
203
What sign is associated with psoriasis which is pinpoint bleeding with the removal of the scale
Auspitz sign
204
What is the treatment for psoriasis
Topical retinoids- medium potency corticosteroid daily
Systemic therapy
Phototherapy
205
What are some factors that influence acne
Oily cosmetics
Rubbing skin surface
Numerous drugs
Endocrine disorders such as PCOS
Stress
High dairy diet
Smoking makes worse
206
What is the treatment for acne
Topical retinoid / topical antimicrobial or topical antimicrobial / topical antibiotic
MODERATE:
Topical retinoid / ORAL antibiotic / topical benzoperoxide
SEVERE:
Oral isotretinoin mono therapy - derm only
207
What is the causative agent of acne
C. Acnes
208
Patient presents with a tender, swollen,fluctuant nodule along the superior gluteal fold. Patient states that sitting or stretching the skin in that region makes the pain worse what is the diagnosis
Pilonidal abscess
209
What is the treatment for pilonidal abscess
Asymptomatic - nothing
Acute abscess - prompt i&d and pack the wound with gauze
Antibiotics are reserved for those with cellulitis in absence of an abscess or if significant cellulitis following drainage
210
What is the most common form of hair loss in males that occurs in a high reproducible pattern affecting the temples, vertex and mid frontal scalp
Androgenetic alopecia
211
What is perfectly smooth, round patches of hair loss believed to be immunologic
Alopecia areata
212
What type of alopecia occurs following any type of trauma or inflammation of the hair follicules
Cicatricial alopecia -scarring alopecia
213
What is the treatment for alopecia
Most areas the hair regrows and no treatment needed
- consider sending to counseling for emotion stress
- consider derm for intense cases
214
What are the complications of a sunburn
Melanoma
AK
215
What is the most important treatment of a sunburn
Prevention - sun avoidance
216
Chronic urticaria is how long
Greater than 6 weeks
217
When working up a patient with urticaria what must be ruled in or out
Ingestants
Inhalants
Injectants
Infections
Internal disease
218
What is the treatment for urticaria
Discontinue trigger
Antihistamine
Prednisone for those who are difficult to treat with antihistamine
Epinephrine for severe cases
219
What commonly effects the greater toe and is caused by improper or excessive trimming of the lateral nail plate or from trauma. Symptoms include pain, redness and swelling around the nail tissue
Ingrown nail
220
What is the treatment for an ingrown nail
Remove the nail
221
What form must be signed before removal of an ingrown nail
Sf522
222
What is the most common injury to the upper extremities resulting from a direct blow to a fingernail
Subungual hematoma
223
What is the treatment for a subungual hematoma
Evacuation of the hematoma via TREPHINATION of the nail
Drain by:
Heated paper clip
Cautery pen
Drill method
Needle method
224
What is a benign skin lesion that is circumscribed tan brown patches or thin plaques that have. Greasy scale and a stuck on appearance
Seborrheic keratosis (SK)
225
What is the treatment for SK
Treatment generally not required
-cryotherapy
- shave/excise
- electrodessication
226
What is a precancerous lesion found on the face, head, neck and dorsal aspect of the hands described as having a rough sandpaper like feeling and as the lesion becomes more defined and develops a thin/adherent yellow - transparent scale. It gets thicker and more yellow in color over time
Actinic keratosis (AK)
227
What is a complication of AK
Squamous cell carcinoma
228
What is a malignant tumor that arises from melanocytic cells and can be any where on the body. Symptoms include pruitis early on and tenderness,bleeding, ulceration as later symptoms. History may include many blistering sunburns as a child
Melanoma
229
What is the treatment for melanoma
Refer
IDC cannot treat
230
What are the goals of wound repair
Achieve HEMOstasis
Prevent infection
Preserve function
Restore appearance
Minimize discomfort
231
What is phase one of wound healing
Lag phase
0-5 days
232
What is phase two of wound healing
Fibroplasia phase
5-14 days
- rapid increase in wound strength
233
What is phase three of wound healing
Final maturation
Day 14 until healing is complete
- further connective tissue remodel
234
What are contraindications of wound repair
Wounds more than 12 hours old (24+ for face)
Animal bites or human bites
Puncture wounds
235
What are four principles that should be incorporated into the process before closing a wound
Stop the bleeding
Eliminate dead space
Accurately approximate tissue layers
Approximate wound with minimal tension
