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Derm > Derm > Flashcards

Derm Flashcards

1
Q

What is actinic keratosis

A

Numerous dry, round, red colored lesions with rough (sandpaper) texture that don’t heal.
Most common sun exposed areas: cheeks, nose, face, neck, arms, back. Occurs in light colored skin hair and eyes. In some cases a precancerous lesion for Squamous cell carcinoma

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2
Q

Early lime disease “signs and symptoms and when they occur.

A

Bull’s-eye rash appears 7 to 14 days after deer tick bite. Rash is hot in rough texture.

Common locations are beltline, axillary area, behind the knees and growing.

flulike symptoms

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3
Q

What is the screening alphabet for melanoma?

A

A asymmetry, B-border, C-color variation, D diameter greater than 6 mm, E enlargement/skin changes, other: bleeding and itching.

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4
Q

Basal cell carcinoma signs and symptoms

A

Perly or waxy skin lesion with a ulcerated center that does not heal.
Color: white, pink, brown or flesh colored. Bleeds easily with trauma

P. Pearly papules
U.  Ulcerating
T.  Telangiectasia
O. On face,  scalp, pinnae
N.  Nodule slow-growing
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5
Q

Acral Lentiginous melanoma

Who does it affect and where is it located

A

Most common type of melanoma and African-Americans and Asians. Dark brown to black lesions on now blades, Palmer and plantar surfaces. Longitudinal brown to black bands on nailbeds

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6
Q

What is signs and symptoms of Steven Johnson syndrome

A

Severe and rare hypersensitivity reaction caused by medications, infections and malignancies.

Lesion appears target like or bull’s-eye. Multiple lesions abrupt abruptly ranging from hives, blisters, petechiae, Purpera, hemorrhagic lesions very painful.

Drug class is associated: penicillins, so far, barbiturates and phenytoin. HIV has a 40 fold increase risk due to Bactrim.

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7
Q

What is a vesicle and how do you describe it give an example.

A

Elevated skin lesion less than 1 cm filled with serious fluid. Herpes lesions

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8
Q

Seborrheic keratosis

A

Waxy Multiple brown -black flat moles on on trunk & back.

Benign

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9
Q

Xanthelasma. What is it

A

Yellow colored soft plaques under brows or on eye lip

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10
Q

Cherry angioma what is it?

A

The benign small and smooth round papules bright cherry red color. Ranges from 1 to 4 and then. Due to malformed arterials and is asymptomatic.

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11
Q

Xerosis

A

Extremely dry skin.

Inherited.

Occur in mouth or conjunctiva of the eye

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12
Q

What is psoriasis?

A

Squamous epithelium cells undergo rapid mycotic division and abnormal maturation.

Inherited.

Plaque

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13
Q

How do you treat eczema?

A

Topical steroids: mild hydrocortisone 1% to 2.5%. Medium Triamcinolone.
Systemic oral antihistamines.
Skin lubricants you soon.
Hydrating baths

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14
Q

Bacteria associated acute cellulitis

Purulent or nonpurulent and cat and dog bites

A

Purulent: S. Aureus
Nonpurulent: streptococci or staph.
Dog and cat bites: Pastorella multi Cody or

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15
Q

How to treat abscesses?
Non-MRSA?
Penicillin allergy?
Suspect MRSA?

A

Non-MRSA: doxycycline 10 days, Cephalexin, clindamycin 10 days

MRSA: Bactrim DS b.i.d. for 10 days, doxycycline b.i.d. for 10 days, clindamycin QID 10 days

Penicillin allergy: erythromycin, selfless Orens, and clindamycin

May want to consider TD booster

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16
Q

Cat bites: treatment

A

P. Multicoda

Culture and sensitivity.
Td booster
Augmentin 10 days
Penicillin allergy: clindamycin plus fluoriquinolone

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17
Q

What animals have rabies and how to treat?

A

Bat, raccoons, skunks, foxes and coyotes

Call local health department. Rabies immune globulin plus rabies vaccine may be required

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18
Q

Hidradenitis Suppurative

A

Bacterial infection of the sebaceous gland of the arm pit

Culture and sensitivity. 
Augmentin or doxycillin 10 days
mupirocin ointment b.i.d. two weeks
Antibacterial soap such as dial
Avoid deodorant
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19
Q

How to treat impetigo

A

Cephalexin QID
Docloxacillin QID for 10 days. Penicillin allergy: azithromycin 250 mg five days, clindamycin 10 days.
Few lesions topical mupirocin ointment times 10 days.
Frequent Handwashing

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20
Q

How do you diagnose early lyme disease?

What do you treat with?

A

IgM early and IgG late

Doxycycline 200mg once
Ceftin
tetracycline 14 days
Tx one time dose. Cv complications: 14-21 days

pregnancy: amoxicillin

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21
Q

What is Rocky Mountains spotted fever caused by?

How to diagnose and treatment? What are the complications

A

tick infected with Rickettsia rickettsii

Diagnostic: anti-body titers R. rickettsii.
CBC, LFT, CSF and punch biopsy.

Treat doxycycline be ID or
tetracycline care QID for 21 days

Complications: death, hearing loss, paraparesis, neuropathy

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22
Q

What is varicella zoster?
What to treat with?
When is the patient no longer contagious?

A

Shingles. Contagious with the onset of rashes and tall lesions have crusted over. Treat with valacyclovir-10days or acyclovir-5days

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23
Q

Who can get a varicella zoster vaccination?

What is a contraindication for this vaccine?

A

Windows for persons 60 years and older but can be as early as 50 years.
Contraindication: HIV, chronic high dose steroids, radiation, chemo, immune compromised

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24
Q

What is herpetic Whitlow

A

Herpes simplex infection on fingers.

Symptoms of extremely painful Redbox and small blisters on the sides of fingers or cubicle areas. Can coexist with oral or genital herpes.

Treat: nSAIDs. Severe: acyclovir

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25
Q

What is scarlet fever

A

Sandpaper rash with sore throat possibly strep throat

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26
Q

What are Koplik spots and what disease of the identified with

A

Whit spots at of oral mucosa by rear molars. Measles

27
Q

What is rosacea?

What her triggers for rosacea?

Treatment?

A

Chronic and relapsing skin inflammatory disorder. No cure symptom control. Avoid triggers. Usually occurs fair skinned people.

UV light, hot/cold exposure, exercise, stress, coffee, chocolate, caffeine, alcohol, spicy foods, certain cosmetic products or meds.

Topical treatment: antimicrobials, immunosuppression some acne products. Metronidazole gel (0.75-1%) is commonly used as first-line agent.

28
Q

What is the rule of nines

A

9% each arm and head.

18% leg, anterior trunk and posterior trunk

29
Q

What is a macule?

A

Flat nonpalpable palpable discoloration less than 1 cm

30
Q

What is the papule?

A

Raised elevation less than 1 cm

31
Q

What is vesicle?

A

Fluid filled less than 1 cm

32
Q

What is a papule

A

Jessica White court purulent discharge content less than 1 cm

33
Q

What is a patch

A

Flat nonpalpable discoloration larger than a macule. Greater than 1 cm

34
Q

What is papule

A

Raised lesion greater than 1 cm

35
Q

What is Bulla

A

Fluid filled greater than 1 cm. Somewhere to lay

36
Q

What is a cyst?

A

Raised encapsulated fluid filled lesion

37
Q

What is the wheal

A

Circumscribed area of skin edema

38
Q

What is Purpura?

A

Flat read – purple discolorations. Larger than particular greater than 1 cm.

39
Q

What is lichenification?

A

Skin thickening usually found over pruritic or friction areas

40
Q

What is scales?

A

Raise superficial lesions that flake with these

41
Q

What is a Erosion?

A

Loss of epidermis

42
Q

What is an ulcer?

A

Loss of epidermis and dermis

43
Q

What is a fissure

A

No linear crack in epidermis exposing dermis

44
Q

How does Bullous impetigo different from regular impetigo

A

Bullous impetigo usually occurs on the legs arms and trunk and a boy us fashion. Where is fluid filled vesicles. We’re regular impetigo is dry honey crusted usually on the face

45
Q

What are the signs of a brown recluse spider bite?

A

Red white and blue. Central blistering surrounded by great to purple discoloration at bite site. Surrounded by a white ring of blanched skin & larger area of redness

After the red white and blue sign follows with a central purple to grey discoloration

46
Q

What anabiotic would use to treat a dog or cat bite?

What do you treat if there’s a concern for MRSA?

What is the organism?

A

Augmenting or Bactrim.

Vancomycin

Pastorella, staph, strep

47
Q

What is a confluent or coalescent description of the lesion?

A

Multiple lesions blending together

48
Q

What is annular description of the lesion?

A

And a ring

49
Q

What is a reticular description of the lesion?

A

Appear in a net like cluster

50
Q

What anabiotic’s would you use to treat non mrsa cellulitis?

A

Cephalexin, Cefadroxil, Cefdinir
Doxacillin, nefcillin

2nd clindamyacin

51
Q

What would you treat purulent cellulitis with?

A

Bactrim and doxycycline

52
Q

What disease presents with a butterfly rash on the face?

What are signs and symptoms of this disease?

Dignosis tool?

A

Lupus

Joint aches, fatigue, oral and nasal ulcers, leukopenia, anemia, thrombocytopenia, gastritis and peptic ulcers

Diagnosis: ANA

53
Q

Herpes Zoster – is it alive, attenuated, or in active toxins?

How long do herpes zoster rash last?

What is defined as post herpetic neuralgia & how is it treated?

A

Live attenuated vaccine

rash last 14 to 21 days.

Post herpetic neuralgia a is pain at least one month after rash is healed and can be treated with try cyclic and I depressants, gabapentin, lyrica or topical lidocaine patch

54
Q

What is psoriasis vulgaris caused by?

What do you treat it with?

A

Accelerated mitosis. Causing rapid skin cell turnover which leads to decreased maturation and Keratinization. Elbows, knees, scalp

Topical corticosteroids medium to high potency short period of time then change to lower potency 3 to 4 times a week to maintain remission.
Tar preparations.
Drithocream- antimitotic.
UV light

55
Q

What is seborrheic dermatitis? And how is it treated?

A

It is greasy, scaling lesions in nasolabial fold, ears, upper trunk, scalp and eyelid margins. Caused by fungus Malassezia

Treat with ketoconazole

2nd line: corticosteroid steroid creams, Lotion, solution

Third line: topical immune modulator’s.

56
Q

Describe Squamous cell carcinoma?

A

No sun

N. Noduler
O. Opaque
S. Sun exposed areas
U.  Ulcerating
N. Non-distinct boarders

Later lesions can scale and have for margins

57
Q

What is verruca vulgaris? Caused by?

A

Warts caused by human papilloma virus one, two, four

58
Q

CA – MRSA infections usually involve what type of skin and soft tissue infection?

A

So you lightest, bullous impetigo, folliculitis, abscess or infected laceration

59
Q

How would you treat an abscess so it is less than 5 cm in diameter? How would you treat of over 5 cm in diameter

A

Lesson 5 cm: incision and drainage. Localized warm soaks.

Abscess greater than 5 cm incision and drainage and antimicrobial treatment

Wound culture

60
Q

What is angular cheilitis?
Caused by?
Treated with?

A

Fissuring and cracking at cornerstone mouth

Candida

Nystatin

61
Q

What is stage one lyme disease?

Stage two?

Stage III?

A

Stage one: mild flulike illness with single annular lesion with central clearing erythema migrans. Symptoms resolve in 3 to 4 weeks without treatment.

Stage two: early disseminate infection: months later: classic rash may reappear with multiple lesions. Arthralgia, myalgia, headache, fatigue. Was common: cardiac medications such as heart block and neurological findings – Facial nerve palsy (Bells palsy)and aseptic meningitis.

Stage III late persistent: 1 after. Musculoskeletal signs and symptoms -ranging from joint pain to arthritis with joint damage. Neuropsychiatric symptoms appear: memory problems, depression, neuropathy.

62
Q

What is the spirochete that causes Lyme disease?

How do you test for Lyme disease?

A

B. Burgdorferi

Serum testing enzyme linked immunosorbent assay and confirmatory Western blot assay for IgM antibodies.

63
Q

What is Rocky Mountain spotted fever

A

Rash: small red spots “petechiae “ erupts on hands and feet progressing rapidly toward trunk. Peers third day after high fever greater than 103. Company with headache, Malaysia, conjunctival injection, nausea vomiting, arthralgia

Derm (2 decks)

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