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Flashcards in Derm Deck (142)
1

Pink, Pearly/waxy, rolled border, bleeding, ulceration

BCC = no mets but invades

2

Invasive cluster of spindle cells surrounded by palisaded basal cells

BCC --> wide resection 1mm

3

Chronic scar --> non-healing, painless, bleeding ulcer?

SCC --> punch bx

4

Non-healing ulcer on arm, scaling plaque w/ central ulceration, polygonal cells

SCC = UV exposure

5

Hyperpigmented lesion, non-healing ulcer

SCC = Marjolin ulcer

6

Invasive cords of squamous cells with keratin pearls, partially encrusted ulcer

SCC --> wide resection 0.5-2cm + LN dissection d/t mets

7

Precursor to SCC

Actinic keratosis

8

Hyperpigmented lesion, asymmetric, irregular, >5mm, NO HAIR

Melanoma --> mets a lot, refractory to chemo/rad, relapsing & remitting

9

Tx for malignent melanoma

Breslow's depth - local resection; 1-2mm wide + LN

10

Malignant melanoma >4mm tx

Mets, resection and supportive care, poor prognosis

11

Volcano-like nodule w/ central keratotic plug

Keratoacanthoma

12

Scabies tx

Permthrin cream

13

Intergidital, groin pruritic, thread-like burrows

Scabies = 5% permethrin

14

Tx Lice

Permethrin 1% cream rinse

15

Centrally umbilicated papules on face, neck, anogential regions

Molluscum contagiosum - Poxvirus = impaired cellular immunity

16

Dome w/ central umbilication tx

Molluscum --> obs, liq-N, extrode plug or canthardin 0.9%

17

Thin hair in pre-term

Lanugo

18

Thick, white creamy skin in newborn

Vernix caseosa

19

Benign, small and dry vesicles

Pustular melanosis

20

Salmon patch

Nevus simplex

21

Port wine stain, IC calcifications

Nevus flammeus

22

Shallow fibrin-coated ulcer w/ mononuclear infiltrate

Aphthous ulcer

23

Whitish macules w/ hyperpigmented borders, mouth, breasts

Vitiligo = destruction of melanocytes

24

Hypopigmentation + anesthesia

Leprosy = get skin bx

25

Velvety pink or whit macules, less pigmentation

Fungal infection

26

Acanthosis nigricans assoc

GI malignancy, PCOS, DM

27

Skin tags assoc

DM, pregnancy, crohn's

28

Vitiligo, hypotension, dehydration, hyperpigmented areas assoc

Addison's disease

29

Tx for human bites

Augmentin or erythromycin + open

30

Sharp edge, head & neck spot, orange

Subcutaneous nevi

31

Present at birth, PITS, ecchymoses, subsides w/in 1 day, Hematoma crosses sutures

Caput succedanuem

32

Few days after birth, no pitting, Hematoma NOT cross sutures = 1 cranial bone, no discoloration

Cephalohematoma --> resorbs on its own

33

Pulsations on scalp, inc pressure w/ crying

Cranial meningocele

34

"Ping-pong ball," rickets --> resolves

craniotabes

35

Lateral neck cysts

Brachial cleft, cystic hygromas

36

Anterior edge SCM, base of neck mass

Brachial cleft cyst

37

Base of neck, large, mushy, ill-defined mass

Cystic hygroma --> CT b4 excision

38

INC COSTOCHONDRAL JUNCTIONS, craniotabes, sciolosis, pigeon breast, hyperpigment, genu varum

Rickets

39

Cough, pink eyes, bluish spots in mouth, blanching, erythematous macropapular rash

Measles = live vaccine, supportive, VitA if hospitalized

40

Cough, coryza, conjunctivitis + High fever and red-brown macropapular rash for 9 days

Measles --> Vit A reduces M&M

41

Rash face --> extermities, cough, conjuctivitis, white spots on tonsils

Measles

42

Clustered white lesions in mouth --> rash on forehead --> trunk --> limbs

Measles

43

Rash starting on face --> chest and limbs, occipital and post. Cervical LAD

Rubella

44

Congestion, low fever, pink rash on face --> trunk, cervical adenopathy, patchy palate erythema

Rubella

45

Fever, sore throat --> rash on face/neck --> trunk --> limbs

Rubella

46

URI --> erythema on face sparing nose, orbits --> lacy pruritic body rash for 1-2wk, resp spread

B-19 "fifths disease"

47

B19 in sickle cell; pregnancy

aplastic crisis; hydrops fetalis

48

Fever/URI + rash on cheeks, worse in sun

Erythema infectiosum (5ths) --> aplastic crisis, arthopathy, hydrops

49

High fever 3d --> red blanching macules, papules on trunk --> limbs, sparing face

Roseola (HHV-6) = supportive tx

50

High Fever --> rash - trunk --> limbs/head

Roseola (HHV6,7)

51

Impetigo or pharyngitis --> tiny blanching rash on trunk to limbs

Scarlet fever - late desquamation

52

Pharyngitis --> neck, axilla, groin rash finely papular erythematous rash blanches, circumoral pallor

Scarlet fever --> PCN V or erythromycin

53

Sore throat, fever --> 2d later rough raised rash upper trunk --> limbs & tongue

Scarlet fever (strep)

54

Tx for strep

PCN or cephalosporins or macrolides --> fever free 24hrs = return to work

55

Fever 5d, B/L conjuctivitis, mucositis, swelling and erythema on palms and soles

Kawasaki - cervical LN >1.5cm

56

Hx strep + amoxicillin, 103, strawberry tonuge, B/L conjunctivitis, cervical LN 1.5cm

Kawasaki --> Aspirin + IVIG

57

B/L conjunctivitis, SWOLLEN LIPS, high fever no relief from tylenol

Kawasaki --> Aspirin + IVIG

58

"Flea bites," on trunk/limbs + EOSINOPHILS

Erythema toxicum

59

Scattered erythematous macules, papules, pustles everywhere, No sx

Erythema toxicum neonatorum = ressurance

60

Vesicular clusters

HSV or VZV --> acyclovir

61

Targetoid (pale center) papule or plaque on palms--arms--face, Niloksy (-)

Erythema multiforme - follows HSV infection

62

Sudden symmetric erythematous target lesions

Erythema multiforme (?recent HSV)

63

Flu-like sx --> erythematous macules --> necrosis/sloughing, involves mucous membranes

Steven-Johnson syndrome --> IVIG

64

Hx atopic dermatitis + vesicles on erythematous base on face

Eczema herpeticum

65

Painful subcutaneous skin lesions on anterior leg ---> next step?

CXR = Erythema nodosum ---> benign or TB, Sarcoid, IBD, Histo

66

Crops of small tender, erythematous nodules over shins & calves

Erythema induratum = TB

67

Erythematous rash, Nilosky (+), perioral crusting

Scalded skin syndrome

68

Fever, irritable --> blistering, exfoliation

Scalded skin syndrome

69

Tender skin, bullae, large sheets slough after illness

SSSS

70

Diffuse red macular rash + peeling of palms and soles

TSS (SA)

71

Recent nasal packing --> rapid hypotension, rash, fever, thrombocytopenia, mouth hyperemia

TSS (tampons, sinusitis, septorhinoplasty, surgical wounds)

72

Complications of GABHS

PSGN, RF, arthritis, PANDAS = OCD (SSRIs) or tic

73

Abx do NOT prevent which GABHS complications

PSGN, arthritis

74

Vesiculopustules on face, arms, crusted golden-yellow, warm, moist climate

Impetigo

75

Impetigo Tx

Topical mupirocin, oral dicloxacillin, clinda, cephalexin

76

Tender, erythematous skin w/ distinct border, scalp, face

Eryipelas --> cephalexin, diclox, clinda, bactrim --> IV if fever present
- pyogenes
---> GN but not rheumatic fever

77

Erythema, warmth, tenderness w/ INDISTINCT borders

Cellulitits = pyogenes or SA --> cephalexin, zosyn

78

Unimmunized kids, blue cheeks, febrile

Buccal cellulitis = Hib --> cefuroxime or taxime

79

Constipation, perianal cellulitis bug

Pyogenes

80

Pain out of proportion w/ findings, crepitus, bullae

Necrotizing fasciitis --> IV Abx + debridement

81

Recent trauma, surg, sudden pain, swelling, purple, serosanguineous discharge & skin bullae

Necrotizing fasciitis

82

S/P laparotomy, fever, hyperglycemia, cloudy-gray discharge, friable tissue, no sensation

Necrotizing surgical infection --> surgery and debridement

83

Recurrent, eczematous, pruritic, scaling red papules over flexor/extensors surfaces

Atopic dermatitis

84

Itchy rash face, hands chest --> erosion, scaling, excoriated plaques and papules

Atopic dermatitis

85

Patchy, fine, white, adherent waxy scales

Sebhorreic dermatitis --> dandruff, anti-fungal, moisturizers

86

Yellow papules, some scaling/plaques on eyebrows, nose, head better w/ shampoo

Sebhorreic dermatitis --> dandruff, anti-fungal, moisturizers

87

Sebhorreic dermatitis cause?

Malessezia furfur

88

Vesicles, erythema in linear pattern, weepy, crusted, edema

Allergic contact dermatitis --> cell-mediated type IV HS

89

Pruritic papules and vesicles over extensor surfaces

Dermatitis herpetiformis = Celiac (anti-endomysial)

90

Erythematous papules, vesicles, bullae on butt, extensor surfaces, intense pruritis

Dermatitis herpetiformis ---> DAPSONE

91

anti-endomysial abs

Dermatitis herpetiformis = celiac

92

Rosy hue w/ telangiectasias, flushing w/ hot drinks, heat, emotion, 30-60 y/o

Rosacea

93

Sudden blisters, oral blisters/erosions that rupture easily, Ab to desmoglein, ACE inhibitors

Pemphigus vulgaris --> prednisone or MTX --> Aza to get off steroids

94

Salmon colored patches, silvery scales over extensor surfaces & scalp

Psoriasis

95

Numerous oval, scaly lesions over back, crinckled, cigarrette paper apperance

Pityriasis rosea

96

Pale, velvety white/pink, scale w/ scraping, doesn't tan

Tinea versicolor --> selenium sulfide or ketconazole

97

Ring lesions w/ scaly border & central clearing

Tinea corporis --> terbinafine or griseofulvin

98

Pruritic, erythematous, scaly, red ring w/ central clearing, swimming

Tinea corporis --> terbinafine

99

Recurrent oral ulcers, genital ulcers, anterior uveitis, hyper-pigmented red skin lesions

Behcet syndrome --> steroids but still --> dementia, blindness

100

Anti-Rho/SSA or Anti-La/SSB Abs

Sjogren syndrome

101

Women, 50s, dry eyes, mouth, dental caries, dysphagia, B/L submand swelling

Sjogren syndrome

102

Winter, Spring papules, vesicles on erythematous base --> erosions, different stages

Varicella --> acyclovir shortens if older than 2, given w/in 24hrs

103

Dx varicella

Tzanck smear or PCR

104

Varicella vaccination ages

12-18mo + 4-6yrs, live attenuated

105

Zoster vaccine ages

60

106

Lesions of all different stages

Chicken Pox

107

Macropapular rash on trunk, palms and soles, painless chancre

Syphilus ---> Benzathine PCN x3

108

Macules, papules, pustules at same stage

Small pox (Variola)

109

Vesicular on tongue/lips/mouth, macoluvesicular on hands, feet, butt, groin

Hand-foot-mouth (Coxsackie)

110

Erythema marginatum, serpiginous macules w/ pale centers, polyarthritis, sydenham corea

Rheumatic fever

111

Petechial rash --> ecchymoses, fever, N/V, myalgias, shock

Meningococcemia

112

Maculopapular rash on lower chest + rose spots on abd, diarrhea, HSM

Typhoid fever

113

Macrocytic anemia w/o hypersegment, low Retic + congenital syndrome (Turner etc)

Diamond-Backfan anemia (congential hypoplastic anemia) --> steroids or transfusion

114

Bright red plaque, compressible, well-defined borders, 3mo old

Strawberry (capillary) hemangioma

115

Small bright red papules in adulthood, do not regress

Cherry hemangioma

116

Lobulated compressible mass on neck, lymph lined by epithelium

Cystic hygromas

117

Dec growth, inc bone growth, inc ICP, puruitis, irritable, alopecia, sebhorreic lesions, mouth fissures

Vit A excess

118

Impaired night vision, dry skin, dry eyes, cloudy cornea, hyperkeratosis

Vit A deficiency

119

Sebhorreic dermatitis, photophobia, cracking lips, mouth, atrophic tongue, pallor, pale

Riboflavin (B2) deficiency

120

Diarrhea, erythematous rash in sun exposed areas - arms, legs, beefy red tongue

Pellagra --> Niacin (B3)

121

Niacin --> NAD, NADP, inc w/ corn eating, diarrhea

Pellagra

122

Abd pain, diarrhea, corn-based diet, difficulty w/ memory, malar rash worse w/ UV

Pellagra (3Ds) - Niacin deficiency - carcinoic, corn, Hartnup, etOH

123

Flushing, pruritis

Niacin toxicity

124

Neuropathy, altered mental status

B6 excess

125

Depression, dermatitis, stomatitis, irritable, NEUROPATHY

B6 deficiency --> inc homocysteine, embolic events

126

Goat milk deficiency

Folate

127

Ecchymoses, petechiae, bleeding gums, arthralgias, weakness, depression, coiled hair, joint swelling

Vit C deficiency

128

Stone, diarrhea, cramps

Vit C excess

129

Diarrhea, polyuria, polydipsia, calcification

Vit D excess

130

Phimosis

Can't retract foreskin

131

Paraphimosis tx

Tournequet

132

Balanitis bugs

Candida or GNs

133

CIs to circumcision

Hypospadias, bleeding, pre-me

134

1st teeth to develop and when

3-16mo, 1st = lower incisor

135

Secondary teeth erupt

6-8y/o

136

Mandibular central incisors erupt early indicates?

Hyperthyroid, Inc GH, precocious puberty

137

Causes of delayed teeth eruption

Hypothyroid, pituitary, Down

138

Pitting teeth, brown/gray, white streaks

No fluoride - need more 2-4 y/o

139

When to supplement Fl-

Breast fed, >6mo, water <0.3ppm

140

#1 caries place and bug

Maxillary; Strep mutans

141

Teeth avulsions tx

Store in milk, more time = bad prognosis

142

Acne treatments

1. Mild --> benzoyl peroxide --> clinda or erythromycin

2. Moderate --> vit A --> oral doxy or minocycline

3. Severe --> isotretinoin (hyperlipemia)