Derm Flashcards
(142 cards)
1
Q
Pink, Pearly/waxy, rolled border, bleeding, ulceration
A
BCC = no mets but invades
2
Q
Invasive cluster of spindle cells surrounded by palisaded basal cells
A
BCC –> wide resection 1mm
3
Q
Chronic scar –> non-healing, painless, bleeding ulcer?
A
SCC –> punch bx
4
Q
Non-healing ulcer on arm, scaling plaque w/ central ulceration, polygonal cells
A
SCC = UV exposure
5
Q
Hyperpigmented lesion, non-healing ulcer
A
SCC = Marjolin ulcer
6
Q
Invasive cords of squamous cells with keratin pearls, partially encrusted ulcer
A
SCC –> wide resection 0.5-2cm + LN dissection d/t mets
7
Q
Precursor to SCC
A
Actinic keratosis
8
Q
Hyperpigmented lesion, asymmetric, irregular, >5mm, NO HAIR
A
Melanoma –> mets a lot, refractory to chemo/rad, relapsing & remitting
9
Q
Tx for malignent melanoma
A
Breslow’s depth - local resection; 1-2mm wide + LN
10
Q
Malignant melanoma >4mm tx
A
Mets, resection and supportive care, poor prognosis
11
Q
Volcano-like nodule w/ central keratotic plug
A
Keratoacanthoma
12
Q
Scabies tx
A
Permthrin cream
13
Q
Intergidital, groin pruritic, thread-like burrows
A
Scabies = 5% permethrin
14
Q
Tx Lice
A
Permethrin 1% cream rinse
15
Q
Centrally umbilicated papules on face, neck, anogential regions
A
Molluscum contagiosum - Poxvirus = impaired cellular immunity
16
Q
Dome w/ central umbilication tx
A
Molluscum –> obs, liq-N, extrode plug or canthardin 0.9%
17
Q
Thin hair in pre-term
A
Lanugo
18
Q
Thick, white creamy skin in newborn
A
Vernix caseosa
19
Q
Benign, small and dry vesicles
A
Pustular melanosis
20
Q
Salmon patch
A
Nevus simplex
21
Q
Port wine stain, IC calcifications
A
Nevus flammeus
22
Q
Shallow fibrin-coated ulcer w/ mononuclear infiltrate
A
Aphthous ulcer
23
Q
Whitish macules w/ hyperpigmented borders, mouth, breasts
A
Vitiligo = destruction of melanocytes
24
Q
Hypopigmentation + anesthesia
A
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)
