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Flashcards in Derm Deck (123):
1

First appears high fever (103-105), headache, red eyes, and N/V, then on 3rd day a rash erupts on hands and feet and spreads to trunk.

Rocky mountain spotted fever

2

dry, round, and red-colored lesions with a rough texture and don't heal; common in sun-exposed areas

actinic keratosis

3

Precursor for squamous cell carinoma

actinic keratosis

4

s/s of meningitis

sore throat, cough, fever, headache, stiff neck, photophobia, changes in LOC

5

rash in meningitis

petechial rash to axilla, flanks, wrist, and ankles

6

trx for close contacts of those with meningitis

rifampin

7

This rash appears within 7-14 days after a deer tick bite

bulls-eye rash in Lyme disease

8

If a vesicular rash appears on nose, then

assume it is shingles until proven otherwise

9

s/s of melanoma

Asymmetry, border irregularity, color is dark, diameter is greater than 6 mm, enlargement or change in size

10

basal cell carcinoma

pearly or waxy skin lesion that can bleed easily

11

most common type of melanoma in blacks and asians

acral lentiginous melanoma

12

acral lentiginous melanoma

black lesions on nailbeds, palmar and plantar surfaces

13

A hematoma that involves _____ of the nail has a high risk of ischemic damage to the nail matrix

more than 25%

14

treatment for subungual hematoma

burn a 18 gauge needle and push 3-4 mm into nail and drain

15

classic lesions appear bulls-eye like but can range from hives, blisters, petechia/purpura, and hemorrhagic lesions that are painful

Steven Johnson syndrome

16

drug classes associated with SJS

PCN, sulfa, barbiturates, dilantin

17

HIV infected patients have a very high risk of SJS due to

TMP/SMZ

18

Bulla is seen in

SJS, impetigo, second degree burns

19

soft and round wart-like fleshy growths mostly on the trunk or back

seborrheic keratoses

20

raised and yellow-colored soft plaques that are located under the brow or upper and lower lids of the eyes

xanthelasma

21

may be a sign of hyperlipidemia if seen in those less than 40

xanthelasma

22

brown to tan colored stains located on the upper cheeks and forehead in women who are pregnant or on OCP

melasma

23

another name for moles

nevi

24

inherited skin disorder that results in extremely dry skin

xerosis

25

velvet thickening of the skin behind the neck

acanthosis nigracans

26

avoid steroids in these cases because it will worsen the infeciton

fungal infection

27

What in use in infants, children, and adults with thin facial skin

0.5-1% hydrocortisone

28

an inherited skin disorder in which squamous epithelial cells undergo rapid mitotic division and abnormal maturation

psoriasis

29

pinpoint areas of bleeding remain in the skin when a plaque is removed

auspitz sign

30

black box warning with topical tacrolimus for psoriasis

malignancy (skin and lymphoma)

31

treatment for actinic keratosis

cryotherapy; fluorouracil cream 5%

32

superficial skin infection caused by yeasts Pityrosporum orbiculare or Pityrosporum ovale

tinea versicolor

33

diagnostic for tinea versicolor

KOH slide shows hyphae and spores

34

trx for tinea versicolor

topical selenium sulfide or ketoconazole cream bid x 2 weeks

35

s/s of atopic dermatitis (eczema)

extremely pruritic rashes on hands, flexural surfaces and neck

36

classic rash of atopic dermatitis (eczema)

multiple small vesicles that rupture and weep; then they become lichenified d/t constant itching

37

trx for atopic dermatitis (eczema)

hydrocortisone 1 to 2.5%; triamcinolone

38

treatment for contact dermatitis

calamine lotion; oatmeal baths; Aveeno;
Severe: oral prednisone tape 12-14 days

39

treatment of candidiasis intertrigo

Nystatin powder bid

40

treatment of HIV esophageal Candida infections

fluconazole

41

treatment for clenched fist injury

refer to ER d/t high risk of infection to bone

42

several boils that coalesce to form a large boil or abscess

carbuncle

43

trx for non-MRSA nonpurulent cellulitis

dicloxacillin QID x 10 days; macrolides for PCN allergy

44

trx for cellulitis

Bactrim DS, doxycycline, or clindamycin x 10 days

45

large and hot indurated red skin lesion located on shins or cheeks; caused by Staph aureus

erypsipelas

46

treatment for human or animal bites

augmentin x 10 days; clindamycin + fluoroquinolone for PCN allergy

47

wounds that stay open

puncture wounds, cat bites, wounds > 12 hours old (24 hours for face)

48

infection caused by Staph aureus to sebaceous glands of axilla that becomes chronic

hidradenitis suppurativa

49

trx for hidradenitis suppurativa

Augmentin or dicloxacillin x 10 days

50

acute superficial infection by strep pyogenes or S. aureus that is very contagious and pruritic; common in warm and humid weather

impetigo

51

trx for impetigo

cephalexin or dicloxacillin x 10 days; mupiricon ointment

52

Caused by Borrelia burgdorferi

Lyme disease

53

trx for lyme disease

doxycycline bid or tetracycline x 14 days

54

caused by Rickettsia rickettsii

rocky mountain spotted fever

55

trx for rocky mountain spotted fever

doxycycline bid x 21 days; refer stat

56

how long is chickenpox contagious

1-2 days before onset of rash until the lesions have crusted over

57

how long is shingles contagious

from the onset of rash until the lesions have crusted over

58

duration of shingles

2-4 weeks

59

labs for shingles

viral culture, PCR for ZDV

60

meds for shingles

acyclovir 5x/day or valacyclovir bid x 10 days for initial breakout and 7 days for flare ups

61

most serious complication of shingles

post hereptic neuralgia

62

trx for post hereptic neuralgia

tricyclic antidepressants, anticonvulsants, or gabapentin

63

for those with varicella vaccine

they can still get shingles but it will be a more mild disease than those who have been unvaccinated

64

shingles vaccine

for those 60 and older

65

extremely painful red bumps/blisters on sides of finger or cuticle area

herpetic whitlow

66

cause of herpetic whitlow

direct contact with cold sore or genital herpes lesion

67

bacterial infection of the nail folds

paronychia

68

causes of paronychia

S. aureus, streptococci, or pseudomonas

69

trx for paronychia

soak finger in warm water for 20 min 3x/day; apply mupiricin ointment after soaking; drain if abscess present

70

salmon-colored oval scaly lesions on cleavage line or a "christmas tree" pattern

pityriasis rosea

71

course of pityrisasis rosea

lasts 2-4 weeks, self-limiting

72

s/s of scabies

itching in webs of hands, axilla, breasts, waist, genital; itching worse at bedtime

73

trx for scabies

permethrin 5% cream; apply head to toe and wash off in 8-14 hours; wash all clothes/linen used in the past 3 days

74

itching duration with scabies

may persist for up to 2-4 weeks

75

trx for tinea infections

terconazole cream bid

76

s/s of tinea capitis

children with scaly patches and alopecia

77

trx for tinea capitis

griseofulvin bid x 6-12 weeks (check baseline LFTs and repeat in 2 weeks)

78

"sandpaper" rash with sore throat

scarlet fever

79

hypopigmented round to oval macular rashes on upper shoulders/back that is not itchy

tinea versicolor

80

smooth papules 5 mm in size that are dome-shaped with a central "plug"

molluscum contagiosum

81

tinea cruris

jock itch

82

topical trx for mild acne

RetinA 0.25% cream every other day at bedtime for 2-3 weeks, then daily;
benzyl peroxide and erythromycin (Benzamycin) cream

83

tetracyclines can be given for acne starting at age

13

84

complication of tetracycline for acne

permanent discoloration of tooth enamel; decrease effectiveness of OCP

85

guidelines for isotretinoin (Accutane)

category X; patient must sign consent, enroll in pregnancy prevention program, use 2 forms of contraception, only monthly supplies, must do pregnancy test monthly.

86

light skinned individual c/o acne-like pustules around nose, mouth, and chin; may blush easily; red-eyes/blepharitis

rosacea

87

trx for rosacea

No cure. metronidazole topical gel; azelaic acid gel; low dose tetracycline or minocycline

88

trx for first degree burns

cold packs for 24-48 hours

89

burn that is red colored skin with superficial blisters (bullae)

second degree burn

90

trx for second degree (partial thickness) burns

cleanse with mild soap and water. DO NOT rupture blisters. Trx with silvadene and apply dressing.

91

refer for these kinds of burns

third degree burns, facial burns, electrical burns, burns on ears or nose, burns greater than 10% BSA.

92

rule of nines for adult burns

each arm and head is 9%;
each leg, anterior trunk, and posterior trunk is 18%

93

caused by Bacillus anthracis

Anthrax

94

three types of anthrax

cutaneous, GI, and pulmonary (bioterrorism)

95

postexposure prophylaxis for anthrax

ciprofloxacin 500 mg bid x 60 days

96

inhalation or ingestion of this can cause respiratory distress and organ failure in 6-8 hours; no known antidote

ricin toxin (from castor beans)

97

difference between erypsipelas and cellulitis

erypsipelas only affects superficial layer of skin; cellulitis affects the deeper layers of the skin

98

treatment for lice

permethrin 1% apply to dry hair x 10 min, may repeat in 2 weeks

99

multiple papules and pustules on lower back and buttocks that do not itch or cause pain.

folliculitis

100

This atbx has poor staph coverage

PCN

101

transmission of shingles

you cannot transmit shingles to another person, but you can transmit chickenpox

102

anti-inflammatory effect of NSAIDs

need to use 600-800 mg to reach anti-inflammatory effect; less than 600 is for analgesic effect.

103

trx for post-herpetic neuralgia

TCA, gabapentin, Lyrica

104

Shingles vaccine is for

those age 60 and older

105

organisms involved in cat, dog, and human bites

pasturella, staph, streptococcus

106

how long to give atbx for bites

for prophylactic: 3-5 days;
for treating infection: 7-10 days

107

application tips for antifungal creams

apply 1-2 inches beyond the rash,
treat for 1-2 weeks,
treat 1-2 weeks after resolution to prevent recurrence

108

fungal infections are usually always

superficial infections; which is why topical agents are effective

109

most effective trx for onychomycosis

oral terbinafine for 6-12 weeks

110

s/s of lupus

fatigue, joint aches, butterfly rash

111

diagnostic for lupus

high ANA

112

common sites for basal cell carcinoma

head and neck

113

disease associated with seborrheic dermatitis

parkinson's

114

least potent to most potent topicals

lotion, cream, gel, ointment

115

best delivery of a topical steroid in an elderly person with thin skin

lotion (least potent)

116

herpangina is caused by

coxsackie A virus

117

rash with measles (rubeola)

brick red rash that starts on head and spreads down to extremities

118

rash with roseola (exanthem subitum)

high fever for 2-4 days, then fever stops and rash appears

119

s/s of herpangina

painful vesicles on soft palate and mouth

120

important education with Fifth's disease

avoid contact with pregnant women, can cause fetal death

121

usual age at which roseola is diagnosed

7-13 months

122

s/s of measles (rubeola)

"three C's": conjunctivitis, coryza (runny nose), cough; Koplik spots

123

grain of sand appearance in oral mucosa

Koplik spots in measles