Derm Flashcards
1
Q
Syndromes associated with acanthosis nigrican?
A
Hashimto's Phenylketonuria Dermatomyositis SLE Scleroderma Wilson syndrome Hodgkin + nonhodgkin Pheochromocytoma Ovarian / endometrial Ca Genitourinary ca GI ca
2
Q
What thyroid conditions associated with acanthosis nigrican?
A
Hashimto’s
Thyroid Ca
3
Q
Rx of ganuloma annulare?
A
Self limiting (None)
Or
IL steroids
Topical / oral steroids
4
Q
Is granuloma annulare contagious?
A
No.
5
Q
Morphology of erysipelas?
A
Well demarcated warm tender erythema with raises borders.
6
Q
Causative organism of erysipelas?
A
GAS (S. pyogenes)
7
Q
Erysipelas in DM?
A
Associated with tinea pedis (portal of entry)
8
Q
Why does s. aureus infection spreads to dermis & SQ?
A
Coagulase enzyme.
9
Q
Characteristic features of actinomyces Israelii?
A
Infection of cervicofacial
Sinuses discharging sulphur granules
10
Q
Hall mark of C. Perfringens?
A
Gas gangrene
11
Q
Organism of molluscum?
A
Pox virus
12
Q
Mode of infection of molluscum?
A
Direct contact
13
Q
Classic molluscum?
A
Small nodule or papule with umbilicated center (1-5 mm)
Filled with caseous material.
14
Q
Rx of erysipelas?
A
1st line: penicillin, dicloxacillin, cefazoline
2nd: cefaloxine, erythromycin
15
Q
Most common cause of chronic urticaria?
A
Unknown
16
Q
Infection associated with urticaria?
A
H. Pylori.
17
Q
Classic BCC?
A
Slowly growing shiny papule with pearly borders and telangiectasia
With central dell or ulcer.
18
Q
Rx of BCC?
A
Curettage
Excision
Radiation
19
Q
Classic pyogenic granuloma?
A
Dumb-bell shapes bright red mass without white areas of surface ulcerations (<2.5 cm)
Found on mucosal surfaces after trauma or infection (oral)
20
Q
Leukoplakia?
A
Persistent adherent white patch / plaque can’t be rubbed off.
Associated with smoking.
21
Q
Rx of leukoplakia,
A
Stop smoking.
Disappears within year after smoking cessation.
22
Q
Pityriasis Rosea Classic?
A
Red thin oval plaques / patches with central scaling
Starts as one herald patch the progresses.
Following Langer’s lines.
Christmas tree on back.
23
Q
Varicella Rash?
A
2-3 successive corps of pruritic vesicles + papule over days
Evolve into pustules + crusts with various stages of development present.
24
Q
Steroid induced acne?
A
Mono-morphic acne form eruption with explosive onset.
Upper trunk.
25
Skin tags association?
Obesity
| DM
26
Skin tags + risk of cancer?
Not significant
27
Skin tags + risk of HIV?
Not associated.
28
Leishmaniasis classic?
Papule > ulcerates > shallow annular with raised margins
None healing after months.
29
Causes of scaring alopecia?
```
1. Infection:
Syphilis
TB
AIDS
HZV
```
2. Autoimmune:
DLE
3. Sarcoidosis
4. Trauma
30
Scalp in trichotillomania?
Decrease hair density
| Broken hair of varying length
31
Rx of rosacea?
Topical metro gel
| Azelaic acid
32
Dupuytren's contracture?
Shortened thickened fibrous fascia of palmar surface
| With nodules on distal palms
33
Dupuytrens Contracture age?
> 40 YO
| Men
34
Dupuytren's contracture association?
DM
Smoking
Alcohol
Epilepsy
35
Rx of dupuytren's contracture?
Observation
IL steroid injection
Surgery
36
Tinea pedis classic?
Painful, pruritic, vesicles/bullae with clear or purulent flui.
On anterior foot
Rupture => Scaling with erythema.
37
Complications of inflammatory tinea pedis?
Cellulitis, lymphangitis, adenopathy.
38
Tinea pedis association?
Dermatophytid reaction
On Palms and side of fingers symmetrically
Hyper sensitivity to infection on foot
(DDx dyshidrosis)
39
Rx of uncomplicated herpes zoster ophthalmicus?
Oral anti vitals
Acyclovir
Famcyclovir
Valicyclovir
Steroids for pain (no effect on post herpetic neuralgia)
40
Rx of post herpetic neurologia?
Capsaicin cream
41
Risk of paronychia?
Handling water
| Exposure to irritant
42
Rx of paronychia?
Avoidance of water / chemicals
Potent topical steroids for 3-4 wk
43
Acute vs chronic paronychia?
Acute: swelling redness around nail + lateral pus
Chronic: swelling tenderness redness + thick discolored nail.
44
Pityriasis Rosea classic?
Herald patch:
3-5 cm erythematous patch with scaly border and central clearing
Followed by similar lesions on cleavage lines of skin.
Rash persist 2-3 mo
45
Rx of pityriasis Rosea?
1. Reassurance
2. Topical Steroids for itch
3. Sever = phototherapy
(?) erythromycin for 2 weeks.
46
Keratoacanthoma classic?
Skin colored - red Dome shaped nodule with central keratin plug smooth shiny surface heals within 6-12 mo
47
Most common cause of EM?
HSV
48
Rheumatological Dz with risk of Ca?
Dermatomyositis
49
Cancer associated with dermatomyositis?
```
Ovarian
Lung
Pancreas
Gastric
CRC
Non-Hodgkin
```
50
Sjogren syndrome associated with what Ca?
Non-Hodgkin lymphoma
51
Dupuytren's contracture affected finger?
4th > 5th
52
Trigger finger classic?
Locking of finger in flexed position when extended snaps back
Due to narrowing of space within sheath that surrounds tendon (inflammation)
53
Sx of trigger finger?
Pain
Stiffness
Clicking with movement
Nodule on base of finger
54
Most common affected finger in tigger finger?
Thumb
55
Camptodactylyl classic?
Painless flexion contracture of the proximal inter-phalangeal joint (progressive slowly)
56
Most affected finger in camptodactylyl?
5th
57
Sx of camptodactylyl?
```
No swelling (IMP)
Involves MP + distal IP
```
58
What mediate an allergic reaction?
IgE
59
Rx of cellulitis?
Oral:
Cephalexin
Dicloxacillin
Clindamycin
IV:
Cefazolin
Oxacillin
Nafcillin
60
Rx of seborrheic dermatitis?
1. Hygiene, shampoo, topical steroids
| 2. Resistant => oral ketoconazole or fluconazole
61
Causative organism in seborrheic dermatitis?
Pityroaporum
62
Rx of dental infection w/ cellulitis?
Penicillin
| Clindamycin if allergic
63
Risk of leukoplakia malignant transformation?
2-6%
64
Onychomycosis classic?
Nail plate separation from nail bed.
Thickened nail
Dystrophic nail
Discolored nail (white, yellow)
65
Rx of onychomycosis?
1st line:
Terbinafine 250mg OD 6wk for fingernails + 12wk for toe nail.
2nd line:
Itraconazole 200mg for 6 + 12 wks.
66
Monitor labs in terbinafine?
CBC, AST, ALT at 0, 4, 6
67
Cause of acute paronychia?
Trauma to nail fold or cuticle
68
Rx of acute paronychia?
Topical Abx +/- steroids.
Oral Abx
Warm compressors
I+D
69
Rx of psoriasis?
Topical Steroid
Phototherapy
MTX
Etretinate stopped = risk of birth defects now used for T-Cell lymphomas.
70
Erythema multiforme classic?
Target / iris like lesions
71
Is nutritional supplement helpful in pressure ulcer healing?
No
72
Head elevation is helpful in pressure ulcer to minimize sheer pressure?
No
73
Degree of bed elevation in pressure ulcer to help minimize sheer pressure?
< 30 degrees
74
When to use oral antibiotics in pressure ulcer?
Complicated by:
Cellulitis
Osteomyelitis
Bacteremia
75
Period to use topical Abx in pressure ulcer?
> 2 wk
76
Cause of stasis dermatitis?
Chronic venous insufficiency
77
Lichen simplex chronicus classic?
Habitual scratching > isolated hyper-pigmented edematous nodules/papules.
78
Cause of chronic paronychia?
Candida
79
Canadiasis classic?
Poorly marginated
Bright red plaques
With satellite papules / pustules
Pruritic
80
Location of candidiasis in M+F?
Men: inguinal-scrotal fold > thighs , gluteal cleft , scrotum
Female: labia majora + minora +
81
Dx of candidiasis?
KOH
| Culture
82
Rx of candidiasis?
Topical imidazoles BID (clotriazole, ketoconazole, miconazole)
Drying agents: anti-fungal powders (miconazole, nystatin, tolnaftate, 12% benzoic acid, undecylenic acid)
Or aluminum sulfate calcium acetate solution.
If sever itchiness > add steroids (hydrocortisone)
83
Topical or oral anti-fungal for tinea capitulation? Why?
Oral
To penetrate hair shaft.
84
Rx of contact dermatitis?
Anti-pruritic
Avoidance of irritants
Cool compressors (burow's solution)
Topical steroid: (triamcinolone 0.1% or betamethasone valerate cream 0.1%)
Oral prednisolone 60mg OD for 7-14 days for sever blistering disease.
85
Mechanism of action of minoxidil?
Prolongs anagen phase
| Increase blood flow to follicle
86
Minoxidil helps what areas of scalp the most?
Vertex alopecia
87
Mechanism of action of finasteride?
5a reductase
| Blocks conversion of testosterone to dihydrotesteron
88
Dose of proscar?
1 mg PO OD
89
Rx of andogentic alopecia?
```
Minoxidil
Finastride
Hair transplant
OCP
Spirnolactone
```
90
Natural course of actinic keratosis?
Most regress spontaneously
Some => SCC
91
Felon classic?
```
Sever pain
Fluctuance
Redness
Tenderness
On top of medial / dorsal finger.
```
92
What's felon / whitlow?
Infection of digital pulp of terminal phalanx
93
Eponychia classic?
Painful
| Pus around nail.
94
When do symptoms of contact dermatitis appear and why?
12-48 hr after contact
Delayed hypersensitivity reaction
95
Patch test results in contact dermatitis?
```
+1 = erythema + edema
+2 = papules
+3 = vesicles / bullae
```
96
Leishmaniasis transmission?
Sandflies bite
97
Rx of leishmaniasis?
Sodium stibogluconate
98
What nutritional intervention help pressure ulcer?
Protein intake at 1.2-1.5 g/kg/day
| + increased calorie intake.
99
Cause of erythrasm?
Corynebacterium infection
100
Erythrasm under woods light?
Coral red
101
Rx of erythrasm?
Topical Abx:
Fusidic acid
Clindamycin (1st line)
Erythromycin
102
Sx of sarcoidosis?
- Eye = uveitis
- Neuro = 7th CN
- skin = lupus pernio + erythema nodosum
- Cardio = restrictive cardiomyopathy
- renal
- hepatic
- hyper calcemia
103
What's pernio lupus?
Indurated red-purple shiny nodules and papules on face
104
Cause of hypercalcemia in sarcoidosis?
Secondary to Vit D production by granulomas
105
Labs for HSV?
Culture
PCR
DIF
Serology
106
Sx of sarcoidosis?
- Eye = uveitis
- Neuro = 7th CN
- skin = lupus pernio + erythema nodosum
- Cardio = restrictive cardiomyopathy
- renal
- hepatic
- hyper calcemia
107
What's pernio lupus?
Indurated red-purple shiny nodules and papules on face
108
Cause of hypercalcemia in sarcoidosis?
Secondary to Vit D production by granulomas
109
Labs for HSV?
Culture
PCR
DIF
Serology
110
Derm causes of pruritus?
```
Scabies
Pediculosis
Insect bite
Urticaria
Atopic dermatitis
Contact dermatitis
Lichen planus
Dermatitis herpetiformis
```
111
Anti-pruritic Rx?
Topical:
Camphor/menthol lotions
Systemic:
Hydroxyzine
112
Rx of scabies?
Permethrin
| Lindane
113
Rx of dermatitis herpitiformis?
Dapson
| Sulfonamides
114
Prodorm of lichen planus?
Low grade fever for 2 days.
115
Lichen planus classic?
```
6 p
Purple
Planar = flat topped
papule
Plaques
Polygonal
Pruritic
Penis
```
116
Maximal period of LP rash to spread!
2-16 wks
117
Rash of 2ry syphilis?
Proceeded by chancre
Maculopapular eruption
Widespread (+palms / soles)
118
Tinea corporis classic?
Pink scaly patches with the raised borders and occasional Papules and pustule
