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Clin Med I > Derm I > Flashcards

Derm I Flashcards

(46 cards)

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1
Q

Pt presents w/ purulent lesion on one leg that developed over the past several days, no systemic sxs

A

Cellulitis

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2
Q

Pt presents w/ a well demarcated erythematous butterfly lesion that developed acutely + fever & chills

A

Erysipelas

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3
Q

Pasteurella multocida

A

cat bite

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4
Q

Capnocytiphaga canimorsus

A

dog bite

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5
Q

Erysipelothrix rhusipathiae

A

petting zoo –> goat, camel, llama bite

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6
Q

Vibro vulnificus

A

ocean related

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7
Q

Pseudomonas aeruginosa cellulitis common in

A

diabetics, IC pts, hospitalizations

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8
Q

Sporothrix schenckii

A

rose gardener

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9
Q

Where do skin abscess’ collect

A

within the dermis or SC space

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10
Q

Pt presents with painful, fluctuant, erythematous nodule & regional adenopathy

A

Skin abscess

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11
Q

For Skin & Soft Tissue infections, which dz has systemic sxs and which do not

A

systemic - Erysipelas

non-systemic - cellulitis & skin abscess

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12
Q

MC pathogens for Erysipelas

A
  • beta hemolytic strep

- staph aureus

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13
Q

MC pathogens for Cellulitis

A
  • beta hemolytic strep

- staph aureus (including MRSA)

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14
Q

MC pathogens for Skin abscess

A

-staph aureus (including MRSA)

mostly bacterial but can be viral

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15
Q

furuncle vs carbuncle

A

-skin abscess of a single hair follicle vs multiple hair follicles

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16
Q

Dx of erysipelas vs cellulitis vs skin abscess

A
  • manifestation & hx

- ultrasound for diff. between cellulitis (cobble stone appearance) vs. skin abscess (fluid filled)

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17
Q

LRINEC Score (use/when/meaningful value)

A
  • used to distinguish Necrotizing Fasciitis from other soft tissue infections
  • use when: concerning hx/exam, pain out of proportion to exam, rapidly progressing cellulitis

> 6 rules in NF

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18
Q

Complications of Cellulitis

A
  • NF –> OR debridement
  • Bacteremia & Sepsis –> draw blood cultures
  • Osteomyelitis –> get X-Rays
  • Septic joints –> aspirate, can culture
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19
Q

Differential dx for cellulitis/erysipelas

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A

Gout, DVT, Venous stasis dermatitis

20
Q

If cellulitis/erysipelas not responding to abx w/in 24-48 h –> consideration?

Study These Flashcards
A

underlying abscess

21
Q

most common bacterial infection in children

22
Q

3 y/o pt presents with thick golden crust around mouth –> 1st line management?

Study These Flashcards
A

non-bullous impetigo

Topical Therapy: Muprocin (Bactroban) TID, Retapamulin (Altabax) BID

23
Q

Progression of non-bullous impetigo

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A

papules –> vesicles surrounded by erythema –> rapid enlargement & breakdown –> form thick adherent golden crusts

24
Q

5 y/o presents w/ dark brown crusted lesion on his trunk –> what pathogen is most likely & how does it cause this lesion?

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A

bullous impetigo

S. aureus –> produces a toxin to cleave the superficial layer

25
Progression of bullous impetigo
vesicles enlarge --> form flaccid bullae w/ clear fluid --> darken and rupture --> thin brown crust
26
pt presents with punched out lesions covered w/ yellow crusts --> what pathogen is most likely?
Ecthyma Group A beta-hemolytic Strep pyogenes
27
Non-bullous impetigo most often caused by:
Staph aureus less commonly --> beta-hemolytic strep group A
28
DX of Impetigo
- manifestation + hx | - gram stain + culture
29
Pt with extensive Impetigo or punched out ulcers --> management?
Oral Therapy - Dicloxacillin 250 mg QID - Cephalexin 250 mg QID
30
Pt presents w/ intensely pruritic, erythematous plaques with central pallor & a swollen upper lip, pt reports increased discomfort @ night for the past 8 weeks --> management?
Chronic urticaria (> 6 weeks) H1 +/- H2 antihistamine D/T angioedema and severe sxs --> Prednisone 30 - 60 mg QD (taper over 5 - 7 days)
31
what % of the population experiences urticaria? age/gender predilection?
20% --> often no trigger affects all ages/genders
32
pt develops multiple raised, circumscribed, erythematous plaques that are intensely itchy, and transiently disappear --> what mediated this reaction?
Cutaneous mast cells in the superficial dermis -release Histamine (pruritus) & vasodilators (Swelling)
33
If allergen is suspected cause of urticaria, what testing is ordered
serum test for allergen specific IgE aBs
34
Management of urticaria focused on
-short-term relief of pruritus & angioedema (H1 +/- H2 antihistamine)
35
H1 antihistamines
diphenhydramine, chlopheniramine, hydroxyzine, certirizine, loratidine, fexodfenadine
36
H2 antihistamines
rantidine, nizatidine, famotidine, cimetidine
37
When do we consider glucocorticoids for the management of urticaria?
- sxs > 2 - 3 days - severe sxs - angioedema
38
Most common benign soft-tissue neoplasm
lipoma
39
pt presents w/ a solitary soft, painless, subQ nodule; round on torso --> what is a possible genetic association?
gene rearrangement of chromosome 12 --> solitary lipoma
40
> 50% lipomas develop where? % of the population to develop a lipoma?
in the subQ tissue majority are on upper extremities or trunk 1% of population
41
Dx of lipoma
- Hx & PE | - can ultrasound to determine if nodule is solid vs. liquid
42
Management of Lipoma
- asymptomatic --> no treatment | - cosmetic issues, pain, or uncertain dx --> surgical excision
43
Most common cutaneous cyst
Epidermal inclusion cyst
44
pt presents w/ a firm, skin-colored dermal nodule w/ a visible central punctum --> what is the pathophysiology
-implantation & proliferation of epithelial (junk) elements into the dermis d/t trauma --> lesion can stay stable or grow --> spontaneous rupture --> cheesy material
45
Who is most likely to develop an epidermal inclusion cyst
men (2x more likely) certain hereditary conditions --> Gardener syndrome
46
Dx & management of epidermal inclusion cyst
- Hx & PE - asymptomatic --> no treatment - can excise cyst or incision & drainage - intralesional injections w/ Triamcinolone

Clin Med I (4 decks)

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